المؤلفون: Wong TS; Division of Nephrology, Department of Medicine, The First Affiliated Hospital, Jinan University, Guangzhou, Guangdong, China., Chen Q; Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, Guangdong, China., Zhong Q; Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, Guangdong, China., Hu B; Division of Nephrology, Department of Medicine, The First Affiliated Hospital, Jinan University, Guangzhou, Guangdong, China., Feng G; Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, Guangdong, China., Huang F; Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, Guangdong, China., Lu J; Division of Nephrology, Department of Medicine, The First Affiliated Hospital, Jinan University, Guangzhou, Guangdong, China., Yin L; Division of Nephrology, Department of Medicine, The First Affiliated Hospital, Jinan University, Guangzhou, Guangdong, China., Yu Z; Division of Nephrology, Department of Medicine, The First Affiliated Hospital, Jinan University, Guangzhou, Guangdong, China., Akinwunmi BO; Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA., Huang J; MRC Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK., Zhang CJ; School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong., Ming WK; Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, Guangdong, China.; Department of Infectious Diseases and Public Health, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Hong Kong.

المصدر: The journal of vascular access [J Vasc Access] 2024 May; Vol. 25 (3), pp. 953-962. Date of Electronic Publication: 2022 Dec 20.

نوع المنشور: Journal Article; Comparative Study

بيانات الدورية: Publisher: Sage Publications Country of Publication: United States NLM ID: 100940729 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1724-6032 (Electronic) Linking ISSN: 11297298 NLM ISO Abbreviation: J Vasc Access Subsets: MEDLINE

مواضيع طبية MeSH: Cost-Benefit Analysis* , Renal Dialysis*/economics , Arteriovenous Shunt, Surgical*/adverse effects , Arteriovenous Shunt, Surgical*/economics , Kidney Failure, Chronic*/therapy , Kidney Failure, Chronic*/economics , Kidney Failure, Chronic*/diagnosis , Quality-Adjusted Life Years* , Blood Vessel Prosthesis Implantation*/economics , Blood Vessel Prosthesis Implantation*/adverse effects , Blood Vessel Prosthesis Implantation*/instrumentation , Models, Economic* , Markov Chains*, Humans ; China ; Treatment Outcome ; Female ; Male ; Middle Aged ; Time Factors ; Quality of Life ; Catheterization, Central Venous/economics ; Catheterization, Central Venous/adverse effects ; Catheterization, Central Venous/instrumentation ; Central Venous Catheters/economics ; Aged ; Hospital Costs ; Blood Vessel Prosthesis/economics ; Cost-Effectiveness Analysis

مستخلص: Objectives: To evaluate the cost-effectiveness of three permanent vascular accesses for maintenance hemodialysis patients from a hospital perspective throughout 5 years, which is the average life expectancy of patients with end-stage kidney disease.
Subjects and Methods: We conducted a EuroQol(EQ-5D) questionnaire survey between January 2021 and March 2021 with 250 patients to estimate the health utility of various states in patients under different hemodialysis vascular access. We designed a Markov model and conducted a cost-effectiveness analysis to compare the cost-effectiveness of three hemodialysis vascular access in Guangzhou throughout 5 years.
Results: The mean costs were US$44,481 with tunneled-cuffed catheter (TCC), and US$68,952 and US$59,247 with arteriovenous graft (AVG) and autogenous arteriovenous fistula (AVF), respectively. The mean quality-adjusted life-years (QALYs) was 1.41 with TCC, and 2.37 and 2.73 with AVG and AVF, respectively. AVG had an incremental cost-effectiveness ratio (ICER) of US$25,491 per QALY over TCC; AVF had an ICER of -US$26,958 per QALY over AVG. At a willingness to pay below US$10,633.8 per QALY, TCC is likely the most cost-effective vascular access. At any willingness to pay between US$10,633.8 and US$30,901.4 per QALY, AVF is likely the most cost-effective vascular access.
Conclusion: These findings illustrate the value of AVF given its relative cost-effectiveness to other hemodialysis modalities. Although AVG costs much more than TCC for slightly higher QALYs than TCC, AVG still has a greater advantage over TCC for patients with longer life expectancy due to its lower probability of death.
Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

المؤلفون: Zhu H; Department of Respiratory and Critical Medicine, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.; Cancer Center, Zhejiang University, Hangzhou, China., Li Y; Department of Respiratory and Critical Medicine, Affiliated Hangzhou First People's Hospital, School of Medicine, Westlake University, Hangzhou, China., Su H; Department of Respiratory and Critical Medicine, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.; Cancer Center, Zhejiang University, Hangzhou, China., Yan C; Department of Respiratory and Critical Medicine, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.; Cancer Center, Zhejiang University, Hangzhou, China., Xin W; Department of Respiratory and Critical Medicine, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.; Cancer Center, Zhejiang University, Hangzhou, China., Ying K; Department of Respiratory and Critical Medicine, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.; Cancer Center, Zhejiang University, Hangzhou, China.

المصدر: Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis [Clin Appl Thromb Hemost] 2024 Jan-Dec; Vol. 30, pp. 10760296241255959.

نوع المنشور: Journal Article

بيانات الدورية: Publisher: Sage Publications Country of Publication: United States NLM ID: 9508125 Publication Model: Print Cited Medium: Internet ISSN: 1938-2723 (Electronic) Linking ISSN: 10760296 NLM ISO Abbreviation: Clin Appl Thromb Hemost Subsets: MEDLINE

مواضيع طبية MeSH: COVID-19*/mortality , COVID-19*/blood , COVID-19*/complications , Fibrin Fibrinogen Degradation Products*/analysis , Fibrin Fibrinogen Degradation Products*/metabolism , SARS-CoV-2*, Humans ; Male ; Female ; Retrospective Studies ; Middle Aged ; Aged ; Neutrophils ; Venous Thrombosis/blood ; Venous Thrombosis/mortality ; Inflammation/blood ; Risk Factors ; Severity of Illness Index ; Hemostasis ; Inpatients/statistics & numerical data ; Leukocyte Count ; Adult ; China/epidemiology

مستخلص: The purpose of the study was to investigate baseline inflammatory, hemostatic indicators and new-onset deep vein thrombosis (DVT) with the risk of mortality in COVID-19 inpatients. In this single-center study, a total of 401 COVID-19 patients hospitalized in Sir Run Run Shaw Hospital, Zhejiang University School of Medicine were enrolled from December 1, 2022 to January 31, 2023. The basic information, first laboratory examination results, imaging examination, and outcome-related indicators were compared between patients in the moderate and severe subgroups. We found that baseline D-dimer and baseline absolute neutrophil count (ANC) levels were associated with new-onset DVT and death in severe hospitalized patients with COVID-19. The odds ratio (OR) of baseline D-dimer and baseline ANC with mortality was 1.18 (95% confidence interval [CI], 1.08-1.28; P  < .001) and 1.13 (95% CI, 1.06-1.21; P  < .001). Baseline ANC was associated with the risk of death in severe hospitalized COVID-19 patients, irrespective of the DVT status. In addition, a significantly higher serum neutrophil activity was observed in severe COVID-19 inpatients with DVT or those deceased during hospital stay. New-onset DVT partially mediated the association between baseline D-dimer (indirect effect: 0.011, estimated mediating proportion: 67.0%), baseline ANC (indirect effect: 0.006, estimated mediating proportion: 48.7%), and mortality in severe hospitalized patients with COVID-19. In summary, baseline D-dimer and baseline absolute neutrophil count (ANC) levels were associated with the mortality in severe hospitalized patients with COVID-19, especially DVT inpatients. New-onset DVT partially mediated the association between baseline D-dimer, baseline ANC, and mortality in severe hospitalized patients with COVID-19.
Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

المؤلفون: Huang L; Department of Vascular Surgery, 92323Zhongshan Hospital, Fudan University, Shanghai, China.; Department of Biostatistics, 92323Zhongshan Hospital, Fudan University, Shanghai, China., Kan Y; Department of Vascular Surgery, 92323Zhongshan Hospital, Fudan University, Shanghai, China., Zhu T; Department of Vascular Surgery, 92323Zhongshan Hospital, Fudan University, Shanghai, China., Chen B; Department of Vascular Surgery, 92323Zhongshan Hospital, Fudan University, Shanghai, China., Xu X; Department of Vascular Surgery, 92323Zhongshan Hospital, Fudan University, Shanghai, China., Dong Z; Department of Vascular Surgery, 92323Zhongshan Hospital, Fudan University, Shanghai, China., Guo D; Department of Vascular Surgery, 92323Zhongshan Hospital, Fudan University, Shanghai, China., Si Y; Department of Vascular Surgery, 92323Zhongshan Hospital, Fudan University, Shanghai, China., Fu W; Department of Vascular Surgery, 92323Zhongshan Hospital, Fudan University, Shanghai, China.

المصدر: Vascular and endovascular surgery [Vasc Endovascular Surg] 2021 May; Vol. 55 (4), pp. 332-341. Date of Electronic Publication: 2020 Dec 29.

نوع المنشور: Journal Article

بيانات الدورية: Publisher: Sage Publications Country of Publication: United States NLM ID: 101136421 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1938-9116 (Electronic) Linking ISSN: 15385744 NLM ISO Abbreviation: Vasc Endovascular Surg Subsets: MEDLINE

مواضيع طبية MeSH: Blood Vessel Prosthesis Implantation*/adverse effects , Blood Vessel Prosthesis Implantation*/economics , Blood Vessel Prosthesis Implantation*/instrumentation , Blood Vessel Prosthesis Implantation*/mortality , Endovascular Procedures*/adverse effects , Endovascular Procedures*/economics , Endovascular Procedures*/instrumentation , Endovascular Procedures*/mortality, Aortic Dissection/*surgery , Aorta, Thoracic/*surgery , Aortic Aneurysm, Thoracic/*surgery, Adult ; Aged ; Aged, 80 and over ; Aortic Dissection/diagnostic imaging ; Aortic Dissection/economics ; Aortic Dissection/mortality ; Aorta, Thoracic/diagnostic imaging ; Aortic Aneurysm, Thoracic/diagnostic imaging ; Aortic Aneurysm, Thoracic/economics ; Aortic Aneurysm, Thoracic/mortality ; Blood Vessel Prosthesis ; China/epidemiology ; Electronic Health Records ; Female ; Hospital Costs ; Hospital Mortality ; Humans ; Incidence ; Length of Stay ; Male ; Middle Aged ; Postoperative Complications/mortality ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Stents ; Time Factors ; Treatment Outcome

مستخلص: Objective/background: This study examined the 10-year hospitalization characteristics, economic patterns and early clinical outcomes of type B aortic dissection (TBAD) patients that underwent thoracic endovascular aortic repair (TEVAR) in one high-volume hospital in China.
Methods: We performed a population-based retrospective analysis based on electronic medical record system data provided by Zhongshan Hospital Fudan University from 2009 to 2018.
Results: We identified 1,367 cases of TBAD patients with TEVAR over the past decade. The total incidence of in-hospital complications was 7.6% (104 of 1,367), among which acute kidney injury (AKI) had the highest incidence (3.1%, 42 of 1,367). Aortic-related reintervention was performed in 7 patients (0.5%). The overall aortic-related in-hospital mortality rate was 2.7% (37 of 1,367) and had no significant time-varying trend ( P = 0.2). Among these, 27% of in-hospital deaths were caused by retrograde type A dissection (RTAD). Chronic TBAD had a higher risk of in-hospital death versus acute TBAD, with a risk ratio of 2.69 (95% confidence interval [CI]: 1.19-6.09). Patients with hypertension (risk ratio 4.63, 95% CI: 1.38, 15.54) also had a higher in-hospital death risk. These 2 factors were also the predictive factors for the composite endpoint of in-hospital adverse events (risk ratio 2.17, 95% CI: 1.43, 3.29 and risk ratio 4.83, 95% CI: 1.90, 12.28, respectively), in addition to Marfan syndrome (risk ratio 4.05, 95% CI: 1.61, 10.19). The average length of hospitalization significantly declined during the past decade (annual percentage change -6.3%, 95% CI -8.2 to -4.3), and the stent-grafts (SGs) cost was the main expenditure of the total hospitalization costs.
Conclusion: Our study showed a favorable early outcome of TEVAR over the past decade. Greater attention should be paid to certain risk factors in order to reduce the in-hospital adverse events. SG expenditure is still the primary economic burden on Chinese TBAD patients.

المؤلفون: Xue Y; Department of Vascular and Endovascular Surgery, First Medical Center of Chinese PLA General Hospital, Beijing, China.; Research Platform for Minimally Invasive Cardiovascular Surgery, Beijing Key Laboratory, Beijing, China., Ge Y; Department of Vascular and Endovascular Surgery, First Medical Center of Chinese PLA General Hospital, Beijing, China.; Research Platform for Minimally Invasive Cardiovascular Surgery, Beijing Key Laboratory, Beijing, China., Ge X; Department of Vascular Surgery, People's Hospital of Xinjiang Uygur Autonomous Region, Urumchi, China., Miao J; Department of General Surgery, Zhongshan People's Hospital, Zhongshan, China., Fan W; Department of Cardiology, Henan Provincial Chest Hospital, Zhengzhou, China., Rong D; Department of Vascular and Endovascular Surgery, First Medical Center of Chinese PLA General Hospital, Beijing, China.; Research Platform for Minimally Invasive Cardiovascular Surgery, Beijing Key Laboratory, Beijing, China., Liu F; Department of Vascular and Endovascular Surgery, First Medical Center of Chinese PLA General Hospital, Beijing, China.; Research Platform for Minimally Invasive Cardiovascular Surgery, Beijing Key Laboratory, Beijing, China., Liu X; Department of Vascular and Endovascular Surgery, First Medical Center of Chinese PLA General Hospital, Beijing, China.; Research Platform for Minimally Invasive Cardiovascular Surgery, Beijing Key Laboratory, Beijing, China., Guo W; Department of Vascular and Endovascular Surgery, First Medical Center of Chinese PLA General Hospital, Beijing, China.; Research Platform for Minimally Invasive Cardiovascular Surgery, Beijing Key Laboratory, Beijing, China.

المصدر: Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists [J Endovasc Ther] 2020 Apr; Vol. 27 (2), pp. 211-220. Date of Electronic Publication: 2020 Feb 06.

نوع المنشور: Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't

بيانات الدورية: Publisher: Sage Publications Country of Publication: United States NLM ID: 100896915 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1545-1550 (Electronic) Linking ISSN: 15266028 NLM ISO Abbreviation: J Endovasc Ther Subsets: MEDLINE

مواضيع طبية MeSH: Blood Vessel Prosthesis* , Stents* , Vascular Remodeling*, Aortic Dissection/*surgery , Aorta, Thoracic/*surgery , Aortic Aneurysm, Thoracic/*surgery , Blood Vessel Prosthesis Implantation/*instrumentation , Endovascular Procedures/*instrumentation, Adult ; Aortic Dissection/diagnostic imaging ; Aortic Dissection/physiopathology ; Aorta, Thoracic/diagnostic imaging ; Aorta, Thoracic/physiopathology ; Aortic Aneurysm, Thoracic/diagnostic imaging ; Aortic Aneurysm, Thoracic/physiopathology ; Blood Vessel Prosthesis Implantation/adverse effects ; China ; Endovascular Procedures/adverse effects ; Female ; Humans ; Male ; Middle Aged ; Prosthesis Design ; Retrospective Studies ; Risk Factors ; Time Factors ; Treatment Outcome

مستخلص: Purpose: To examine the association between the extent of stent-graft coverage and thoracic aortic expansion after thoracic endovascular aortic repair (TEVAR) for type B aortic dissection. Materials and Methods: A retrospective analysis was conducted of 201 patients (mean age 52.4±11.5 years; 178 men) with acute (135, 67.2%) or chronic (66, 32.8%) type B aortic dissection who underwent TEVAR at 4 medical centers. The mean stent-graft length was 157.1±33.3 mm. The percentage of stented descending aorta (PSDA) represented the extent of stent-graft coverage. After using restricted cubic smoothing spline plots to confirm the roughly linear relationship between PSDA and the risk of thoracic aortic expansion, patients were stratified into 2 groups on the median PSDA: the lower group (≤31.3%) and the higher group (>31.3%). Thoracic aortic expansion was defined as a ≥20% increase in the total thoracic aortic volume on the most recent postoperative computed tomography angiography scan compared with the preoperative measurement. The Kaplan-Meier method was used to estimate the cumulative freedom from thoracic aortic expansion after TEVAR; estimates are given with the 95% confidence interval (CI). A multivariable Cox proportional hazards model was used to analyze any independent association of the PSDA as a continuous or categorical variable with the risk of thoracic aortic expansion; results are presented as the hazard ratio (HR) and 95% CI. Results: No patients developed symptoms of spinal cord ischemia during hospitalization. Over a median 12.4 months of imaging follow-up, 34 (16.9%) patients developed thoracic aortic expansion. The estimate of freedom from thoracic aortic expansion at 12 months for the overall PSDA was 84.0% (95% CI 77.8% to 88.6%); between the groups, the freedom from thoracic aortic expansion estimate for the PSDA ≤31.3% group was significantly lower than in the higher group (p=0.032). Regression analysis showed no significant association between the risk of thoracic aortic expansion and the PSDA as a continuous variable (HR 0.97, 95% CI 0.91 to 1.03, p=0.288); however, analyzing the PSDA as a categorical variable indicated a significantly lower risk of thoracic aortic expansion for the PSDA >31.3% group (HR 0.46, 95% CI 0.22 to 0.95, p=0.036) after adjusting for a variety of demographic and anatomical characteristics. Conclusion: More extensive stent-graft coverage appears to improve thoracic aortic remodeling after TEVAR. However, the clinician should balance the benefit of extensive stent-graft coverage and its related risk of spinal cord ischemia.

المؤلفون: Li X; Affiliated Haian Hospital of Nantong University, Haian, China., Wu Z; Affiliated Haian Hospital of Nantong University, Haian, China., Xue M; Affiliated Haian Hospital of Nantong University, Haian, China., Du W; Department of Pulmonary and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.; Institute of Respiratory Diseases, School of Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

المصدر: Chronic respiratory disease [Chron Respir Dis] 2020 Jan-Dec; Vol. 17, pp. 1479973120916184.

نوع المنشور: Journal Article; Observational Study

بيانات الدورية: Publisher: SAGE Publications Country of Publication: England NLM ID: 101197408 Publication Model: Print Cited Medium: Internet ISSN: 1479-9731 (Electronic) Linking ISSN: 14799723 NLM ISO Abbreviation: Chron Respir Dis Subsets: MEDLINE

مواضيع طبية MeSH: Pulmonary Disease, Chronic Obstructive*/epidemiology , Pulmonary Disease, Chronic Obstructive*/physiopathology , Pulmonary Disease, Chronic Obstructive*/psychology , Pulmonary Disease, Chronic Obstructive*/therapy , Smoking*/adverse effects , Smoking*/blood , Smoking*/physiopathology , Symptom Flare Up* , Tobacco Smoke Pollution*/adverse effects , Tobacco Smoke Pollution*/analysis, Carbon Dioxide/*blood , Oxygen/*blood, Aged ; Blood Gas Analysis/methods ; China/epidemiology ; Cough/diagnosis ; Cough/etiology ; Disease Progression ; Dyspnea/diagnosis ; Dyspnea/etiology ; Humans ; Male ; Middle Aged ; Respiratory Function Tests/methods ; Respiratory Function Tests/statistics & numerical data ; Severity of Illness Index ; Vital Capacity

مستخلص: Existing studies primarily explored chronic obstructive pulmonary disease (COPD) in smokers, whereas the clinical characteristics and the disease course of passive or nonsmokers have been rarely described. In the present study, patients hospitalized and diagnosed as acute exacerbation of COPD (AECOPD) were recruited and followed up until being discharged. Clinical and laboratory indicators were ascertained and delved into. A total of 100 patients were covered, namely, 52 active smokers, 34 passive smokers, and 14 nonsmokers. As revealed from the results here, passive or nonsmokers developed less severe dyspnea (patients with modified Medical Research Council scale (mMRC) <2, 0.0% vs. 8.8% vs. 14.3%, p < 0.05, active, passive, and nonsmokers, respectively), higher oxygenation index (206.4 ± 45.5 vs. 241.2 ± 51.1 vs. 242.4 ± 41.8 mmHg, p < 0.01), as well as lower arterial partial pressure of carbon dioxide (70.8 ± 12.7 vs. 58.85 ± 9.9 vs. 56.6 ± 6.5 mmHg, p < 0.001). Despite lower treatment intensity over these patients, amelioration of dyspnea, mitigation of cough, and elevation of oxygenation index were comparable to those of active smokers. However, in terms of patients exhibiting mMRC ≥2 and type 2 respiratory failure, amelioration of dyspnea was more common in nonsmokers as compared with passive smokers (46.4% vs. 83.3%, p < 0.05, passive and nonsmokers, respectively). In terms of patients exhibiting Global Initiative for COPD severity <3, mMRC ≥2, and type 2 respiratory failure, active smokers achieved the least mitigation of cough symptom (8.7% vs. 35.0% vs. 44.4%, p < 0.05). Similar results could be achieved after the effects of confounders were excluded, with the most prominent amelioration of dyspnea (odds ratio (OR) 3.8, 95% confidence interval (CI) 1.1-13.6, p < 0.05, as compared with active smokers) and cough (OR 3.3, 95% CI 1.0-10.7, p < 0.05) in nonsmokers, and relatively better amelioration of hypoxemia in passive smokers (oxygenation index change, 39.0 ± 34.6 vs. 51.5 ± 32.4 vs. 45.3 ± 25.4 mmHg, p < 0.05). In brief, passive or nonsmokers with AECOPD were subjected to less severe disease, and nonsmokers, especially patients with more severe disease, might achieve the optimal enhancement of clinical presentation after treatment.

المؤلفون: Liu H; Department of Endocrinology, Aerospace Center Hospital, Beijing, China.; Department of Endocrinology, First Hospital of Handan City, Handan, China., Dong S; Department of Endocrinology, Aerospace Center Hospital, Beijing, China., Yang H; Department of Outpatient, The First Medical Center, Chinese PLA General Hospital, Beijing, China., Wang L; Department of Endocrinology, Aerospace Center Hospital, Beijing, China., Liu J; Department of Endocrinology, Aerospace Center Hospital, Beijing, China., Du Y; Department of Endocrinology, Aerospace Center Hospital, Beijing, China., Liu J; Clinics of Cadre, Department of Outpatient, The First Medical Center, Chinese PLA General Hospital, Beijing, China., Lyu Z; Department of Endocrinology, The First Medical Center, Chinese PLA General Hospital, Beijing, China., Wang Y; Department of Endocrinology, The First Medical Center, Chinese PLA General Hospital, Beijing, China., Jiang L; Department of Endocrinology, The First Medical Center, Chinese PLA General Hospital, Beijing, China., Yu S; Department of Endocrinology, The First Medical Center, Chinese PLA General Hospital, Beijing, China., Fu X; Clinics of Cadre, Department of Outpatient, The First Medical Center, Chinese PLA General Hospital, Beijing, China.

المصدر: The Journal of international medical research [J Int Med Res] 2024 Jun; Vol. 52 (6), pp. 3000605241253786.

نوع المنشور: Journal Article; Comparative Study

بيانات الدورية: Publisher: Sage Publications Country of Publication: England NLM ID: 0346411 Publication Model: Print Cited Medium: Internet ISSN: 1473-2300 (Electronic) Linking ISSN: 03000605 NLM ISO Abbreviation: J Int Med Res Subsets: MEDLINE

مواضيع طبية MeSH: Diabetes Mellitus, Type 2*/epidemiology , Diabetes Mellitus, Type 2*/diagnosis , Machine Learning* , ROC Curve*, Humans ; Female ; Male ; Retrospective Studies ; Middle Aged ; China/epidemiology ; Adult ; Risk Factors ; Blood Glucose/metabolism ; Logistic Models ; Support Vector Machine ; Asian People/statistics & numerical data ; Aged ; East Asian People

مستخلص: Objective: To evaluate the effectiveness of machine learning (ML) models in predicting 5-year type 2 diabetes mellitus (T2DM) risk within the Chinese population by retrospectively analyzing annual health checkup records.
Methods: We included 46,247 patients (32,372 and 13,875 in training and validation sets, respectively) from a national health checkup center database. Univariate and multivariate Cox analyses were performed to identify factors influencing T2DM risk. Extreme Gradient Boosting (XGBoost), support vector machine (SVM), logistic regression (LR), and random forest (RF) models were trained to predict 5-year T2DM risk. Model performances were analyzed using receiver operating characteristic (ROC) curves for discrimination and calibration plots for prediction accuracy.
Results: Key variables included fasting plasma glucose, age, and sedentary time. The LR model showed good accuracy with respective areas under the ROC (AUCs) of 0.914 and 0.913 in training and validation sets; the RF model exhibited favorable AUCs of 0.998 and 0.838. In calibration analysis, the LR model displayed good fit for low-risk patients; the RF model exhibited satisfactory fit for low- and high-risk patients.
Conclusions: LR and RF models can effectively predict T2DM risk in the Chinese population. These models may help identify high-risk patients and guide interventions to prevent complications and disabilities.
Competing Interests: Declaration of conflicting interestThe authors declare that there is no conflict of interest.

المؤلفون: Zhan B; 1 Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang Shi, Jiangxi, China., Huang X; 1 Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang Shi, Jiangxi, China., Wang J; 2 Renal Division, Nanfang Hospital, National Clinical Research Study Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Southern Medical University, Guangzhou, China., Qin X; 2 Renal Division, Nanfang Hospital, National Clinical Research Study Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Southern Medical University, Guangzhou, China., Zhang J; 3 Institute of Biomedicine, Anhui Medical University, Hefei, China., Cao J; 3 Institute of Biomedicine, Anhui Medical University, Hefei, China., Song Y; 4 Beijing Advanced Innovation Center for Food Nutrition and Human Health, the Key Laboratory for Functional Dairy, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, China., Liu L; 4 Beijing Advanced Innovation Center for Food Nutrition and Human Health, the Key Laboratory for Functional Dairy, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, China., Li P; 1 Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang Shi, Jiangxi, China., Yang R; 1 Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang Shi, Jiangxi, China., Wu Y; 1 Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang Shi, Jiangxi, China., Wu Q; 1 Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang Shi, Jiangxi, China., Zhang Y; 5 Department of Cardiology, Peking University First Hospital, Beijing, China., Li J; 5 Department of Cardiology, Peking University First Hospital, Beijing, China., Huo Y; 4 Beijing Advanced Innovation Center for Food Nutrition and Human Health, the Key Laboratory for Functional Dairy, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, China.; 5 Department of Cardiology, Peking University First Hospital, Beijing, China., Wang B; 3 Institute of Biomedicine, Anhui Medical University, Hefei, China., Xu X; 2 Renal Division, Nanfang Hospital, National Clinical Research Study Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Southern Medical University, Guangzhou, China.; 3 Institute of Biomedicine, Anhui Medical University, Hefei, China.; 4 Beijing Advanced Innovation Center for Food Nutrition and Human Health, the Key Laboratory for Functional Dairy, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, China., Bao H; 1 Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang Shi, Jiangxi, China., Cheng X; 1 Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang Shi, Jiangxi, China.

المصدر: Angiology [Angiology] 2019 Jul; Vol. 70 (6), pp. 515-522. Date of Electronic Publication: 2019 Jan 16.

نوع المنشور: Journal Article

بيانات الدورية: Publisher: Sage Publications Country of Publication: United States NLM ID: 0203706 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1940-1574 (Electronic) Linking ISSN: 00033197 NLM ISO Abbreviation: Angiology Subsets: MEDLINE

مواضيع طبية MeSH: Blood Pressure* , Vascular Stiffness*, Dyslipidemias/*blood , Hypertension/*physiopathology , Lipids/*blood , Peripheral Arterial Disease/*physiopathology, Aged ; Ankle Brachial Index ; Asian People ; Biomarkers/blood ; China/epidemiology ; Comorbidity ; Cross-Sectional Studies ; Dyslipidemias/diagnosis ; Dyslipidemias/ethnology ; Female ; Humans ; Hypertension/diagnosis ; Hypertension/ethnology ; Male ; Middle Aged ; Multicenter Studies as Topic ; Peripheral Arterial Disease/diagnosis ; Peripheral Arterial Disease/ethnology ; Prevalence ; Randomized Controlled Trials as Topic ; Risk Factors ; Rural Health

مستخلص: Arterial stiffness plays a key role in the pathogenesis of cardiovascular disease. However, the relationship between lipid levels and arterial stiffness is controversial. We aimed to investigate the association between lipid parameters and brachial-ankle pulse-wave velocity (baPWV) in Chinese patients with hypertension. A total of 14 071 participants with hypertension in the China Stroke Primary Prevention Trial (CSPPT) were enrolled in the present study. Patients were assigned to 4 equal groups according to their baPWV. Participants in the highest baPWV group were older with a higher prevalence of stroke and diabetes mellitus as well as higher body mass index (BMI), blood pressure, fasting plasma glucose, uric acid, total cholesterol (TC), triglycerides (TG), homocysteine (Hcy), and vitamin B12 levels ( P < .001). After adjusting for age, sex, BMI, and other cardiovascular risks, high-density lipoprotein cholesterol (HDL-C) was negatively related to baPWV (β = -0.22, P = .012), TC (β = 0.08, P = 0.001), TG (β = 0.14, P = .001); non-HDL-C (β = 0.12, P = .001) and positively related to baPWV. The effect was not observed for low-density lipoprotein cholesterol (LDL-C; β = 0.12, P = .335).These results suggested that non-HDL-C, TG, and TC were associated with arterial stiffness in a Chinese population with hypertension. HDL-C was inversely associated with arterial stiffness.

المؤلفون: Yang Q; Department of General Surgery, Chongqing Emergency Medical Center (Chongqing University Central Hospital), Chongqing, China., Gao Y; Department of General Surgery, Chongqing Emergency Medical Center (Chongqing University Central Hospital), Chongqing, China., Fu W; Department of General Surgery, Chongqing Emergency Medical Center (Chongqing University Central Hospital), Chongqing, China., Ma S; Department of General Surgery, Chongqing Emergency Medical Center (Chongqing University Central Hospital), Chongqing, China.

المصدر: The Journal of international medical research [J Int Med Res] 2024 Jan; Vol. 52 (1), pp. 3000605231225540.

نوع المنشور: Journal Article

بيانات الدورية: Publisher: Sage Publications Country of Publication: England NLM ID: 0346411 Publication Model: Print Cited Medium: Internet ISSN: 1473-2300 (Electronic) Linking ISSN: 03000605 NLM ISO Abbreviation: J Int Med Res Subsets: MEDLINE

مواضيع طبية MeSH: Snake Bites*/therapy, Humans ; Retrospective Studies ; Tourniquets ; China/epidemiology ; Blood Platelets ; Creatine Kinase

مستخلص: Objective: To identify risk factors associated with snakebite severity and determine whether tourniquet use can affect the severity and outcome of snakebites.
Methods: The clinical data of patients who sustained limb snakebites from 1 March 2021 to 31 October 2022 were reviewed. The patients were divided into three groups according to snakebite severity: mild (517 cases), moderate (112 cases), and severe (8 cases). We compared the clinical data of mild versus moderate to severe snakebites. Multivariate logistic regression was used to determine the independent risk factors for moderate to severe snakebites.
Results: The study involved 637 patients. There were statistically significant differences in age, tourniquet use, onset time, white blood cell increase, platelet decrease, creatine kinase (CK) increase, activated partial thromboplastin time shortening, and length of stay between patients with mild snakebites and those with moderate to severe snakebites. Multivariate logistic regression analysis showed that age, tourniquet use, and CK increase were independent risk factors for moderate to severe snakebites.
Conclusion: The overall severity of snakebites in Chongqing is mild, and the prognosis is good. Age, tourniquet use, and CK increase are independent risk factors for the severity of snakebites. We do not recommend tourniquet use after snakebites in Chongqing.
Competing Interests: Declaration of conflicting interestsThe authors declare that there is no conflict of interest.

المؤلفون: Zhu L; 1 Department of Blood Transfusion, Chinese PLA General Hospital, Beijing, China., Sun L; 1 Department of Blood Transfusion, Chinese PLA General Hospital, Beijing, China., Fan F; 1 Department of Blood Transfusion, Chinese PLA General Hospital, Beijing, China., Zhang D; 1 Department of Blood Transfusion, Chinese PLA General Hospital, Beijing, China., Li C; 2 Institute of Blood Transfusion, Chinese Academy of Medical Sciences and Peking Union Medical College, Chengdu, China., Wang D; 1 Department of Blood Transfusion, Chinese PLA General Hospital, Beijing, China.

المصدر: The Journal of international medical research [J Int Med Res] 2019 Jun; Vol. 47 (6), pp. 2637-2646. Date of Electronic Publication: 2018 Oct 08.

نوع المنشور: Journal Article

بيانات الدورية: Publisher: Sage Publications Country of Publication: England NLM ID: 0346411 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1473-2300 (Electronic) Linking ISSN: 03000605 NLM ISO Abbreviation: J Int Med Res Subsets: MEDLINE

مواضيع طبية MeSH: Blood Preservation* , Freezing*, Blood Coagulation Factors/*analysis , Blood Coagulation Factors/*chemistry , Blood Proteins/*analysis , Blood Proteins/*chemistry , Plasma/*chemistry, China ; Humans

مستخلص: Objective: This study aimed to determine the precision dose of Chinese universal pooled plasma (CUPP) developed by our laboratory, and the stability of plasma proteins and factors.
Methods: A total of 100 single fresh-frozen plasma (FFP) units were selected to test plasma proteins, including total protein, albumin, fibrinogen, factor V, factor VIII, antithrombin-III, and protein C. Different pooling protocols with 20, 40, 60, 80, and 100 units were used to optimize the number of pooled units. The pooled plasma was then used to further evaluate the optimal storage conditions and duration at 22°C, 4°C, and -20°C.
Results: There were considerable differences in plasma protein levels among single units of FFP. After different pooling protocols, the mean value of plasma proteins did not significantly change. However, with a larger number of pooled samples, plasma proteins were more stable with a smaller standard deviation. Acceptable storage for CUPP was achieved with storage for 1 day at 22°C, 4 days at 4°C, and 3 months at -20°C.
Conclusion: A uniform level of plasma proteins and factors in CUPP appears to support establishment of a precise dose of plasma.

المؤلفون: Long Y; Department of Rheumatology and Immunology, Peking Union Medical College Hospital (PUMCH), Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China., Zhang S; Department of Rheumatology and Immunology, Peking Union Medical College Hospital (PUMCH), Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.; National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Beijing, China.; Ministry of Education, Key Laboratory of Rheumatology and Clinical Immunology, Beijing, China., Zhao J; Department of Rheumatology and Immunology, Peking Union Medical College Hospital (PUMCH), Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.; National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Beijing, China.; Ministry of Education, Key Laboratory of Rheumatology and Clinical Immunology, Beijing, China.; Chinese Rheumatism Data Center (CRDC), Chinese SLE Treatment and Research Group (CSTAR), Beijing, China.; State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China., You H; Department of Rheumatology and Immunology, Peking Union Medical College Hospital (PUMCH), Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China., Zhang L; Department of Rheumatology and Immunology, Peking Union Medical College Hospital (PUMCH), Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.; National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Beijing, China.; Ministry of Education, Key Laboratory of Rheumatology and Clinical Immunology, Beijing, China., Li J; Department of Rheumatology and Immunology, Peking Union Medical College Hospital (PUMCH), Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.; National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Beijing, China.; Ministry of Education, Key Laboratory of Rheumatology and Clinical Immunology, Beijing, China., Leng X; Department of Rheumatology and Immunology, Peking Union Medical College Hospital (PUMCH), Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.; National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Beijing, China.; Ministry of Education, Key Laboratory of Rheumatology and Clinical Immunology, Beijing, China., Wang Q; Department of Rheumatology and Immunology, Peking Union Medical College Hospital (PUMCH), Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.; National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Beijing, China.; Ministry of Education, Key Laboratory of Rheumatology and Clinical Immunology, Beijing, China.; Chinese Rheumatism Data Center (CRDC), Chinese SLE Treatment and Research Group (CSTAR), Beijing, China.; State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China., Tian X; Department of Rheumatology and Immunology, Peking Union Medical College Hospital (PUMCH), Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.; National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Beijing, China.; Ministry of Education, Key Laboratory of Rheumatology and Clinical Immunology, Beijing, China.; Chinese Rheumatism Data Center (CRDC), Chinese SLE Treatment and Research Group (CSTAR), Beijing, China.; State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China., Li M; Department of Rheumatology and Immunology, Peking Union Medical College Hospital (PUMCH), Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.; National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Beijing, China.; Ministry of Education, Key Laboratory of Rheumatology and Clinical Immunology, Beijing, China.; Chinese Rheumatism Data Center (CRDC), Chinese SLE Treatment and Research Group (CSTAR), Beijing, China.; State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China., Zeng X; Department of Rheumatology and Immunology, Peking Union Medical College Hospital (PUMCH), Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.; National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Beijing, China.; Ministry of Education, Key Laboratory of Rheumatology and Clinical Immunology, Beijing, China.; Chinese Rheumatism Data Center (CRDC), Chinese SLE Treatment and Research Group (CSTAR), Beijing, China.; State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China.

المصدر: Lupus [Lupus] 2021 Aug; Vol. 30 (9), pp. 1459-1468. Date of Electronic Publication: 2021 Jun 04.

نوع المنشور: Journal Article; Multicenter Study

بيانات الدورية: Publisher: SAGE Publications Country of Publication: England NLM ID: 9204265 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1477-0962 (Electronic) Linking ISSN: 09612033 NLM ISO Abbreviation: Lupus Subsets: MEDLINE

مواضيع طبية MeSH: Lupus Erythematosus, Systemic*/blood , Lupus Erythematosus, Systemic*/complications , Lupus Erythematosus, Systemic*/drug therapy , Lupus Erythematosus, Systemic*/epidemiology , Osteonecrosis*/blood , Osteonecrosis*/epidemiology , Osteonecrosis*/etiology, Adolescent ; Adult ; Antibodies, Antiphospholipid/blood ; Antirheumatic Agents/therapeutic use ; China/epidemiology ; Cohort Studies ; Female ; Femur Head Necrosis/blood ; Femur Head Necrosis/epidemiology ; Femur Head Necrosis/etiology ; Glucocorticoids/adverse effects ; Glucocorticoids/therapeutic use ; Humans ; Hydroxychloroquine/therapeutic use ; Male ; Prednisolone/adverse effects ; Prednisolone/therapeutic use ; Prevalence ; Risk Factors ; Young Adult

مستخلص: Objective: Osteonecrosis (ON), which can lead to physical disability, is a common complication of systemic lupus erythematosus (SLE). The purpose of this study was to determine the prevalence of ON and identify possible risk factors in Chinese SLE patients.
Methods: SLE patients who fulfilled the 1997 American College of Rheumatology SLE classification criteria were recruited from the Peking Union Medical College Hospital. The chi-square test (χ ² test) and multivariate regression analyses were used to evaluate risk factors. The Cox proportional-hazards model was used to construct the survival curves and estimate the simultaneous effects of prognostic factors on survival.
Results: We consecutively enrolled 1,158 patients, of which 88 patients (7.6%) developed ON. Among ON patients, 57.1% of patients had isolated femoral head necrosis and 42.9% had multiple joint involvement. The mean age of ON patients (24.62 ± 8.89 years) was significantly younger than SLE patients without ON (27.23 ± 10.16 years, p  = 0.09). The ON group presented with a much longer disease course (10.68 ± 5.97 years, p  < 0.001) and increased incidence of arthritis, kidney, and central nervous system (CNS) involvement (65.9% [ p  < 0.05], 57.6% [ p  < 0.05], and 16.5% [ p  < 0.05], respectively, in the ON group). ON patients were more likely to be treated with glucocorticoid (GC) and to receive a high dose of prednisolone at the initial stage of SLE ( p  < 0.05). The percentage of patients who received hydroxychloroquine was much higher in the control group ( p  < 0.001). Cox regression analysis suggested that CNS involvement and GC therapy were two independent risk factors for ON in SLE patients. The presence of anti-phospholipid antibodies (aPLs) was a risk factor for multiple joint necrosis (odds ratio: 6.28, p  = 0.009).
Conclusions: ON remains a serious and irreversible complication in SLE. In addition to glucocorticoid therapy, we found that CNS system involvement was a risk factor for ON, while the administration of hydroxychloroquine was a protective factor. The clinical characteristics of multiple site ON patients were distinct from isolated femoral head necrosis patients. The presence of aPLs was a risk factor for multiple site osteonecrosis.