INTRODUCTIONPneumonia is associated with considerable mortality. However, there is limited information on age-specific prognostic factors for death from pneumonia.

METHODSPatients hospitalised with a diagnosis of pneumonia through the emergency department were stratified into three age groups: 18-64 years, 65-84 years and ≥ 85 years. Multivariate logistic regression and receiver operating characteristic curve analyses were conducted to evaluate prognostic factors for mortality and the performance of pneumonia severity scoring tools for mortality prediction.

RESULTSA total of 1,902 patients were enrolled (18-64 years: 614 [32.3%]; 65-84 years: 944 [49.6%]; ≥ 85 years: 344 [18.1%]). Mortality rates increased with age (18-64 years: 7.3%; 65-84 years: 16.1%; ≥ 85 years: 29.7%; p < 0.001). Malignancy and tachycardia were prognostic of mortality among patients aged 18-64 years. Male gender, malignancy, congestive heart failure and eight other parameters reflecting acute disease severity were associated with mortality among patients aged 65-84 years. For patients aged ≥ 85 years, altered mental status, tachycardia, blood urea nitrogen, hypoxaemia, arterial pH and pleural effusion were significantly predictive of mortality. The Pneumonia Severity Index (PSI) was more sensitive than CURB-65 (confusion, uraemia, respiratory rate ≥ 30 per minute, low blood pressure, age ≥ 65 years) for mortality prediction across all age groups.

CONCLUSIONThe predictive effect of prognostic factors for mortality varied among patients with pneumonia from the different age groups. PSI performed significantly better than CURB-65 for mortality prediction, but its discriminative power decreased with advancing age.

Adolescent ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; Algorithms ; Community-Acquired Infections ; diagnosis ; mortality ; Female ; Hospitalization ; Humans ; Male ; Middle Aged ; Multivariate Analysis ; Patient Admission ; Pneumonia ; diagnosis ; mortality ; Predictive Value of Tests ; Prognosis ; ROC Curve ; Risk Factors ; Sensitivity and Specificity ; Severity of Illness Index ; Singapore ; epidemiology ; Young Adult

Objective To investigate the regulation of T cells in the process of liver regeneration using a model of mice after 70% liver resection.Methods We performed 70% hepatectomy in T-cell-deficient mice and control mice.The liver mass and body mass ratio, BrdU infiltration level, proliferating cell nuclear antigen (PCNA),expression of M phase marker protein p-HDAC3, and serum transaminase levels were measured.Results The recovery of liver mass and body mass ratio of thymus-deficient mice occurred significantly later than that of control mice.The peak time of BrdU infiltration levels and the expression of PCNA and p-HDAC3 in T-cell-deficient mice were later than in control mice, but the degree of liver injury was lower.Conclusion T cells are involved in the regulation of liver regeneration, and the absence of T cells delays the process of liver regeneration.

Objective To investigate the optimal injury time point of cardiac arrest (CA) induced electrically, and establish a reproducible prolonged CA and cardiopulmonary resuscitation (CPR) model in pigs. Methods Forty healthy domestic male pigs were randomly divided into four groups, which were ventricular fibrillation (VF) 8, 10, 11, and 12 minutes groups, each group for 10 animals. In these groups, VF was induced by alternating current delivered to right ventricular endocardium and untreated for 8, 10, 11, and 12 minutes, respectively, followed by 6 minutes of CPR procedure. The resuscitation and survival outcomes were recorded. Hemodynamic parameters and arterial blood gases of animals after successful resuscitation were measured and recorded for 6 hours. Those successful resuscitation animals were regularly evaluated for the neurological deficit score (NDS) and survival outcomes every 24 hours till 96 hours after resuscitation. Results The shortest duration of CPR (minute: 6.9±1.3) and the highest successful ratio of the first defibrillation (7/10) were observed in group VF 8 minutes, and the ratio of successful resuscitation was 100%. The best coronary perfusion pressure (CPP) during the CPR, less neurological impairment, longer survival time, more stable hemodynamics, and shorter time for arterial pH and lactate level restoring to the original state after CPR were also observed in group VF 8 minutes, and no severe damage was found in those animals. The longest duration of CPR (minute:10.3±2.9) and the lowest successful ratio of the first defibrillation (1/10) were observed in group VF 12 minutes, and only 4 animals achieved restoration of spontaneous circulation (ROSC), and no animal survived to CPR 96 hours. The worst CPP during CPR and the highest NDS after resuscitation were also found in VF 12 minutes animals compared to those animals in the other groups. The injuries caused by ischemia and hypoxia in groups VF 10 minutes and VF 11 minutes were in between those of the groups VF 8 minutes and VF 12 minutes, and the duration of CPR were (7.0±2.1) minutes and (8.2±2.6) minutes. There were 9 and 7 animals achieved ROSC in groups VF 10 minutes and VF 11 minutes correspondingly, and 6 and 4 animals survived to 96 hours respectively. Obviously unstable hemodynamics was observed during the period of CPR 2 hours in the two groups. At CPR 1 hour, the heart rates (HR, beats/min) in groups VF 10 minutes and VF 11 minutes increased to 172 (155, 201) and 168 (136, 196) respectively, and the mean arterial pressures (MAP, mmHg, 1 mmHg = 0.133 kPa) declined to 97 (92, 100) and 81 (77, 100), the cardiac output (CO, L/min) decreased to 5.0 (4.0, 5.8), 3.7 (3.0, 5.4) correspondingly. Distinct injuries were found in the two groups [CPR 24-96 hours NDS in groups VF 10 minutes and VF 11 minutes: 180 (110, 255)-20 (0, 400) and 275 (223, 350)-240 (110, 400)], and the arterial pH of the two group decreased to 7.26±0.09 and 7.23±0.09 respectively, and the level of lactate (mmol/L) increased to 9.17±1.48 and 12.80±2.71 correspondingly at CPR 0.5 hour. Significantly lower pH was observed in group VF 11 minutes compared to group VF 8 minutes at CPR 0.5 hour (7.23±0.09 vs. 7.33±0.04, P < 0.05). The highest level of lactate (mmol/L) was also found at the same time point in group VF 11 minutes, which recovered to normal slowly, and was still significantly higher than groups VF 8, 10, 12 minutes (7.58±3.99 vs. 2.55±1.53, 2.13±2.00, 3.40±2.30, all P < 0.05) at CPR 4 hours. Conclusions The longer duration of CA was, the more severe damage would be, the longer CPR time would be required, and the harder of the animals to achieve ROSC. In this prolonged CA and CPR porcine model, 10-11 minutes for untreated VF, was an optimal time point with appropriate successful rate of resuscitation, survival outcomes, and post-resuscitation injuries. Therefore, we recommended 10-11 minutes might be the rational length of no-flow time in this model.

OBJECTIVETo establish two double-antigen sandwich ELISA systems to detect anti-Afmp1cr and Afmp2cr antibodies of Aspergillus fumigatus.

METHODSRecombinant Afmp1cr and Afmp2cr proteins of A.fumigatus expressed in Pichia pastoris were obtained. Double-antigen sandwich ELISA systems for detecting specific anti-Afmp1cr and anti-Afmp2cr antibodies were developed after chessboard titrating to determine the appropriate concentrations of the recombinant proteins and HRP-labeled proteins. The sensitivity of the assay was evaluated using serum samples of rabbits immunized with Afmp1cr and Afmp2cr. The specificity of the assay was evaluated by detecting serum samples from healthy donors and patients with other pathogenic fungal and baterial infections. The performance of the two ELISA kits was furthered evaluated using serum samples from patients with suspected Aspergillus infection.

RESULTSThe established ELISA kits were capable of detecting anti-Afmp1cr and anti-Afmp2cr antibodies in immunized rabbit serum at the maximum dilutions of 800 and 3200, respectively. No cross-reactivity was observed in detecting serum from patients with other pathogenic fungal or bactetial infections. Both of the two kits yielded positive results in sera from two established Aspergillus-infected cases and a suspected case.

CONCLUSIONSTwo antibody-capture ELISA kits were developed for the laboratory diagnosis of A.fumigatus infection and can be potentially useful in the clinical diagnosis of Aspergillosis infections.

Animals ; Antibodies, Fungal ; isolation & purification ; Antigens, Fungal ; Aspergillosis ; diagnosis ; Aspergillus fumigatus ; Cross Reactions ; Enzyme-Linked Immunosorbent Assay ; Humans ; Pichia ; Rabbits ; Recombinant Proteins ; Sensitivity and Specificity

OBJECTIVEThis study aims to evaluate the reliability and validity of the Chinese version of the chronic oral mucosal disease questionnaire (COMDQ).

METHODSUsing translation, back-translation, quality evaluation, cross-cultural adaptation, and pre-assessment, a Chinese version of the COMDQ was drafted. A 26-item instrument which comprised of four domains: pain and functional limitation, medications and side effects, social and emotional aspects, and patient support was designed and tested. This questionnaire was given to patients who visited our clinic. After the patients accomplished the questionnaires, we analyzed the collected data to evaluate the reliability and validity of the scale.

RESULTSA total of 130 patients were enrolled in our study. All the COMDQ questionnaires were completely filled out. The Chinese version of the COMDQ showed the following psychometric properties: Cronbach's alpha of 0.914, split-half reliability of 0.809, and correlation of 0.697. Factor analysis of construct validity demonstrated that the 26 items were classified into four domains, and the cumulative proportion was 67.62%. Thus, the scale had certain logical relation between the items in the same domains.

CONCLUSIONThe Chinese version of the COMDQ demonstrate good reliability and validity by rigorous psychometric properties. It can be widely used to test the oral health-related quality of life of patients with oral mucosal diseases.

China ; Humans ; Oral Health ; Psychometrics ; Quality of Life ; Reproducibility of Results ; Surveys and Questionnaires

Objective To evaluate the rational preventive application of antibiotics during perioperative period of intracranial operations.Methods A prospective study was adopted to investigate the differences of infection rate of surgical site between the group of rational application of antibiotics (406 patients with type Ⅰ incision intracranial operations of neurosurgery in 2011) and the control group (479 patients with type Ⅰ incision intracranial operations ofneurosurgery in 2012).Results The antibiotic treatment period was shortened from (5.16±3.90) days in the control group to (2.77± 1.81) days in group of rational application of antibiotics (t=11.994,P=0.000); while surgical site infection rate was decreased from 14.61％ to 10.10％ (x2=.084,P=0.043).Conclusion Surgical site infection rate in type Ⅰ incision intracranial operations could be reduced and the antibiotic treatment period would be shortened if rational preventive application of antibiotics during the perioperative period could be applied.

Objective To establish two double-antigen sandwich ELISA systems to detect anti-Afmp1cr and Afmp2cr antibodies of Aspergillus fumigatus. Methods Recombinant Afmp1cr and Afmp2cr proteins of A.fumigatus expressed in Pichia pastoris were obtained. Double-antigen sandwich ELISA systems for detecting specific anti-Afmp1cr and anti-Afmp2cr antibodies were developed after chessboard titrating to determine the appropriate concentrations of the recombinant proteins and HRP-labeled proteins. The sensitivity of the assay was evaluated using serum samples of rabbits immunized with Afmp1cr and Afmp2cr. The specificity of the assay was evaluated by detecting serum samples from healthy donors and patients with other pathogenic fungal and baterial infections. The performance of the two ELISA kits was furthered evaluated using serum samples from patients with suspected Aspergillus infection. Results The established ELISA kits were capable of detecting anti-Afmp1cr and anti-Afmp2cr antibodies in immunized rabbit serum at the maximum dilutions of 800 and 3200, respectively. No cross-reactivity was observed in detecting serum from patients with other pathogenic fungal or bactetial infections. Both of the two kits yielded positive results in sera from two established Aspergillus-infected cases and a suspected case. Conclusion Two antibody-capture ELISA kits were developed for the laboratory diagnosis of A.fumigatus infection and can be potentially useful in the clinical diagnosis of Aspergillosis infections.

Objective This study aims to evaluate the reliability and validity of the Chinese version of the chronic oral mucosal disease questionnaire (COMDQ). Methods Using translation, back-translation, quality evaluation, cross-cultural adaptation, and pre-assessment, a Chinese version of the COMDQ was drafted. A 26-item instrument which comprised of four domains: pain and functional limitation, medications and side effects, social and emotional aspects, and patient support was designed and tested. This questionnaire was given to patients who visited our clinic. After the patients accomplished the questionnaires, we analyzed the collected data to evaluate the reliability and validity of the scale. Results A total of 130 patients were enrolled in our study. All the COMDQ questionnaires were completely filled out. The Chinese version of the COMDQ showed the following psychometric properties: Cronbach’s alpha of 0.914, split-half reliability of 0.809, and correlation of 0.697. Factor analysis of construct validity demonstrated that the 26 items were classified into four domains, and the cumulative proportion was 67.62%. Thus, the scale had certain logical relation between the items in the same domains. Conclusion The Chinese version of the COMDQ demonstrate good reliability and validity by rigorous psychometric properties. It can be widely used to test the oral health-related quality of life of patients with oral mucosal diseases.

Objective To establish two double-antigen sandwich ELISA systems to detect anti-Afmp1cr and Afmp2cr antibodies of Aspergillus fumigatus. Methods Recombinant Afmp1cr and Afmp2cr proteins of A.fumigatus expressed in Pichia pastoris were obtained. Double-antigen sandwich ELISA systems for detecting specific anti-Afmp1cr and anti-Afmp2cr antibodies were developed after chessboard titrating to determine the appropriate concentrations of the recombinant proteins and HRP-labeled proteins. The sensitivity of the assay was evaluated using serum samples of rabbits immunized with Afmp1cr and Afmp2cr. The specificity of the assay was evaluated by detecting serum samples from healthy donors and patients with other pathogenic fungal and baterial infections. The performance of the two ELISA kits was furthered evaluated using serum samples from patients with suspected Aspergillus infection. Results The established ELISA kits were capable of detecting anti-Afmp1cr and anti-Afmp2cr antibodies in immunized rabbit serum at the maximum dilutions of 800 and 3200, respectively. No cross-reactivity was observed in detecting serum from patients with other pathogenic fungal or bactetial infections. Both of the two kits yielded positive results in sera from two established Aspergillus-infected cases and a suspected case. Conclusion Two antibody-capture ELISA kits were developed for the laboratory diagnosis of A.fumigatus infection and can be potentially useful in the clinical diagnosis of Aspergillosis infections.

OBJECTIVEThis study was conducted to determine the three-dimensional structure, course, and adjacent structure of the mandibular incisive canal (MIC) to ensure safety of dental implantation by cone beam CT (CBCT).

METHODSThe CBCT images of the bilateral mandibles of 80 patients were retrospectively studied. The diameters of the mandibular incisive canal and the location in the adjacent structure were determined, including the distances between the MIC and the buccal and lingual plates of the alveolar bone, the inferior border of the mandible and the tooth apex, and the horizontal plane of the mental foramen.

RESULTSApproximately 78.75% (63 cases) of the CBCT scans showed the presence of the MIC with a mean diameter of 1.21 mm +/- 0.29 mm. The distances from the canal to the inferior border of the mandible and to the tooth apex were 7.82 mm +/- 1.86 mm and 7.24 mm +/- 2.82 mm, respectively. The distances between the canal and the buccal plate as well as between the canal and the lingual plate of the alveolar bone were 3.80 mm +/- 1.37 mm and 4.45 mm +/- 1.34 mm, respectively. The distance from the canal to the horizontal plane of the mental foramen was 5.62 mm +/- 2.21 mm.

CONCLUSIONCBCT could clearly show the three-dimensional structure, course, and adjacent structure of the MIC. Therefore, this technique could provide guidance for dental implantation in clinical applications.

Bone and Bones ; Cone-Beam Computed Tomography ; Dental Implants ; Humans ; Mandible ; anatomy & histology ; Maxilla ; Retrospective Studies ; Tongue