简介：Estrogendeficiencyhasbeenproposedasariskfactorforalveolarboneloss,butwhetherornotestrogenwillinflucencethebonerebuiltingprocessduringorthodontictoothmovementandwhatthemechanismsinvolvedremainunclear.Thepaperaimstoprovidenewinformationthatmayelucidatethemodulatoryeffectofestrogenonthebone-resorbingcytokinesRANKLanditsanti-resorptivefactorOPGsecrectedbyHPLFswhicharealreadyforce-stimulated.TheexpressionofOPGmRNAisrisingaftermechanicalloadingeitherwithorwithoutstimulatedbyestrogenbefore.ButHPDLcellsexposuredtoestrogenfor24hbeforeloadedtendtoexpressmoreOPGmRNA.Comparedwiththeno-estrogengroup,theinhibittrendofRANKLmRNAismuchmoreapparentinwith-estrogengroup.Moreover,estrogenandmechanicforcetime-dependentlyincreasedOPGexpressionandattenuatedtheRANKLexpression.

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简介：Theepidemiologyofbenignprostatichyperplasia(BPH)andmalelowerurinarytractsymptoms(LUTS)hasevolvedconsiderablyduringthepastseveralyears.ThetermLUTSdescribesadistinctphenotypeandallowsforabroadepidemiologicdescriptionofurinarysymptomsatapopulationlevel.Althoughitisbecomingthepreferredtermforstudyingurinarysymptomsinpopulations,LUTS

简介：AIM:Toidentifyriskfactorsassociatedwithpost-cataractsurgeryendophthalmitis(PCE)intype2diabeticpatients.METHODS:Ahospital-basedretrospectivecase-controlstudywasconductedon194type2diabeticpatientsundergoingcataractsurgeryinRajavithiHospitalfromJanuary2007toDecember2015.FifteenpatientswithPCEwereincludedasthecasegroupand179patientswithoutPCEwereincludedasthecontrolgroup.PotentialfactorsassociatedwithPCEamongbothgroupsincludingdemographics,pre-operativecharacteristics,surgicalsettingsandcomplications,werestatisticallyanalyzedusingChi-squaretestingandalogisticregressionmodel.RESULTS:Withinthecasegroup,53%werefemalesandthemedianagewas68y.Univariateanalysisofpre-operativecharacteristics,surgicalsettingsandcomplicationsrevealedthatrecentpre-operativefastingplasmaglucose,insulintherapy,presenceofdiabeticretinopathy,andseverenon-proliferativeorproliferativediabeticretinopathyweresignificantlyassociatedwithPCE.Inamultivariateanalysisadjustingforbloodglucoselevel,insulintreatmentwastheonlysignificantfactorassociatedwithanincreasedriskofPCE(OR3.9,95%CI1.0-15.0,P=0.04)comparedtopatientswithoutinsulintreatment.Themostcommoncausativeorganismsweregram-positivebacteria(89%).Staphylococcusspeciesrepresentedthemostcommongroup(67%).Medianbestcorrectedvisualacuityat1-monthand3-monthfollow-upwasequalat0.7logMAR(20/100).CONCLUSION:Theauthorsidentifyinsulintreatmentastheonlyriskfactorassociatedwithendophthalmitisaftercataractsurgeryintype2diabeticpatients.Furtherstudieswithserumlevelsofpre-operativeglycatedhemoglobin(HbA1c)andpost-operativefastingplasmaglucoselevelareessentialtotrulydemonstratetheroleofperi-operativeglycemicmarkersasariskfactorforPCE.

简介：AbstractBackground:Coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has rapidly spread throughout the world. In this study, we aimed to identify the risk factors for severe COVID-19 to improve treatment guidelines.Methods:A multicenter, cross-sectional study was conducted on 313 patients hospitalized with COVID-19. Patients were classified into two groups based on disease severity (nonsevere and severe) according to initial clinical presentation. Laboratory test results and epidemiological and clinical characteristics were analyzed using descriptive statistics. Univariate and multivariate logistic regression models were used to detect potential risk factors associated with severe COVID-19.Results:A total of 289 patients (197 nonsevere and 92 severe cases) with a median age of 45.0 (33.0, 61.0) years were included in this study, and 53.3% (154/289) were male. Fever (192/286, 67.1%) and cough (170/289, 58.8%) were commonly observed, followed by sore throat (49/289, 17.0%). Multivariate logistic regression analysis suggested that patients who were aged ≥ 65 years (OR: 2.725, 95% confidence interval [CI]: 1.317-5.636; P = 0.007), were male (OR: 1.878, 95% CI: 1.002-3.520, P = 0.049), had comorbid diabetes (OR: 3.314, 95% CI: 1.126-9.758, P = 0.030), cough (OR: 3.427, 95% CI: 1.752-6.706, P < 0.001), and/or diarrhea (OR: 2.629, 95% CI: 1.109-6.231, P = 0.028) on admission had a higher risk of severe disease. Moreover, stratification analysis indicated that male patients with diabetes were more likely to have severe COVID-19 (71.4% vs. 28.6%, χ2 = 8.183, P = 0.004).Conclusions:The clinical characteristics of those with severe and nonsevere COVID-19 were significantly different. The elderly, male patients with COVID-19, diabetes, and presenting with cough and/or diarrhea on admission may require close monitoring to prevent deterioration.

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简介：AbstractObjective:To detect the expression of caspase-3, baculoviral inhibitor of apoptosis repeat containing 5 (BIRC-5), vascular endothelial growth factor (VEGF), hypoxia-inducible factor (HIF), and the concentration of resistin protein in placental of patients with gestational diabetes mellitus (GDM) and normal pregnant women, and to explore its correlation with the pathogenesis of GDM and its significance.Methods:This study includes 30 pregnant women who chose cesarean section at Tongji Hospital of Tongji Medical College during May 2013 to February 2014: 15 GDM patients and 15 normal glucose tolerance patients, 26-36 years old. The expression of caspase-3, VEGF, HIF, and BIRC-5 in placenta of 15 patients with GDM (GDM group) and 15 normal late pregnancy (control group) was detected by real-time fluorescence quantitative polymerase chain reaction. The concentration of resistin protein in the placenta was detected by enzyme-linked immunosorbent assay.Results:Compared with the control group, the expression of caspase-3, HIF, VEGF, resistin in placenta of GDM group increased significantly (P < 0.05); the expression of BIRC-5 in placenta of GDM group decreased significantly (P < 0.05).Conclusion:The expression of caspase-3, BIRC-5, VEGF, HIF, and resistin in placenta of GDM patients and normal pregnant women are significantly different, which may be involved in the pathogenesis of GDM disease.

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简介：在分数之间的关系在风险分数系统(RSS)获得了的AIMTo分析与渗透keratoplasty(PKP)由希克斯等求婚了在1y的接枝失败手术后地并且在在有PKP接枝失败的风险的RSS的每个因素之中使用univariate和multivariateanalysis.METHODSThe有的回顾的队学习152从152个病人的PKP。十八个盒子由于主要失败(10个盒子)从我们的学习被排除，不完全的医药笔记(5个盒子)和后续不到1y(3个盒子)。我们从134个病人包括了134PKP在外科手术前的风险分数成层。枪兵系数在1y为在获得的分数和失败的风险之间的关系被计算。Univariate和multivariate分析为在1y.RESULTSSpearman系数在接枝失败上在RSS包括的每个单个风险因素的影响被计算在在RSS和接枝失败的分数之间的显示出的统计上重要的关联(P<0.05)。Multivariate逻辑回归分析没显示出统计上重要的关系(P>0.05)在有接枝失败的诊断和透镜地位之间。在因素学习了的另外的风险和接枝失败之间的关系是重要的(P<0.05)，尽管以前的接枝的结果和接枝失败是不可靠的。这样，任何一个都没我们的病人有以前的输血它没有impact.CONCLUSIONAftermultivariate分析技术的申请，一些风险因素不在1y在接枝失败上显示出期望的影响。

简介：AIM:Toinvestigatetheprevalenceandriskfactorsofdiabeticretinopathy(DR)innorthernChinesepatientswithtype2diabetesmellitus(T2DM).METHODS:Thisretrospectivecross-sectionalstudywasperformedbetweenMay2011andApril2012.Atotalof1100patients(male/female,483/617)wereincludedinthisstudy.DRwasdefinedfollowingtheEarlyTreatmentDiabeticRetinopathyStudy(ETDRS)severityscale.Allincludedpatientsacceptedacomprehensiveophthalmicexaminationincludingretinalphotographs.Logisticregressionmodelswereusedtoestimateoddsratios(ORs)and95%confidenceinterval(CI)afteradjustingforageandgender.RESULTS:Retinopathywaspresentin307patientswithaprevalenceof27.9%.Inunivariatelogisticanalysis,presenceofDRwasassociatedwithlongerdurationofdiabetes(OR,5.70;95%CI,2.91-12.56),higherconcentrationoffastingbloodglucose(OR,12.94;95%CI,2.40-67.71),higherlevelofglycosylatedhemoglobinHbA1c(OR,5.50;95%CI,3.78-11.97)andinsulintreatment(OR,6.99;95%CI,1.39-35.12).ThelifestyleofpatientswithT2DMincludingsmoking,alcoholconsumptionandregularexerciseseemednotassociatedwiththedevelopmentofDR.CONCLUSION:Ourstudysuggeststhatfastingserumglucoseconcentration,HbA1clevel,durationofdiabetesandinsulintreatmentarepotentialriskfactorsforDRinnorthernChinesepatientswithT2DM,whilethelifestyleofincludedpatientsseemsnotassociatedwithDR.

简介：Objective:Thisstudyaimstoexploretheclinicopathologiccharacteristicsandprognosticfactorsofgastriccancerpatientswithmetachronousovarianmetastasis.Methods:Clinicopathologicdatawerecollectedfrom63post-operativegastriccancerpatientswithmetachronousovarianmetastasis.ThepatientswereadmittedtotheCancerInstituteandHospital,ChineseAcademyofMedicalScienceandPekingUnionMedicalCollegebetweenJanuary1999andDecember2011.Alog-ranktestwasconductedforsurvivalanalysis.Possibleprognosticfactorsthataffectsurvivalwereexaminedbyunivariateanalysis.ACoxregressionmodelwasusedformultivariateanalysis.Results:Theincidenceofovarianmetastasiswas3.4%withameanageof45years.Upto65.1%ofthepatientswerepre-menopausal.Themeanintervalbetweenovarianmetastasisandprimarycancerwas16months.Lowlydifferentiatedcarcinomarankedfirstintheprimarygastriccancers.Themajorityoflesionsoccurredintheserousmembrane(87.3%).ThemetastaticsitesincludedN2-3lymphnodes(68.3%),bilateralovaries(85.7%),andperitonealmembrane(73%).Totalresectionofmetastaticsiteswasperformed(31.7%).Theoverallmediansurvivalwas13.6months,whereastheoverall1-,2-,and3-yearsurvivalrateswere52.5%,22.0%,and9.8%,respectively.The5-yearsurvivalratewaszero.Univariateanalysisshowedthatthepatientprognosiswascorrelatedwithmetastaticperitonealseeding,vasculartumorembolus,rangeoflesionexcision,andmodeofcomprehensivetreatmentwithadjuvantchemotherapy(P<0.05).Multivariateanalysisindicatedthatmetastaticperitonealseedingwasanindependentprognosticfactorforgastriccancerpatientswithovarianmetastasis(P<0.01).Conclusion:Effectivecontrolofperitonealseeding-inducedmetastasisisimportantforimprovingtheprognosisofgastriccancerpatientswithovarianmetastasis.

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简介：AbstractPurpose:Stable Weber B ankle fractures are treated by a walking boot for 6 weeks and bearing full weight through the boot as tolerated. The aim of the present study was to assess the outcome parameters of this treatment protocol, evaluate the efficacy of using the walking boot, and investigate any possible predicting factors that could affect the outcomes.Methods:All the patients with stable Weber B ankle fractures, treated in our hospital between January 2018 and December 2018, were prospectively included to the study. The patients were evaluated clinically, and the patient-reported outcome measures data were collected at the 2 and 6 weeks post-injury. Chi square, Spearman's rho test, independent samples and paired sample t-tests were used for the monovariant analysis.Results:A total of 128 consecutive patients (aged 52.2 ± 19.1 years) with supination external rotation type 2 fracture were finally included to the study. At the 2 weeks follow-up, the reported outcome measures scores were in moderate levels, but improved significantly at the 6 weeks follow-up (p < 0.0001). Multivariant analysis revealed that the ability to bear full weight without the boot at the 2 weeks after diagnosis was the only variable, which made statistically unique contribution to the foot and ankle disability index score at the 6 weeks (p = 0.005).Conclusion:Conservative treatment using a walking boot with advice to bear full weight of stable ankle Weber B fractures can bring to good functional outcomes. The ability to bear full weight without the aid of the walking boot at 2 weeks after diagnosis was the only significant predicting factor for better outcomes at 6 weeks after diagnosis.

简介：AbstractBackground:Ankylosing spondylitis (AS) is a common chronic progressive rheumatic disease. The aim of this study was to explore factors influencing abnormal bone mineral density (BMD) in young and middle-aged patients with AS.Methods:From July 2014 to August 2018, hospitalized patients with AS and health examinees in the health examination center of our clinics, ranging in age from 20 to 50 years, were monitored. The BMD of the lumbar spine and femoral neck of AS patients and those of a healthy control group were measured using dual-energy X-ray absorption. The BMDs of AS patients were compared with respect to age, course of disease, iritis, smoking habits, sex, height, weight, body mass index (BMI), medication use, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), platelet volume, platelet count, uric acid (UA), alkaline phosphatase (AKP), and calcium ion levels. Single-nucleotide polymorphisms (SNPs) related to BMD were screened using genome-wide association analysis.Results:There was no statistical difference in the proportion of abnormal bone masses between the different body parts. The BMD of all bones in AS patients was lower than that in healthy controls (P < 0.05). Additionally, BMD was correlated with serum calcium and CRP in AS patients (P < 0.05), but not with age, platelet volume, platelet count, ESR, UA, AKP, height, weight, and BMI. The incidence of abnormal bone mass in AS patients was correlated with sex (P < 0.05), but not with medication use, iritis, or smoking. BMD of the lumbar spine in AS patients did not correlate linearly with the course of the disease, but BMD of the femoral neck correlated linearly with the course of the disease (P < 0.05). BMD was correlated with multiple SNPs in patients with AS. Lumbar BMD was correlated with rs7025373 and rs7848078. Femoral head BMD was correlated with 3:102157365, 3:102157417, rs1252202, rs1681355, rs3891857, rs7842614, and rs9870734, suggesting that genetic factors play a role in BMD in patients with AS.Conclusions:The proportion of abnormal bone mass in AS patients was higher than that in healthy individuals of the same age. The factors related to BMD in patients with AS are gender, CRP, and blood calcium. The BMD of the femoral neck of AS patients decreases with the course of the disease, but BMD of the lumbar spine is not related to the course of the disease. BMD in AS patients is associated with multiple SNPs.

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简介：AbstractBackground:Feeding intolerance (FI) among intensive care unit (ICU) patients undergoing early continuous enteral nutrition (EN) is related to poor outcomes. This study aimed to explore the prevalence and risk factors of FI in ICU patients.Methods:We retrospectively enrolled 1057 patients who received early continuous EN via a nasogastric tube between January 2014 and August 2019. The prevalence of FI during the first 7 days of ICU stay was calculated, and the risk factors were investigated using multivariate logistic regression analysis.Results:The prevalence of FI during the first 7 days of ICU stay was 10.95%. FI occurred in 159 of 1057 (15.04%) patients on ICU day 2, 114 of 977 (11.67%) patients on ICU day 3, and 86 of 715 (12.03%) patients on ICU day 7. Mechanical ventilation (MV) (odds ratio [OR]: 1.928, 95% confidence interval [CI]: 1.064–3.493, P = 0.03) was an independent risk factor for FI defined by a gastric residual volume (GRV) of 200 mL and/or vomiting, and acute renal failure (OR: 3.445, 95% CI: 1.115–10.707, P = 0.032) was an independent risk factor of FI defined by a GRV of 500 mL and/or vomiting. Continuous renal replacement therapy (CRRT) was an independent predictor regardless of the FI defined by a GRV of 200 mL (OR: 2.064, 95% CI: 1.233–3.456, P = 0.006) or 500 mL (OR: 6.199, 95% CI: 2.108–18.228, P = 0.001) in the ICU patients.Conclusions:FI occurs frequently in early ICU days, especially in patients receiving MV and CRRT. However, further investigation of a consensus definition of FI and risk factors is still warranted in future studies.

简介：AbstractObjective:To compare and analyze the pass rate and screening strategy of hearing rescreening for newborns with high risk factors.Methods:Retrospective chart review of high-risk newborns who failed their initial newborn hearing screen and subsequently underwent secondary hearing tests from June 2011 to June 2018 in Guangzhou Women and Children's Medical Center were performed.Results:Eight hundred and sixty-eight newborns with high risk factors were included in the study. The 57-70 days (83.5%) and 71-84 days (83.4%) group had the highest pass rate compared with 42-56 days (75.8%) and < 42 days (68.3%) group. As for different screening strategies, the pass rate of OAE(otoacoustic emissions), AABR (auto auditory brainstem response) and OAE + AABR was the highest in 57-70 days group and 71-84 days group, respectively. The OAE + AABR had the lowest pass rate compared to the other two modalities. When the pass rate was compared as different risk factors, the 57-70 days and 71-84 days group also had the highest pass rate compared with 42-56 days and < 42 days group and the pass rate had no significant differences among various risk factors group.Conclusion:Our results showed that all the pass rate of OAE, AABR and OAE+ AABR was the highest in 57-70 days group and 71-84 days group with significant difference, suggesting that the delayed screening time (>57 days) may increase the re-screening pass rate and reduce anxiety of parents, which is of great significance for clinical work.

简介：ObjectivesToevaluatetheeffectofdifferentstylesofcoronaryheartdisease(CHD),differentregionsofacutemyocardialinfarction(AMI),itsriskfactorsandbranchesofcoronarystenosisonleftventricularremodelinganddysfunctionbyapplyingechocardiography.Methods251patientswithCHDand96patientswithoutCHD(NoCHD)wereverifiedbyselectivecoronaryangiography.CHDpatientsweredividedintostableanginapectoris(SAP)26,unstableanginapectoris(UAP)53,acutemyocardialinfarction(AMI)140andoldmyocardialinfarction(OMI)30basedonclinicalsituation,cTnT,cardiacenzymeandEGG.AMIpatientswerefurtherdividedintosubgroupsincludingacuteanteriormyocardialinfarct(Aa,n=53),acuteinferiormyocardialinfarction(Ai,n,=54)andAa+Ai(n=33)basedonECG.Cardiacparameters:end-diastolicinterventricularseptumthickness(IVSd),end-diastolicleftventricularinternaldiameter(LVd),leftventricularmass(LM),end-diastolicleftventricularvolume(EDV),end-systolicleftventricularvolume(ESV)andleftventricularejectionfraction(LVEF)weremeasuredbyACUSON128XP/10echocardiography.MultipleslinearregressionanalyseswereperformedtoteststatisticalassociationsbetweenLVEFandtheinvolvedbranchesofcoronarystenosis,bloodpressure,lipids,glucoseandetcafteronsetofmyocardialinfarction.ResultsEDVandESVwereincreasedandLVEFdecreasedonpatientswithAMI,OMIandUAP(P<0.05-0.0001).LMwasmainlyincreasedinpatientswithOMI(P<0.01)andLVdwasmainlyenlargedinpatientswithAMI.EFwassignificantlydecreasedandEDV,ESV,LMandLVdwereremarkablyincreasedinAMIpatientswithAaandAa+Ai.WiththemultiplelinearregressionanalysesbySPSSsoftware,wefoundthatLVEFwasnegativelycorrelatedtotheinvolvedbranchesofcoronarystenosisaswellastosystolicbloodpressureafteronsetofmyocardialinfarctionwhiletherewasnosignificantcorrelationbetweenLVEFandotherfactors.LVEFwassignificantlydecreased,and

简介：Objective:Gastriccancer(GC)isoneoftheleadingcausesofdeathinChinaandotherAsiancountries.Recently,gastricendoscopyhasbecomethemainapproachforGCscreening,buttheidentificationofhigh-riskindividualsremainsachallengeinGCscreeningprograms.Methods:Therewere7,302patientswithchronicgastritisinvolvedinthisstudy.Endoscopicexaminationswereperformed,andtheirdemographiccharacteristicsandlifestyledatawerecollected.EachpossibleassociatedfactorofGC/premalignantandprecursorlesionswasevaluatedbyunivariateandmultivariatelogisticregressions.Nomogramswereusedforvisualizationofthosemodels,andreceiveroperatingcharacteristic(ROC)curveanalysiswasusedtopresentthepredictiveaccuracy.Results:Wedetected8(0.11%)gastricadenocarcinomas,17(0.23%)dysplasiacases,14(0.19%)hyperplasiacases,52(0.71%)intestinalmetaplasiacases,217(2.97%)inflammatorylesions,141(1.93%)gastriculcers,10(0.14%)atrophicgastritiscases,1,365(18.69%)erosivegastritiscases,and5,957(81.58%)superficialgastritiscasesin7,302patients.Theage(P<0.001),gender(P=0.086),laborintensity(P=0.018)andleekfoodintake(P=0.143)wereidentifiedasindependentpredictivefactorsofGC/premalignantlesionspossibility.Thecorrespondingnomogramexhibitedanareaunderthecurve(AUC)[95%confidenceinterval(95%CI)]of0.82(0.74–0.89)forthemodelinggroupand0.80(0.75–0.85)forthevalidationgroup.Theage(P=0.002),gender(P=0.024),smoking(P=0.002)andleekfoodintake(P=0.039)wereindependentpredictivefactorsofprecursorlesionspossibility.ThecorrespondingnomogramexhibitedanAUC(95%CI)of0.62(0.60–0.65)forthemodelinggroupand0.61(0.59–0.63)forthevalidationgroup.Conclusions:WeidentifiedseveralpotentialassociatedfactorsandprovidedapreclinicalnomogramwiththepotentialtopredictthepossibilityofGC/premalignantandprecursorlesions.

简介：OBJECTIVE:Toinvestigatethefactorsassociatedwithsensoryandmotorrecoveryaftertherepairofupperlimbperipheralnerveinjuries.DATASOURCES:TheonlinePubMeddatabasewassearchedforEnglisharticlesdescribingoutcomesaftertherepairofmedian,ulnar,radial,anddigitalnerveinjuriesinhumanswithapublicationdatebetween1January1990and16February2011.STUDYSELECTION:Thefollowingtypesofarticlewereselected:(1)clinicaltrialsdescribingtherepairofmedian,ulnar,radial,anddigitalnerveinjuriespublishedinEnglish;and(2)studiesthatreportedsufficientpatientinformation,includingage,mechanismofinjury,nerveinjured,injurylocation,defectlength,repairtime,repairmethod,andrepairmaterials.SPSS13.0softwarewasusedtoperformunivariateandmultivariatelogisticregressionanalysesandtoinvestigatethepatientandinterventionfactorsassociatedwithoutcomes.MAINOUTCOMEMEASURES:SensoryfunctionwasassessedusingtheMackinnon-Dellonscaleandmotorfunctionwasassessedusingthemanualmuscletest.SatisfactorymotorrecoverywasdefinedasgradeM4orM5,andsatisfactorysensoryrecoverywasdefinedasgradeS3+orS4.RESULTS:Seventy-onearticleswereincludedinthisstudy.Univariateandmultivariatelogisticregressionanalysesshowedthatrepairtime,repairmaterials,andnerveinjuredwereindependentpredictorsofoutcomeaftertherepairofnerveinjuries(P<0.05),andthatthenerveinjuredwasthemainfactoraffectingtherateofgoodtoexcellentrecovery.CONCLUSION:Predictorsofoutcomeaftertherepairofperipheralnerveinjuriesincludeage,gender,repairtime,repairmaterials,nerveinjured,defectlength,anddurationoffollow-up.