脑卒中患者血管危险因素与颈动脉粥样硬化的关系

目的研究脑卒中患者血管危险因素与颈动脉粥样硬化的关系。方法受试者151人主要为脑梗死及椎-基底动脉供血不足病例。将所有受试对象行颈动脉超声检查,采用二分类变量的Logistic回归分析方法对其危险因素进行筛选,找出与颈动脉粥样硬化改变相关的因素。结果年龄及吸烟与颈动脉内中膜增厚之间存在相关性,P=0.006（OR=1.08,95%CI 1.02-1.14）和0.01（OR=5.09,95%CI 1.47-17.61）;年龄、吸烟同样与颈动脉斑块之间存在相关性,P=0.006（ORn=n1.06,95%CI 1.06-1.11）和0.04（ORn=2.97,95%CI 1.04-8.50）,收缩压与颈动脉斑块呈正相关,P=0.04（OR=1.03,95%CI 1.00-1.05）,舒张压与颈动脉斑块呈负相关P=0.04（OR=0.96,95%CI 0.92-1.00）。结论随年龄的增大动脉内中膜增厚及颈动脉斑块的患病率增加,吸烟者内中膜增厚及颈动脉斑块比率高于不吸烟者;收缩压增加颈动脉斑块患病率增加,舒张压增加斑块患病率下降。     

贲门癌患者营养风险的危险因素及其与生活质量的关系研究

摘要 目的：探讨贲门癌患者营养风险的危险因素,分析其与生活质量的关系。方法：纳入我院2017年8月～2020年8月收治的贲门癌患者102例,采用营养风险筛查2002（NRS2002）将患者分成营养风险组（n=45）、无营养风险组（n=57）,分析患者发生营养风险的危险因素。采用简明生活质量量表（SF-36）评估患者的生活质量,分析NRS2002评分与SF-36评分的相关性。结果：在102例患者中,营养风险发生率为44.12%。Logistic多元回归模型分析显示：年龄≥60岁（OR=3.914,95%CI：1.718-8.917）、术前血红蛋白异常（OR=2.522,95%CI：1.124-5.659）、文化程度小学及以下（OR=3.447,95%CI：1.519-7.822）、家庭月收入≤1000元（OR=2.974,95%CI：1.415-6.251）均是贲门癌患者发生营养风险的危险因素（P＜0.05）,文化程度大专及以上（OR=0.941,95%CI：0.897-0.987）、家庭月收入>5000元（OR=0.947,95%CI：0.901-0.995）均是其营养风险发生的保护性因素（P＜0.05）。营养风险组情绪角色功能、心理健康、躯体功能、躯体疼痛、躯体角色功能、总体健康评分均低于无营养风险组（P＜0.05）。NRS2002评分与情绪角色功能（r=-0.811）、心理健康（r=-0.627）、躯体功能（r=-0.524）、躯体疼痛（r=-0.619）、躯体角色功能（r=-0.587）、总体健康（r=-0.718）评分均呈负相关（P＜0.05）。结论：贲门癌患者营养风险发生率较高,其发生与多种因素存在关联,可降低患者生活质量,临床需尽早对患者营养风险进行评估,并采取相应措施,以期改善患者生活质量。     

侧脑室旁白质病变患者认知功能损害的特点研究

目的:脑白质病变与老年认知功能障碍关系密切,尤其是深部白质病变更是血管性认知功能损害的常见危险因素,但临床上对于侧脑室旁白质病变与认知功能损害的关系研究较少,本研究旨在探讨侧脑室旁白质病变患者认知功能损害的特点。方法:选取2011年2月-2012年10月住院健康查体者159例,根据有无侧脑室旁白质病变分为脑白质病变组及对照组,根据侧脑室白质病变严重程度分为轻度组及中重度组。所有患者分别进行蒙特利尔认知评估表(Montreal Cognitive Assessment,MoCA)中文版、简易精神状态检查表(Mini Mental State Examination,MMSE)和画钟测验(clock drawing test,CDT)评估。结果:脑白质病变组MMSE量表总分、CDT、MoCA量表总分及视空间、计算力、延迟回忆及空间执行功能分低于对照组,差异有统计学意义(P0.05);白质病变中重度组MMSE、MoCA量表总分及计算力得分低于轻度组,差异有统计学意义(P0.05)。结论:本研究显示侧脑室旁白质病变患者总体认知功能评分明显低于对照组,中重度患者的计算力下降尤为突出,提示我们侧脑室旁白质病变是导致患者总体认知功能下降及计算力损害的危险因素,临床上应该提高对于侧脑室旁白质病变的重视。     

侧脑室旁白质病变患者认知功能损害的特点研究

目的：脑白质病变与老年认知功能障碍关系密切,尤其是深部白质病变更是血管性认知功能损害的常见危险因素,但临床上对于侧脑室旁白质病变与认知功能损害的关系研究较少,本研究旨在探讨侧脑室旁白质病变患者认知功能损害的特点。方法：选取2011年2月．2012年10月住院健康查体者159例,根据有无侧脑室旁白质病变分为脑白质病变组及对照组,根据侧脑室白质病变严重程度分为轻度组及中重度组。所有患者分别进行蒙特利尔认知评估表（MontrealCognitiveAssessment,MoCA）中文版、简易精神状态检查表（MiniMentalStateExamination,MMSE）和画钟测验（clockdrawingtest,CDT）评估。结果：脑白质病变组MMSE量表总分、CDT、MoCA量表总分及视空间、计算力、延迟回忆及空间执行功能分低于对照组,差异有统计学意义（P〈0．05）;白质病变中重度组MMSE、MoCA量表总分及计算力得分低于轻度组,差异有统计学意义（P〈0．05）。结论：本研究显示侧脑室旁白质病变患者总体认知功能评分明显低于对照组,中重度患者的计算力下降尤为突出,提示我们侧脑室旁白质病变是导致患者总体认知功能下降及计算力损害的危险因素,临床上应该提高对于侧脑室旁白质病变的重视。     

脑小血管病患者血清尿酸水平和步态障碍之间的相关性

目的:探讨脑小血管病(Cerebral small vessel disease,CSVD)患者血清尿酸(Uric acid,UA)水平和步态障碍之间的相关性。方法:将我院自2018年1月至2019年1月收治的CSVD患者172例作为研究对象,根据患者血清尿酸水平分为研究组87例,对照组85例。收集和比较两组的临床资料,使用Logistic回归分析血清尿酸和CSVD患者脑室旁、深部白质高信号、步态障碍之间的相关性。结果:两组的年龄、性别、体质指数、血糖指标、血脂指标水平,合并高血压、糖尿病病史和吸烟情况比较差异无统计学意义(P0.05)。研究组血清尿酸水平、饮酒患者比例明显高于对照组(P0.05),脑室旁高信号和深部白质高信号中重度比例均明显高于对照组(P0.05);将步态障碍、脑室旁高信号与深部白质高信号作为影响因素带入相关分析,结果显示血清尿酸水平与步态障碍、脑室旁高信号与深部白质高信号比较存在正相关(P0.05)。结论:CSVD患者血清高尿酸水平与脑室旁、深部白质高信号病变程度呈明显的正相关性,也是患者步态障碍的影响因素。     

胃癌患者营养风险与生活质量及近期预后的关系研究

摘要 目的：探讨胃癌患者的营养风险的危险因素,并分析其与患者生活质量及近期预后的关系。方法：纳入我院2017年4月～2019年10月收治的胃癌患者81例,利用营养风险筛查2002（NRS2002）评分分析患者有无营养风险,经Logistic多元回归分析胃癌患者营养风险的危险因素。经简明生活质量量表（SF-36）评估患者生活质量并进行比较,前瞻性随访3、12个月,统计患者近期预后,分析胃癌患者NRS2002评分与SF-36评分的相关性。结果：在81例胃癌患者中,营养风险发生率为53.09%。Logistic多元回归分析显示：年龄≥60岁（OR=1.657,95%CI：1.042-2.635）、疼痛分度Ⅲ～Ⅳ度（OR=4.515,95%CI：1.656-12.310）、消化道反应Ⅲ～Ⅳ度（OR=3.947,95%CI：1.599-9.743）是胃癌患者营养风险发生的危险因素（P＜0.05）,而营养补充（OR=0.899,95%CI：0.846-0.955）是胃癌患者营养风险发生的保护因素（P＜0.05）。营养风险组情绪角色功能、躯体角色功能、躯体功能、总体健康、心理健康、躯体疼痛评分低于无营养风险组,NRS2002评分高于无营养风险组（P＜0.05）。胃癌患者NRS2002评分与情绪角色功能、躯体角色功能、躯体功能、总体健康、心理健康、躯体疼痛评分呈负相关（P＜0.05）。营养风险组随访3个月的生存率为95.35%,与无营养风险组的100%比较无差异（P＞0.05）。营养风险组随访12个月的生存率为79.07%,低于无营养风险组的94.74%（P＜0.05）。结论：胃癌患者营养风险发生率较高,其发生与多种因素有关,营养风险会影响生活质量和近期预后,临床需及时对胃癌患者进行营养风险评估,并尽早干预。     

中老年肩痛患者疼痛及肩关节功能恢复的影响因素分析

摘要 目的：探究分析中老年肩痛患者疼痛及肩关节功能恢复的影响因素分析。方法：采用便利抽样法,随机抽取2020年9月至2022年9月期间于我院门诊就诊的2010名中老年患者作为调查对象,对患者进行筛查、复查、确诊、随访等。并对所搜集信息进行疼痛及肩关节功能恢复单因素与多因素Logistic回归分析。结果：单因素分析显示,年龄（x²=15.274, P＜0.001）、性别（x²=10.401, P=0.001）、病程（x²=16.410, P＜0.001）和是否进行功能锻炼（x²=6.293, P=0.012）为影响中老年肩痛患者肩关节功能恢复的主要因素;年龄≥70岁（OR=1.292, 95%CI 0.953-1.750）、女性（OR=1.672, 95%CI 1.348-2.074）、病程＞1个月（OR=1.470, 95%CI 1.021-2.116）和未进行功能锻炼（OR=1.844, 95%CI 1.175-2.894）为影响中老年肩痛患者肩关节功能恢复的独立危险因素。结论：年龄≥70岁、女性、病程＞1个月和未进行功能锻炼为影响中老年肩痛患者肩关节功能恢复的独立危险因素,根据上述因素尽早快速甄别高风险患者,及早给予合理有效的康复治疗措施,可显著改善肩痛患者肩关节功能的预后。     

肺癌根治术后并发症危险因素分析及其生活质量变化研究

摘要 目的：探讨肺癌根治术后并发症的危险因素,并分析其生活质量的变化。方法：纳入我院2018年9月～2020年7月收治的行肺癌根治术患者104例,对患者的临床资料进行回顾性分析。根据患者术后3个月的并发症发生情况,分成并发症组（n=32）和非并发症组（n=72）,分析肺癌根治术后并发症发生的影响因素,利用癌症病人生活质量测定量表（QLQ-C30）评估患者术前及术后3个月的生活质量。结果：肺癌根治术后32例出现并发症,其中切口感染6例,肺炎7例,肺不张9例,心律失常6例,脓胸4例。并发症组年龄≥60岁、烟龄≥10年、传统开胸术、慢性阻塞性肺疾病史人数占比高于非并发症组（P＜0.05）。多因素Logistic回归分析显示,年龄≥60岁（OR=2.978,95%CI：1.415-6.267）、烟龄≥10年（OR=3.847,95%CI：1.869-7.918）、传统开胸术（OR=3.065,95%CI：1.544-6.084）、慢性阻塞性肺疾病史（OR=2.848,95%CI：1.481-5.477）是肺癌根治术后患者发生并发症的危险因素（P＜0.05）。非并发症组术后3个月的总体生活质量量表、角色功能、躯体功能、情绪功能、社会功能评分高于术前与并发症组,且恶心呕吐、疲乏、疼痛、便秘、呼吸困难、食欲下降、睡眠障碍、腹泻评分较术前与并发症组明显降低（P＜0.05）。结论：肺癌根治术后并发症的发生主要与患者年龄、烟龄、手术方式、慢性阻塞性肺疾病史有关,且并发症对患者术后生活质量影响较大。     

老年脑梗死患者急性期全脑血管造影及脑动脉狭窄的危险因素分析

目的:探究老年脑梗死患者急性期全脑血管造影(DSA)及脑动脉狭窄的危险因素。方法:选择2010年1月~2016年9月期间我院收治的562例老年脑卒中患者为研究对象。经DSA造影观察脑血管动脉造影脉狭窄情况,并收集患者一般资料,采用单因素分析及多因素logistics回归分析脑动脉狭窄的危险因素。结果:562例脑卒中患者经DSA检查共发现469例患者出现脑动脉狭窄,中度狭窄301例,血管重度狭窄168例;颅内段发生率显著高于颅外段(P0.05);高龄(OR=1.434,P0.05)、高血压(OR=2.084,P0.05)、糖尿病(OR=2.235,P0.05)及吸烟(OR=2.734,P0.05)是老年脑卒中患者脑血管狭窄的危险因素。结论:DSA显示老年人脑卒中患者多存在脑血管动脉狭窄的发生,年龄、高血压、糖尿病及吸烟是老年脑卒中患者脑血管狭窄的危险因素。     

绝经女性冠状动脉钙化积分与踝臂指数的相关性研究

目的:研究绝经女性中冠脉钙化积分(CACS)与踝臂指数(ABI)之间的相关性。方法:从1918名社区人群筛选出608名无冠心病病史并可以进行CACS检查的绝经女性为样本,对其进行标准化问卷调查、实验室指标检测、ABI及CACS测量。根据CACS将研究对象分为钙化阴性组和钙化阳性组,并根据ABI结果分为五类:外周血管病组(ABI0.9)、临界ABI组(ABI:0.90-0.99)、低-正常ABI组(ABI:1.00-1.09)、正常ABI组(ABI:1.10-1.29)和高ABI组(ABI≥1.3),分析不同冠脉钙化程度与不同等级ABI的相关性。结果:研究人群中钙化阴性514例(84.5%),钙化阳性94例(15.5%)。其中钙化阳性组在年龄、高血压、收缩压、总胆固醇、高密度脂蛋白、低密度脂蛋白及糖尿病方面均高于钙化阴性组,同时绝经女性多数集中在低-正常ABI组和正常ABI组,分别为235例(38.7%)和313例(51.5%)。钙化阳性组存在外周血管病变和临界ABI状态者多(5.3%vs.0.8%,9.6%vs.6.4%),两组间差异有统计学意义(P0.001),并且Logistic回归发现,绝经女性年龄(OR=1.115,95%CI 1.060-1.174,P0.001)、高血压(OR=1.941,95%CI 1.107-3.402,P=0.021)、收缩压(OR=1.018,95%CI 1.003-1.034,P=0.020)、外周血管病变(ABI0.9)(OR=6.771,95%CI 1.483-30.923,P=0.014)是冠脉钙化的独立危险因素。高密度脂蛋白(OR=0.322,95%CI 0.104-0.994,P=0.049)则是防止冠脉钙化的有利因素。结论:绝经女性ABI降低与CACS相关,ABI可以作为一种评估冠脉钙化程度和心血管风险的有效手段为临床医生服务。     

A Unique Protease Cleavage Site Predicted in the Spike Protein of the Novel Pneumonia Coronavirus (2019-nCoV) Potentially Related to Viral Transmissibility

正Dear Editor,In December 2019, a novel human coronavirus caused an epidemic of severe pneumonia(Coronavirus Disease 2019,COVID-19) in Wuhan, Hubei, China(Wu et al. 2020; Zhu et al. 2020). So far, this virus has spread to all areas of China and even to other countries. The epidemic has caused 67,102 confirmed infections with 1526 fatal cases     

Curcuminoids as inhibitors of thioredoxin reductase: A receptor based pharmacophore study with distance mapping of the active site

Curcumin is the yellow pigment of turmeric that interacts irreversibly forming an adduct with thioredoxin reductase (TrxR), an enzyme responsible for redox control of cell and defence against oxidative stress. Docking at both the active sites of TrxR was performed to compare the potency of three naturally occurring curcuminoids, namely curcumin, demethoxy curcumin and bis-demethoxy curcumin. Results show that active sites of TrxR occur at the junction of E and F chains. Volume and area of both cavities is predicted. It has been concluded by distance mapping of the most active conformations that Se atom of catalytic residue SeCYS498, is at a distance of 3.56 from C13 of demethoxy curcumin at the E chain active site, whereas C13 carbon atom forms adduct with Se atom of SeCys 498. We report that at least one methoxy group in curcuminoids is necessary for interation with catalytic residues of thioredoxin. Pharmacophore of both active sites of the TrxR receptor for curcumin and demethoxy curcumin molecules has been drawn and proposed for design and synthesis of most probable potent antiproliferative synthetic drugs.     

Comparative morphology of the carpel in the Liliaceae: Hewardieae, Petrosavieae, and Tricyrteae

The young pistils in the melanthioid tribes, Hewardieae, Petrosavieae and Tricyrteae, are uniformly tricarpellate and syncarpous. They lack raphide idioblasts. All are multiovulate, with bitegmic ovules. The Petrosavieae are marked by the presence of septal glands and incomplete syncarpy. Tepals and stamens adhere to the ovary in the Hewardieae and the Petrosavieae but not in the Tricyrteae. Two vascular bundles occur in the stamens of the Hewartlieae and Tricyrtis latifolia. Ventral bundles in the upper part of the ovary of the Hewardieae are continuous with compound septal bundles and placental bundles in the lower part. Putative ventral bundles occur in the alternate position in the Tricyrteae and putative placental bundles in the opposite. position in the Petrosavieae. The dichtomously branched stigma in each carpel of the Tricyrteae is supplied by a bifurcated dorsal bundle.     

Enterovirus 71 3C proteolytically processes the histone H3 N-terminal tail during infection

Highlights
1. The N-terminal tail of histone H3 is specifically cleaved during EV71 infection.
2. Viral protease 3C is identified as a protease responsible for proteolytically processing the N-terminal H3 tail.
3. Our finding reveals a new epigenetic regulatory mechanism for Enterovirus 71 in virus-host interactions.     

Detection of EBV and HHV6 in the Brain Tissue of Patients with Rasmussen’s Encephalitis

Rasmussen’s encephalitis (RE) is a rare pediatric neurological disorder, and the exact etiology is not clear. Viral infection may be involved in the pathogenesis of RE, but conflicting results have reported. In this study, we evaluated the expression of both Epstein-Barr virus (EBV) and human herpes virus (HHV) 6 antigens in brain sections from 30 patients with RE and 16 control individuals by immunohistochemistry. In the RE group, EBV and HHV6 antigens were detected in 56.7% (17/30) and 50% (15/30) of individuals, respectively. In contrast, no detectable EBV and HHV6 antigen expression was found in brain tissues of the control group. The co-expression of EBV and HHV6 was detected in 20.0% (6/30) of individuals. In particular, a 4-year-old boy had a typical clinical course, including a medical history of viral encephalitis, intractable epilepsy, and hemispheric atrophy. The co-expression of EBV and HHV6 was detected in neurons and astrocytes in the brain tissue, accompanied by a high frequency of CD8⁺ T cells. Our results suggest that EBV and HHV6 infection and the activation of CD8⁺ T cells are involved in the pathogenesis of RE.     

Perinatal Vertical Transmission of Chikungunya Virus in Ruili,a Town on the Border between China and Myanmar

正Dear Editor,Chikungunya virus (CHIKV), an arbovirus in the family of Togaviridae, genus Alphavirus, is transmitted by the A.aegyptii or A. albopictus mosquito, and causes disease in humans characterized by fever, rash, and arthralgia (Silva and Dermody 2017; Suhrbier 2019). It was first reported in 1953 in Tanzania, and caused only a few outbreaks and sporadic cases in Africa and Asia in last century. However, in the epidemic in 2004, CHIKV acquired mutations that conferred enhanced transmission by the A. albopictus mosquito(Schuffenecker et al. 2006). Since then, it has successively caused outbreaks in Africa, the Indian Ocean, South East Asia, the South America, and Europe (Zeller et al. 2016).     

Development of a Novel Reverse Transcription Loop-Mediated Isothermal Amplification Method for Rapid Detection of SARS-CoV-2

In conclusion, the novel visual RT-LAMP assay is a simple, rapid, and sensitive approach for detection of SARS-CoV-2, and it is ready for application in primary care and community hospitals or health care centers, and even patients' own houses in response to the current SARS-CoV-2 epidemic because the assay does not require sophisticated equipment and skilled personnel. Furthermore, it is also ready to be used in fields for screening samples from wild animals and environments to facilitate the identification of potential intermediate hosts that mediate the cross-species transmission of SARS-CoV-2 from bats to humans.