目的:探讨MEDS评分系统在判断老年肺部感染患者病情严重程度和预后方面的有效性和可行性。方法:以83例老年肺部感染患者为研究对象,比较患者急诊科MEDS评分与入院后24 h APACHEⅡ和CPIS评分的相关性,并计算MEDS、APACHEⅡ、CPIS评分预测...目的:探讨MEDS评分系统在判断老年肺部感染患者病情严重程度和预后方面的有效性和可行性。方法:以83例老年肺部感染患者为研究对象,比较患者急诊科MEDS评分与入院后24 h APACHEⅡ和CPIS评分的相关性,并计算MEDS、APACHEⅡ、CPIS评分预测28 d死亡率,入住ICU以及接受辅助通气情况的曲线下面积。结果:MEDS和APACHEⅡ评分的相关系数为0.876,MEDS和CPIS评分的相关系数为0.272,MEDS、APACHEⅡ、CPIS评分预测患者28 d死亡率的AUC分别为0.76、0.72、0.47,预测入住ICU的AUC分别为0.80、0.79、0.55,预测患者受辅助通气的AUC分别为0.88、0.89、0.62。结论:MEDS评分能够较为有效地判断老年肺部感染患者病情严重程度和预后。展开更多
目的 探讨英国国家早期预警评分（national early warning score, NEWS）、改良早期预警评分（modified early warning score，MEWS）和急诊脓毒症死亡风险评分（mortality in emergency department sepsis score，MEDS）对急诊感染患...目的 探讨英国国家早期预警评分（national early warning score, NEWS）、改良早期预警评分（modified early warning score，MEWS）和急诊脓毒症死亡风险评分（mortality in emergency department sepsis score，MEDS）对急诊感染患者预后的评估价值，并探究新的评分方法。 方法 回顾性分析2016-01～2016-08就诊于清华大学附属北京清华长庚医院急诊科的215例感染患者，记录性别、年龄、既往基础疾病、就诊时生命体征、感染部位及相关实验室检验，分别进行NEWS、MEWS和MEDS，以进入研究后28 d生存情况分为死亡组与存活组，分析两组间各评分差异。为探究新的评分方法，进一步应用Logistic回归分析评估各因素与28 d预后的关系，并最终获得拟合方程。应用受试者工作特征曲线（ROC曲线）比较各评分系统及拟合方程对28 d预后的预测能力。结果 215例急性感染患者28 d 病死率为14.88%。死亡组NEWS、MEWS和MEDS均高于存活组。单因素Logistic回归分析显示，年龄、恶性肿瘤病史、心率、呼吸频率、收缩压、血氧饱和度（SpO2）、血小板、红细胞压积、血肌酐（serum creatinine, Scr）、肾小球滤过率（estimated glomerular filtration rate, eGFR）是28 d死亡的预测因素（P＜0.05）。NEWS、MEWS、MEDS和联合多变量建立的拟合方程对28 d死亡预测的ROC曲线下面积分别为0.881、0.757、0.935和0.954。NEWS与MEDS比较差异无统计学意义（P＞0.05），与MEWS比较差异有统计学意义（P＜0.01）。联合多变量后建立的拟合方程敏感度最佳，曲线下面积最大，优于MEWS（P＜0.01）及NEWS（P＜0.05）。结论 MEDS的预测能力同NEWS能力相当，优于MEWS。联合MEDS与心率、Scr获得的拟合方程的预测能力更优于NEWS和MEWS。展开更多
Objective:To more rapidly and accurately obtain minimal erythema dose(MED)and minimal persistent pigment dose(MPPD)values in sun protection testing,we conducted a retrospective exploration of previous test data.Method...Objective:To more rapidly and accurately obtain minimal erythema dose(MED)and minimal persistent pigment dose(MPPD)values in sun protection testing,we conducted a retrospective exploration of previous test data.Methods:This retrospective study analyzed sunscreen test data collected from January 1,2021,to September 1,2024,among long-term East Asian residents in Shenzhen,China.We investigated correlations between skin color characteristics,age,seasonal variations,and UV sensitivity indicators(MED and MPPD).Results:The results indicate that in the population tested,there is a significant negative correlation between ITA°and the unprotected MED of participants(P<0.05),but no statistical correlation with the unprotected MPPD(P>0.05).There was a minimal correlation between participant age and both unprotected MED and MPPD.When compared to the other seasons,participants in winter exhibited significantly higher unprotected MED(P<0.05),and the unprotected MPPD was significantly higher in the autumn and winter than in spring and summer(P<0.05).Conclusion:In conclusion,defining proprietary predictive MED and MPPD values based on laboratory test population data in sunscreen efficacy testing enhances the probability of actual values conforming to preset gradients,thereby improving test success rates and overall efficiency.Moreover,while the impact of age is relatively minor,differences in skin color,population,and season do affect the results of MED and MPPD,which in turn influence the outcomes of sun protection product testing.Therefore,it may be necessary to conduct customized sun protection capability tests tailored to the product's target demographic and environmental context.展开更多
Mediator Complex Subunit 16(MED16,MIM:604062)is a member of the Mediator complex,which controls many aspects of transcriptional activity in all eukaryotes.Here,we report two individuals from a non-consanguineous famil...Mediator Complex Subunit 16(MED16,MIM:604062)is a member of the Mediator complex,which controls many aspects of transcriptional activity in all eukaryotes.Here,we report two individuals from a non-consanguineous family with biallelic variants in MED16 identified by exome sequencing.The affected individuals present with global developmental delay,intellectual disability,and dysmorphisms.To assess the pathogenicity of the variants,functional studies are performed in Drosophila and patient-derived cells.The fly ortholog med16 is expressed in neurons and some glia of the developing central nervous system(CNS).Loss of med16 leads to a reduction in eclosion and lifespan,as well as impaired synaptic transmission.In neurons differentiated from the patient-derived induced pluripotent stem cells(iPSCs),the neurite outgrowth is impaired and rescued by expression of exogenous MED16.The patient-associated variants behave as loss-of-function(LoF)alleles in flies and iPSCs.Additionally,the transcription of genes related to neuronal maturation and function is preferentially altered in patient cells relative to differentiated H9 controls.In summary,our findings support that MED16 is important for appropriate development and function,and that biallelic MED16 variants cause a neurodevelopmental disease.展开更多
文摘目的:探讨MEDS评分系统在判断老年肺部感染患者病情严重程度和预后方面的有效性和可行性。方法:以83例老年肺部感染患者为研究对象,比较患者急诊科MEDS评分与入院后24 h APACHEⅡ和CPIS评分的相关性,并计算MEDS、APACHEⅡ、CPIS评分预测28 d死亡率,入住ICU以及接受辅助通气情况的曲线下面积。结果:MEDS和APACHEⅡ评分的相关系数为0.876,MEDS和CPIS评分的相关系数为0.272,MEDS、APACHEⅡ、CPIS评分预测患者28 d死亡率的AUC分别为0.76、0.72、0.47,预测入住ICU的AUC分别为0.80、0.79、0.55,预测患者受辅助通气的AUC分别为0.88、0.89、0.62。结论:MEDS评分能够较为有效地判断老年肺部感染患者病情严重程度和预后。
文摘Objective:To more rapidly and accurately obtain minimal erythema dose(MED)and minimal persistent pigment dose(MPPD)values in sun protection testing,we conducted a retrospective exploration of previous test data.Methods:This retrospective study analyzed sunscreen test data collected from January 1,2021,to September 1,2024,among long-term East Asian residents in Shenzhen,China.We investigated correlations between skin color characteristics,age,seasonal variations,and UV sensitivity indicators(MED and MPPD).Results:The results indicate that in the population tested,there is a significant negative correlation between ITA°and the unprotected MED of participants(P<0.05),but no statistical correlation with the unprotected MPPD(P>0.05).There was a minimal correlation between participant age and both unprotected MED and MPPD.When compared to the other seasons,participants in winter exhibited significantly higher unprotected MED(P<0.05),and the unprotected MPPD was significantly higher in the autumn and winter than in spring and summer(P<0.05).Conclusion:In conclusion,defining proprietary predictive MED and MPPD values based on laboratory test population data in sunscreen efficacy testing enhances the probability of actual values conforming to preset gradients,thereby improving test success rates and overall efficiency.Moreover,while the impact of age is relatively minor,differences in skin color,population,and season do affect the results of MED and MPPD,which in turn influence the outcomes of sun protection product testing.Therefore,it may be necessary to conduct customized sun protection capability tests tailored to the product's target demographic and environmental context.
基金supported by the National Key R&D Program of China (2020YFA0112500 and 2021YFA1100400)the National Natural Science Foundation of China (32271019 and 12411530079)+6 种基金the Natural Science Foundation of Shanghai Municipality (22ZR1462600)supported by the Natural Science Foundation of Hunan Province, China (2022JJ40206)Ruixin project of Hunan Provincial Maternal and Child Health Care Hospital (2023RX01)supported by the Clinical Research Center Projects for Genetic Birth Defects and Rare Diseases in Hunan Province (2023SK4053)Major Scientific and Technological Projects for Collaborative Prevention and Control of Birth Defects in Hunan Province (2019SK1010)supported by the Model Organisms Screening Center of the UDN by U54NS093793 of the NIH (NINDS)supported by the Office of Research Infrastructure Programs of the NIH (awards R24 OD022005 and R24 OD031447).
文摘Mediator Complex Subunit 16(MED16,MIM:604062)is a member of the Mediator complex,which controls many aspects of transcriptional activity in all eukaryotes.Here,we report two individuals from a non-consanguineous family with biallelic variants in MED16 identified by exome sequencing.The affected individuals present with global developmental delay,intellectual disability,and dysmorphisms.To assess the pathogenicity of the variants,functional studies are performed in Drosophila and patient-derived cells.The fly ortholog med16 is expressed in neurons and some glia of the developing central nervous system(CNS).Loss of med16 leads to a reduction in eclosion and lifespan,as well as impaired synaptic transmission.In neurons differentiated from the patient-derived induced pluripotent stem cells(iPSCs),the neurite outgrowth is impaired and rescued by expression of exogenous MED16.The patient-associated variants behave as loss-of-function(LoF)alleles in flies and iPSCs.Additionally,the transcription of genes related to neuronal maturation and function is preferentially altered in patient cells relative to differentiated H9 controls.In summary,our findings support that MED16 is important for appropriate development and function,and that biallelic MED16 variants cause a neurodevelopmental disease.
