Objective:To analyze the status of anemia at the beginning of dialysis in maintenance hemodialysis (MHD) adult patients, and to explore the relationship between early dialysis anemia and early survival and long-term survival.Methods:It was a retrospective cohort study. The baseline demographic and clinical data of newly admitted MHD patients from January 1, 2013 to December 31, 2020 were retrospectively analyzed. According to the hemoglobin (Hb) level at the beginning of dialysis, the patients were divided into high Hb group (Hb≥110 g/L), middle Hb group (80 g/L≤Hb<110 g/L) and low Hb group (Hb<80 g/L). The baseline data among the three groups were compared, and the changing trend of Hb level in MHD patients during the 8 years was analyzed. The follow-up ended at peritoneal dialysis, kidney transplantation, death or on December 31, 2021. All-cause death event within 6 months after the initiation of dialysis was defined as early death, while all-cause death event more than 6 months after the initiation of dialysis was defined as long-term death. Kaplan-Meier survival curve was used to analyze the survival rate, and log-rank test was used to compare the survival rates among the three groups. Multivariate Cox regression analysis model was used to analyze the association between anemia (Hb<110 g/L) at the beginning of dialysis and both early and long-term mortality.Results:A total of 36 216 MHD patients were included in this study, with age of (61.3±15.5) years old and 22 163 males (61.20%). The Hb at the beginning of dialysis was (89.33±20.89) g/L. The compliance rate of Hb (≥110 g/L) was 16.43% (5 952/36 216). There were 12 232 patients (33.78%), 18 032 patients (49.79%), and 5 952 patients (16.43%) in low Hb group, middle Hb group, and high Hb group, respectively. There were statistically significant differences in gender distribution, age, serum creatinine, blood phosphorus, blood calcium, C-reactive protein, intact parathyroid hormone, blood leukocytes, platelets, serum albumin, triglyceride, total cholesterol, and proportions of chronic glomerulonephritis, diabetic nephropathy, diabetes mellitus, cardiovascular and cerebrovascular diseases, tumors, emporary catheter, long-term catheter and autologous arteriovenous fistula among the three groups (all P<0.05). During the 8-year period, the Hb level had an increased trend steadily each year, and Hb was (88.48±22.07) g/L, (88.52±21.43) g/L, (87.86±21.29) g/L, (88.93±20.69) g/L, (88.87±20.69) g/L, (90.03±20.47) g/L, (90.74±20.31) g/L and (90.31±20.54) g/L year by year. There were 2 176 early deaths (6.01%), and 6 557 long-term deaths (18.10%) by the end of follow-up. Kaplan-Meier survival curve showed that early survival rate of low Hb group was significantly lower than those of high Hb group (log-rank test, χ2=57.115, P<0.001) and middle Hb group (log-rank test, χ2=49.918, P<0.001), and long-term survival rates of low Hb group (log-rank test, χ2=107.097, P<0.001) and middle Hb group (log-rank test, χ2=47.430, P<0.001) were significantly lower than that of high Hb group. Multivariate Cox regression analysis showed that Hb<80 g/L at the beginning of dialysis was an independent influencing factor of early death (Hb ≥110 g/L as a reference, HR=1.307, 95% CI 1.096-1.559), and 80 g/L≤Hb<110 g/L and Hb<80 g/L at the beginning of dialysis were the independent influencing factors of long-term death (Hb≥110 g/L as a reference, HR=1.108, 95% CI 1.021-1.203; HR=1.228, 95% CI 1.127-1.339, respectively) in MHD patients. Conclusions:The compliance rate of Hb at the beginning of dialysis in MHD patients is low. Hb <80 g/L at the beginning of dialysis is an independent risk factor of early death, and Hb <110 g/L at the beginning of dialysis is an independent risk factor of long-term death in MHD patients.

[Abstract] [Objective] To analyze the detection ability of one imported and three domestic microcolumn agglutination anti-human globulin cards in unexpected antibody screening test. [Methods] A total of 104 positive samples from antibody screening test conducted at our hospital from July to September 2022 were selected. Microcolumn agglutination antiglobulin tests were performed in parallel with antibody screening tests using one imported card (A Card) and three domestic cards (B, C and D Cards ) to analyze the differences in the sensitivity, specificity and agglutination intensity scores. [Results] The sensitivity of the four anti-human globulin cards was as follows: D card 88.51% (131/148) > C card 83.22% (124/149) > B card 81.63% (120/147) > A card 80.54% (120/149); the specificity was A card 97.79% (133/136) > B card 95.65% (132/138) > D card 95.62% (131/137) > C card 93.38% (127/136); and the average agglutination intensity score (points) was D card 214.57 > C card 191.90 > A Card 179.69 > B Card 175.83, and the H value of Kruskal-Wallis test was 7.221, with no statistically significant difference (P > 0.05). Among them, C card was prone to false positives, accounting for 3.16% (9/285), and A card was prone to false negatives, accounting for 10.18% (29/285). [Conclusion] There were differences in the detection ability of anti-human globulin cards of different manufacturers, and some domestic cards have higher detection performance than imported cards. It is recommended to use anti-human globulin cards of two manufacturers routinely in clinical practice, that is, to use cards with high detection sensitivity for antibody screening tests to avoid antibody missed detection as much as possible, and to use cards with high specificity for cross-matching blood tests to avoid delays in transfusion due to false positives, which could hinder transfusion treatment.

Objective To compare the early effect of arthroscopic modified Mason-Allen(mMA)and suture-bridge technique for small and medium-size rotator cuff tear.Methods 60 patients with small and medium-size rotator cuff tear were divided into mMA group and suture bridge group,30 cases each.The mMA group was treated with mMA technique,and the suture bridge group was treated with suture-bridge technique.The operative time,the number of anchors used,blood loss,shoulder mobility,pain visual analogue scale(VAS),American Shoulder and Elbow Surgeons(ASES)scale,the Constant-Murley score and the rate of re-tear were compared between the two groups.Results The operative time and the number of anchors used in mMA group were less than those in suture bridge group(P<0.05),and there was no difference of blood loss between the two groups(P>0.05).After operation,the shoulder joint motion of two groups was increased compared with before operation(P<0.05),and there was no statistical difference between the two groups(P>0.05).After surgery,VAS of the two groups was lower than that before surgery,ASES scale and Constant-Murley scores were higher than those before surgery(P<0.05),there was no difference in VAS,ASES and Constant-Murley scores between the two groups(P>0.05).There was no difference in re-tear rate between the two groups(P>0.05).Conclusion Arthroscopic mMA is similar to suture-bridge technique in the treatment of small and medium-size rotator cuff tear,but operative time of mMA is shorter and it requires less anchors.

Objective:To analyze the distribution and genomic characteristics of SARS-CoV-2 variants isolated from imported cases of COVID-19 in Sichuan Province from December 2022 to January 2023.Methods:This study selected 108 nasal and throat swab samples with fluorescence threshold (Ct)≤32 that were collected from imported COVID-19 cases in Sichuan Province from December 2022 to January 2023. Targeted amplification and Illumina NextSeq? 2000 system were used for whole-genome sequencing. Nextclade and Pangolin online platforms were used to determine the virus genotypes and analyze the mutation loci. A phylogenetic tree was constructed using maximum likelihood.Results:A total of 55 SARS-CoV-2 whole genome sequences with coverage of >95% were obtained, and all of the strains were Omicron variants. Compared with the sequence of reference strain Wuhan-Hu-1, the median number of nucleotide mutation sites of 21L, 22B, 22D, 22E, and 22F genotypes were 93, 75, 92, 78, and 92, and the median number of amino acid mutation sites were 68, 53, 68, 69, and 65, respectively. From December 2022 to January 2023, the predominant circulating SARS-CoV-2 variants from imported cases in Sichuan Province were BA.5.2 (10.91%, 6/55), XBB.1.1 (9.10%, 5/55), BF.7.14 (7.23%, 4/55), and BQ.1.1 (7.23%, 4/55).Conclusions:The distribution of SARS-CoV-2 variants can reflect the global epidemic trend to a certain extent. However, it is different from the distribution of local circulating variants in the Chinese mainland. The XXB variants with transmission advantages can be detected in large numbers of inbound travelers before becoming the predominant circulating strains in the Chinese mainland.

Betacoronavirus ; Coronavirus Infections ; Humans ; Pandemics ; Pneumonia, Viral ; Single-Cell Analysis

Objective To investigate the clinical outcome of pancreatic pseudocyst(PPC)treated with non-surgical methods,and to compare the efficacy and safety between percutaneous drainage and endoscopic drainage in the management of PPC.Methods From February 2010 to July 2017,clinical data of patients with PPC,who received percutaneous drainage or endoscopic drainage,were retrospectively analyzed.The symptom relief rate,short-term and long-term radiologic remission rate,complication rate, recurrence rate and length of hospital stay were compared between patients treated by ultrasound guided percutaneous drainage(percutaneous group),by endoscopic ultrasonography-guided drainage(EUS group)and by endoscopic retrograde pancreatography guided transpapillary drainage(ERP group).Two independent samples t test,one-way analysis of variance,non-parametric test and Fisher′s exact test were performed for statistical analysis.Results A total of 153 patients were treated and the operation was successfully conducted in 148 patients(96.7%),of whom 39 were in percutaneous group,73 in EUS group and 36 in ERP group.The median follow-up time was 26 weeks(two weeks to 358 weeks).The symptom relief rate,long-term radiographic remission rate,complication rate,recurrence rate and retreatment rate of percutaneous group,EUS group and ERP group were 87.2%(34/39),79.5%(58/73),80.6%(29/36);81.5%(22/27),88.6%(39/44),66.7%(16/24);17.9%(7/39),28.8%(21/73),16.7%(6/36);15.0%(3/20),13.8%(8/58),10.0%(2/20);and 10.3%(4/39),8.2%(6/73),2.8%(1/36),respectively.There was no statistically significant difference among three groups (all P> 0.05).The short-term radiographic remission rate of ERP group was significantly lower than those of percutaneous group and EUS group(46.7%,14/30 vs 77.1%,27/35 and 87.7%,64/73),and the differences were statistically significant(χ2 =6.442 and 19.450,both P<0.01).The median hospital stay of percutaneous group was longer than those of EUS group and ERP group(14.0 days vs 9.0 days and 8.0 days),and the differences were statistically significant(Z= -3.687 and -2.630,both P<0.01).Conclusions The efficacies of percutaneous drainage and EUS-guided drainage are both better than ERP,and they are effective and safe methods especially for the patients with complication of pseudocysts and necrosis debris in pseudocysts.However,the hospitalization time of percutaneous drainage is longer. In addition,percutaneous drainage can be an alternative method after failed endoscopic drainage.

Objective In order to establish a basis for exploring diagnostic biomarkers of type 2 diabetes mellitus (T2DM), our research screened differentially expressed circRNAs in high glucose treated human umbilical vein endothelial cells ( HUVECs) and validated these circRNAs in both cell models and peripheral blood samples of T 2DM patients.Methods The research used HUVECs as experimental model . The control group (n=3) and high glucose group (n=3) were set up and treated under normal condition (5.5 mmol/L) and high glucose condition (30.0 mmol/L), respectively.The research utilized high-throughput sequencing technology to preliminarily screen differentially expressed circRNAs .Differentially expressed circular RNAs were validated in the endothelial cell model by PCR and real -time quantitative PCR ( q-PCR) techniques.Subsequently , in the peripheral blood samples of T 2DM patients ( n=32) and control individuals ( n=28 ), the differentially expressed circRNAs were further validated . Finally, t-Test, correlation analysis and ROC curve were used to analyze the experimental results .Results Total 1087 differentially expressed circular RNAs were screened by high-throughput sequencing;and of these , 554 were up-regulated, 533 were down-regulated.Six increased circRNAs were selected and validated in HUVEC model;and their PCR and q-PCR results matched with sequencing results .Further validation was conducted in peripheral blood samples for three most up-regulated circRNAs.This study found that the differential expression of hsa_circ_0031739 in peripheral blood samples was statistically significant ( 0.015 ±0.0025 vs.0.006 ±0.0013,P=0.0059 <0.05).The area under the ROC curve (AUC) was 0.730 and the expression level of hsa_circ_0031739 was positively correlated with blood glucose ( GLU ) and glycated hemoglobin ( GHb ) ( r=0.317, P=0.0137 <0.05;r=0.348, P=0.0064 <0.05 ) .Conclusion HUVECs were commonly utilized as cell models in the study of T 2DM, and differentially expressed circular RNA profiles existed afterhigh glucose treatment .The differential expression of hsa_circ_0031739 was significant in both high glucose treated HUVECs and peripheral blood samples of T 2DM patients, and the expression level of hsa_circ_0031739 was correlated with GLU and GHb , which has certain diagnostic significance.Therefore, hsa_circ_0031739 may become a new diagnostic biomarker for T2DM and be helpful for the comprehensive diagnosis and mechanism research of T 2DM.

Aim To explore the influence of metformin(a first-line drug for type 2 diabetes) on ATP-induced inflammasome activation and the release of interleukin-1β(IL-1β) by LPS-activated peritoneal macrophages, a commonly-used inflammatory cell model.Methods Peritoneal macrophages were elicited by intraperitoneal injection of 30 g·L-1 thioglycollate into C57BL/6 mice.Inflammasome was activated and cell pyroptosis was induced by LPS plus ATP treatment, and the pyroptotic cells were calculated after propidium iodide(PI) staining.The protein levels of IL-1β and caspase-1 expressed in the cells and released from them into the supernatant were evaluated by Western blot.Immunofluorescent microscopy was recruited to detect the subcellular distribution and fluorescent intensity of the purinergic P2X7 receptor(P2X7R).Results Metformin per se did not induce pyroptosis in LPS-activated peritoneal macrophages, but it significantly and dose-dependently increased cell pyroptosis induced by ATP treatment.At protein levels, maturated IL-1β(17 ku) could not be released from the cells upon single LPS or LPS plus metformin stimulation;but after ATP was added, maturated IL-1β was released into the supernatants of the cells.Moreover, metformin dose-dependently increased the protein levels of both maturated IL-1β and active caspase-1 released by the LPS-activated peritoneal macrophages upon ATP stimulation.Conclusion Metformin intensifies the activation of inflammasome and increases the release of active caspase-1 and maturated IL-1β upon ATP stimulation in the LPS-activated peritoneal macrophages, which should promote inflammatory responses.

OBJECTIVE: To study the intervention effects of participatory training on the occupational health in polishing workers. METHODS: By the stratified random sampling method,930 front-line polishing workers were selected from 50 manufacturing enterprises in Guangzhou,467 workers in the intervention group and 463 workers in the control group. The intervention group adopted participatory training and the control group adopted the traditional training. We evaluated the changes of occupational health knowledge,attitude and practice( KAP) in workers of these two groups using the questionnaire table of occupational health KAP for polishing workers. Data of before intervention,immediately after intervention and 3 months after intervention were collected. RESULTS: The workers 'knowledge,attitude and practice scores at the time point of immediately after intervention were higher than those before intervention in the same group( P <0. 05). The workers' knowledge and practice scores of 3 months after intervention in intervention group were higher than those before intervention( P < 0. 05). The knowledge and practice scores of 3 months after intervention in the intervention group were higher than that in the control group( P < 0. 05). The evaluation scores on protection measure and warning signs of workers in the intervention group were lower than those in workers of control group 3 months after the intervention( P < 0. 05). Three months after the intervention,the workers in intervention group believed that the training was more effective than that in the control group in the following 6 aspects: improving the knowledge of occupational health,improving the ability of identifying risk factors, learning to use the personal protective equipment, helping other workmates,having confidence to make suggestions and introducing other workmates to participate in training( P < 0. 05).CONCLUSION: The participatory training is an effective intervention model in improving the workers ' awareness of occupational health KAP.

ObjectiveTo investigate the relationship between gastrointestinal dysfunction and both severity and prognosis in patients with heatstroke (HS).Methods A retrospective analysis was conducted. Clinical data from 39 patients with HS seeking for treatment in Department of Critical Care Medicine of Chinese PLA General Hospital from January 2013 to September 2014 were enrolled. The patients were divided into two groups: gastrointestinal dysfunction group and non-gastrointestinal dysfunction group. The acute physiology and chronic health evaluationⅡ(APACHEⅡ) score within 24 hours of admission and 28-day mortality were compared between two groups. In gastrointestinal dysfunction group, the gastrointestinal dysfunction score, the duration days of gastrointestinal dysfunction, the length of intensive care unit (ICU) stay, and the duration of mechanical ventilation were collected. Pearson correlation analysis was used to analyze the relationship between gastrointestinal function and the severity of the ailment as well as the prognosis.Results Among 39 patients with HS, 32 of them showed gastrointestinal dysfunction with an incidence of 82.05%. In gastrointestinal dysfunction group, the gastrointestinal dysfunction score was 2.3±0.8, the duration of gastrointestinal dysfunction was (17.3±15.2) days, the length of ICU stay was (37.8±25.0) days, and the duration of mechanical ventilation was (27.8±14.0) days. APACHEⅡ score in gastrointestinal dysfunction group was significantly higher than that of the non-gastrointestinal dysfunction group (26.30±6.00 vs. 17.40±6.00, t = 3.555,P = 0.001). The 28-day mortality in gastrointestinal dysfunction group was slightly higher than that of the non-gastrointestinal dysfunction group without statistically significant difference [43.75% (14/32) vs. 14.29% (1/7),P = 0.216]. It was shown by Pearson analysis that gastrointestinal dysfunction score was positively correlated with APACHEⅡ score (r = 0.727,P = 0.000), and the duration of gastrointestinal dysfunction was positively correlated with the length of ICU stay (r = 0.797,P = 0.000) and the duration of mechanical ventilation (r = 0.634,P = 0.000). Conclusion The results suggest that gastrointestinal function in patients with HS reflects the severity and prognosis of the ailment.