Objective To explore the relationship between atherosclerotic index of plasma(AIP)and cognitive function in older adults.Methods A cross-sectional study method was used to include the National Health and Nutrition Examination Survey(NHANES)2011 to 2014 population aged>60 years as study subjects,and the population was divided into>-2.158 to≤-0.624 AIP group,>-0.624 to≤-0.123 AIP group,>-0.123 to≤0.309 AIP group,>0.309 AIP group 4 groups.Demographic data(including gender,age,race,education,marriage,height,and body mass),chronic disease-related data(including angina pectoris,emphysema,depression score,chronic bronchitis,coronary heart disease,history of stroke,hypertension,and diabetes mellitus),lifestyle-related data(including smoking and sleep duration),and cognitive function assessment[including the United Registry for consortium to establish a registry for Alzheimer's disease word list(CERAD W-L)score,animal fluency test(AFT)score and digit symbol substitution test(DSST)score],and to compare the differences in the above information between groups with different levels of AIP;and to analyze the factors affecting the cognitive function of the population by using multifactorial Logistic regression.Results A total of 1 335 participants were included in the analysis,and the results of the multivariate linear regression suggested that in model 3 after adjusting for all covariates,no linear relationship existed between AIP and CERAD W-L score for the>-0.624-≤-0.123 AIP group,the>-0.123-≤-0.309 AIP group,and the>-0.309 AIP group,compared with the>-2.158-≤-0.624 AIP group have a linear relationship(P=0.500 for the>-0.624-≤-0.123 AIP group,P=0.110 for the>-0.123-≤0.309 AIP group,and P=0.200 for the>0.309 AIP group).Weighted multifactor Logistic regression analyses after adjusting for covariates showed that AIP was a risk correlate for decline in representing immediate and delayed recall CERAD W-L score[odds ratio(OR)=0.970,95％confidence interval(95％CI)of 0.950-1.000,P=0.050].Restricted Cubic Splines of AIP versus CERAD W-L score restricted cubic spline(RCS)curves suggested a significant overall effect of CERAD W-L score on AIP(overall P=0.005),but not a significant nonlinear relationship(nonlinear P=0.278);and subgroup analyses showed that among 65-70 years old who were college-educated or better,married,and free of hypertension,AIP was the most prevalent among CERAD W-L scores.AIP is an associated risk factor for the development of CERAD W-L decline in people(OR<1,P<0.05).Conclusion AIP is a risk factor for cognitive decline associated with delayed and immediate memory,suggesting that AIP can be used as a predictor or assessment of cognitive function.

Objective To explore the relationship between atherosclerotic index of plasma(AIP)and cognitive function in older adults.Methods A cross-sectional study method was used to include the National Health and Nutrition Examination Survey(NHANES)2011 to 2014 population aged>60 years as study subjects,and the population was divided into>-2.158 to≤-0.624 AIP group,>-0.624 to≤-0.123 AIP group,>-0.123 to≤0.309 AIP group,>0.309 AIP group 4 groups.Demographic data(including gender,age,race,education,marriage,height,and body mass),chronic disease-related data(including angina pectoris,emphysema,depression score,chronic bronchitis,coronary heart disease,history of stroke,hypertension,and diabetes mellitus),lifestyle-related data(including smoking and sleep duration),and cognitive function assessment[including the United Registry for consortium to establish a registry for Alzheimer's disease word list(CERAD W-L)score,animal fluency test(AFT)score and digit symbol substitution test(DSST)score],and to compare the differences in the above information between groups with different levels of AIP;and to analyze the factors affecting the cognitive function of the population by using multifactorial Logistic regression.Results A total of 1 335 participants were included in the analysis,and the results of the multivariate linear regression suggested that in model 3 after adjusting for all covariates,no linear relationship existed between AIP and CERAD W-L score for the>-0.624-≤-0.123 AIP group,the>-0.123-≤-0.309 AIP group,and the>-0.309 AIP group,compared with the>-2.158-≤-0.624 AIP group have a linear relationship(P=0.500 for the>-0.624-≤-0.123 AIP group,P=0.110 for the>-0.123-≤0.309 AIP group,and P=0.200 for the>0.309 AIP group).Weighted multifactor Logistic regression analyses after adjusting for covariates showed that AIP was a risk correlate for decline in representing immediate and delayed recall CERAD W-L score[odds ratio(OR)=0.970,95％confidence interval(95％CI)of 0.950-1.000,P=0.050].Restricted Cubic Splines of AIP versus CERAD W-L score restricted cubic spline(RCS)curves suggested a significant overall effect of CERAD W-L score on AIP(overall P=0.005),but not a significant nonlinear relationship(nonlinear P=0.278);and subgroup analyses showed that among 65-70 years old who were college-educated or better,married,and free of hypertension,AIP was the most prevalent among CERAD W-L scores.AIP is an associated risk factor for the development of CERAD W-L decline in people(OR<1,P<0.05).Conclusion AIP is a risk factor for cognitive decline associated with delayed and immediate memory,suggesting that AIP can be used as a predictor or assessment of cognitive function.

Objective:To explore the influencing factors of severity of upper gastrointestinal bleeding (UGIB) and to establish the early warning evaluation model in the form of line chart, so as to provide a feasible basis for emergency nurses' triage.Methods:A total of 680 UGIB patients admitted to the Emergency Department of the First Affiliated Hospital of Wenzhou Medical University from January 2019 to January 2020 were retrospectively analyzed. They were divided into a modeling group ( n=510) and a validation group ( n=170) by random number table method, and were divided into a high-risk group and a low-risk group according to the expert Consensus on Emergency Diagnosis and Treatment Procedures for Acute Upper Gastrointestinal Bleeding in 2020. The differences of various indicators between groups were compared, the factors affecting the severity of the disease were analyzed by Logistic regression, and the nomogram was drawn and validated. Results:Multivariate logistic regression analysis showed that hematemesis ( OR=3.875, 95% CI: 2.212-6.79), diabetes ( OR=2.64, 95% CI: 1.184-5.883), syncope ( OR=10.57, 95% CI: 3.675-30.403), heart rate ( OR=3.262, 95% CI: 1.753-6.068), red blood cell distribution width ( OR=3.904, 95% CI: 2.176-7.007), prothrombin time ( OR=3.665, 95% CI: 1.625-8.269), lactic acid ( OR=3.498, 95% CI: 1.926-6.354) and hemoglobin ( OR=4.984, 95% CI: 2.78-8.938) were the influencing factors of the severity of UGIB patients ( P < 0.05). The nomogram model showed good consistency and differentiation (C-index=0.903, 95% CI: 0.875-0.931), and was verified internally (C-index=0.895) and Hosmer-Lemeshow goodness-of-fit test ( P=0.7936). Externally verified C-index was 0.899 (95% CI: 0.846-0.952). The calibration curve prompt warning evaluation model had good stability and the prediction efficiency was better than the modified early warning score ( P < 0.05). Conclusions:The early warning evaluation model has a reliable predictive value, which can provide a reference for emergency medical staff to screen high-risk patients and formulate targeted nursing interventions.

OBJECTIVEThis study aimed to explore the main features and advantages of the muscle pedicled platysma myocutaneous flap (PMF), the degree of improvement of flap harvest. To evaluate the application value of the flap in the reconstruction of buccal mucosa carcinoma defects.

METHODSTwenty-three patients received PMF with MacFee incision to reconstruct buccal mucosa defects that were caused by the resection of precancer lesions and benign and malignant tumors from August 2012 to April 2015. When elevating the cervical skin from the platysma, most of the subcutaneous tissue was preserved on the muscle. The continuity of the facial vessels was retained. The external jugular vein was preserved on the reverse side of the platysma.

RESULTSTwenty-one flaps survived completely, whereas the other two flaps presented partial skin loss. Two patients showed disturbed wound healing in the neck. Secondary healing was achieved after attentive wound care. All patients were followed up from 11 to 43 months. The function of the recipient sites recovered well. Except for the two patients with large-area scarring in the neck, the remaining cases presented satisfactory neck contours. No relapses were observed during the follow-up period.

CONCLUSIONSCompared with the traditional PMF, the muscle pedicled PMF provides a larger skin paddle and presents a better aesthetic and functional effect. Thus, this approach is a novel and ideal option for the restoration of buccal mucosa defects.

Face ; Humans ; Mouth Mucosa ; Mouth Neoplasms ; surgery ; Myocutaneous Flap ; Neck ; Neck Muscles ; Neoplasm Recurrence, Local ; Postoperative Complications ; Reconstructive Surgical Procedures ; Surgical Flaps

Objective:To introduce a new style of platysma myocutaneous flap and to evaluate its application value in the restoration of oral-maxiofacial defects.Methods:Platysma myocutaneous flap with apron incision was used for the restoration of oral-maxiofacial defects after oral lesion ablation in 15 cases from January,2014 to September,2015.The platysma muocutaneous flap was harvested with a U shaped apron incision.The skin above the flap pedicle was preserved.The platysma pedicle was widened to ensure the flap survival.All the patients were followed up form 4 to 33 months.Results:Of the 15 platysma myocutaneous flaps,12 survived completely and 3 had partial flap necrosis.The total survival rate of the flaps at the recipient site of buccal mucosa,tongue and alveolar was 8/9,1/3 and 3/3 respectively.Additionally,there were 2 cases of disturbed wound healing in the neck.Except for 1 case of carcinoma of gingiva which had apparent cervical scar and 1 case of tongue carcinoma which had limited tongue mobility,the other cases showed a satisfactory recovery of oral-maxillofacial contour and fucnction.Conclusion:Compared with the traditional platysma myocutaneous flap,the platysma myocutaneous flap with apron incision can provide a larger skin paddle,and is suitable for the restoration of small and medium sized buccal mucosa and alveloar defects,but not for tongue defect.

OBJECTIVETo construct the eukaryotic expression vector, encoding major histocompatibility complex class I-related chain A gene (MICA), for the further research of transfecting Tca8113-Tb cell line(a metastatic cell line of brain metastasis from human tongue cancer Tca8113 cells in nude mouse), and to establish a stable MICA overexpression oral squamous cell line.

METHODScDNA of MICA gene from pCMV-SPORT6-MICA was amplified by PCR, and subcloned into eukaryotic expression vector pEGFP-N1 marked with green fluorescent protein (GFP). The recombinant plasmid was sequenced and transfected into Tca8113-Tb cell line by lipofectamine 2000. After screen culture by G418, stable tranfected Tca8113-Tb cell line was established using definite dilution method. The expressions of GFP protein was viewed directly with fluorescence microscopy and the overexpression of MICA was identified by RT-PCR, real time PCR and immunocytochemistry.

RESULTSThe MICA gene was amplified by PCR and then cloned into the vector, whose sequence was identical to that in the GenBank. The transfected cells showed the expression of GFP. And the overexpression of MICA gene in transfected cells was detected by RT-PCR, real time PCR and immunocytochemistry.

CONCLUSIONThe recombinant eukaryotic expression vector pEGFP-N1-MICA has been constructed successfully and stably expressed in Tca8113-Tb cell line, providing a foundation for further studies on the function of MICA in vitro.

Animals ; Cell Line ; Genetic Vectors ; Green Fluorescent Proteins ; Humans ; Mice ; Mice, Nude ; Tongue Neoplasms ; Transfection