Objective:To evaluate the predictive value of whole blood cell derived inflammatory marker (including systemic immunoinflammatory index (SII), systemic inflammatory response index (SIRI), neutrophil count/lymphocyte count (NLR), platelet count/lymphocyte count (PLR), and monocyte count/lymphocyte count (MLR)) and in combination with N-terminal pro-B-type natriuretic peptide (NT-proBNP) on the prognosis of patients with chronic heart failure.Methods:This study was a retrospective cohort study. Patients with chronic heart failure hospitalized in the Department of Cardiovascular Medicine, Nanfang Hospital, Southern Medical University from January 2019 to August 2022 were enrolled. Patients were followed up and were divided into survival group and death group according to the follow-up results. Clinical characteristics of the two groups were compared. Receiver operating characteristic (ROC) curve was used to determine the optimal cut-off value of each whole blood cell derived inflammatory marker for predicting all-cause death in patients with chronic heart failure. Kaplan-Meier survival curve was drawn, and log-rank test was used to compare the difference in survival of chronic heart failure patients with different levels of whole blood cell derived inflammatory markers. Univariate and multivariate Cox proportional hazards models were used to analyze the effects of whole blood cell derived inflammatory markers and NT-proBNP on the all-cause death of patients with chronic heart failure. ROC curve was used to analyze the predictive value of whole blood cell derived inflammatory markers combined with NT-proBNP on the prognosis of patients with chronic heart failure.Results:A total of 324 patients with heart failure aged (64.76±13.78) years were enrolled, with 212 males (65.43%). 297 patients (91.67%) completed follow-up, 27 patients (8.33%) were lost to follow-up. The follow-up time was 24.0 (18.0, 41.8) months. There were 258 patients in the survival group and 66 patients in the death group. The optimal cut-off values of SII, SIRI, NLR, PLR and MLR determined by ROC curve were 739.83, 1.65, 3.14, 151.95 and 0.37, respectively. Kaplan-Meier survival curve analysis showed that patients with chronic heart failure with high levels of SII (≥739.83), SIRI (≥1.65), NLR (≥3.14), PLR (≥151.95) and MLR (≥0.37) had higher incidence of all-cause death than patients with low levels of inflammatory markers (all P<0.001). Multivariate Cox proportional hazard regression analysis showed that age ( HR=1.04, 95% CI 1.01-1.06, P=0.002), NT-proBNP ( HR=2.93, 95% CI 1.64-5.23, P<0.001), SII≥739.83 ( HR=3.27, 95% CI 1.18-9.02, P=0.022) and PLR≥151.95 ( HR=2.67, 95% CI 1.02-6.96, P=0.045) were independent predictors of all-cause death in patients with chronic heart failure. ROC curve analysis showed that the predictive value of SII and PLR combined with NT-proBNP ( AUC=0.850) for the prognosis of patients with chronic heart failure was better than that of SII ( AUC=0.779)、PLR ( AUC=0.782)、NT-proBNP ( AUC=0.727) and CRP ( AUC=0.668) alone (all P<0.001). Conclusions:Whole blood cell derived inflammatory markers——SII, PLR, and NT-pro BNP were independently associated with all-cause death in patients with chronic heart failure. SII and PLR can independently predict the prognosis of patients with chronic heart failure, combination of SII and PLR with NT-pro BNP has better predictive value for the prognosis of patients with chronic heart failure.

Objective:To evaluate the predictive value of whole blood cell derived inflammatory marker (including systemic immunoinflammatory index (SII), systemic inflammatory response index (SIRI), neutrophil count/lymphocyte count (NLR), platelet count/lymphocyte count (PLR), and monocyte count/lymphocyte count (MLR)) and in combination with N-terminal pro-B-type natriuretic peptide (NT-proBNP) on the prognosis of patients with chronic heart failure.Methods:This study was a retrospective cohort study. Patients with chronic heart failure hospitalized in the Department of Cardiovascular Medicine, Nanfang Hospital, Southern Medical University from January 2019 to August 2022 were enrolled. Patients were followed up and were divided into survival group and death group according to the follow-up results. Clinical characteristics of the two groups were compared. Receiver operating characteristic (ROC) curve was used to determine the optimal cut-off value of each whole blood cell derived inflammatory marker for predicting all-cause death in patients with chronic heart failure. Kaplan-Meier survival curve was drawn, and log-rank test was used to compare the difference in survival of chronic heart failure patients with different levels of whole blood cell derived inflammatory markers. Univariate and multivariate Cox proportional hazards models were used to analyze the effects of whole blood cell derived inflammatory markers and NT-proBNP on the all-cause death of patients with chronic heart failure. ROC curve was used to analyze the predictive value of whole blood cell derived inflammatory markers combined with NT-proBNP on the prognosis of patients with chronic heart failure.Results:A total of 324 patients with heart failure aged (64.76±13.78) years were enrolled, with 212 males (65.43%). 297 patients (91.67%) completed follow-up, 27 patients (8.33%) were lost to follow-up. The follow-up time was 24.0 (18.0, 41.8) months. There were 258 patients in the survival group and 66 patients in the death group. The optimal cut-off values of SII, SIRI, NLR, PLR and MLR determined by ROC curve were 739.83, 1.65, 3.14, 151.95 and 0.37, respectively. Kaplan-Meier survival curve analysis showed that patients with chronic heart failure with high levels of SII (≥739.83), SIRI (≥1.65), NLR (≥3.14), PLR (≥151.95) and MLR (≥0.37) had higher incidence of all-cause death than patients with low levels of inflammatory markers (all P<0.001). Multivariate Cox proportional hazard regression analysis showed that age ( HR=1.04, 95% CI 1.01-1.06, P=0.002), NT-proBNP ( HR=2.93, 95% CI 1.64-5.23, P<0.001), SII≥739.83 ( HR=3.27, 95% CI 1.18-9.02, P=0.022) and PLR≥151.95 ( HR=2.67, 95% CI 1.02-6.96, P=0.045) were independent predictors of all-cause death in patients with chronic heart failure. ROC curve analysis showed that the predictive value of SII and PLR combined with NT-proBNP ( AUC=0.850) for the prognosis of patients with chronic heart failure was better than that of SII ( AUC=0.779)、PLR ( AUC=0.782)、NT-proBNP ( AUC=0.727) and CRP ( AUC=0.668) alone (all P<0.001). Conclusions:Whole blood cell derived inflammatory markers——SII, PLR, and NT-pro BNP were independently associated with all-cause death in patients with chronic heart failure. SII and PLR can independently predict the prognosis of patients with chronic heart failure, combination of SII and PLR with NT-pro BNP has better predictive value for the prognosis of patients with chronic heart failure.

Objective:To obtain the parameters associated with hematoma morpholoy by finite element analysis(FEA) and investigated their performance on predicting and diagnosis hematoma expansion(HE) in patients with spontaneous intracrebral hemorrhage(SICH).Methods:Patients with SICH who met research criteria were retrospective enrolled between June 2015 and December 2017. Clinical parameters on admission were collected, Perform 2 independent methodology on same patient to analysis the hematoma shape base on computed tomography(CT): Clinical routine method that performed by clinical investigator to identified margin irregularity of hematoma by CT ,and calculated the volume of hematoma by simplify Tada formula(ABC/2);The FEA method performed by FEA investigator and gain the hematoma 3 dimensional morphology and variables, include Volume, Surface area, and The quantity of triangles per square milimet surface(TQOT/mm 2). The HE was defined as volume enlargement of >33% compared with that on addmission. All patients were divided into HE and none HE group ,respectively, ABC/2 and FEA generated thire own HE and none HE group as different volume calcuation. The HE risk factors of ABC/2 and FEA were assessed in univariate and multivariable Logistic regression models. and the risk fators diagnosis value for HE were determined by the receiver operating characteristic(ROC) curves. Results:Total of 127 patients were enrolled, The mean time of symptom onset to hospital admitted was 3.08±1.34 h. There were 34(26.77%) cases HE identifed by ABC/2 and 31(24.41%)by FEA. Althought there are significant different (pearson χ2=53.66, P<0.01) of HE identification between ABC/2 and FEA, the 2 methods has moderate consistency (Kappa=0.65). All patients’ hematoma 3D reconstruction were performed by FEA and general observation show that TQOT/mm 2 most likely correlate to irregularity of hematoma 3D shape. Multivariable Logistic regression models indicated that ICH score( OR=1.79, 95% CI:1.19~2.68)was independent HE risk factor for ABC/2, respectively, TQOT/mm 2≥1.95/mm 2 ( OR=16.99,95% CI:5.98~48.33)and Ultraearly Hematoma Growth,(uHG) ( OR=1.05, 95% CI:1.01~1.09)were independent HE risk factor for FEA. With ROC analysis, both the ICH score of ABC/2 and uHG of FEA have low HE predictive and diagnosis value ,the area under the curve (AUC) were 0.64 and 0.67 respectively. However, TQOT/mm 2 was found to have excellent diagnosis value (AUC:0.9), sensitivity and specificity were 77% and 83% when the cut-off value was 1.95. Panel parameter model (TQOT/mm 2+uHG) was not be found to have a significant higher AUC than single parameter on FEA and the clinical routine parameters panel model (ICH +SB P>180 mmHg on addmission) have a unacceptable AUC(<0.7) as well as single parameters. Conclusions:Hematoma shape could be reconstructed and analysis by FEA and TQOT/mm 2 was likely relevance to hematoma morphology. TQOT/mm 2≥1.95 was indicate to have a better HE predicting and diagnosis value than any other risk factors and clinical parameters panel models in our reaserch.

Objective:To investigate the clinical characteristics, drug resistance and serotypes of children′s invasive pneumococcal disease(IPD) in Shenzhen.Methods:Clinical data and drug sensitivity results of IPD children enrolled in Shenzhen Children′s Hospital, from January 2012 to December 2018, were analyzed retrospectively, and serotypes of the retained strains were identified by capsule swelling method or polymerase chain reaction(PCR) method.Results:One hundred and forty-one cases were enrolled, majority of them were less than 2 years old (86 cases, 61.0%). A total of 99 cases(70.2%) had onset in autumn and winter.The clinical manifestation included single bloodstream infection(62 cases, 45.4%), purulent meningitis(30 cases, 21.3%), pneumonia with bacteremia(28 cases, 19.9%), bone and joint infection(12 cases, 8.5%), purulent pleurisy (4 cases, 2.8%), peritonitis (3 cases, 2.1%), and infective endocarditis (2 cases, 1.4%). Underlying diseases were found in 33 cases(23.4%), co-infection in 14 cases (9.9%), complications in 39 cases (27.7%). After active treatment, 5 cases (3.5%) who were all under 2 years old died, and all of the isolates had multi-drug resistance.Four cases (2.8%) were discharged without recovery, and the rest cases were improved.The incidence of Penicillin insensitive Streptococcus pneumoniae (PNSP) with underlying diseases (30.7% vs.15.4%, χ2=3.956), meningitis(32.0% vs.9.2%, χ2=10.722) and multiple drug resistance (86.7% vs.63.1%, χ2=10.538)were higher than those of Penicillin sensitive Streptococcus pneumo- niae(PSSP)(all P<0.05). The serotypes of 97 invasive Streptococcus pneumoniae strains were identified.Types of 14 and 19F (21 strains for each type, 21.6%) were the most common, followed by type 19A (15 strains, 15.5%), type 6B and 23F (13 strains for each type, 13.4%), and type 3 (3 strains, 3.1%). The serotype coverage of 13-valent pneumococcal conjugate vaccine (PCV13) was 92.8% (90/97 strains). Conclusions:Children under 2 years old are prone to IPD and death.The IPD distribution varies in different seasons, and single bloodstream infection is the most common clinical manifestation; PNSP is more likely to occur in children with underlying diseases and meningitis, and the multi-drug resistance of pathogenic strains may be related to poor prognosis.PCV13 can cover most IPD serotypes.

Objective To investigate the relationship between clinical efficacy and cage subsidence,and to identify the risk factors of cage subsidence after transforaminal lumbar interbody fusion (TLIF) in treating single level lumbar disc herniation and lumbar spondylolisthesis.Methods According to the inclusion/exclusion criteria,a series of 107 patients who underwent TLIF with polyetheretherketone (PEEK) cage in our department were evaluated retrospectively between May 2011 and May 2014.Intervertebral space height and segmental angle were measured on the preoperative and postoperative iconography according to the metrical software.All patients were divided into cage subsidence group (cage subsidence ≥ 2 mm) and cage non-subsidence group (cage subsidence ＜ 2 mm) based on the threshold value of intervertebral space height via X-ray.The Oswestry disability index (ODI) and visual analogue scale (VAS) was used to evaluate the clinical efficacy.Univariate analysis and logistic regression analysis were performed to identify the potential risk factors.Results Of all 107 patients,thirty-six patients (15 males and 21 females)aged 52.61 ± 13.82 years were divided into in the cage subsidence group with an average follow-up duration 26.33±7.66 months,seventy-one patients aged 53.80± 14.94 years,28 males and 43 females in the cage non-subsidence group,were followed-up for 23.82±8.95 months.There was no significant difference between cage subsidence group and cage non-subsidence group in gender,age,course of disease and time of follow-up (P＞ 0.05).The average 2.79±0.78 mm (range 2.02-5.53 mm) subsidence was observed in cage subsidence group.The preoperative intervertebral space height,postoperative intervertebral space height,postoperative segmental angle were related to cage subsidence by univariate analysis (P ＜ 0.05).Postoperative intervertebral space height [OR=1.864,95％CI(1.207,2.879) mm] was the risk factor of cage subsidence by logistic regression (P ＜ 0.05).There was no significant difference between cage subsidence group and cage non-subsidence group in ODI and VAS (P ＞ 0.05).Conclusion Cage subsidence is affected by the preoperative intervertebral space height,postoperative intervertebral space height,and postoperative segmental angle.Postoperative intervertebral space height is the independent risk factor of cage subsidence.Over distraction of intervertebral space height could increase the risk of cage subsidence.

Objective To investigate the effect of methylguanidine and 1-methylhydantoin on cells cytotoxicity, apoptosis in human renal tubular epithelial cell line (HK-2). Methods Human PTEC cell line HK-2 was used in this study. HK-2 was cultured and divided into 3 groups: Norma1 control group (A), methylguanidine group(B) and 1-methylhydantoin group (C). The cell inhibitory rate of HK-2 was detected by MTT method. The cytotoxicity of methylguanidine to HK-2 was determined by NAG release test. Cell apoptosis was evaluated by using Hoechst stain and FACS with Annexin-V/PI. Results The OD value and NAG concentration of creatinine, methylguanidine and 1-methylhydantoin group were compared with normal control group. OD value decreased and NAG concentration significantly increased(0.188±0.011, 0.176±0.010 vs 0.545±0.021, F＝1557.74, P＜0.01; 20.488±0.473, 22.225±0.565 vs 5.125±0.198, F＝3848.22, P＜0.01). By Hoechst stain, pycnosis and apoptotic body could be found when HK-2 was cultivated in methylguanidine 1-methylhydantoin group. In methylguanidine, 1-methylhydantoin group apoptotic HK-2 apparently increased, compared with that in control group (18.23±1.1581, 20.22±1.1433 vs 2.473±0.321, F＝526.06, P＜0.01). Compared with group B, the OD value in group C decreased significantly (0.176±0.010 vs 0.188±0.011,t＝2.26, P＜0.05), NAG concentration increased significantly (22.225±0.565 vs 20.488±0.473,t＝-6.67, P＜0.01), and apoptotic rate in-creased significantly (20.22±1.1433 vs 18.23±1.1581,t＝-2.762, P＜0.05). Conclusions 1-methylhydantoin has more powerful cytotoxic effect to renal tubular epithelial cells than that of Methylguanidine.