Systemic abnormalities often occur in patients with liver disease. In particular, cardiopulmonary or renal diseases accompanied by advanced liver disease can be serious and may determine the quality of life and progno...Systemic abnormalities often occur in patients with liver disease. In particular, cardiopulmonary or renal diseases accompanied by advanced liver disease can be serious and may determine the quality of life and prognosis of patients. Therefore, both hepatologists and non-hepatologists should pay attention to such abnormalities in the management of patients with liver diseases.展开更多
Hydronephrosis and ureteral obstruction are rare sequelae of Crohn’s disease. Chronic obstruction can ultimately lead to dysfunction of the affected kidney, and atypical presenting symptoms create pitfalls in diagnos...Hydronephrosis and ureteral obstruction are rare sequelae of Crohn’s disease. Chronic obstruction can ultimately lead to dysfunction of the affected kidney, and atypical presenting symptoms create pitfalls in diagnosis. Few reviews in the literature focus on this process and are limited to isolated case reports and case reviews. We performed a PubMed search using such terms as “Hydronephrosis” AND “Crohn’s disease” AND/OR “ureteral obstruction.” References from selected papers were reviewed for relevance and used for information-gathering as well. Ureteral obstruction most commonly occurs on the right side, due to ileal involvement. Clinical diagnosis is difficult, as symptoms are notably not genitourinary in origin;rather they are more musculoskeletal in nature. Treatment centers on disease control and temporary drainage of the affected kidney. Though rare, hydronephrosis and ureteral obstruction may develop as a result of inflammatory bowel disease. Due to atypical presenting symptoms, a high clinical suspicion is needed to affirm the diagnosis and ensure proper treatment.展开更多
Owing to the extreme rainfall and evaporation events under the changing climate,coastal zones are experiencing salinity fluctuations that stress aquatic organisms.However,the biological consequences of ongoing alterat...Owing to the extreme rainfall and evaporation events under the changing climate,coastal zones are experiencing salinity fluctuations that stress aquatic organisms.However,the biological consequences of ongoing alteration in salinity levels on euryhaline organisms remain inconclusive.Herein,we sought to uncover how variation in salinity level adversely alters the bacterioplankton community,the gut microbiota of euryhaline shrimp Penaeus monodon,and subsequent shrimp disease risk.To mimic the extreme weather that induces abrupt changes in coastal water salinity,three salinity levels(10,20,and 30)were selected to investigate the differences in shrimp gut microbiota using bacterial 16S rRNA gene sequencing.Results shows that salinity level and days post experiment(dpe)respectively constrained 45.9%and 13.0%of the variance in the gut bacterial communities.Particularly,abnormal salinity levels accelerated temporal turnover rate,disrupted gut network stability,augmented average variation degree,and increased pathogenic potential in the gut microbiota of shrimp reared at 10 and 30 salinities compared with 20 salinity controls.These changes were accompanied with the shifts in the gut microbiota-mediated functions,especially the compromised immunity and elevated infectious diseases potentials,thereby increasing shrimp disease risk.In addition,abnormal salinity levels increased the role of homogeneous selection governing the gut microbiota.After excluding the dpe-effect,we screened 35 gut salinity-discriminatory taxa that quantitatively discriminated the salinity levels where shrimp were reared,with overall accuracy of 91.1%.Collectively,abnormal salinity levels profoundly disrupt the structure,stability,assembly,and functions of the gut microbiota,which in turn increased disease risk in shrimp.In addition,gut symbionts sensitively responded to the changes in external salinity level.These findings deepened our understanding on the biological consequence of abnormal salinity levels on shrimp health.展开更多
BACKGROUND Chronic kidney disease is a progressive disease that evolves towards the deve-lopment of end-stage renal disease.The superimposition of renal impairment on a complex disease,namely human immunodeficiency vi...BACKGROUND Chronic kidney disease is a progressive disease that evolves towards the deve-lopment of end-stage renal disease.The superimposition of renal impairment on a complex disease,namely human immunodeficiency virus(HIV)infection,will raise the burden of comorbidities and,predict worse outcomes in this group of the population.AIM To evaluate the structural and functional defects of kidney in patients with HIV infection.METHODS This cross-sectional study involved 227 patients with HIV infection.Participants were selected by simple random sampling method.Eligible participants included HIV infection-positive adults aged 18 years and above.Exclusion criteria en-compassed individuals with preexisting hypertension,diabetes mellitus,chronic kidney disease,chronic liver disease,and those receiving nephrotoxic drugs.Informed consent was obtained.Data collection involved recording medical histories,conducting clinical examinations,and performing baseline blood investigations and ultrasono-graphy to assess renal function and structural abnormalities.RESULTS The mean age of participants was 41 years.Females constituted 66.5%;78% were on Tenofovir-based regimen.The mean duration of HIV infection was 5 years;mean duration of antiretroviral therapy was 4 years.67.4% had a body mass index over 25.World Health Organization staging of HIV infection revealed that 41.9%were in stage 3,30%in stage 2.35.7% had cluster differentiation 4 counts<200.The mean creatinine was 1 mg/dL and mean urea was 25.1 mg/dL.54.6%had estimated glomerular filtration rate of<60.Enlarged kidneys in 39.2%and increased echogenicity in 82.8%of participants.A decline in estimated glomerular filtration rate and an increase in kidney size was significantly associated with advancing HIV stages.CONCLUSION Both structural and functional kidney abnormalities are common in patients with HIV infection.These abnor-malities increase with disease progression,underscoring the need for regular and consistent renal monitoring.展开更多
Background:Patients with coronavirus disease 2019(COVID-19)have high resource utilization.Identifying the causes of severe COVID-19 is helpful for early intervention to reduce the consumption of medical resources.Meth...Background:Patients with coronavirus disease 2019(COVID-19)have high resource utilization.Identifying the causes of severe COVID-19 is helpful for early intervention to reduce the consumption of medical resources.Methods:We included 103 patients with COVID-19 in this single-center observational study.To evaluate the incidence,predictors,and effects of COVID-19,we analyzed demographic information,laboratory results,comorbidities,and vital signs as factors for association with severe COVID-19.Results:The incidence of severe COVID-19 was 16.5%and the percent poor outcome(including mortality,entering in ICU or transferred to a superior hospital)was 6.8%.The majority of severe COVID-19 patients had abnormal electrocardiogram(ECG)(82.35%),hypertension(76.47%)and other cardiac diseases(58.82%).Multivariate logistic regression was used to determine the predictors of severe illness.Abnormal body mass index(BMI)and ECG(P<0.05)were independent predictors of severe COVID-19.ECG abnormality was associated with increased odds of poor outcome(area under the receiver operating characteristic curves[AUC],0.793;P=0.010)and severe COVID-19(AUC,0.807;P<0.0001).Overweight was also associated with increased odds of poor outcome(AUC,0.728;P=0.045)and severe illness COVID-19(AUC,0.816;P<0.0001).Conclusion:Overweight and electrophysiological disorders on admission are important predictors of prognosis of patients with COVID-19.展开更多
Objective To analyze the diagnostic efficacy of lipid-related insulin resistance(IR)markers in patients with non-alcoholic fatty liver disease(NAFLD)and metabolic abnormalities(MA).Method Patients with NAFLD with MA,n...Objective To analyze the diagnostic efficacy of lipid-related insulin resistance(IR)markers in patients with non-alcoholic fatty liver disease(NAFLD)and metabolic abnormalities(MA).Method Patients with NAFLD with MA,non-NAFLD patients with MA,and patients with NAFLD without MA underwent liver biopsy.Homeostasis model assessment of insulin resistance(HOMA-IR),triglyceride/high-density lipoprotein cholesterol(TG/HDL-C),visceral obesity index(VAI),lipid accumulation product(LAP),and triglyceride glucose(TyG)index were analyzed.The diagnostic efficacy of these indicators of NAFLD was also evaluated.Results In the NAFLD-MA group,BMI,HOMA-IR,LAP,VAI,TyG index,and TG/HDL-C ratio were higher than those in the non-NAFLD-MA group(P<0.001).Logistic regression indicated that BMI and TyG index were independent risk factors for NAFLD.Receiver Operating Characteristic(ROC)curves analysis revealed that the Area Under the ROC Curve(AUC)for TyG-BMI was 0.819,and the optimal cutoff for NAFLD was TyG-BMI 39.77.For patients with NAFLD with or without MA,logistic regression analysis suggested that age,TG level,and TyG index were independent risk factors.The area under the ROC curve showed that AUC for the TyG index was 0.724.The optimal cutoff for NAFLD-non MA was a TyG index of 1.580.Conclusion TyG index has diagnostic value in both types of NAFLD;however,TyG-BMI is better in patients with NAFLD with MA and may be an effective screening indicator alone in patients with NAFLD without MA.展开更多
Congenital abnormalities of the kidney and urinary tract(CAKUT) include a wide range of abnormalities ranging from asymptomatic ectopic kidneys to life threatening renal agenesis(bilateral). Many of them are detected ...Congenital abnormalities of the kidney and urinary tract(CAKUT) include a wide range of abnormalities ranging from asymptomatic ectopic kidneys to life threatening renal agenesis(bilateral). Many of them are detected in the antenatal or immediate postnatal with a significant proportion identified in the adult population with varying degree of severity. CAKUT can be classified on embryological basis in to abnormalities in the renal parenchymal development, aberrant embryonic migration and abnormalities of the collecting system. Renal parenchymal abnormalities include multi cystic dysplastic kidneys, renal hypoplasia, number(agenesis or supernumerary), shape and cystic renal diseases. Aberrant embryonic migration encompasses abnormal location and fusion anomalies. Collecting system abnormalities include duplex kidneys and Pelvi ureteric junction obstruction. Ultrasonography(US) is typically the first imaging performed as it is easily available, noninvasive and radiation free used both antenatally and postnatally. Computed tomography(CT) and magnetic resonance imaging(MRI) are useful to confirm the ultrasound detected abnormality, detection of complex malformations, demonstration of collecting system and vascular anatomy and more importantly for early detection of complications like renal calculi, infection and malignancies. As CAKUT are one of the leading causes of end stage renal disease, it is important for the radiologists to be familiar with the varying imaging appearances of CAKUT on US, CT and MRI, thereby helping in prompt diagnosis and optimal management.展开更多
Depression and cardiovascular disease （CVD） are both highly prevalent disorders, and some evidence shows that there is a ＇vicious cy- cle＇ linking major depression and CVD. There is also growing evidence that immu...Depression and cardiovascular disease （CVD） are both highly prevalent disorders, and some evidence shows that there is a ＇vicious cy- cle＇ linking major depression and CVD. There is also growing evidence that immune abnormalities underpin the common pathophysiology of both CVD and major depression. The abnormalities include the following： abnormal levels of inflammatory markers, such as interleukin-6 （IL-6）, interleukin-1β （IL-1β）, minor necrosis factor α （TNF-α） and interleukin-12 （IL-12）; increased acute phase proteins, such as C-reactive protein, fibrinogen and haptoglobin; and abnormal complement factors. The findings show that major depression and CVD patients have greater immune abnormalities, which may increase depressive symptoms and cardiovascular pathological changes, and that there may be a bidirectional relationship, therefore more prospective studies are needed to draw conclusions.展开更多
Background: Relationship between abnormal posture and QOL of Parkinson's disease is not clear. Objectives: To clarify the association between quality of life (QOL) and abnormal posture in patients with Parkinson’...Background: Relationship between abnormal posture and QOL of Parkinson's disease is not clear. Objectives: To clarify the association between quality of life (QOL) and abnormal posture in patients with Parkinson’s disease (PD) and examine which QOL dimensions are involved. Methods: This study retrospectively examined PD patients (n = 57) who had undergone outpatient rehabilitation between January and March 2014. Evaluation items were Modified Hoehn Yahr (H-Y) stage, Unified Parkinson’s Disease Rating Scale (UPDRS)-Part III score, Timed Up and Go test (TUG, 3-m walking) result, Parkinson’s Disease Questionnaire (PDQ)-39 score, and the angle of forward and lateral trunk flexion in the standing position. Statistical analysis was performed to reveal the relationship between the total PDQ-39 score and individual evaluation items and which QOL dimensions were affected by abnormal posture due to forward or lateral flexion. Results: A total of 38 PD patients (17 men, 21 women;mean age, 73.2 ± 8.6 years) were enrolled. Among the evaluation items, lateral flexion angle showed a significant correlation with the total PDQ-39 score (r = 0.422, P = 0.008). PDQ-39 dimensions showing an association with forward flexion were activities of daily living (ADL) (P = 0.002) and communication (P = 0.007), whereas ADL (P = 0.004), communication (P = 0.021), and social support (P = 0.029) were associated with lateral flexion. Mobility was not associated with forward or lateral flexion. Conclusion: The present findings revealed a correlation between lateral flexion and QOL in PD patients. Among the PDQ-39 dimensions, ADL and communication were associated with abnormal posture.展开更多
Alzheimer’s disease (AD) is the leading and one of the most severe forms of dementia. Molecular mechanisms underlying AD pathogenesis despite much work on this subject still remain unclear. Cleavage of amyloid precur...Alzheimer’s disease (AD) is the leading and one of the most severe forms of dementia. Molecular mechanisms underlying AD pathogenesis despite much work on this subject still remain unclear. Cleavage of amyloid precursor protein (APP) to amyloid beta peptide (A-beta) and following formation of amyloid plaques are the key events of Alzheimer’s pathology. Thus changes in APP expression and metabolism can lead to pathology development. Here we show that overexpression of human APP in Drosophila neural cells manifests in different morphological abnormalities of Drosophila imago that can be observed immediately after fly eclosion. This observation can help to further understand APP molecular functions and its participation in different molecular pathways.展开更多
BACKGROUND: Researches indicate that patients with Wilson disease (WD) have abnormal skeletal metabolism, which is induced by various factors. OBJECTIVE: To probe into the changing characteristics of abnormal skeletal...BACKGROUND: Researches indicate that patients with Wilson disease (WD) have abnormal skeletal metabolism, which is induced by various factors. OBJECTIVE: To probe into the changing characteristics of abnormal skeletal metabolism in WD patients and observe the effect of decopper therapy. DESIGN: Case-contrast and self-control study. SETTING: Department of Neurology, Affiliated Hospital of Neurological Institute, Anhui College of Traditional Chinese Medicine. PARTICIPANTS: A total of 35 patients with WD including 21 males and 14 females aged from 10 to 42 years with the mean age of (20±8) years were selected from Department of Neurology, Affiliated Hospital of Neurological Institute, Anhui College of Traditional Chinese Medicine from September 2000 to February 2001. All the patients were in compliance with the diagnostic criteria: history of family heredity; cone symptoms in vitro, physical sign or liver symptoms; positive Kayser-Fleischer ring; serum copper protein < 200 mg/L or A copper oxidase < 0.2; urine copper > 1.6 μmol/24 hours; liver copper > 250 μg/g (dry weight). The control group was selected from 25 cases of health individuals including 13 males and 12 females aged from 16 to 35 years with the mean age of (22±6) years. All patients who participated in the study were informed first and consented. METHODS: Patients in treatment group were treated with venous injection of 1.0 g sodium dimercaptosulfonate, once a day for totally 6 successive days. And then, patients rested for 2 days. This procedure mentioned above was regarded as a course, and the treatment lasted for 4-8 courses. Before and after injection of sodium dimercaptosulfonate, serum calcitonin (CT), osteocalcin (BGP), parathyroid hormone (PTH) and 1,25-(OH)2VitD3 were measured with radio-immunity method; blood, urine calcium, phosphorum and urine creatinine were measured with biochemical analyzer; urine dihydropyrimidine dehydrogenase(DPD) was detected with enzyme-immunity method; bone mineral density (BMD) was checked at the one third from distal end of ulna and radius with single photon absorptiometry (SPA). MAIN OUTCOME MEASURES: Relative indexes of bone metabolism of blood and urine and results of BMD in both two groups before and after treatment. RESULTS: Among 35 patients with WD and 25 healthy subjects, 5 patients were excluded because of uncompleted decopper therapy; therefore, 30 patients with WD and 25 healthy subjects were involved in the final analysis. ① Comparisons between the two groups: Contents of serum calcium, PTH and 1,25-(OH)2VitD3 were lower in treatment group than those in control group [(2.49±0.34) mmol/L vs. (2.69±0.19) mmol/L; (218.7±50.5) ng/L vs. (262.5±88.9) ng/L; (23.53±14.21) ng/L vs. (42.78±14.44) ng/L; P < 0.05-0.01]; however, contents of serum BGP and CT were higher in treatment group than those in control group [(10.22±6.11) μg/L vs. (5.78±4.22) μg/L; (282.8±109.6) ng/L vs. (62.5±37.9) ng/L, P < 0.01]; moreover, there was no significant difference of contents of serum phosphorum, urine calcium, phosphorum and DPD/creatinine between treatment group and control group (P > 0.05). BMD of males and females was lower in treatment group than that in control group [(0.617±0.197) g/cm2 vs. (0.718±0.274) g/cm2; (0.594±0.124) g/cm2 vs. (0.677±0.157) g/cm2, P < 0.05]. ② Comparisons in treatment group before and after treatment: Contents of CT and urine calcium were lower after treatment than those before treatment [(95.3±55.4) ng/L vs. (283.3±96.7) ng/L; (2.38±1.68) mmol/L vs. (3.31±2.30) mmol/L; P < 0.01, 0.05]; however, contents of 1,25-(OH)2VitD3 and DPD/creatinine were higher after treatment than those before treatment [(33.61±19.30) ng/L vs. (24.21±14.47) ng/L; (42.95±19.92) nmol/mmol vs. (19.51±9.96) nmol/mmol, P < 0.05]; moreover, there were no significant differences among other indexes before and after treatment (P > 0.05). Furthermore, there was no significant difference of BMD before and after treatment (P > 0.05). CONCLUSION: WD patients have changes in the related indexes of abnormal skeletal metabolism. In addition, contents of CT and urine calcium are decreased remarkably after decopper therapy; however, value of BMD is not changed obviously.展开更多
Objective: to analyze the abnormal CT findings in schizophrenia. Methods: the selected study subjects were 60 schizophrenia patients treated in our hospital from May to December 2021. All the selected subjects were co...Objective: to analyze the abnormal CT findings in schizophrenia. Methods: the selected study subjects were 60 schizophrenia patients treated in our hospital from May to December 2021. All the selected subjects were confirmed according to the relevant diagnostic criteria of schizophrenia and underwent CT examination including the CT detection rate, CT typing, age distribution and disease course distribution of the patients. Results: after the 60 schizophrenia patients were selected for a CT scan, forty-one patients were found to have structural brain abnormalities. The CT classification was: 5 cases of diffuse cerebral atrophy, 12.19%), 25 (60.97%) and 11 (26.83%) respectively;at the same time, Schizophrenic patients with structural brain abnormalities are mainly 21-55 years old;for 85.36% (35 / 41), the disease duration is mainly 10 years, accounting for 53.66% (22 / 41);the CT value of the left frontal CT was lower than that of the healthy group. Statistical significance was observed (P 0.05). Conclusion: using CT examination can evaluate the brain structure of schizophrenia patients. This study found that the most common clinical symptoms of schizophrenia is brain atrophy in the elderly compared with age. CT can provide more reliable information for clinical diagnosis and treatment of schizophrenia. But because of abnormal brain structure, there is no high specificity, so patients with schizophrenia will not have significant performance, clinical to do further research in this aspect.展开更多
BACKGROUND 2D-echocardiography(2DE)has been the primary imaging modality in children with Kawasaki disease(KD)to assess coronary arteries.AIM To report the presence and implications of incidental congenital coronary a...BACKGROUND 2D-echocardiography(2DE)has been the primary imaging modality in children with Kawasaki disease(KD)to assess coronary arteries.AIM To report the presence and implications of incidental congenital coronary artery anomalies that had been misinterpreted as coronary artery abnormalities(CAAs)on 2DE.METHODS Records of children diagnosed with KD,who underwent computed tomography coronary angiography(CTCA)at our center between 2013-2023 were reviewed.We identified 3 children with congenital coronary artery anomalies in this cohort on CTCA.Findings of CTCA and 2DE were compared in these 3 children.RESULTS Of the 241 patients with KD who underwent CTCA,3(1.24%)had congenital coronary artery anomalies on CTCA detected incidentally.In all 3 patients,baseline 2DE had identified CAAs.CTCA was then performed for detailed evaluation as per our unit protocol.One(11-year-boy)amongst the 3 patients had complete KD,while the other two(3.3-year-boy;4-month-girl)had incomplete KD.CTCA revealed separate origins of left anterior descending artery and left circumflex from left sinus[misinterpreted as dilated left main coronary artery(LCA)on 2DE],single coronary artery(interpreted as dilated LCA on 2DE)and dilated right coronary artery on 2DE in case of anomalous origin of LCA from the main pulmonary artery.The latter one was subsequently operated upon.CONCLUSION CTCA is essential for detailed assessment of coronary arteries in children with KD especially in cases where there is suspicion of congenital coronary artery anomalies.Relying solely on 2DE may not be sufficient in such cases,and findings from CTCA can significantly impact therapeutic decision-making.展开更多
This mini-review explores the transformative potential of artificial intelligence(AI)in improving the diagnosis,management,and long-term care of congenital heart diseases(CHDs).AI offers significant advancements acros...This mini-review explores the transformative potential of artificial intelligence(AI)in improving the diagnosis,management,and long-term care of congenital heart diseases(CHDs).AI offers significant advancements across the spectrum of CHD care,from prenatal screening to postnatal management and long-term monitoring.Using AI algorithms,enhanced fetal echocardiography,and genetic tests improves prenatal diagnosis and risk stratification.Postnatally,AI revolutionizes diagnostic imaging analysis,providing more accurate and efficient identification of CHD subtypes and severity.Compared with traditional methods,advanced signal processing techniques enable a more precise assessment of hemodynamic parameters.AI-driven decision support systems tailor treatment strategies,thereby optimizing therapeutic interventions and predicting patient outcomes with greater accuracy.This personalized approach leads to better clinical outcomes and reduced morbidity.Furthermore,AI-enabled remote monitoring and wearable devices facilitate ongoing surveillance,thereby enabling early detection of complications and provision of prompt interventions.This continuous monitoring is crucial in the immediate postoperative period and throughout the patient’s life.Despite the immense potential of AI,challenges remain.These include the need for standardized datasets,the development of transparent and understandable AI algorithms,ethical considerations,and seamless integration into existing clinical workflows.Overcoming these obstacles through collaborative data sharing and responsible implementation will unlock the full potential of AI to improve the lives of patients with CHD,ultimately leading to better patient outcomes and improved quality of life.展开更多
Allied disorders of Hirschsprung diseases(ADHDs)have abnormal enteric ganglia and symptoms that are similar to congenital megacolon.The classification of ADHDs includes neuronal dysplasia,enteric gangliocytomatosis,is...Allied disorders of Hirschsprung diseases(ADHDs)have abnormal enteric ganglia and symptoms that are similar to congenital megacolon.The classification of ADHDs includes neuronal dysplasia,enteric gangliocytomatosis,isolated ganglion dysfunction,immature ganglion,and internal anal sphincter achalasia.The diagnosis,treatment and prognosis of ADHDs are distinct from congenital megacolon.This review summarizes the classification,epidemiology,pathogenesis,gene basis,pathology,diagnosis,treatment,and prognosis of ADHDs based on existing diagnostic criteria.展开更多
文摘Systemic abnormalities often occur in patients with liver disease. In particular, cardiopulmonary or renal diseases accompanied by advanced liver disease can be serious and may determine the quality of life and prognosis of patients. Therefore, both hepatologists and non-hepatologists should pay attention to such abnormalities in the management of patients with liver diseases.
文摘Hydronephrosis and ureteral obstruction are rare sequelae of Crohn’s disease. Chronic obstruction can ultimately lead to dysfunction of the affected kidney, and atypical presenting symptoms create pitfalls in diagnosis. Few reviews in the literature focus on this process and are limited to isolated case reports and case reviews. We performed a PubMed search using such terms as “Hydronephrosis” AND “Crohn’s disease” AND/OR “ureteral obstruction.” References from selected papers were reviewed for relevance and used for information-gathering as well. Ureteral obstruction most commonly occurs on the right side, due to ileal involvement. Clinical diagnosis is difficult, as symptoms are notably not genitourinary in origin;rather they are more musculoskeletal in nature. Treatment centers on disease control and temporary drainage of the affected kidney. Though rare, hydronephrosis and ureteral obstruction may develop as a result of inflammatory bowel disease. Due to atypical presenting symptoms, a high clinical suspicion is needed to affirm the diagnosis and ensure proper treatment.
基金Supported by the National Natural Science Foundation of China(Nos.32371596,32071549)the Zhejiang Provincial Key Natural Science Foundation of China(No.Z25C030002)+2 种基金the Science and Technology Innovation Yongjiang 2035 Key Research and Development Project of Ningbo(No.2024Z279)the One Health Interdisciplinary Research Project(No.HZ202404)the K.C.Wong Magna Fund in Ningbo University。
文摘Owing to the extreme rainfall and evaporation events under the changing climate,coastal zones are experiencing salinity fluctuations that stress aquatic organisms.However,the biological consequences of ongoing alteration in salinity levels on euryhaline organisms remain inconclusive.Herein,we sought to uncover how variation in salinity level adversely alters the bacterioplankton community,the gut microbiota of euryhaline shrimp Penaeus monodon,and subsequent shrimp disease risk.To mimic the extreme weather that induces abrupt changes in coastal water salinity,three salinity levels(10,20,and 30)were selected to investigate the differences in shrimp gut microbiota using bacterial 16S rRNA gene sequencing.Results shows that salinity level and days post experiment(dpe)respectively constrained 45.9%and 13.0%of the variance in the gut bacterial communities.Particularly,abnormal salinity levels accelerated temporal turnover rate,disrupted gut network stability,augmented average variation degree,and increased pathogenic potential in the gut microbiota of shrimp reared at 10 and 30 salinities compared with 20 salinity controls.These changes were accompanied with the shifts in the gut microbiota-mediated functions,especially the compromised immunity and elevated infectious diseases potentials,thereby increasing shrimp disease risk.In addition,abnormal salinity levels increased the role of homogeneous selection governing the gut microbiota.After excluding the dpe-effect,we screened 35 gut salinity-discriminatory taxa that quantitatively discriminated the salinity levels where shrimp were reared,with overall accuracy of 91.1%.Collectively,abnormal salinity levels profoundly disrupt the structure,stability,assembly,and functions of the gut microbiota,which in turn increased disease risk in shrimp.In addition,gut symbionts sensitively responded to the changes in external salinity level.These findings deepened our understanding on the biological consequence of abnormal salinity levels on shrimp health.
文摘BACKGROUND Chronic kidney disease is a progressive disease that evolves towards the deve-lopment of end-stage renal disease.The superimposition of renal impairment on a complex disease,namely human immunodeficiency virus(HIV)infection,will raise the burden of comorbidities and,predict worse outcomes in this group of the population.AIM To evaluate the structural and functional defects of kidney in patients with HIV infection.METHODS This cross-sectional study involved 227 patients with HIV infection.Participants were selected by simple random sampling method.Eligible participants included HIV infection-positive adults aged 18 years and above.Exclusion criteria en-compassed individuals with preexisting hypertension,diabetes mellitus,chronic kidney disease,chronic liver disease,and those receiving nephrotoxic drugs.Informed consent was obtained.Data collection involved recording medical histories,conducting clinical examinations,and performing baseline blood investigations and ultrasono-graphy to assess renal function and structural abnormalities.RESULTS The mean age of participants was 41 years.Females constituted 66.5%;78% were on Tenofovir-based regimen.The mean duration of HIV infection was 5 years;mean duration of antiretroviral therapy was 4 years.67.4% had a body mass index over 25.World Health Organization staging of HIV infection revealed that 41.9%were in stage 3,30%in stage 2.35.7% had cluster differentiation 4 counts<200.The mean creatinine was 1 mg/dL and mean urea was 25.1 mg/dL.54.6%had estimated glomerular filtration rate of<60.Enlarged kidneys in 39.2%and increased echogenicity in 82.8%of participants.A decline in estimated glomerular filtration rate and an increase in kidney size was significantly associated with advancing HIV stages.CONCLUSION Both structural and functional kidney abnormalities are common in patients with HIV infection.These abnor-malities increase with disease progression,underscoring the need for regular and consistent renal monitoring.
基金supported by the scientific research project approved by Heilongjiang Provincial Health Committee in 2019(2019-253).
文摘Background:Patients with coronavirus disease 2019(COVID-19)have high resource utilization.Identifying the causes of severe COVID-19 is helpful for early intervention to reduce the consumption of medical resources.Methods:We included 103 patients with COVID-19 in this single-center observational study.To evaluate the incidence,predictors,and effects of COVID-19,we analyzed demographic information,laboratory results,comorbidities,and vital signs as factors for association with severe COVID-19.Results:The incidence of severe COVID-19 was 16.5%and the percent poor outcome(including mortality,entering in ICU or transferred to a superior hospital)was 6.8%.The majority of severe COVID-19 patients had abnormal electrocardiogram(ECG)(82.35%),hypertension(76.47%)and other cardiac diseases(58.82%).Multivariate logistic regression was used to determine the predictors of severe illness.Abnormal body mass index(BMI)and ECG(P<0.05)were independent predictors of severe COVID-19.ECG abnormality was associated with increased odds of poor outcome(area under the receiver operating characteristic curves[AUC],0.793;P=0.010)and severe COVID-19(AUC,0.807;P<0.0001).Overweight was also associated with increased odds of poor outcome(AUC,0.728;P=0.045)and severe illness COVID-19(AUC,0.816;P<0.0001).Conclusion:Overweight and electrophysiological disorders on admission are important predictors of prognosis of patients with COVID-19.
基金Beijing Research Ward Excellence Program(BRWEP2024W102170101)The National Key Research and Development Program(2022YFC2603500,2022YFC2603505)+5 种基金Beijing Municipal Health Commission high-level public health technical personnel construction project(discipline leader-03-26,discipline backbone-02-28)Capital’s Funds for Health Improvement and Research(2022-1-2172)Beijing Hospitals Authority Clinical medicine Development of special funding support(ZLRK202301)Beijing Hospitals Authority"peak"talent training program(DFL20241803)National Key Research and Development Program of China(2023YFC2306900)National Key Research and Development Program of Ministry of Science and Technology(2023YFC2308105).
文摘Objective To analyze the diagnostic efficacy of lipid-related insulin resistance(IR)markers in patients with non-alcoholic fatty liver disease(NAFLD)and metabolic abnormalities(MA).Method Patients with NAFLD with MA,non-NAFLD patients with MA,and patients with NAFLD without MA underwent liver biopsy.Homeostasis model assessment of insulin resistance(HOMA-IR),triglyceride/high-density lipoprotein cholesterol(TG/HDL-C),visceral obesity index(VAI),lipid accumulation product(LAP),and triglyceride glucose(TyG)index were analyzed.The diagnostic efficacy of these indicators of NAFLD was also evaluated.Results In the NAFLD-MA group,BMI,HOMA-IR,LAP,VAI,TyG index,and TG/HDL-C ratio were higher than those in the non-NAFLD-MA group(P<0.001).Logistic regression indicated that BMI and TyG index were independent risk factors for NAFLD.Receiver Operating Characteristic(ROC)curves analysis revealed that the Area Under the ROC Curve(AUC)for TyG-BMI was 0.819,and the optimal cutoff for NAFLD was TyG-BMI 39.77.For patients with NAFLD with or without MA,logistic regression analysis suggested that age,TG level,and TyG index were independent risk factors.The area under the ROC curve showed that AUC for the TyG index was 0.724.The optimal cutoff for NAFLD-non MA was a TyG index of 1.580.Conclusion TyG index has diagnostic value in both types of NAFLD;however,TyG-BMI is better in patients with NAFLD with MA and may be an effective screening indicator alone in patients with NAFLD without MA.
文摘Congenital abnormalities of the kidney and urinary tract(CAKUT) include a wide range of abnormalities ranging from asymptomatic ectopic kidneys to life threatening renal agenesis(bilateral). Many of them are detected in the antenatal or immediate postnatal with a significant proportion identified in the adult population with varying degree of severity. CAKUT can be classified on embryological basis in to abnormalities in the renal parenchymal development, aberrant embryonic migration and abnormalities of the collecting system. Renal parenchymal abnormalities include multi cystic dysplastic kidneys, renal hypoplasia, number(agenesis or supernumerary), shape and cystic renal diseases. Aberrant embryonic migration encompasses abnormal location and fusion anomalies. Collecting system abnormalities include duplex kidneys and Pelvi ureteric junction obstruction. Ultrasonography(US) is typically the first imaging performed as it is easily available, noninvasive and radiation free used both antenatally and postnatally. Computed tomography(CT) and magnetic resonance imaging(MRI) are useful to confirm the ultrasound detected abnormality, detection of complex malformations, demonstration of collecting system and vascular anatomy and more importantly for early detection of complications like renal calculi, infection and malignancies. As CAKUT are one of the leading causes of end stage renal disease, it is important for the radiologists to be familiar with the varying imaging appearances of CAKUT on US, CT and MRI, thereby helping in prompt diagnosis and optimal management.
文摘Depression and cardiovascular disease （CVD） are both highly prevalent disorders, and some evidence shows that there is a ＇vicious cy- cle＇ linking major depression and CVD. There is also growing evidence that immune abnormalities underpin the common pathophysiology of both CVD and major depression. The abnormalities include the following： abnormal levels of inflammatory markers, such as interleukin-6 （IL-6）, interleukin-1β （IL-1β）, minor necrosis factor α （TNF-α） and interleukin-12 （IL-12）; increased acute phase proteins, such as C-reactive protein, fibrinogen and haptoglobin; and abnormal complement factors. The findings show that major depression and CVD patients have greater immune abnormalities, which may increase depressive symptoms and cardiovascular pathological changes, and that there may be a bidirectional relationship, therefore more prospective studies are needed to draw conclusions.
文摘Background: Relationship between abnormal posture and QOL of Parkinson's disease is not clear. Objectives: To clarify the association between quality of life (QOL) and abnormal posture in patients with Parkinson’s disease (PD) and examine which QOL dimensions are involved. Methods: This study retrospectively examined PD patients (n = 57) who had undergone outpatient rehabilitation between January and March 2014. Evaluation items were Modified Hoehn Yahr (H-Y) stage, Unified Parkinson’s Disease Rating Scale (UPDRS)-Part III score, Timed Up and Go test (TUG, 3-m walking) result, Parkinson’s Disease Questionnaire (PDQ)-39 score, and the angle of forward and lateral trunk flexion in the standing position. Statistical analysis was performed to reveal the relationship between the total PDQ-39 score and individual evaluation items and which QOL dimensions were affected by abnormal posture due to forward or lateral flexion. Results: A total of 38 PD patients (17 men, 21 women;mean age, 73.2 ± 8.6 years) were enrolled. Among the evaluation items, lateral flexion angle showed a significant correlation with the total PDQ-39 score (r = 0.422, P = 0.008). PDQ-39 dimensions showing an association with forward flexion were activities of daily living (ADL) (P = 0.002) and communication (P = 0.007), whereas ADL (P = 0.004), communication (P = 0.021), and social support (P = 0.029) were associated with lateral flexion. Mobility was not associated with forward or lateral flexion. Conclusion: The present findings revealed a correlation between lateral flexion and QOL in PD patients. Among the PDQ-39 dimensions, ADL and communication were associated with abnormal posture.
文摘Alzheimer’s disease (AD) is the leading and one of the most severe forms of dementia. Molecular mechanisms underlying AD pathogenesis despite much work on this subject still remain unclear. Cleavage of amyloid precursor protein (APP) to amyloid beta peptide (A-beta) and following formation of amyloid plaques are the key events of Alzheimer’s pathology. Thus changes in APP expression and metabolism can lead to pathology development. Here we show that overexpression of human APP in Drosophila neural cells manifests in different morphological abnormalities of Drosophila imago that can be observed immediately after fly eclosion. This observation can help to further understand APP molecular functions and its participation in different molecular pathways.
文摘BACKGROUND: Researches indicate that patients with Wilson disease (WD) have abnormal skeletal metabolism, which is induced by various factors. OBJECTIVE: To probe into the changing characteristics of abnormal skeletal metabolism in WD patients and observe the effect of decopper therapy. DESIGN: Case-contrast and self-control study. SETTING: Department of Neurology, Affiliated Hospital of Neurological Institute, Anhui College of Traditional Chinese Medicine. PARTICIPANTS: A total of 35 patients with WD including 21 males and 14 females aged from 10 to 42 years with the mean age of (20±8) years were selected from Department of Neurology, Affiliated Hospital of Neurological Institute, Anhui College of Traditional Chinese Medicine from September 2000 to February 2001. All the patients were in compliance with the diagnostic criteria: history of family heredity; cone symptoms in vitro, physical sign or liver symptoms; positive Kayser-Fleischer ring; serum copper protein < 200 mg/L or A copper oxidase < 0.2; urine copper > 1.6 μmol/24 hours; liver copper > 250 μg/g (dry weight). The control group was selected from 25 cases of health individuals including 13 males and 12 females aged from 16 to 35 years with the mean age of (22±6) years. All patients who participated in the study were informed first and consented. METHODS: Patients in treatment group were treated with venous injection of 1.0 g sodium dimercaptosulfonate, once a day for totally 6 successive days. And then, patients rested for 2 days. This procedure mentioned above was regarded as a course, and the treatment lasted for 4-8 courses. Before and after injection of sodium dimercaptosulfonate, serum calcitonin (CT), osteocalcin (BGP), parathyroid hormone (PTH) and 1,25-(OH)2VitD3 were measured with radio-immunity method; blood, urine calcium, phosphorum and urine creatinine were measured with biochemical analyzer; urine dihydropyrimidine dehydrogenase(DPD) was detected with enzyme-immunity method; bone mineral density (BMD) was checked at the one third from distal end of ulna and radius with single photon absorptiometry (SPA). MAIN OUTCOME MEASURES: Relative indexes of bone metabolism of blood and urine and results of BMD in both two groups before and after treatment. RESULTS: Among 35 patients with WD and 25 healthy subjects, 5 patients were excluded because of uncompleted decopper therapy; therefore, 30 patients with WD and 25 healthy subjects were involved in the final analysis. ① Comparisons between the two groups: Contents of serum calcium, PTH and 1,25-(OH)2VitD3 were lower in treatment group than those in control group [(2.49±0.34) mmol/L vs. (2.69±0.19) mmol/L; (218.7±50.5) ng/L vs. (262.5±88.9) ng/L; (23.53±14.21) ng/L vs. (42.78±14.44) ng/L; P < 0.05-0.01]; however, contents of serum BGP and CT were higher in treatment group than those in control group [(10.22±6.11) μg/L vs. (5.78±4.22) μg/L; (282.8±109.6) ng/L vs. (62.5±37.9) ng/L, P < 0.01]; moreover, there was no significant difference of contents of serum phosphorum, urine calcium, phosphorum and DPD/creatinine between treatment group and control group (P > 0.05). BMD of males and females was lower in treatment group than that in control group [(0.617±0.197) g/cm2 vs. (0.718±0.274) g/cm2; (0.594±0.124) g/cm2 vs. (0.677±0.157) g/cm2, P < 0.05]. ② Comparisons in treatment group before and after treatment: Contents of CT and urine calcium were lower after treatment than those before treatment [(95.3±55.4) ng/L vs. (283.3±96.7) ng/L; (2.38±1.68) mmol/L vs. (3.31±2.30) mmol/L; P < 0.01, 0.05]; however, contents of 1,25-(OH)2VitD3 and DPD/creatinine were higher after treatment than those before treatment [(33.61±19.30) ng/L vs. (24.21±14.47) ng/L; (42.95±19.92) nmol/mmol vs. (19.51±9.96) nmol/mmol, P < 0.05]; moreover, there were no significant differences among other indexes before and after treatment (P > 0.05). Furthermore, there was no significant difference of BMD before and after treatment (P > 0.05). CONCLUSION: WD patients have changes in the related indexes of abnormal skeletal metabolism. In addition, contents of CT and urine calcium are decreased remarkably after decopper therapy; however, value of BMD is not changed obviously.
文摘Objective: to analyze the abnormal CT findings in schizophrenia. Methods: the selected study subjects were 60 schizophrenia patients treated in our hospital from May to December 2021. All the selected subjects were confirmed according to the relevant diagnostic criteria of schizophrenia and underwent CT examination including the CT detection rate, CT typing, age distribution and disease course distribution of the patients. Results: after the 60 schizophrenia patients were selected for a CT scan, forty-one patients were found to have structural brain abnormalities. The CT classification was: 5 cases of diffuse cerebral atrophy, 12.19%), 25 (60.97%) and 11 (26.83%) respectively;at the same time, Schizophrenic patients with structural brain abnormalities are mainly 21-55 years old;for 85.36% (35 / 41), the disease duration is mainly 10 years, accounting for 53.66% (22 / 41);the CT value of the left frontal CT was lower than that of the healthy group. Statistical significance was observed (P 0.05). Conclusion: using CT examination can evaluate the brain structure of schizophrenia patients. This study found that the most common clinical symptoms of schizophrenia is brain atrophy in the elderly compared with age. CT can provide more reliable information for clinical diagnosis and treatment of schizophrenia. But because of abnormal brain structure, there is no high specificity, so patients with schizophrenia will not have significant performance, clinical to do further research in this aspect.
文摘BACKGROUND 2D-echocardiography(2DE)has been the primary imaging modality in children with Kawasaki disease(KD)to assess coronary arteries.AIM To report the presence and implications of incidental congenital coronary artery anomalies that had been misinterpreted as coronary artery abnormalities(CAAs)on 2DE.METHODS Records of children diagnosed with KD,who underwent computed tomography coronary angiography(CTCA)at our center between 2013-2023 were reviewed.We identified 3 children with congenital coronary artery anomalies in this cohort on CTCA.Findings of CTCA and 2DE were compared in these 3 children.RESULTS Of the 241 patients with KD who underwent CTCA,3(1.24%)had congenital coronary artery anomalies on CTCA detected incidentally.In all 3 patients,baseline 2DE had identified CAAs.CTCA was then performed for detailed evaluation as per our unit protocol.One(11-year-boy)amongst the 3 patients had complete KD,while the other two(3.3-year-boy;4-month-girl)had incomplete KD.CTCA revealed separate origins of left anterior descending artery and left circumflex from left sinus[misinterpreted as dilated left main coronary artery(LCA)on 2DE],single coronary artery(interpreted as dilated LCA on 2DE)and dilated right coronary artery on 2DE in case of anomalous origin of LCA from the main pulmonary artery.The latter one was subsequently operated upon.CONCLUSION CTCA is essential for detailed assessment of coronary arteries in children with KD especially in cases where there is suspicion of congenital coronary artery anomalies.Relying solely on 2DE may not be sufficient in such cases,and findings from CTCA can significantly impact therapeutic decision-making.
文摘This mini-review explores the transformative potential of artificial intelligence(AI)in improving the diagnosis,management,and long-term care of congenital heart diseases(CHDs).AI offers significant advancements across the spectrum of CHD care,from prenatal screening to postnatal management and long-term monitoring.Using AI algorithms,enhanced fetal echocardiography,and genetic tests improves prenatal diagnosis and risk stratification.Postnatally,AI revolutionizes diagnostic imaging analysis,providing more accurate and efficient identification of CHD subtypes and severity.Compared with traditional methods,advanced signal processing techniques enable a more precise assessment of hemodynamic parameters.AI-driven decision support systems tailor treatment strategies,thereby optimizing therapeutic interventions and predicting patient outcomes with greater accuracy.This personalized approach leads to better clinical outcomes and reduced morbidity.Furthermore,AI-enabled remote monitoring and wearable devices facilitate ongoing surveillance,thereby enabling early detection of complications and provision of prompt interventions.This continuous monitoring is crucial in the immediate postoperative period and throughout the patient’s life.Despite the immense potential of AI,challenges remain.These include the need for standardized datasets,the development of transparent and understandable AI algorithms,ethical considerations,and seamless integration into existing clinical workflows.Overcoming these obstacles through collaborative data sharing and responsible implementation will unlock the full potential of AI to improve the lives of patients with CHD,ultimately leading to better patient outcomes and improved quality of life.
文摘Allied disorders of Hirschsprung diseases(ADHDs)have abnormal enteric ganglia and symptoms that are similar to congenital megacolon.The classification of ADHDs includes neuronal dysplasia,enteric gangliocytomatosis,isolated ganglion dysfunction,immature ganglion,and internal anal sphincter achalasia.The diagnosis,treatment and prognosis of ADHDs are distinct from congenital megacolon.This review summarizes the classification,epidemiology,pathogenesis,gene basis,pathology,diagnosis,treatment,and prognosis of ADHDs based on existing diagnostic criteria.
