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Molecular mechanism of electroacupuncture for improving perioperative complications with the guidance of enhanced recovery after surgery 电针在术后强化康复指导下改善围手术期并发症的分子机制
Q4 Biochemistry, Genetics and Molecular Biology Pub Date : 2023-06-30 DOI: 10.37349/emed.2023.00149
Yuzhu Mao, Lifang Yang
Enhanced recovery after surgery (ERAS) is a recommended surgical strategy at present, the core content is to reduce perioperative stress response and postoperative complications through perioperative multi-mode analgesia and intensive surgery. Electroacupuncture (EA) has been widely used in various clinical applications, and its efficacy and safety have been fully proven. The application of acupuncture in ERAS will have an important impact on rehabilitation research and development. In this review, the molecular mechanism of EA in ERAS are summed up from promoting perioperative efficacy to improving postoperative immune status. The combination of EA and ERAS may better promote the recovery of patients and the development of rehabilitation.
Enhanced recovery after surgery (ERAS)是目前推荐的手术策略,其核心内容是通过围术期多模式镇痛和强化手术,减少围术期应激反应和术后并发症。电针已广泛应用于各种临床应用,其有效性和安全性已得到充分证明。针刺在ERAS中的应用将对康复研究和发展产生重要影响。本文从促进ERAS围手术期疗效到改善术后免疫状态两方面综述EA在ERAS中的分子机制。EA与ERAS的结合可以更好地促进患者的康复和康复的发展。
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引用次数: 0
Associations between methamphetamine and alcohol use disorder, suicidal ideation, and lowered quality of life in methamphetamine users 甲基苯丙胺与甲基苯丙胺使用者的酒精使用障碍、自杀意念和生活质量下降之间的关系
Q4 Biochemistry, Genetics and Molecular Biology Pub Date : 2023-06-30 DOI: 10.37349/emed.2023.00151
K. Jirakran, M. Maes, Napakkawat Buathong, R. Kalayasiri
Aim: There is a strong comorbidity between methamphetamine (MA) and alcohol use whereby MA use may contribute to increased alcohol consumption. This study aims to determine the associations between alcohol drinking and MA-associated behaviors among MA users in relation to mood disorders, suicidal ideation, and health-related quality of life (HR-QoL).Methods: Substance use characteristics were obtained in 106 participants with MA use at a substance abuse treatment center by using the Severity of Dependence Scale (SDS) and the Thai version of the Semi-Structured Assessment for Drug Dependence and Alcoholism (SSADDA). Current alcohol drinking behaviors were estimated using the Substance Outcomes Profile (SOP), which was developed and translated from the Treatment Outcomes Profile, by computing the number of alcohol units x days per month of alcohol use. The Mini-International Neuropsychiatric Interview (M.I.N.I.) was used to estimate lifetime histories of mood disorders and substance abuse and current suicidal ideation.Results: Current suicidal ideation in MA users is to a large extent predicted by the severity of current alcohol and MA use, female gender, and a lifetime history of mood disorders (major depression, dysthymia, and hypo-mania). Moreover, a lifetime history of mood disorders is positively associated with the severity of MA, but not with alcohol use. Partial least squares (PLS) path modeling shows that lowered HR-QoL in MA users is predicted by the SDS score and alcohol dosing (both inversely) and that lifetime diagnoses of mood disorders and MA use (both inversely) and alcohol dependence (positively) have significant effects on HR-QoL which are completely mediated via the SDS score.Conclusions: In MA users, the severity of dependence, and MA and/or alcohol use exert adverse effects on current suicidal ideation and HR-QoL. Mechanistic explanations are given which may explain the inverse associations between the severity of MA and alcohol use in MA abusers.
目的:甲基苯丙胺(MA)和饮酒之间存在强烈的共病性,因此使用MA可能会导致饮酒量增加。本研究旨在确定MA使用者饮酒和MA相关行为与情绪障碍、自杀意念和健康相关生活质量(HR-QoL)之间的关系。方法:采用依赖性严重程度量表(SDS)和泰国版药物依赖和酗酒半结构评估(SSADDA),对药物滥用治疗中心106名MA使用参与者的药物使用特征进行分析。目前的饮酒行为是使用物质结果档案(SOP)来估计的,该档案是根据治疗结果档案开发和翻译的,通过计算每月饮酒天数x酒精单位来估计。迷你国际神经精神访谈(M.I.N.I.)用于评估情绪障碍、药物滥用和当前自杀意念的终生病史。结果:MA使用者目前的自杀意念在很大程度上是由目前饮酒和MA使用的严重程度、女性和一生的情绪障碍史(严重抑郁症、心境恶劣和轻躁狂)预测的。此外,终生有情绪障碍史与MA的严重程度呈正相关,但与饮酒无关。偏最小二乘(PLS)路径建模表明,MA用户的HR生活质量降低是由SDS评分和酒精剂量(均为负向)预测的,情绪障碍的终身诊断、MA使用(均为反向)和酒精依赖(正向)对HR生活质量有显著影响,这完全是通过SDS评分介导的。结论:在MA使用者中,依赖的严重程度、MA和/或酒精的使用对当前的自杀意念和HR生活质量产生不利影响。给出了机制解释,可以解释MA滥用者MA严重程度与饮酒之间的反向关联。
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引用次数: 0
Cannabinoid-based medicines in clinical care of chronic non-cancer pain: an analysis of pain mechanism and cannabinoid profile 大麻素类药物用于慢性非癌性疼痛的临床治疗:疼痛机制和大麻素概况分析
Q4 Biochemistry, Genetics and Molecular Biology Pub Date : 2023-06-30 DOI: 10.37349/emed.2023.00148
Lucile Rapin, M. Arboleda, Erin Prosk, C. Su, A. Watier, M. Dworkind
Aim: Among treatments for chronic non-cancer pain (CNCP), cannabinoid-based medicines (CBMs) have become extremely popular. Evidence remains modest and limited primarily to delta-9-tetrahydrocannabinol (THC) for neuropathic pain; nevertheless, the use of various CBMs, including cannabidiol (CBD) to treat neuropathic, nociceptive, and mixed pain has increased globally. This observational case-series assessed the impact of CBMs as a complementary treatment by pain mechanism and cannabinoid profile over three months.Methods: An analysis of patients with CNCP and treated with CBMs who consented to an ongoing registry was performed. Outcomes were patient-reported such as the Edmonton symptom assessment system-revised, brief pain inventory-short form, and 36-item short form health survey. Data from patients with complete outcomes for baseline and 3-month follow-up was extracted. Characteristics of adverse drug reactions (ADRs), including a description of the suspected product were also assessed.Results: A total of 495 patients were part of this analysis (mean age = 56 years old; 67% women). At 3-month, the proportional use of THC:CBD balanced and THC-dominant products increased. Patients with neuropathic pain had higher pain-severity scores vs. nociceptive pain. In addition to patients with neuropathic pain, patients with nociceptive and mixed pain also reported improvements in pain severity and secondary symptoms such as anxiety, depression, drowsiness, fatigue, sleep disturbances, and overall, health-related quality of life. THC-dominant treatment is more likely to be recommended when pain is severe, whereas CBD-dominant is favored for less severe cases. ADRs were more frequent among cannabis-naive patients and included dizziness, headache, and somnolence among others. Conclusions: Findings suggest that CBMs can be effective for neuropathic as well as nociceptive and mixed pain. THC is more frequently recommended for neuropathic and severe pain. Future research on CBMs in pain management must include details of CBM composition, and pain mechanism and must consider potential ADRs.
目的:在慢性非癌性疼痛(CNCP)的治疗中,大麻素类药物(CBM)已经变得非常流行。证据仍然有限,主要局限于δ-9-四氢大麻酚(THC)治疗神经性疼痛;然而,包括大麻二酚(CBD)在内的各种CBM在全球范围内用于治疗神经性、伤害性和混合性疼痛的情况有所增加。这一观察性病例系列通过疼痛机制和大麻素特征在三个月内评估了CBM作为一种补充治疗的影响。方法:对同意进行登记的CNCP患者和接受CBM治疗的患者进行分析。结果是患者报告的,如修订的埃德蒙顿症状评估系统、简短的疼痛清单和36项简短的健康调查。从基线和3个月随访的完全结果患者中提取数据。还评估了药物不良反应(ADR)的特征,包括可疑产品的描述。结果:共有495名患者参与了该分析(平均年龄=56岁;67%为女性)。在3个月时,四氢大麻酚的比例使用:CBD平衡和四氢大麻醚占主导地位的产品增加。与伤害性疼痛相比,神经性疼痛患者的疼痛严重程度评分更高。除了神经性疼痛患者外,伤害性疼痛和混合性疼痛患者的疼痛严重程度和次要症状(如焦虑、抑郁、嗜睡、疲劳、睡眠障碍)也有所改善,总体而言,与健康相关的生活质量也有所改善。当疼痛严重时,更可能推荐以四氢大麻酚为主的治疗,而CBD为主的治疗则适用于不太严重的病例。不良反应在未吸食大麻的患者中更为常见,包括头晕、头痛和嗜睡等。结论:研究结果表明CBMs对神经性疼痛、伤害性疼痛和混合性疼痛都有效。THC更经常被推荐用于神经性和严重疼痛。未来对CBM在疼痛管理中的研究必须包括CBM成分和疼痛机制的细节,并且必须考虑潜在的ADR。
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引用次数: 0
Association between coronavirus 2019 disease and pseudoneurological complaints: analysis of case-control data 2019冠状病毒病与假性神经系统疾病的相关性:病例对照数据分析
Q4 Biochemistry, Genetics and Molecular Biology Pub Date : 2023-06-28 DOI: 10.37349/emed.2023.00146
M. Ali, A. S. Bonna, Tajnuva Mehjabin
Aim: Pseudoneurological complaints (PNCs) are highly prevalent among the general population. Coronavirus disease 2019 (COVID-19) adversely influences such complaints in individuals who recovered from COVID-19. This study determined the prevalence and identified the predictors of PNCs among individuals who had previously experienced COVID-19 and their healthy counterparts.Methods: This case-control study analyzed the data of 878 Bangladeshi adults (439 patients). Laboratory-confirmed COVID-19 individuals were considered cases, and the controls were those who never tested positive for COVID-19. The controls were matched with cases’ sex and age. The seven-item pseudoneurological sub-scale of the subjective health complaints scale produced by Eriksen et al. evaluated PNCs. The descriptive analysis estimated the prevalence of PNCs among the subgroups, whereas multiple logistic regression models were used to determine the predictors of PNCs.Results: Overall, the prevalence of PNCs was 40%; however, patients who recovered from COVID-19 reported a PNC rate of 67.4%. The regression analysis identified COVID-19 as a robust independent predictor of PNCs. Furthermore, occupation, monthly household income, current living location, hypertension, and recovery period from acute COVID-19 were independently associated with PNCs.Conclusions: This study revealed a significant association between COVID-19 and PNCs. The results of this study will be helpful when discussing, planning, and implementing strategies to alleviate the overburden of PNCs among COVID-19 survivors.
目的:伪神经系统疾病(PNCs)在普通人群中非常普遍。2019冠状病毒病(新冠肺炎)对新冠肺炎康复者的此类投诉产生不利影响。这项研究确定了先前经历过新冠肺炎的个体及其健康同行中PNC的患病率并确定了预测因素。方法:本病例对照研究分析了878名孟加拉国成年人(439名患者)的资料。实验室确诊的新冠肺炎患者被视为病例,对照组为从未检测出新冠肺炎呈阳性的患者。对照组与病例的性别和年龄相匹配。Eriksen等人编制的主观健康抱怨量表的七项伪神经子量表评估了PNCs。描述性分析估计了亚组中PNCs的患病率,而多元逻辑回归模型用于确定PNCs的预测因素。结果:PNCs的患病率为40%;然而,新冠肺炎康复患者的PNC率为67.4%。回归分析确定新冠肺炎是PNC的一个强大的独立预测因子。此外,职业、每月家庭收入、当前居住地点、高血压和急性新冠肺炎的恢复期与PNC独立相关。结论:本研究揭示了新冠肺炎与PNC之间的显著关联。这项研究的结果将有助于讨论、规划和实施战略,以减轻新冠肺炎幸存者中PNC的负担。
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引用次数: 0
Type 2 diabetes mellitus and coronary artery stenosis: a risk pattern association study 2型糖尿病和冠状动脉狭窄:一项风险模式关联研究
Q4 Biochemistry, Genetics and Molecular Biology Pub Date : 2023-06-28 DOI: 10.37349/emed.2023.00145
D. Shrivastav, P. Dabla, D. Singh, V. Mehta
Aim: Cardiovascular diseases (CVD) are the leading cause of death globally. In the condition of type 2 diabetes mellitus (T2DM), the prevalence of CVD increase parallel with the rise of metabolic complication and higher incidence of coronary artery stenosis. The aim of this study was to compare the level of percent stenosis in coronary arteries in patients with coronary artery disease (CAD) with and without T2DM, and to measure the severity of CVD using Gensini score (GS) through angiographic data.Methods: The current study was conducted in tertiary care specialized hospital in Delhi, India. The level of percent stenosis in coronary arteries was compared in patients with CAD with and without T2DM. The patients were divided into two groups: group I included 100 patients with T2DM, and group II included 100 non-diabetic CAD patients who underwent coronary angiography by Judkin’s technique. The severity of CVD was measured by GS through angiographic data. The serum levels of glycated haemoglobin (HbA1c) ≥ 6.5% were considered diabetic.Results: Significant difference was observed in serum HbA1c, and random blood sugar levels between group I and group II were also observed (P ≤ 0.001). Serum HbA1c shows a significant positive association with GS (r = 0.36, P = 0.007).Conclusions: The study shows a significant level of stenosis in coronary arteries of CAD diabetic patients. However, further prospective analysis of a larger population size will be needed to strengthen the findings and the significant association.
目的:心血管疾病(CVD)是全球死亡的主要原因。在2型糖尿病(T2DM)患者中,心血管疾病的患病率随着代谢并发症的增加和冠状动脉狭窄的发生率升高而增加。本研究的目的是比较合并和不合并T2DM的冠心病患者冠状动脉狭窄百分比的水平,并通过血管造影数据使用Gensini评分(GS)来衡量CVD的严重程度。方法:本研究在印度德里的三级专科医院进行。比较冠心病合并和不合并T2DM患者冠状动脉狭窄百分比的水平。患者分为两组:1组100例T2DM患者,2组100例非糖尿病性CAD患者行Judkin技术冠状动脉造影。通过血管造影资料,GS测量CVD的严重程度。血清糖化血红蛋白(HbA1c)水平≥6.5%为糖尿病。结果:两组患者血清HbA1c及随机血糖水平差异均有统计学意义(P≤0.001)。血清HbA1c与GS呈显著正相关(r = 0.36, P = 0.007)。结论:本研究显示冠心病糖尿病患者冠状动脉狭窄程度明显。然而,需要对更大的人口规模进行进一步的前瞻性分析,以加强研究结果和显著相关性。
{"title":"Type 2 diabetes mellitus and coronary artery stenosis: a risk pattern association study","authors":"D. Shrivastav, P. Dabla, D. Singh, V. Mehta","doi":"10.37349/emed.2023.00145","DOIUrl":"https://doi.org/10.37349/emed.2023.00145","url":null,"abstract":"Aim: Cardiovascular diseases (CVD) are the leading cause of death globally. In the condition of type 2 diabetes mellitus (T2DM), the prevalence of CVD increase parallel with the rise of metabolic complication and higher incidence of coronary artery stenosis. The aim of this study was to compare the level of percent stenosis in coronary arteries in patients with coronary artery disease (CAD) with and without T2DM, and to measure the severity of CVD using Gensini score (GS) through angiographic data.\u0000Methods: The current study was conducted in tertiary care specialized hospital in Delhi, India. The level of percent stenosis in coronary arteries was compared in patients with CAD with and without T2DM. The patients were divided into two groups: group I included 100 patients with T2DM, and group II included 100 non-diabetic CAD patients who underwent coronary angiography by Judkin’s technique. The severity of CVD was measured by GS through angiographic data. The serum levels of glycated haemoglobin (HbA1c) ≥ 6.5% were considered diabetic.\u0000Results: Significant difference was observed in serum HbA1c, and random blood sugar levels between group I and group II were also observed (P ≤ 0.001). Serum HbA1c shows a significant positive association with GS (r = 0.36, P = 0.007).\u0000Conclusions: The study shows a significant level of stenosis in coronary arteries of CAD diabetic patients. However, further prospective analysis of a larger population size will be needed to strengthen the findings and the significant association.","PeriodicalId":72999,"journal":{"name":"Exploration of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43029666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The impact of COVID-19 pandemic on diagnosis and management of gastrointestinal cancers 新冠肺炎大流行对胃肠道癌症诊断和管理的影响
Q4 Biochemistry, Genetics and Molecular Biology Pub Date : 2023-06-28 DOI: 10.37349/emed.2023.00147
B. Yoo, Ankit Patel, Kevin V. Houston, Alejandra Vargas, Ana Rosa Vilela Sangay, Steve M. D’Souza, David A. Johnson
Gastrointestinal (GI) cancer is one of the leading causes of death that affect many patients around the world. The coronavirus disease 2019 (COVID-19) pandemic significantly impacted our healthcare system in large that diagnosis and management of GI cancer have suffered with a reduction in cancer screening. This review will describe the current practices of cancer screening during COVID-19 pandemic and summarize how each GI cancer (esophageal, gastric, colorectal, and hepatocellular cancers) has been affected by COVID-19. World widely there has been a decreasing trend in screening, diagnosis, and management of GI cancers during the COVID-19 pandemic. Many healthcare institutions are now observing the effect of this change and implementing practice variations to adapt to the pandemic.
癌症是影响世界各地许多患者的主要死亡原因之一。2019冠状病毒病(新冠肺炎)大流行对我们的医疗保健系统产生了重大影响,导致癌症筛查减少,胃肠道癌症的诊断和管理受到影响。这篇综述将描述新冠肺炎大流行期间癌症筛查的当前实践,并总结每种癌症(食道癌、胃癌、结直肠癌和肝细胞癌)如何受到新冠肺炎的影响。在新冠肺炎大流行期间,全球胃肠道癌症的筛查、诊断和管理呈下降趋势。许多医疗机构现在正在观察这一变化的影响,并实施实践变化以适应疫情。
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引用次数: 0
Vascular accesses: Which choice? Less is more, more or less 血管通路:选择哪一种?少即是多,或多或少
Q4 Biochemistry, Genetics and Molecular Biology Pub Date : 2023-05-31 DOI: 10.37349/emed.2023.00144
Regina Frontera, M. Barone
In the context of in-hospital care management, the need for infusion therapies involves the choice of appropriate devices. Historically, there is no consensus about the preference for vascular accesses, although the data present in the literature would seem to favor peripheral ones due to fearful complications and a non-negligible rate of bloodstream infections. It is also true the decision for central routes is sometimes dictated by the patient’s general clinical conditions (especially as a result of surgery) or by the need to establish continuous short or long-term support therapies. Therefore, it would seem anachronistic to favor one strategy rather than another. Probably data should be reviewed, considering and evaluating the correct application of indications and guidelines for both positioning and management of venous accesses, without facing methodological biases that could lead to scarcy and inconclusive results; although it is undeniable that some conditions promote the onset of complications.
在医院护理管理的背景下,输液疗法的需求涉及到适当设备的选择。从历史上看,尽管由于可怕的并发症和不容忽视的血液感染率,文献中的数据似乎倾向于外周血管通路,但对于血管通路的偏好并没有达成共识。确实,中心路线的决定有时取决于患者的一般临床状况(尤其是手术结果)或建立持续的短期或长期支持疗法的需要。因此,倾向于一种战略而不是另一种战略似乎是不合时宜的。可能应该审查数据,考虑和评估静脉通路定位和管理的适应症和指南的正确应用,而不会面临可能导致稀少和不确定结果的方法偏差;尽管不可否认的是,某些情况会促进并发症的发生。
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引用次数: 0
Effect of overweight and obesity on spirometric parameters in children and adolescent with asthma 超重和肥胖对哮喘儿童和青少年肺活量测定参数的影响
Q4 Biochemistry, Genetics and Molecular Biology Pub Date : 2023-05-30 DOI: 10.37349/emed.2023.00143
R. N. Khramova, T. Eliseeva, E. Tush, D. Ovsyannikov, V. Bulgakova, Georgii S. Ignatov, Lamara A. Oganyan, O. Khaletskaya
Aim: Being overweight and obesity are factors in the negative modification of bronchial asthma (BA). The mechanisms of the aggravating effect of obesity on the course of BA have not yet been fully determined, but include changes in external respiration. The aim of the study was to study the effect of being overweight/obesity on spirometric parameters and on the occurrence of dysanapsis in children and adolescents with BA. Methods: It was a cross-sectional, open, single-center study. The data were obtained from 428 patients with atopic BA aged 7 years to 17 years, 12.0 [9.0; 14.0], and 72.9% (312/428) of them were boys. The children were divided into 3 groups: group 1—normal body weight; group 2—overweight; and group 3—obesity. All participants underwent spirometry, the ratio of forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC) was calculated and the diagnosis of dysanapsis was performed. Results: As body weight increases, a progressive decrease in FEV1/FVC is revealed—group 1: 79.55% [71.37; 85.43]; group 2: 76.82% [70.12; 82.03]; and group 3: 76.28% [67.04; 79.89] P = 0.004; as well as a decrease in Z FEV1/FVC: group 1—1.23 [–2.18; –0.28]; group 2—1.54 [–2.19; –0.68]; and group 3—1.75 [–2.63; –0.90] P = 0.02. Dysanapsis was detected in 37.7% (159/428) of patients. The incidence of dysanapsis increased statistically significantly with increasing body mass index (BMI) and amounted to: with normal body weight—31.7% (77/243), with overweight—42.0% (55/131), and with obesity—50% (27/54) P = 0.016. Conclusions: In children and adolescents with BA, as BMI increases, there is a statistically significant decrease in the ratio of FEV1/FVC, and, consequently, bronchial patency; the incidence of dysanapsis also increases statistically significantly. Taken together, this indicates the formation of an obstructive pattern of external respiration under the influence of being overweight and obesity in children and adolescents with BA.
目的:超重和肥胖是支气管哮喘(BA)负性改变的因素。肥胖加重BA进程的机制尚未完全确定,但包括外呼吸的变化。本研究的目的是研究超重/肥胖对BA儿童和青少年肺活量测定参数和呼吸功能障碍发生的影响。方法:这是一项横断面、开放式、单中心研究。数据来自428名7岁至17岁的特应性BA患者,12.0[9.0;14.0],其中72.9%(312/428)为男孩。将儿童分为3组:第一组为正常体重组;第2组——超重;第3组——肥胖。所有参与者都进行了肺活量测定,计算1秒用力呼气量(FEV1)/用力肺活量(FVC)的比值,并诊断为呼吸困难。结果:随着体重的增加,FEV1/FVC逐渐降低——第1组:79.55%[71.37;85.43];第2组:76.82%[70.12;82.03];第3组:76.28%[67.04;79.89]P=0.004;以及Z FEV1/FVC降低:组1--1.23[-2.18;-0.28];2--1.54组[-2.19;-0.68];3--1.75[–2.63;–0.90]组P=0.02。37.7%(159/428)的患者出现无菌异常。随着体重指数(BMI)的增加,味觉障碍的发生率在统计学上显著增加,达到:正常体重为31.7%(77/243),超重为42.0%(55/131),肥胖为50%(27/54)P=0.016。结论:在患有BA的儿童和青少年中,随着BMI的增加,FEV1/FVC的比率在统计学上显著降低,从而导致支气管通畅;斜视的发生率在统计学上也显著增加。总之,这表明患有BA的儿童和青少年在超重和肥胖的影响下形成了外呼吸阻塞模式。
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引用次数: 0
Effect of number of dissected lymph nodes on prognosis of patients with stage II and III colorectal cancer 结直肠癌II期、III期淋巴结清扫数对预后的影响
Q4 Biochemistry, Genetics and Molecular Biology Pub Date : 2023-05-30 DOI: 10.37349/emed.2023.00142
Reihane Mokarian Rajabi, Fariborz Mokarian Rajabi, E. Moazam, S. Mohseni, Mohammad Tarbiat, Anahita Emami, Amir Nik, Sayyideh Forough Hosseini
Aim: There is a correlation between the number of resected lymph nodes (LNs) and survival as well as staging in patients with colorectal cancer (CRC). This cohort discussed the effect of the number of dissected LNs on the prognosis [survival, disease-free survival (DFS)] of patients with stage II and III CRC.Methods: In this historical prospective cohort study, the records of 946 patients with CRC operated in the Seyyed-Al-Shohada hospital in Isfahan from 1998 to 2014 were enrolled. Then the impact of LNs on the overall survival (OS) and DFS were analyzed.Results: The number of removed LNs was higher among males [mean difference = 1.38, t (944) = 2.232, P-value = 0.02]. The median of the DFS for the patients with 1 to 20 LN removal was 104 months [95% confidence interval (CI): 90.97–117.03], while this number for the patients with more than 20 nodes was 166 months (95% CI: 140.41–191.58). DFS between two groups of CRCs, LN removal 1–20, and greater than 20. Age and number of LN removal were significant predictors of the DFS. There was a strong and statistically significant correlation between DFS and OS among CRC patients.Conclusions: This study shows that if the number of resected LNs in patients with CRC is more than 20, it will increase in DFS and OS.
目的:结直肠癌(CRC)患者的淋巴结切除数量与生存及分期之间存在相关性。本队列研究探讨了淋巴结清扫数目对II期和III期结直肠癌患者预后[生存、无病生存(DFS)]的影响。方法:回顾性分析1998 - 2014年在伊斯法罕Seyyed-Al-Shohada医院手术的946例结直肠癌患者的资料。然后分析ln对总生存期(OS)和DFS的影响。结果:男性切除的LNs数量较多[平均差异= 1.38,t (944) = 2.232, p值= 0.02]。1 ~ 20个淋巴结切除术患者的DFS中位数为104个月[95%可信区间(CI): 90.97-117.03],而超过20个淋巴结切除术患者的DFS中位数为166个月(95% CI: 140.41-191.58)。两组红细胞间DFS, LN去除1 ~ 20,大于20。年龄和LN切除数量是DFS的重要预测因子。结直肠癌患者的DFS与OS之间存在很强的统计学意义相关。结论:本研究表明,如果CRC患者中切除的LNs数量大于20,则DFS和OS增加。
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引用次数: 0
Prognostic importance of neutrophil-lymphocyte ratio in non-dialysis chronic kidney disease patients—a hospital-based prospective cohort 中性粒细胞-淋巴细胞比率对非透析慢性肾脏病患者预后的重要性——一项基于医院的前瞻性队列研究
Q4 Biochemistry, Genetics and Molecular Biology Pub Date : 2023-05-17 DOI: 10.37349/emed.2023.00141
I. Rashid, P. Tiwari, S. D’Cruz, S. Jaswal
Aim: In patients with cancer, ischemic heart disease, and peripheral vascular disease, the neutrophil-lymphocyte ratio (NLR), a measure of systemic inflammation, has been demonstrated to predict mortality. This study aimed to evaluate the inflammatory status, and also examine the impact of NLR on renal outcomes (mortality and composite endpoints) in non-dialysis chronic kidney disease (CKD) patients.Methods: This prospective cohort was conducted at a tertiary care public teaching hospital. The NLR greater than 3.53 was taken as an indication of systemic inflammation. The outcome measures include composite endpoints (end-stage renal disease, dialysis commencement, doubling serum creatinine from the baseline), and mortality. Kaplan-Meier plots and a multivariate Cox proportional hazard model were employed to analyze the outcomes.Results: A cohort of 360 patients aged 53.7 years ± 13.9 years had a median follow-up of 14 months ± 4.24 months and was evaluated for inflammatory status and renal outcomes. The proportion of inflammation was found to be 101 (28.7%). Higher NLR levels had shown an increased incidence of mortality (5.3%) and composite endpoints (12.3%). In reference to the NLR quartile (Q1), the highest quartile (Q4) had shown 3 times increased hazards for mortality and 95.0% increased risk of hazards for composite endpoints Q4 hazard ratio (HR) 3.09; 95% confidence interval (CI) 1.38–6.91 (P = 0.006), and Q4 HR 1.93; 95% CI 1.22–3.08 (P = 0.005), respectively. Higher NLR was positively associated with urea, creatinine, alkaline phosphatase, Pt-Global web tool©/Patient-Generated Subjective Global Assessment score and negatively correlated with estimated glomerular filtration rate, albumin, hemoglobin.Conclusions: NLR is a potential predictor of mortality and composite endpoints in CKD patients even before they undergo dialysis. Additionally, inflammation should be regarded as a common comorbid condition in CKD patients due to its high prevalence.
目的:在患有癌症、缺血性心脏病和周围血管疾病的患者中,中性粒细胞-淋巴细胞比率(NLR),一种衡量全身炎症的指标,已被证明可以预测死亡率。本研究旨在评估非透析慢性肾病(CKD)患者的炎症状态,并研究NLR对肾脏结局(死亡率和复合终点)的影响。方法:本前瞻性队列研究在某三级公立教学医院进行。NLR大于3.53作为全身性炎症的指示。结局指标包括复合终点(终末期肾病、开始透析、血清肌酐较基线翻倍)和死亡率。采用Kaplan-Meier图和多变量Cox比例风险模型对结果进行分析。结果:360例患者,年龄53.7岁±13.9岁,中位随访时间为14个月±4.24个月,并评估了炎症状态和肾脏预后。炎症的比例为101(28.7%)。较高的NLR水平显示出死亡率(5.3%)和复合终点(12.3%)的增加。在NLR四分位数(Q1)中,最高四分位数(Q4)显示死亡风险增加3倍,复合终点风险增加95.0% Q4风险比(HR) 3.09;95%置信区间(CI) 1.38 ~ 6.91 (P = 0.006), Q4 HR 1.93;95% CI分别为1.22 ~ 3.08 (P = 0.005)。较高的NLR与尿素、肌酐、碱性磷酸酶、Pt-Global网络工具©/患者生成的主观总体评估评分呈正相关,与肾小球滤过率、白蛋白、血红蛋白的估计值呈负相关。结论:NLR是CKD患者甚至在透析前死亡率和复合终点的潜在预测因子。此外,由于炎症的高患病率,应将其视为CKD患者的常见合并症。
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Exploration of medicine
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