Objective To explore the clinical characteristics and risk factors of death during hospitalization in patients with community-acquired pneumonia(CAP)complicated with diabetes mellitus(DM).Methods A retrospective analysis was performed on 566 patients with CAP hospitalized in the Second Affiliated Hospital of Kunming Medical University from January 2018 to January 2022.The patients were divided into simple CAP group(n=478)and CAP combined with diabetes(CAP+DM)group(n=88)according to whether they had diabetes,and then CAP+DM group(n=88)was divided into survival group(n=69)and death group(n =19)according to whether the patients died during hospitalization.The clinical data and laboratory test indicators of patients in different groups were compared.Cox regression analysis was used to screen the risk factors of death during hospitalization in the CAP+DM group.Receiver operating characteristic(ROC)curve was plotted to evaluate the predictive value of independent risk factors on hospitalization death.Results Compared with the simple CAP group,the CAP+DM group had significant differences in age,concomitant hypertension,coronary heart disease,CURB-65 score,neutrophil to lymphocyte ratio(NLR),C-reactive protein(CRP),procalcitonin(PCT),albumin(ALB),prealbumin(PA),glucose(GLU),serum potassium(K),calcium(Ca),phosphorus(P),magnesium(Mg),lactic acid(Lac),non-invasive ventilation time,ICU occupancy rate and mortality rate(P<0.05);Compared with the survival group,there were statistically significant differences in CURB-65 score,NLR,CRP,PCT,GIU,ALB,PA,serum iron(Fe),Ca,non-invasive ventilation time,and ICU admission rate among the death group patients(P<0.05).Cox regression analysis showed that the increase of NLR level and the decrease in PA level were the risk factors for in-hospital death in patients with CAP complicated with diabetes(P<0.05).When the PA cutoff value was 91 mg/L,the AUC,sensitivity,and specificity for predicting in-hospital death of CAP patients with diabetes were 0.849,84.2%and 81.2%,respectively.Conclusion Patients with CAP combined with diabetes are more serious and have worse prognosis than those with CAP alone.PA has a good predictive value for the prognosis of these patients.Early detection and active intervention should be carried out to reduce the in-hospital mortality of patients.

BACKGROUND:Kinesio taping has been widely used as a means of sports protection,but its role as a means to correct abnormal biomechanical changes of the lower limbs during side-step cutting remains unclear. OBJECTIVE:To analyze and compare the changes in lower limb kinematics and dynamics when the subjects complete the side-step cutting of the knee joint under the conditions of kinesio taping,placebo taping and blank control. METHODS:Thirty-nine male college students majoring in basketball were recruited as subjects.Each subject was tested with kinesio taping,placebo taping or no taping.The mechanical correction method was used to patch the dominant knee joint of each subject.The run-up speed of 4.5-5.5 m/s was selected to complete the 45° side-step cutting motion,and the kinematics and kinetics data were collected synchronously by the three-dimensional dynamic capture system and the force measuring platform.The kinematics and kinetics parameters at the moment of initial touchdown and peak ground reaction force were selected for data analysis.SPSS 27.0 software was used for statistical analysis of the test data. RESULTS AND CONCLUSION:Kinematic indexes:compared with no taping and placebo taping,the hip abduction and knee valgus angles at the initial touchdown moment were significantly decreased when kinesio taping was used(P<0.05);at the moment of peak lateral ground reaction force,the angles of hip abduction,knee valgus and ankle plantar flexion decreased significantly(P<0.05),and the knee flexion angle was significantly increased(P<0.05).Kinetic indexes:Compared with no taping,both kinesio taping and placebo taping significantly reduced hip abduction and external rotation torque,knee valgus and external rotation torque at the moment of initial touchdown(P<0.05),and significantly reduced peak vertical ground reaction force and peak horizontal backward ground reaction force(P<0.05);in addition,kinesio taping significantly reduced peak lateral ground reaction force compared with no taping and placebo taping(P<0.05).These results indicate that kinesio taping of the knee joint may improve some kinematic and kinetic indexes associated with lower limb injury risk factors during the completion of the side-step cutting in basketball specialized college students to some extent,and may have a positive effect on the prevention of injury during the side-step cutting.In addition,the trends in the effects of placebo taping and kinesio taping on the knee joint are more consistent in terms of changes in some indexes,suggesting that there may be a placebo effect on the mechanism of action of kinesio taping.

Objective:To juxtapose laparoscopic cholecystectomy combined with common bile duct exploration and stone extraction (LC+ LCBDE) against endoscopic retrograde cholangiopancreatography/sphincterotomy with laparoscopic cholecystectomy (LC+ ERCP/EST) in the therapeutic context of acute biliary pancreatitis.Methods:The clinical data of patients with acute biliary pancreatitis in Department of Hepatobiliary Surgery, Datong Third People's Hospital from January 2017 to January 2021 were retrospectively analyzed. A total of 44 patients were inrolled, including 23 males and 21 females, with the age of (60.6±11.7) years. Based on different treatment approaches, the patients were divided into the LC+ LCBDE group ( n=33) and the LC+ ERCP group ( n=11, LC+ ERCP/EST). Total bilirubin, direct bilirubin, alanine aminotransferase (ALT), aspartate aminotransferase (AST), blood amylase, operation time, postoperative hospitalization stays, total hospitalization cost, postoperative anal exhaust time, and postoperative complications (bile leakage, fever, bleeding) were compared between the two groups. Results:There were no significant differences in preoperative total bilirubin, direct bilirubin, ALT, AST, and blood amylase between LC+ ERCP group and LC+ LCBDE groups (all P>0.05). In LC+ LCBDE group, operation time was 110.0 (96.3, 147.5) min, postoperative hospitalization time was 9.0 (7.5, 11.0) d, postoperative exhaust time was 2.0 (1.0, 2.0) d, and in LC+ LCBDE group, operation time was 60.0 (32.0, 65.0) min, postoperative hospitalization time was 7.0 (4.0, 8.0) d, postoperative exhaust time was 1.0 (1.0, 1.0) d. Comparisons with LC+ LCBDE group, LC+ ERCP group had shorter postoperative hospitalization stay and earlier postoperative exhaust time, the total hospitalization cost of LC+ LCBDE group was 23 829.3 (21 779.6, 27 221.9) yuan, which was higher than 36 894.8 (31 963.5, 41 172.2) yuan in LC+ ERCP group, and the differences were statistically significant (all P<0.05). Comparison of postoperative total bilirubin, direct bilirubin, ALT and AST between LC+ ERCP group and LC+ LCBDE group, with no significant difference(all P>0.05). No postoperative complications such as bile leakage, residual stones, fever and bleeding occurred in both groups. Conclusion:Compared with LC+ ERCP/EST, LC+ LCBDE in the treatment of acute biliary pancreatitis, although the operation time and hospital stay are longer, but the total hospitalization cost is less, there is no need for multiple operations, and it can be used as the first choice for acute biliary pancreatitis.

Objective To investigate the clinical efficacy of interesting respiratory rehabilitation training(IRRT)combined with budesonide and montelukast sodium in the treatment of bronchial asthma(BA).Methods This is a pilot clinical research.Children with BA who visited Ma'anshan Shiqiye Hospital of Anhui province from January 2023 to December 2023 in were prospectively recruited as study subjects,and were divided into the IRRT group and the conventional group according to the random number table method.After 8 weeks of continuous intervention,the clinical efficacy,recovery of related symptoms and adverse reactions of BA children were evaluated.The changes in lung function parameters,inflammation indicators and quality of life were compared before and after treatment in the IRRT group and the conventional group,and the changes in lung function parameters,inflammation indicators and quality of life between the IRRT group and the conventional group after treatment were compared.Results A total of 120 BA children were included in the study,with 60 cases in each group.Before treatment,there was no significant difference in baseline data such as age and gender between the two groups(P>0.05).After 8 weeks of treatment,pulmonary function parameters,inflammation indicators,and quality of life were all improved in the IRRT group and the conventional group,(P<0.05),and the improvement in the IRRT group was better than that in the conventional group(P<0.05).In addition,the disappearance time of wheezing,disappearance time of cough,and disappearance time of dyspnea were significantly shorter than those in the conventional group(P<0.05).In terms of safety,no significant serious adverse effects were seen in the IRRT group and the conventional group.Conclusion Adjuvant IRRT therapy can significantly improve children's lung function,reduce the level of inflammatory factors,shorten the course of the disease,improve quality of life,and promote early recovery in children.

Objective:To investigate the diagnostic value of Helicobacter pylori-immunoglobulin G (Hp-IgG) antibody combined with serum secretory protein Dikkopf-associated protein 1 (DKK1) and soluble B7 homolog 3 (sB7-H3) in early gastric cancer (EGC) . Methods:Forty-eight patients with EGC admitted to Nantong Haimen People's Hospital of Jiangsu Province from June 2020 to August 2023 were selected as the study objects (EGC group). Fifty patients with chronic atrophic gastritis (CAG) diagnosed in the same period were selected as CAG group, and 58 healthy subjects were selected as control group. Hp-IgG antibody was detected by colloidal gold method, and serum DKK1, sB7-H3 levels were determined by enzyme-linked immunosorbent assay. The value of serum Hp-IgG antibody, DKK1 and sB7-H3 in differential diagnosis of CAG and EGC was analyzed by receiver operating characteristic (ROC) curve, and the consistency of differential diagnosis was evaluated by Kappa consistency test.Results:The positive rates of Hp-IgG antibody in the control group, CAG group, and EGC group were 36.21% (21/58), 72.00% (36/50), and 89.58% (43/48), respectively. The levels of DKK1 in the three groups were (13.78±3.35), (21.36±4.52), and (38.86±7.24) μg/L, respectively, and the levels of sB7-H3 were (7.63±1.59), (12.34±3.64), and (25.35±5.27) μg/L, respectively. There were statistically significant differences ( χ2=34.51, P<0.001; F=316.95, P<0.001; F=314.22, P<0.001). Compared with the control group, the positive rates of Hp-IgG antibody, DKK1 and sB7-H3 levels were all higher in the CAG group and EGC group (all P<0.05). Compared with the CAG group, the positive rates of Hp-IgG antibody, as well as the levels of DKK1 and sB7-H3 were all higher in the EGC group (all P<0.05). Among the CAG patients, 36 had positive Hp-IgG antibody and 14 had negative results. The levels of DKK1 were (22.18±4.84), (16.33±3.57) μg/L in the positive and negative patients, respectively, and the levels of sB7-H3 were (12.83±3.84), (9.33±2.32) μg/L, respectively. There were statistically significant differences ( t=4.10, P<0.001; t=3.18, P=0.003). There were 43 positive and 5 negative cases of Hp-IgG antibody in EGC patients, with serum DKK1 levels of (39.66±7.61) μg/L and (30.05±5.23) μg/L, and sB7-H3 levels of (26.18±5.62) μg/L and (16.24±4.25) μg/L, respectively, and there were statistically significant differences ( t=2.74, P=0.009; t=3.82, P<0.001). ROC curve showed that, the area under the curve (AUC) of Hp-IgG antibody for differential diagnosis of CAG and EGC was 0.81 (95% CI: 0.72-0.88), with a sensitivity of 72.00% and a specificity of 89.58%, while the DKK1 AUC for the differential diagnosis of CAG and EGC was 0.90 (95% CI: 0.82-0.95), and the optimal cutoff value was 28.32 μg/L, with a sensitivity of 70.00% and a specificity of 95.83%; sB7-H3 AUC for the differential diagnosis of CAG and EGC was 0.86 (95% CI: 0.78-0.92), and the optimal cutoff value was 16.44 μg/L, with a sensitivity of 70.00% and a specificity of 95.83%; the AUC of the three combined for the differential diagnosis of CAG and EGC was 0.95 (95% CI: 0.89-0.98), with a sensitivity of 90.00% and a specificity of 87.50%; and the combination of the three was superior to each of the Hp-IgG antibody, DKK1, and sB7-H3 alone for the differential diagnosis of CAG and EGC ( Z=3.62, P<0.001; Z=2.13, P=0.035; Z=2.69, P=0.016). The Kappa consistency test showed that the serum Hp-IgG antibody combined with DKK1 and sB7-H3 for the differential diagnosis of CAG and EGC was in better agreement with histopathological examination (Kappa=0.78) . Conclusion:Hp-IgG antibody positive rate, serum DKK1 and sB7-H3 levels of EGC patients are high, and the combination of the three tests is more effective in the differential diagnosis of CAG and EGC.

OBJECTIVE: To explore the therapeutic mechanism of Liushen Wan (LSW) against colitis-associated colorectal cancer (CAC) by network pharmacology. METHODS: TCMSP, BATMAN-TCM, CNKI, PubMed, Genecards, OMIM, and TTD databases were used to obtain the related targets of LSW and CAC. The common targets of LSW and CAC were obtained using Venny online website. The PPI network was constructed using Cytoscape 3.8.2 to screen the core targets of LSW in the treatment of CAC. GO and KEGG enrichment analysis were conducted using DAVID database. The therapeutic effect of LSW on CAC was evaluated in a C57BL/6J mouse model of AOM/DSS-induced CAC by observing the changes in body weight, disease activity index, colon length, and size and number of the tumor. HE staining and RT-qPCR were used to analyze the effect of LSW on inflammatory mediators. Immunohistochemistry and TUNEL staining were used to evaluate the effect of LSW on the proliferation and apoptosis of AOM/DSS-treated colon tumor cells. Immunohistochemistry and Western blotting were used to detect the effects of LSW on the expression of TLR4 proteins in CAC mice. RESULTS: Network pharmacology analysis identified 69 common targets of LSW and CAC, and 33 hub targets were screened in the PPI network. KEGG pathway enrichment analysis suggested that the effect of LSW on CAC was mediated by the Toll-like receptor signaling pathway. In the mouse model of AOM/DSS-induced CAC, LSW significantly inhibited colitis-associated tumorigenesis, reduced tumor number and tumor load (P < 0.05), obviously improved histopathological changes in the colon, downregulated the mRNA levels of proinflammatory cytokines, and inhibited the proliferation (P < 0.01) and promoted apoptosis of colon tumor cells (P < 0.001). LSW also significantly decreased TLR4 protein expression in the colon tissue (P < 0.05). CONCLUSION LSW can inhibit CAC in mice possibly by regulating the expression of TLR4 to reduce intestinal inflammation, inhibit colon tumor cell proliferation and promote their apoptosis.
Mice ; Animals ; Toll-Like Receptor 4 ; Colitis-Associated Neoplasms ; Network Pharmacology ; Mice, Inbred C57BL ; Colonic Neoplasms/pathology*

Objective To investigate the combined effect of noise and hand-transmitted vibration on hearing loss in male noise-exposed workers. Methods A total of 952 male noise-exposed workers from an automobile manufacturing enterprise were selected as the research subjects using judgment sampling method. Occupational epidemiological surveys, assessments of occupational hazards in workplace, and pure-tone audiometry tests were conducted on the research subjects, and they were divided into low-level noise group, low-level combined group, high-level noise group, and high-level combined group according to whether the noise exposure level exceeded the national standard and whether they were jointly exposed to hand-transmitted vibration. The joint effects of noise and hand-transmitted vibration on hearing loss were analyzed. Results The detection rate of hearing loss in 952 noise-exposed workers was 21.7%. The detection rate of hearing loss of four groups, from high to low, was as follows： high-level combined group, high-level noise group, low-level combined group, and low-level noise group (44.9% vs 32.7% vs 12.9% vs 5.7%, P<0.01). The results of multivariate logistic regression analysis showed that the risk of hearing loss in the low-level noise group, the low-level combined group, the high-level noise group and the high-level combined group increased sequentially after adjusting for the confounding factors such as age, education level, smoking, drinking, listening to music with headphones, frequency of wearing noise-blocking earplugs and body mass index. The risk of hearing loss in the high-level noise group was 8.62 times more than that of the low-level noise group (P<0.01). The risk of hearing loss in the low-level noise combined group was 2.50 times more than that of the low-level noise group (P<0.01). The risks of hearing loss in the high-level combined group were 5.76 and 1.67 times more than that of the low-level combined group and the high-level noise group. Conclusion Combined exposure to noise and hand-transmitted vibration can increase the risk of hearing loss in male noise-exposed workers, and the higher the noise intensity, the greater the synergistic effect. Hand-transmitted vibration is a synergistic risk factor for occupational noise-induced hearing loss.

Objective:To reveal the research focus of doctoral dissertation of China Academy of Chinese Medical Sciences by information visualization.Methods:Based on the relevant documents from January 1st, 2008 to December 31st, 2018 retrieved by CNKI, through the methods of CiteSpace high-frequency word visualization analysis and co word clustering, the research focus was explored in three time segments, and comparative analysis was carried out.Results:A total of 1 918 literatures were included. The methodology research based on Traditional Chinese Medicine (TCM) syndromes, the application research of data mining technology, and the clinical research of TCM were identified by knowledge atlas as the research hotspots of academic dissertation of China Academy of Chinese Medical Sciences from 2008 to 2018, with good continuity. The disease types of related researcheswere close to the clinical frontier, and the continuity of syndrome and treatment research of coronary heart disease were poor. The number of basic researches represented by TCM syndrome were always lower than that of clinical research. The diagnosis and treatment mode and modern research methods based on the combination of disease and syndrome and the combination of traditional Chinese and Western medicine were gradually deepening in the field of TCM.Conclusions:Interdisciplinary research is a hot topic in the dissertation research of the China Academy of Chinese Medical Sciences. The use of information visualization tools can provide reference for scientific and in-depth exploration of the research direction of TCM.

Fetal alloimmune thrombocytopenia (FAIT) is a severe perinatal complication, which can seriously affect fetal development, and may even lead to intrauterine hemorrhage and intrauterine death. There are controversies in the clinical diagnosis and treatment of the disease due to its low incidence and limited treatment experience. This paper reviews the progress to date in understanding the condition, incidence, screening of high-risk factors, prenatal and delivery management of FAIT based on domestic and foreign guidelines, in order to help obstetricians in the clinical management of FAIT.

Objective To compare the differences of optic nerve head (ONH) parameters and the thickness of circumpapillary retinal nerve fiber layer (CP-RNFL) between acute Vogt-Koyanagi-Harada syndrome (VKH) and acute central serous chorioretinopathy (CSC) patients.Methods Retrospective clinical case control analysis.This study included 38 eyes of 20 acute VKH patients (VKH group) and 37 eyes of 37 acute CSC patients (CSC group).Seventy five eyes of 57 normal healthy subjects,matching patients with age and gender,were collected as control group.The disc RPE angle,the thickness of average CP-RNFL,the nasal,superior,temporal and inferior quadrant CP-RNFL thickness,and ONH parameters including optic disc area,cup area,rim area,C/D area ratio,linear CD ratio (CDR),vertical CDR were measured by 3D-OCT.Analysis of variance was performed for comparison among three groups.Minimum significant difference t test was performed for comparison between two groups.Results The differences of ONH parameters between VKH group and CSC group:29 eyes of VKH group appeared retinal detachment next to disc,only 12 eyes appeared in CSC group.Twenty one eyes of VKH group appeared optic disc hyperemia while none in CSC group.The three groups' disc RPE angles were (138.62± 11.96)°,(154.09±5.85)° and (153.41 ±5.77)°.VKH group were significantly smaller than CSC group (t=-2.05,P=0.00) and control group (t=-1.68,P=0.00),while there was no significant difference between CSC group and control group (t=-1.88,P=0.72).The optic cup area and rim area were significantly bigger in VKH group than in CSC group (t=4.61,2.71;P=0.00,0.01),and the thickness of mean CP-RNFL,all quadrants of CP-RNFL were significantly thicker in VKH group than in CSC group (t=6.25,4.40,3.53,5.48,2.69;P=0.00,0.00,0.00,0.00,0.01).Conclusion Compared with the acute CSC,VKH patients are likely to appear retinal detachment next to disc,their disc RPE angles are smaller,their optic cup area and rim area are bigger,and their CP-RNFL thickness are thicker.