AIM:To examine the determinants of maternal-neonatal transmission of hepatitis B virus(HBV) METHODS:A nested case-control study was conducted in Changsha,Hunan,People's Republic of China from January 1,2005 to Sep...AIM:To examine the determinants of maternal-neonatal transmission of hepatitis B virus(HBV) METHODS:A nested case-control study was conducted in Changsha,Hunan,People's Republic of China from January 1,2005 to September 31,2006 To avoid potential maternal blood contamination,we collected vein blood of newborns immediately after birth and before initial hepatitis B vaccination to determine the HBV infection status of the newborn For each HBsAg-positive infant,one HBsAg-negative infant born to an HBsAg-positive mother was matched by hospital at birth(same),gender(same),and date of birth(within 1 mo) A faceto-face interview was conducted to collect clinical and epidemiological data Conditional logistic regression analysis was used to estimate the independent effects of various determinants on maternal-neonatal transmission of HBV RESULTS:A total of 141 HBsAg-positive infants and 141 individually matched HBsAg-negative infants were included in the final analysis Maternal first-degree family history of HBV infection,intrahepatic cholestasis,and premature rupture of membranes were risk factors for perinatal transmission of HBV,whereas systematic treatment and HBV immunoglobulin injections for mothers with HBV infection were protective factors for maternal-neonatal transmission of HBV,after adjustment for potential confounding factors CONCLUSION:For HBsAg-positive mothers,systematic treatment,HBV immunoglobulin administration,and controlling intrahepatic cholestasis and pregnancy complications may reduce the incidence of perinatal transmission of HBV.展开更多
To assess the relationship between serum levels of insulin-like growth factor-1(IGF1)/IGF-binding protein-3(IGFBP3)and the risk of esophageal carcinoma.METHODSWe assessed the relationship between the serum levels of t...To assess the relationship between serum levels of insulin-like growth factor-1(IGF1)/IGF-binding protein-3(IGFBP3)and the risk of esophageal carcinoma.METHODSWe assessed the relationship between the serum levels of these molecules and the risk of esophageal cancer in a prospective,nested case-control study of participants from the Japan Collaborative Cohort Study.A baseline survey was conducted from 1988 to 1990.Of the 110585 enrolled participants,35%donated blood samples.Those who had been diagnosed with esophageal cancer were considered cases for nested case-control studies.A conditional logistic model was used to estimate odds ratios for the incidence of esophageal cancer associated with serum IGF1 and IGFBP3 levels.RESULTSThirty-one cases and 86 controls were eligible for the present assessment.The molar ratio of IGF1/IGFBP3,which represents the free and active form of IGF1,was not correlated with the risk of esophageal carcinoma.A higher molar difference between IGFBP3 and IGF1,which estimates the free form of IGFBP3,was associated with a decreased risk of esophageal carcinoma(P=0.0146),and people in the highest tertile had the lowest risk(OR=0.107,95%CI:0.017-0.669).After adjustment for body mass index,tobacco use,and alcohol intake,the molar difference of IGFBP3-IGF1 was inversely correlated with the risk of esophageal carcinoma(P=0.0150).CONCLUSIONThe free form of IGFBP3,which is estimated by this molar difference,may be inversely associated with esophageal cancer incidence.展开更多
Objective This study prospectively investigates the association between immunoglobulin G(IgG)N-glycan traits and ischemic stroke(IS) risk.Methods A nested case-control study was conducted in the China suboptimal healt...Objective This study prospectively investigates the association between immunoglobulin G(IgG)N-glycan traits and ischemic stroke(IS) risk.Methods A nested case-control study was conducted in the China suboptimal health cohort study,which recruited 4,313 individuals in 2013–2014. Cases were identified as patients diagnosed with IS, and controls were 1:1 matched by age and sex with cases. Ig G N-glycans in baseline plasma samples were analyzed.Results A total of 99 IS cases and 99 controls were included, and 24 directly measured glycan peaks(GPs) were separated from Ig G N-glycans. In directly measured GPs, GP4, GP9, GP21, GP22, GP23, and GP24 were associated with the risk of IS in men after adjusting for age, waist and hip circumference,obesity, diabetes, hypertension, and dyslipidemia. Derived glycan traits representing decreased galactosylation and sialylation were associated with IS in men(FBG2S2/(FBG2 + FBG2S1 + FBG2S2): odds ratio(OR) = 0.92, 95% confidence interval(CI): 0.87–0.97;G1n: OR = 0.74, 95% CI: 0.63–0.87;G0n: OR =1.12, 95% CI: 1.03–1.22). However, these associations were not found among women.Conclusion This study validated that altered Ig G N-glycan traits were associated with incident IS in men, suggesting that sex discrepancies might exist in these associations.展开更多
This paper discusses the nested case-control analysis under a class of general additive-multiplicative hazard models which includes the Cox model and the additive hazard model as special cases.A pseudo-score is constr...This paper discusses the nested case-control analysis under a class of general additive-multiplicative hazard models which includes the Cox model and the additive hazard model as special cases.A pseudo-score is constructed to estimate the regression parameters.The resulting estimator is shown to be consistent and asymptotically normally distributed.The limiting variance-covariance matrix can be consistently estimated by the nested case-control data.A simulation study is conducted to assess the finite sample performance of the proposed estimator and a real example is provided for illustration.展开更多
BACKGROUND Dementia is a prevalent condition in type 2 diabetes mellitus(T2DM)patients.While Chinese herbal medicine(CHM)is often employed as complementary therapy for glycemic control,its effect in controlling likeli...BACKGROUND Dementia is a prevalent condition in type 2 diabetes mellitus(T2DM)patients.While Chinese herbal medicine(CHM)is often employed as complementary therapy for glycemic control,its effect in controlling likelihood of dementia has not yet been fully elucidated.AIM To compare the risk of dementia between T2DM patients with and without CHM treatment.METHODS We undertook a nested case-control study and obtained data on patients 20-70 years of age who received medical care for T2DM between 2001 and 2010 from the National Health Insurance Research database in Taiwan.Cases,defined as those with dementia that occurred at least one year after the diagnosis of T2DM,were randomly matched to controls without dementia from the study cohort at a 1:1 ratio.We applied conditional logistic regression to explore the associations between CHM treatment and dementia.RESULTS A total of 11699 dementia cases were matched to 11699 non-dementia controls.We found that adding CHM to conventional care was related to a lower risk of dementia[adjusted odds ratio(OR)=0.51],and high-intensity CHM treatment was associated with an adjusted OR of 0.22.CONCLUSION This study shows that the cumulative CHM exposure was inversely associated with dementia risk in an exposureresponse manner,implying that CHM treatment may be embraced as a disease management approach for diabetic patients to prevent dementia.展开更多
BACKGROUND Type 1 diabetes(T1D)is a severe and prevalent metabolic disease.Due to its high heredity,an increasing number of genome-wide association studies have been performed,most of which were from hospital-based ca...BACKGROUND Type 1 diabetes(T1D)is a severe and prevalent metabolic disease.Due to its high heredity,an increasing number of genome-wide association studies have been performed,most of which were from hospital-based case-control studies with a relatively small sample size.The association of single nucleotide polymorphisms(SNPs)and T1D has been less studied and is less understood in natural cohorts.AIM To investigate the significant variants of T1D,which could be potential biomarkers for T1D prediction or even therapy.METHODS A genome-wide association study(GWAS)of adult T1D was performed in a nested case-control study(785 cases vs 804 controls)from a larger 5-year cohort study in Suzhou,China.Potential harmful or protective SNPs were evaluated for T1D.Subsequent expression and splicing quantitative trait loci(eQTL and sQTL)analyses were carried out to identify target genes modulated by these SNPs.RESULTS A harmful SNP for T1D,rs3117017[odds ratio(OR)=3.202,95%confidence interval(CI):2.296-4.466,P=9.33×10-4]and three protective SNPs rs55846421(0.113,0.081-0.156,1.76×10-9),rs75836320(0.283,0.205-0.392,1.07×10-4),rs362071(0.568,0.495-0.651,1.66×10-4)were identified.Twenty-two genes were further identified as potential candidates for T1D onset.CONCLUSION We identified a potential genetic basis of T1D,both protective and harmful,using a GWAS in a larger nested case-control study of a Chinese population.展开更多
BACKGROUND When opportunistic infections occur, patients with inflammatory bowel disease(IBD) commonly display a significantly increased rate of morbidity and mortality.With increasing use of immunosuppressive agents ...BACKGROUND When opportunistic infections occur, patients with inflammatory bowel disease(IBD) commonly display a significantly increased rate of morbidity and mortality.With increasing use of immunosuppressive agents and biological agents,opportunistic infections are becoming a hot topic in the perspective of drug safety in IBD patients. Despite the well-established role of opportunistic infections in the prognosis of IBD patients, there are few epidemiological data investigating the incidence of opportunis-tic infections in IBD patients in China. Besides, the risk factors for opportunistic infection in Chinese IBD patients remain unclear.AIM To predict the incidence of opportunistic infections related to IBD in China, and explore the risk factors for opportunistic infections.METHODS A single-center, prospective study of IBD patients was conducted. The patients were followed for up to 12 mo to calculate the incidence of infections. For each infected IBD patient, two non-infected IBD patients were selected as controls. A conditional logistic regression analysis was used to assess associations between putative risk factors and opportunistic infections, which are represented as odds ratios(OR) and 95% confidence intervals(CIs).RESULTS Seventy(28.11%) out of 249 IBD patients developed opportunistic infections.Clostridium difficile infections and respiratory syncytial virus infections were found in 24 and 16 patients, respectively. In a univariate analysis, factors such as the severity of IBD, use of an immunosuppressant or immunosuppressants, high levels of fecal calprotectin, and C-reactive protein or erythrocyte sedimentation rate were individually related to a significantly increased risk of opportunistic infection. Multivariate analysis indicated that the use of any immunosuppressant yielded an OR of 3.247(95%CI: 1.128-9.341), whereas the use of any two immunosuppressants yielded an OR of 6.457(95%CI: 1.726-24.152) for opportunistic infection. Interestingly, when immunosuppressants were used in combination with infliximab(IFX) or 5-aminosalicylic acid, a significantly increased risk of opportunistic infection was also observed. The relative risk of opportunistic infection was greatest in IBD patients with severe disease activity(OR = 9.090; 95%CI: 1.532-53.941, relative to the remission stage). However, the use of IFX alone did not increase the risk of opportunistic infection.CONCLUSION Factors such as severe IBD, elevated levels of fecal calprotectin, and the use of immunosuppressive medications, especially when used in combination, are major risk factors for opportunistic infections in IBD patients. The use of IFX alone does not increase the risk of opportunistic infection.展开更多
BACKGROUND Currently, it is difficult to predict the complications of children at the early stage of sepsis. Brighton pediatric early warning score(PEWS) is a disease risk assessment system that is simple and easy to ...BACKGROUND Currently, it is difficult to predict the complications of children at the early stage of sepsis. Brighton pediatric early warning score(PEWS) is a disease risk assessment system that is simple and easy to operate, which has good sensitivity and specificity in disease recognition among children. Because detection indicators vary widely in children, a single indicator is difficult to assess the posttreatment status of children with sepsis.AIM To investigate the relationship between serological markers, Brighton PEWS, and death in children with sepsis after treatment.METHODS A total of 205 children diagnosed with sepsis at our hospital were enrolled. The baseline data, serum scores, and PEWS scores were recorded. In the nested casecontrol study, children who died during the study period were included in an observation group. According to the matching principle, the children who were not dead in the same cohort were included in a control group. The influencing factors of death in children with sepsis after treatment and the value of each evaluation index in predicting the prognosis of children were analyzed.RESULTS A total of 96 children were enrolled in the study, including 48 each in the observation group and the control group. Multivariate logistic regression analysis indicated that antibacterial treatments within 1 h(P = 0.017), shock(P = 0.044),multiple organ dysfunction syndrome(MODS)(P = 0.027), serum procalcitonin(PCT)(P = 0.047), serum albumin(ALB)(P = 0.024), and PEWS(P = 0.012) were independent risk factors for the death of children with sepsis. The area under the curve of the combination of ALB, PCT, and PEWS to predict the death in children with sepsis was the highest(0.908).CONCLUSION Antibacterial treatments within 1 h, shock, MODS, PCT, ALB, and PEWS are independent risk factors for the death of children with sepsis. The predictive accuracy of the combination of PCT, ALB, and PEWS for the prognosis of children with sepsis is the best.展开更多
To the Editor:Stroke is among the leading public health problems in China,with high rates of recurrent stroke,cardiovascular events and mortality,resulting in a considerable medical and economic burden.[1]The identifi...To the Editor:Stroke is among the leading public health problems in China,with high rates of recurrent stroke,cardiovascular events and mortality,resulting in a considerable medical and economic burden.[1]The identification of new molecular markers and therapeutic targets is necessary to better refine the risk prediction of cardiovascular events and develop new treatment strategies for ischemic stroke.Succinate is a tricarboxylic acid(TCA)cycle intermediate and has received considerable attention for its involvement in various signaling pathways associated with cardiovascular diseases.[2–4]Recent studies have reported that succinate is a novel mediator that promotes atherosclerotic lesion progression,fibroblast activation,and apoptosis resistance.展开更多
Background and Objectives:Malnutrition is associated with a higher risk of osteoporosis.We aim to assess the relationship between serum albumin with geriatric nutritional risk index and osteopenia in Chinese elderly m...Background and Objectives:Malnutrition is associated with a higher risk of osteoporosis.We aim to assess the relationship between serum albumin with geriatric nutritional risk index and osteopenia in Chinese elderly men.Methods and S tudy Design:This is a nested case-control study from a prospective cohort enrolled 1109 indi viduals who were followed for seven years.Demographic data,medical history,signs and symptoms,and labora tory parameters were collected and analysed.Nutritional status and Geriatric Nutritional Risk Index(GNRI)were assessed.The nutrition-related indexes predictive value for osteopenia development was analyzed through multi variate Cox regression analysis and by creating a receiver operating characteristic curve(ROC),calculating the area under the curve(AUC).Kaplan-Meier(K-M)method was further used to find the nutritional status level in the elderly men.Results:The ALB and GNRI correlated with the risk of osteopenia in Chinese elderly men.Af ter adjusting for all covariates,people with higher ALB level(HR:0.821;95%CI:0.790-0.852)and higher GNRI score(HR:0.889;95%CI:0.869-0.908)had a smaller risk of o steopenia.ROC analysis showed that the AUC for ALB was 0.729(p˂0.05)and for the GNRI score was 0.731(p˂0.05).K-M curve indicated a significant difference in ALB level(p˂0.001)and GNRI score(p˂0.001)in the respective subgroups.Conclusions:This study found that lower ALB level and lower GNRI score are associat ed with a higher prevalence of osteopenia among elderly men in China.展开更多
Sparse array design has significant implications for improving the accuracy of direction of arrival(DOA)estimation of non-circular(NC)signals.We propose an extended nested array with a filled sensor(ENAFS)based on the...Sparse array design has significant implications for improving the accuracy of direction of arrival(DOA)estimation of non-circular(NC)signals.We propose an extended nested array with a filled sensor(ENAFS)based on the hole-filling strategy.Specifically,we first introduce the improved nested array(INA)and prove its properties.Subsequently,we extend the sum-difference coarray(SDCA)by adding an additional sensor to fill the holes.Thus the larger uniform degrees of freedom(uDOFs)and virtual array aperture(VAA)can be abtained,and the ENAFS is designed.Finally,the simulation results are given to verify the superiority of the proposed ENAFS in terms of DOF,mutual coupling and estimation performance.展开更多
为了进一步提高分布式阵列的自由度和分辨力,提出一种分布式nested阵列。该阵列将nested阵列作为分布式阵列的子阵。基于Khatri-Rao积,nested子阵可提高整个阵列的自由度。分布式nested阵列以较少的阵元数及硬件成本实现大的孔径和较高...为了进一步提高分布式阵列的自由度和分辨力,提出一种分布式nested阵列。该阵列将nested阵列作为分布式阵列的子阵。基于Khatri-Rao积,nested子阵可提高整个阵列的自由度。分布式nested阵列以较少的阵元数及硬件成本实现大的孔径和较高的分辨力,而且提高了目标波达方向(direction of arrival,DOA)估计的精度。并利用基于Khatri-Rao积的空间平滑酉旋转不变子空间(estimation of signal parameters via rotational invariance techniques,ESPRIT)算法进行DOA估计。其先对协方差矩阵向量化提高自由度,然后利用空间平滑对新数据协方差矩阵进行秩恢复,最后使用双尺度酉ESPRIT算法得到DOA估计。仿真结果证明所提方法的有效性。展开更多
基金Supported by Hunan Ministry of Science and Technology,No.06FJ3177,China
文摘AIM:To examine the determinants of maternal-neonatal transmission of hepatitis B virus(HBV) METHODS:A nested case-control study was conducted in Changsha,Hunan,People's Republic of China from January 1,2005 to September 31,2006 To avoid potential maternal blood contamination,we collected vein blood of newborns immediately after birth and before initial hepatitis B vaccination to determine the HBV infection status of the newborn For each HBsAg-positive infant,one HBsAg-negative infant born to an HBsAg-positive mother was matched by hospital at birth(same),gender(same),and date of birth(within 1 mo) A faceto-face interview was conducted to collect clinical and epidemiological data Conditional logistic regression analysis was used to estimate the independent effects of various determinants on maternal-neonatal transmission of HBV RESULTS:A total of 141 HBsAg-positive infants and 141 individually matched HBsAg-negative infants were included in the final analysis Maternal first-degree family history of HBV infection,intrahepatic cholestasis,and premature rupture of membranes were risk factors for perinatal transmission of HBV,whereas systematic treatment and HBV immunoglobulin injections for mothers with HBV infection were protective factors for maternal-neonatal transmission of HBV,after adjustment for potential confounding factors CONCLUSION:For HBsAg-positive mothers,systematic treatment,HBV immunoglobulin administration,and controlling intrahepatic cholestasis and pregnancy complications may reduce the incidence of perinatal transmission of HBV.
基金Supported by the Ministry of Education,Culture,Sports,Science,and Technology and from the Ministry of Health,Labour and Welfare,Japan
文摘To assess the relationship between serum levels of insulin-like growth factor-1(IGF1)/IGF-binding protein-3(IGFBP3)and the risk of esophageal carcinoma.METHODSWe assessed the relationship between the serum levels of these molecules and the risk of esophageal cancer in a prospective,nested case-control study of participants from the Japan Collaborative Cohort Study.A baseline survey was conducted from 1988 to 1990.Of the 110585 enrolled participants,35%donated blood samples.Those who had been diagnosed with esophageal cancer were considered cases for nested case-control studies.A conditional logistic model was used to estimate odds ratios for the incidence of esophageal cancer associated with serum IGF1 and IGFBP3 levels.RESULTSThirty-one cases and 86 controls were eligible for the present assessment.The molar ratio of IGF1/IGFBP3,which represents the free and active form of IGF1,was not correlated with the risk of esophageal carcinoma.A higher molar difference between IGFBP3 and IGF1,which estimates the free form of IGFBP3,was associated with a decreased risk of esophageal carcinoma(P=0.0146),and people in the highest tertile had the lowest risk(OR=0.107,95%CI:0.017-0.669).After adjustment for body mass index,tobacco use,and alcohol intake,the molar difference of IGFBP3-IGF1 was inversely correlated with the risk of esophageal carcinoma(P=0.0150).CONCLUSIONThe free form of IGFBP3,which is estimated by this molar difference,may be inversely associated with esophageal cancer incidence.
基金supported by grants from the National Natural Science Foundation of China [No.81673247, 8187268281903401]。
文摘Objective This study prospectively investigates the association between immunoglobulin G(IgG)N-glycan traits and ischemic stroke(IS) risk.Methods A nested case-control study was conducted in the China suboptimal health cohort study,which recruited 4,313 individuals in 2013–2014. Cases were identified as patients diagnosed with IS, and controls were 1:1 matched by age and sex with cases. Ig G N-glycans in baseline plasma samples were analyzed.Results A total of 99 IS cases and 99 controls were included, and 24 directly measured glycan peaks(GPs) were separated from Ig G N-glycans. In directly measured GPs, GP4, GP9, GP21, GP22, GP23, and GP24 were associated with the risk of IS in men after adjusting for age, waist and hip circumference,obesity, diabetes, hypertension, and dyslipidemia. Derived glycan traits representing decreased galactosylation and sialylation were associated with IS in men(FBG2S2/(FBG2 + FBG2S1 + FBG2S2): odds ratio(OR) = 0.92, 95% confidence interval(CI): 0.87–0.97;G1n: OR = 0.74, 95% CI: 0.63–0.87;G0n: OR =1.12, 95% CI: 1.03–1.22). However, these associations were not found among women.Conclusion This study validated that altered Ig G N-glycan traits were associated with incident IS in men, suggesting that sex discrepancies might exist in these associations.
基金Supported by the National Natural Science Foundation of China(10971033,11101091)
文摘This paper discusses the nested case-control analysis under a class of general additive-multiplicative hazard models which includes the Cox model and the additive hazard model as special cases.A pseudo-score is constructed to estimate the regression parameters.The resulting estimator is shown to be consistent and asymptotically normally distributed.The limiting variance-covariance matrix can be consistently estimated by the nested case-control data.A simulation study is conducted to assess the finite sample performance of the proposed estimator and a real example is provided for illustration.
文摘BACKGROUND Dementia is a prevalent condition in type 2 diabetes mellitus(T2DM)patients.While Chinese herbal medicine(CHM)is often employed as complementary therapy for glycemic control,its effect in controlling likelihood of dementia has not yet been fully elucidated.AIM To compare the risk of dementia between T2DM patients with and without CHM treatment.METHODS We undertook a nested case-control study and obtained data on patients 20-70 years of age who received medical care for T2DM between 2001 and 2010 from the National Health Insurance Research database in Taiwan.Cases,defined as those with dementia that occurred at least one year after the diagnosis of T2DM,were randomly matched to controls without dementia from the study cohort at a 1:1 ratio.We applied conditional logistic regression to explore the associations between CHM treatment and dementia.RESULTS A total of 11699 dementia cases were matched to 11699 non-dementia controls.We found that adding CHM to conventional care was related to a lower risk of dementia[adjusted odds ratio(OR)=0.51],and high-intensity CHM treatment was associated with an adjusted OR of 0.22.CONCLUSION This study shows that the cumulative CHM exposure was inversely associated with dementia risk in an exposureresponse manner,implying that CHM treatment may be embraced as a disease management approach for diabetic patients to prevent dementia.
基金the National Science Foundation for Young Scientists of China(No.81602919)the National Science Foundation for Young Scientists of China(No.82070814)+1 种基金the Suzhou Science and Technology Development Plan(No.SYS2018099)and the 5th Suzhou Health Talent Program(No.GSWS2019071).
文摘BACKGROUND Type 1 diabetes(T1D)is a severe and prevalent metabolic disease.Due to its high heredity,an increasing number of genome-wide association studies have been performed,most of which were from hospital-based case-control studies with a relatively small sample size.The association of single nucleotide polymorphisms(SNPs)and T1D has been less studied and is less understood in natural cohorts.AIM To investigate the significant variants of T1D,which could be potential biomarkers for T1D prediction or even therapy.METHODS A genome-wide association study(GWAS)of adult T1D was performed in a nested case-control study(785 cases vs 804 controls)from a larger 5-year cohort study in Suzhou,China.Potential harmful or protective SNPs were evaluated for T1D.Subsequent expression and splicing quantitative trait loci(eQTL and sQTL)analyses were carried out to identify target genes modulated by these SNPs.RESULTS A harmful SNP for T1D,rs3117017[odds ratio(OR)=3.202,95%confidence interval(CI):2.296-4.466,P=9.33×10-4]and three protective SNPs rs55846421(0.113,0.081-0.156,1.76×10-9),rs75836320(0.283,0.205-0.392,1.07×10-4),rs362071(0.568,0.495-0.651,1.66×10-4)were identified.Twenty-two genes were further identified as potential candidates for T1D onset.CONCLUSION We identified a potential genetic basis of T1D,both protective and harmful,using a GWAS in a larger nested case-control study of a Chinese population.
基金National Natural Science Foundation of China,No.81473506Natural Science Foundation of Zhejiang Province,No.LY16H290001 and No.LY17H290009+1 种基金Project of Department of Construction of Zhejiang Province,No.WKJ-ZJ-1531Zhejiang TCM Science and Technology Project,No.2016ZB047 and No.2017ZA056
文摘BACKGROUND When opportunistic infections occur, patients with inflammatory bowel disease(IBD) commonly display a significantly increased rate of morbidity and mortality.With increasing use of immunosuppressive agents and biological agents,opportunistic infections are becoming a hot topic in the perspective of drug safety in IBD patients. Despite the well-established role of opportunistic infections in the prognosis of IBD patients, there are few epidemiological data investigating the incidence of opportunis-tic infections in IBD patients in China. Besides, the risk factors for opportunistic infection in Chinese IBD patients remain unclear.AIM To predict the incidence of opportunistic infections related to IBD in China, and explore the risk factors for opportunistic infections.METHODS A single-center, prospective study of IBD patients was conducted. The patients were followed for up to 12 mo to calculate the incidence of infections. For each infected IBD patient, two non-infected IBD patients were selected as controls. A conditional logistic regression analysis was used to assess associations between putative risk factors and opportunistic infections, which are represented as odds ratios(OR) and 95% confidence intervals(CIs).RESULTS Seventy(28.11%) out of 249 IBD patients developed opportunistic infections.Clostridium difficile infections and respiratory syncytial virus infections were found in 24 and 16 patients, respectively. In a univariate analysis, factors such as the severity of IBD, use of an immunosuppressant or immunosuppressants, high levels of fecal calprotectin, and C-reactive protein or erythrocyte sedimentation rate were individually related to a significantly increased risk of opportunistic infection. Multivariate analysis indicated that the use of any immunosuppressant yielded an OR of 3.247(95%CI: 1.128-9.341), whereas the use of any two immunosuppressants yielded an OR of 6.457(95%CI: 1.726-24.152) for opportunistic infection. Interestingly, when immunosuppressants were used in combination with infliximab(IFX) or 5-aminosalicylic acid, a significantly increased risk of opportunistic infection was also observed. The relative risk of opportunistic infection was greatest in IBD patients with severe disease activity(OR = 9.090; 95%CI: 1.532-53.941, relative to the remission stage). However, the use of IFX alone did not increase the risk of opportunistic infection.CONCLUSION Factors such as severe IBD, elevated levels of fecal calprotectin, and the use of immunosuppressive medications, especially when used in combination, are major risk factors for opportunistic infections in IBD patients. The use of IFX alone does not increase the risk of opportunistic infection.
文摘BACKGROUND Currently, it is difficult to predict the complications of children at the early stage of sepsis. Brighton pediatric early warning score(PEWS) is a disease risk assessment system that is simple and easy to operate, which has good sensitivity and specificity in disease recognition among children. Because detection indicators vary widely in children, a single indicator is difficult to assess the posttreatment status of children with sepsis.AIM To investigate the relationship between serological markers, Brighton PEWS, and death in children with sepsis after treatment.METHODS A total of 205 children diagnosed with sepsis at our hospital were enrolled. The baseline data, serum scores, and PEWS scores were recorded. In the nested casecontrol study, children who died during the study period were included in an observation group. According to the matching principle, the children who were not dead in the same cohort were included in a control group. The influencing factors of death in children with sepsis after treatment and the value of each evaluation index in predicting the prognosis of children were analyzed.RESULTS A total of 96 children were enrolled in the study, including 48 each in the observation group and the control group. Multivariate logistic regression analysis indicated that antibacterial treatments within 1 h(P = 0.017), shock(P = 0.044),multiple organ dysfunction syndrome(MODS)(P = 0.027), serum procalcitonin(PCT)(P = 0.047), serum albumin(ALB)(P = 0.024), and PEWS(P = 0.012) were independent risk factors for the death of children with sepsis. The area under the curve of the combination of ALB, PCT, and PEWS to predict the death in children with sepsis was the highest(0.908).CONCLUSION Antibacterial treatments within 1 h, shock, MODS, PCT, ALB, and PEWS are independent risk factors for the death of children with sepsis. The predictive accuracy of the combination of PCT, ALB, and PEWS for the prognosis of children with sepsis is the best.
基金This study was supported by the National Natural Science Foundation of China(Nos.82273706 and 82220108001)the Suzhou Science and Technology Project(No.SYW2024067)+1 种基金Interdisciplinary Basic Frontier Innovation Program of Suzhou Medical College of Soochow University(No.YXY2302013)the Project of MOE Key Laboratory of Geriatric Diseases and Immunology(No.JYN202406).
文摘To the Editor:Stroke is among the leading public health problems in China,with high rates of recurrent stroke,cardiovascular events and mortality,resulting in a considerable medical and economic burden.[1]The identification of new molecular markers and therapeutic targets is necessary to better refine the risk prediction of cardiovascular events and develop new treatment strategies for ischemic stroke.Succinate is a tricarboxylic acid(TCA)cycle intermediate and has received considerable attention for its involvement in various signaling pathways associated with cardiovascular diseases.[2–4]Recent studies have reported that succinate is a novel mediator that promotes atherosclerotic lesion progression,fibroblast activation,and apoptosis resistance.
基金National Key Research and Development Program of Chi na(No.2020YFC2004900)Multi-center RCT Clinical Project of the National Clinical Research Centre for Geriatric Diseases,Chinese PLA General Hospital(No.NCRCG-PLAGH-2023001)The Open Project of the National Clinical Research Centre for Geriatric Diseases,Chinese PLA General Hospital(No.NCRCG-PLAGH-2022016).
文摘Background and Objectives:Malnutrition is associated with a higher risk of osteoporosis.We aim to assess the relationship between serum albumin with geriatric nutritional risk index and osteopenia in Chinese elderly men.Methods and S tudy Design:This is a nested case-control study from a prospective cohort enrolled 1109 indi viduals who were followed for seven years.Demographic data,medical history,signs and symptoms,and labora tory parameters were collected and analysed.Nutritional status and Geriatric Nutritional Risk Index(GNRI)were assessed.The nutrition-related indexes predictive value for osteopenia development was analyzed through multi variate Cox regression analysis and by creating a receiver operating characteristic curve(ROC),calculating the area under the curve(AUC).Kaplan-Meier(K-M)method was further used to find the nutritional status level in the elderly men.Results:The ALB and GNRI correlated with the risk of osteopenia in Chinese elderly men.Af ter adjusting for all covariates,people with higher ALB level(HR:0.821;95%CI:0.790-0.852)and higher GNRI score(HR:0.889;95%CI:0.869-0.908)had a smaller risk of o steopenia.ROC analysis showed that the AUC for ALB was 0.729(p˂0.05)and for the GNRI score was 0.731(p˂0.05).K-M curve indicated a significant difference in ALB level(p˂0.001)and GNRI score(p˂0.001)in the respective subgroups.Conclusions:This study found that lower ALB level and lower GNRI score are associat ed with a higher prevalence of osteopenia among elderly men in China.
基金supported by China National Science Foundations(Nos.62371225,62371227)。
文摘Sparse array design has significant implications for improving the accuracy of direction of arrival(DOA)estimation of non-circular(NC)signals.We propose an extended nested array with a filled sensor(ENAFS)based on the hole-filling strategy.Specifically,we first introduce the improved nested array(INA)and prove its properties.Subsequently,we extend the sum-difference coarray(SDCA)by adding an additional sensor to fill the holes.Thus the larger uniform degrees of freedom(uDOFs)and virtual array aperture(VAA)can be abtained,and the ENAFS is designed.Finally,the simulation results are given to verify the superiority of the proposed ENAFS in terms of DOF,mutual coupling and estimation performance.
文摘为了进一步提高分布式阵列的自由度和分辨力,提出一种分布式nested阵列。该阵列将nested阵列作为分布式阵列的子阵。基于Khatri-Rao积,nested子阵可提高整个阵列的自由度。分布式nested阵列以较少的阵元数及硬件成本实现大的孔径和较高的分辨力,而且提高了目标波达方向(direction of arrival,DOA)估计的精度。并利用基于Khatri-Rao积的空间平滑酉旋转不变子空间(estimation of signal parameters via rotational invariance techniques,ESPRIT)算法进行DOA估计。其先对协方差矩阵向量化提高自由度,然后利用空间平滑对新数据协方差矩阵进行秩恢复,最后使用双尺度酉ESPRIT算法得到DOA估计。仿真结果证明所提方法的有效性。
