Prevalence and association of mycoplasma infection in the development of coronary artery disease

Coronary heart disease (CHD) has been associated with significant morbidity and mortality worldwide. Although remain controversial, several studies have demonstrated the association of M. pneumoniae infections with atherosclerosis. We evaluated the possible association of mycoplasma infections in patients diagnosed with atherosclerosis by ELISA and PCR methods. Atherosclerotic tissue samples and blood samples were collected for the detection of mycoplasma antibodies (IgA) by ELISA from the 97 patients with coronary artery disease (CAD). M. pneumoniae specific IgA, IgG and IgM were measured by using the Anti-M. pneumoniae IgA/IgG/IgM ELISA. Detection of M. pneumoniae targeting the P1 adhesion gene was performed by PCR Acute infection of M. pneumoniae was diagnosed in 43.3% (42) of patients by PCR. The M. pneumoniae specific antibodies were detected in 36.1% (35) of patients. Twenty-five (25.8%) cases had IgG antibodies, 15 (15.5%) cases had IgM antibodies, 3 (3.1%) cases had IgA antibodies, 10 (10.3%) cases had both IgM + IgG antibodies and 1 (1%) case of each had IgM + IgA and IgG + IgA antibodies. None of the cases was positive for all three antibodies. A Pearson correlation coefficient analysis revealed an excellent correlation between the PCR and the serological results (r=0.921, p<0.001). A majority (17, 40.5%) of the M. pneumoniae positive patients are within the 41-50 years of age group, followed by 10 (23.8%) patients in the age group of 61-70 years and 2 (4.8%) patients were >70 years of age. Our study reported an unusually higher prevalence of M. pneumoniae by serological tests (36.1%) and PCR (43.3%). Although the hypothesis of the association of M. pneumoniae and CAD is yet to be proven, the unusually high prevalence of M. pneumoniae in CAD patients indicates an association, if not, in the development of atherosclerosis.

P16.08 Inhibition of melanoma brain metastasis by targeting miR-146a

BACKGROUND

Melanoma has the highest propensity of any cancer to metastasize to the brain, with late-stage patients developing brain metastasis (MBM) in 40% of cases. Survival of patients with MBM is around 8 months with current therapies, illustrating the need for new treatments. MBM development is likely caused by molecular interactions between tumor cells and the brain, constituting the brain metastatic niche. miRNAs delivered by exosomes released from the primary tumor cells may play a role in niche establishment, yet the mechanisms are poorly understood. Here, the aim was to identify miRNAs released by exosomes from melanomas, which may be important in niche establishment and MBM progression.

MATERIAL AND METHODS

miRNAs in exosomes collected from human astrocytes, melanocytes, and MBM cell lines were profiled to determine differential expression. Functional in vitro validation was performed by cell growth and migration assays, cytokine arrays, qPCR and Western blots. Functional in vivo studies were performed after miR knockdown in MBM cell lines. An in silico docking study was performed to determine drugs that potentially inhibit transcription of miR-146a to impede MBM development.

RESULTS

miR-146a was the most upregulated miRNA in exosomes from MBM cells and was highly expressed in human and animal MBM samples. miR-146a mimics activated human astrocytes, shown by increased proliferation and migration, elevated expression of GFAP in vitro and in mouse brain tumor samples, and increased cytokine production. In animal studies, knockdown of miR-146 in MBM cells injected intracardially into mice reduced BM burden and increased animal survival. Based on the docking studies, deserpidine was found to be an effective inhibitor of MBM growth in vitro and in vivo.

CONCLUSION

miR-146a may play an important role in MBM development, and deserpidine is a promising candidate for clinical use.

The OsIME4 gene identified as a key to meiosis initiation by RNA in situ hybridization

The formation of asexual seeds in plants holds great promise as a breeding system for one-line hybrid rice. Entry into meiosis is a key developmental decision in gametogenesis, especially in formation of asexual seeds in plants. Apomeiosis in MeMCs can be achieved by identifying and manipulating meiosis-specific genes. Using methods based on in situ hybridization and expression analysis, we identified OsIME4 (inducer of meiosis 4) sense and antisense transcripts involved in rice meiosis initiation, similar to initiation of meiosis in budding yeast. Our data suggest that the OsIME4 sense transcript, which encodes a putative mRNA N6-adenosine methyltransferase, keeps rice cells at mitosis stage through some form of epigenesis (DNA/RNA methylation), and the non-coding antisense transcript of OsIME4 converts the cell status from mitosis to meiosis by inhibiting expression (transcription and translation) of the sense transcript. We identified that the non-coding antisense transcript of OsIME4 converts archesporial cell status from mitosis to meiosis by inhibiting expression of the OsIME4 sense transcript in rice. Our results provide novel insights into meiosis initiation in rice and for engineering of apomixis in sexual crops by manipulating the OsIME4 sense and antisense transcripts, which has great promise for producing apomictic rice in the future.

[Risk factors of occurrence and treatment failure of peritoneal dialysis-associated polymicrobial peritonitis: a multicenter retrospective study]

OBJECTIVE

To determine the risk factors of occurrence and treatment failure of peritoneal dialysis associatedperitonitis (PDAP) due to polymicrobial infections.

METHODS

We retrospectively collected the clinical data of patients with PDAP from the peritoneal dialysis (PD) centers in 4 general hospitals in Jilin Province from 2013 to 2019. The patients were divided, according to the results of peritoneal dialysate culture, into polymicrobial PDAP group and control group for comparison of the clinical data, treatment outcomes, and long-term prognosis. The independent risk factors of the occurrence and treatment failure of polymicrobial PDAP were explored using multivariate regression analysis.

RESULTS

We recruited a total of 625 patients from the 4 PD centers, among whom 1085 episodes of PDAP were recorded. Polymicrobial PDAP accounted for 7.6% of the total PDAP episodes, and this proportion increased from 5.3% in 2013-2016 to 9.4% in 2017-2019 (P= 0.012). Compared with the control group, polymicrobial PDAP group had higher proportions of elderly patients and patients with refractory PDAP, with greater white blood cell counts in the first-day dialysate and longer course of antibiotic treatment (P < 0.05). The risk of catheter removal and treatment failure (catheter removal or PDAP-related death) in polymicrobial PDAP group was 2.972 times (OR=2.972, 95% CI: 1.634-5.407, P < 0.001) and 2.692 times (OR=2.692, 95% CI: 1.578-4.591, P < 0.001) that in the control group, respectively. The risk of withdrawal from PD (technical failure + all-cause death) was 1.5- fold higher in polymicrobial PDAP group than that in the control group (OR=1.500, 95% CI: 1.085-2.074, P=0.014). Elderly patients (>65 years) had a 1.937-fold higher risk of experiencing polymicrobial PDAP than younger patients (OR=1.937, 95% CI: 1.207-3.109, P= 0.006). Diabetes mellitus (OR=5.554, 95% CI: 1.021-30.201, P=0.047), mixed fungal infeciton (OR=343.687, 95% CI: 21.554- 5480.144, P < 0.001), and Pseudomonas aeruginosa infection (OR=11.518, 95% CI: 1.632 to 81.310, P=0.014) were associated with increased risks of treatment failure by 4.554, 342.687 and 10.518 times, respectively.

CONCLUSION

The proportion of polymicrobial PDAP in the total PDAP cases tends to increase in recent years. Polymicrobial infection is an independent risk factor of both treatment failure and poor prognosis in patients with PDAP. An old age is an independent risk factor for polymicrobial PDAP, while diabetes mellitus and infections with mixed fungi or Pseudomonas aeruginosa are independent risk factors for treatment failure.

The effect of strength-endurance training on serum and urine metabolic profiles of female adolescent volleyball athletes

Aim

Limited investigations on metabolic responses to exercise training in female adolescent volleyball athletes exist. The aim of this study was to obtain serum and urine metabolite markers in female adolescent volleyball athletes within 2-week strength-endurance training using a metabolomics approach coupled with biochemical analysis, which would be potential biomarkers for evaluating the physiological state of athletes.

Methods

Twelve female adolescent volleyball athletes were recruited for 2-week strength-endurance training. Differential serum and urine metabolic profiles between the pre- and post-training group were obtained on gas chromatography coupled to mass spectrometry (GC-MS) and data subsequently underwent orthogonal partial least-squares analysis (OPLS).

Results

Strength-endurance training exerted a significant influence on the athletes' serum and urine metabolic profiles. The changed metabolites were primarily involved in energy metabolism, lipid metabolism and amino acids metabolism. Results support the hypothesis that female athletes displayed an increased propensity to oxidize lipids as the major energy source. Exposure to strength-endurance training also led to a significant increase in cortisol, but a decrease in testosterone, indicating disordered hormone adjustment. Exercise-induced oxidative stress occurred, as was evidenced by the decrease in reduced glutathione, and increases in blood malondialdehyde and oxidized glutathione. Since the muscle damage markers creatine kinase and lactate dehydrogenase did not show significant changes, the training might not cause cell membrane damage and the athletes did not cross the adaptive injury level.

Conclusion

By measurement of endogenous metabolites, the metabolomics study has the potential to reveal the global physiological changes in response to exercise training.

Effect of age at first egg on reproduction performance and characterization of the hypothalamo-pituitary-gonadal axis in chickens

As an important indicator of sexual maturity of hens, age at first egg (AFE) is significantly associated with reproduction performance. In this study, 400 hens were divided into 6 groups based on AFE to analyze the difference of reproduction performance, reproduction hormone levels and the characterization of the hypothalamo-pituitary-gonadal axis in chickens. The results showed that the egg production of the hens in the late-maturing groups was significantly lower than that of the ones in other groups and the precocious hens had a lower egg production rate. The hens in late-maturing group had a lower fertility rate, LH levels and shorter duration of peak of egg production (PEP), the precocious hens had lower PRL levels. In addition, the characterization of the hypothalamo-pituitary-gonadal axis showed that the individuals with normal AFE had higher GNRH, GNRHR, ESR1, KITLG, and CYP11A1 expression levels than late-maturing and precocious individuals, which indicated that the chickens with normal AFE advantages on reproduction regulation system.

Analysis of the MCL-1 gene in Chinese women with idiopathic premature ovarian insufficiency

OBJECTIVE

Animal studies have demonstrated that myeloid cell leukemia-1 (Mcl-1) gene deficiency leads to premature ovarian failure and decreased reproductive ability in mice. This study investigated the relationship between MCL-1 gene variation and idiopathic premature ovarian insufficiency (POI) in Chinese women.

METHODS

A total of 200 idiopathic POI patients and 100 healthy controls were recruited for this study, and peripheral blood was collected. First, genomic DNA was extracted from peripheral leukocytes. Then, the entire coding region and splice sites of the MCL-1 gene were amplified by polymerase chain reaction. Chi-squared tests were used to compare the genotype distribution and allele frequency of single nucleotide polymorphisms between the POI and control groups.

RESULTS

Three mutations of the MCL-1 gene (c.-36C > T, c.-131C > T and c.78C > T) were identified. After data analysis, c.-36C > T and c.-131C > T in the 5'-untranslated region were both found in the POI group and the control group. No difference was found in the genotype distribution or allelic frequency of either variant between the POI group and the control group (p > 0.05). The synonymous variant (c.78C > T) in exon 1 was discovered in only one of the control subjects and did not result in a change in amino acid sequence (p.Gly26Gly).

CONCLUSION

MCL-1 gene mutation may not be associated with idiopathic POI in Chinese women.

AB0146 HAND AND WRIST ACTIVE RANGE OF MOTIONS AND CONTRIBUTING FACTORS IN RHEUMATOID ARTHRITIS: A CROSS-SECTIONAL STUDY

Background:

Patients with rheumatoid arthritis (RA) usually impaired range of motions (ROMs), especially hand and wrist active ROMs (AROMs), thus influencing their ability to perform daily activities and health-related quality of life (HR-QoL). However, little is known about the potential factors of reduced hand and wrist AROMs and their relations to quality of life in Chinese RA patients.

Objectives:

To explore the contributing factors of hand and wrist AROMs and their associations with HR-QoL and functional limitation in Chinese RA population.

Methods:

In this cross-sectional study, 108 patients were enrolled from Affiliated Hospital of Nantong University between November 2018 and July 2019. We measured all the participants’ AROMs with different directions of the hand and wrist in both sides, including volar flexion, ulnar deviation, radial deviation and radial deviation of the wrist joint, the first metacarpophalangeal (MCP1) flexion, interphalangeal (IP) flexion, volar abduction, radial abduction and thumb opposition (cm) in the thumb, average flexion, hypertension and abduction of the MCP2-5, average proximal interphalangeal (PIP) 2-5 and distal interphalangeal (DIP) 2-5 flexions, total active range of motion (TAM) of the second to the fifth fingers (TAM2-TAM5). Their sociodemographic, physical, psychological, disease-related data, acute phase reactants, laboratory indicators, drug usage and HR-QoL were examined as well. Statistical analysis used Pearson’s and Spearman’s correlation analysis, univariate and multivariate linear regression analyses.

Results:

In univariate analyses, we found that living in rural area, longer disease duration, comorbidity, hospitalization, more swollen joints, higher disease activity, pain level, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), red blood cell count and glucocorticoids usage were associated with most of the decreased hand and wrist AROMs (P ≤ 0.050), while higher education and annual income were related to most of the increased hand and wrist AROMs (P ≤ 0.048). In multivariate analyses, higher disease duration (P ≤ 0.023) and higher disease activity (P ≤ 0.033) were corelated with most of the decreased hand and wrist AROMs. Interestingly, the psychological factor, anxiety, was only positively associated with thumb opposition in both univariate and multivariate analyses (P ≤ 0.001). Additionally, most of the declined hand and wrist AROMs were associated with functional impairment and poor HR-QoL, especially in physical components (P < 0.05).

Conclusion:

Various factors, especially longer disease duration and higher disease activity, were related to decreased hand and wrist AROMs, and thus causing functional impairment and poor HR-QoL in RA patients. Clinical physicians and medical faculties should pay more attention to disease activity and disease-related symptoms of these patients in order to maintain their activity of daily living (ADL) ability and improve HR-QoL.

References:

[1]Rheumatoid arthritis. Nat Rev Dis Primers. 2018;4:18002.

[2]Zhang L, Cao H, Zhang Q, Fu T, Yin R, Xia Y, et al. Motion analysis of the wrist joints in Chinese rheumatoid arthritis patients: a cross-sectional study. BMC Musculoskelet Disord. 2018;19(1):270.

Acknowledgements:

This work was funded by Postgraduate Research & Practice Innovation Program of Jiangsu Province (Grant/Award number: KYCX19_2071), National Natural Science Foundation of China (Grant/Award number: 81871278, Science and technology Project of Jiangsu Province (Grant/Award number: BE2018671)

Disclosure of Interests:

None declared

[Electronic cigarette use-associated lung injury: a case report and literature review]

Objective: To improve the clinical recognition of electronic cigarette or vaping product use-associated lung injury. Methods: A 67 year old patient with lung injury induced by e-cigarette was reported. The concentrations of vitamin E acetate (VEA) and tetrahydrocannabinol (Δ9-THC) in BALF were measured by UHPLC-MS/MS. A literature review was performed with"Vaping-Associated Lung Injury""vape","e-cigarette","electronic cigarette","EVALI","electronic nicotine device","lung","injury","case"as Mesh terms in PubMed. Results: There were 208 cases reported in the literature, 71.6% of whom were male, and 28.4% were female, with a median age of 27 years (17-67 years), while 2 patients (1%) were over 60 years old. The median time of using e-cigarette was 90 days (2 weeks-3 years). Of the 208 patients, the most common symptoms were dyspnea, fever, chest pain, hemoptysis, and gastrointestinal symptoms such as nausea, abdominal pain or diarrhea. The most common manifestation of chest CT was bilateral ground glass opacity (n=119, 57.2%). A total of 70 patients received bronchoscopy and BALF, which showed that the ratio of macrophages was (49.5±29.8)%, neutrophil (34.7±28.7)%, lymphocytes (10.1±7.4)%, and eosinophils (2.4±3.6)%. The "foamy" alveolar macrophages were positive in 65 cases (92.9%).A total of 132 patients (63.5%) were treated with antibiotics, and 162 patients (77.9%) were treated with glucocorticoids. The initial dose of methylprednisolone was 40 mg and the maximum was 500 mg. 48 patients (23.1%) were mechanically ventilated and 10 patients (4.8%) were treated with extracorporeal membrane oxygenation (ECMO). Of the 208 patients, 202(97.1%) patients improved and 6 (2.9%) died. Conclusion: Our case and reported cases should alert physicians to the clinical presentation of vaping-associated lung injury for early diagnosis and prompt management. It is suggested that the standardized management of e-cigarette should be strengthened to avoid similar situation of e-cigarette-related lung injury in China. Additional work is needed to characterize the pathophysiology of this disease.

Accurate diagnosis of colorectal cancer based on histopathology images using artificial intelligence

BACKGROUND

Accurate and robust pathological image analysis for colorectal cancer (CRC) diagnosis is time-consuming and knowledge-intensive, but is essential for CRC patients' treatment. The current heavy workload of pathologists in clinics/hospitals may easily lead to unconscious misdiagnosis of CRC based on daily image analyses.

METHODS

Based on a state-of-the-art transfer-learned deep convolutional neural network in artificial intelligence (AI), we proposed a novel patch aggregation strategy for clinic CRC diagnosis using weakly labeled pathological whole-slide image (WSI) patches. This approach was trained and validated using an unprecedented and enormously large number of 170,099 patches, > 14,680 WSIs, from > 9631 subjects that covered diverse and representative clinical cases from multi-independent-sources across China, the USA, and Germany.

RESULTS

Our innovative AI tool consistently and nearly perfectly agreed with (average Kappa statistic 0.896) and even often better than most of the experienced expert pathologists when tested in diagnosing CRC WSIs from multicenters. The average area under the receiver operating characteristics curve (AUC) of AI was greater than that of the pathologists (0.988 vs 0.970) and achieved the best performance among the application of other AI methods to CRC diagnosis. Our AI-generated heatmap highlights the image regions of cancer tissue/cells.

CONCLUSIONS

This first-ever generalizable AI system can handle large amounts of WSIs consistently and robustly without potential bias due to fatigue commonly experienced by clinical pathologists. It will drastically alleviate the heavy clinical burden of daily pathology diagnosis and improve the treatment for CRC patients. This tool is generalizable to other cancer diagnosis based on image recognition.

[Investigation and analysis of noise hazards in three key industries in Shenzhen City]

Objective: To understand the basic situation of noise hazards in wood furniture manufacturing, stone processing and special equipment manufacturing industries in Shenzhen City, and to provide basis for preventing and controlling noise hazards. Methods: In August 2019, stratified random sampling ws used to select 21 wood funiture manafacturing, 15 stone processing and 24 special equipment manufactruing as survey object. Through the methods of occupational health field investigation, noise intensity measurement and occupational health examination data collection, the noise hazards of 60 enterprises in three industries were statistically analyzed. Results: There were 154, 44 and 113 noise detection points in wood furniture manufacturing, stone processing and special equipment manufacturing enterprises, and 101, 27 and 78 out of standard points respectively, and the exceeding standard rates were 65.6% (101/154) , 61.4% (27/44) and 69.0% (78/113) , respectively. There were 1670, 172 and 856 workers exposed to noise in the three industries. Among them, 1198, 134 and 703 people had taken occupational health examination. The physical examination rates were 71.7% (1198/1670) , 77.9% (134/172) and 82.1% (703/856) , respectively. The abnormal rates were 19.1% (229/1198) , 51.5% (69/134) and 37.8% (266/703) , respectively. Conclusion: High intensity noise working environment, too long noise exposure time, incorrect wearing of personal protective equipment and neglect of occupational health examination are important reasons for hearing loss of noise exposed personnel.

Interplay between the Reorientational Dynamics of the B3H8 - Anion and the Structure in KB3H8

The structure and reorientational dynamics of KB₃H₈ were studied by using quasielastic and inelastic neutron scattering, Raman spectroscopy, first-principles calculations, differential scanning calorimetry, and in situ synchrotron radiation powder X-ray diffraction. The results reveal the existence of a previously unknown polymorph in between the α'- and β-polymorphs. Furthermore, it was found that the [B₃H₈]^- anion undergoes different reorientational motions in the three polymorphs α, α', and β. In α-KB₃H₈, the [B₃H₈]^- anion performs 3-fold rotations in the plane created by the three boron atoms, which changes to a 2-fold rotation around the C ₂ symmetry axis of the [B₃H₈]^- anion upon transitioning to α'-KB₃H₈. After transitioning to β-KB₃H₈, the [B₃H₈]^- anion performs 4-fold rotations in the plane created by the three boron atoms, which indicates that the local structure of β-KB₃H₈ deviates from the global cubic NaCl-type structure. The results also indicate that the high reorientational mobility of the [B₃H₈]^- anion facilitates the K⁺ cation conductivity, since the 2-orders-of-magnitude increase in the anion reorientational mobility observed between 297 and 311 K coincides with a large increase in K⁺ conductivity.

MicroRNA-429 inhibits the proliferation and migration of esophageal squamous cell carcinoma cells by targeting RAB23 through the NF-κB pathway

OBJECTIVE

Esophageal squamous cell carcinoma (ESCC) is the main type of esophageal cancer and is a devastating malignancy. Recent research shows that microRNA-429 (miR-429) has a role in suppressing cell proliferation, cell cycle and promoting apoptosis in many cancers. This study aims to explore the great role of miR-429 in esophageal squamous cell carcinoma.

MATERIAL AND METHODS

The mRNA and protein levels of miR-429 and genes were calculated by using Real Time-quantitative Polymerase Chain Reaction (RT-qPCR) and Western blot. We applied Cell Counting Kit-8 (CCK-8) and transwell assays to measure the proliferative and migratory abilities. Meanwhile, the Kaplan-Meier method was used to calculate the overall survival of esophageal squamous cell carcinoma patients.

RESULTS

MiR-429 was downregulated while RAB23 was upregulated in ESCC tissues and cell lines, and downregulation of miR-429 predicted poor prognosis in ESCC. RAB23 was found to be a direct target gene of miR-429 and its expression was regulated by miR-429 in ESCC. Moreover, miR-429 inhibited the proliferation through nuclear factor-kappa B (NF-κB) pathway and inhibited cell migration-mediated epithelial-mesenchymal transition (EMT) in TE-2 cells. In addition, overexpression of miR-429 suppressed tumor growth of ESCC in vivo.

CONCLUSIONS

MiR-429 inhibited the proliferation through the RAB23/NF-κB pathway and the migration-mediated EMT in ESCC. The newly identified miR-429/RAB23 axis provides novel insight into the pathogenesis of ESCC.

[Efficacy and safety of Kangbingdu granules in the treatment of influenza: a randomized, double-blind, double-dummy, positive-drug parallel control multicenter clinical trial]

Objective: To observe the efficacy and safety of Kangbingdu granules (KBD) in the treatment of influenza. Methods: A multicenter, randomized, double-blind, double-dummy, and positive-drug parallel control trial was conducted in 27 Grade ⅢA hospitals in China and the subjects were randomly assigned to the KBD test group or the oseltamivir phosphate capsule control group at a ratio of 1∶1. 200 subjects were planned to be enrolled in each group. The experimental group was given KBD (18g each time, 3 times a day) and oseltamivir phosphate simulator orally, while the control group was given oseltamivir phosphate capsule (75 mg each time, twice a day) and KBD simulator orally for 5 days. The primary efficacy indicators included the remission time of major clinical symptoms and the time of complete defervescence. The secondary efficacy indicators included dosage of acetaminophen, the change of traditional Chinese medicine (TCM) syndrome score and the remission time of other important clinical symptoms. The efficacy of KBD in the test group and Oseltamivir phosphate control group were compared. Adverse events or adverse reactions were observed at the same time to evaluate the safety of KBD Granules. Results: A total of 393 subjects from 27 Grade ⅢA hospitals in China were enrolled. The experimental group included 195 subjects and 191 subjects (97.95%) completed the trial, While the control group included 198 subjects and 195 subjects (98.48%) completed the trial. There was no significant difference in the shedding rate and rejection rate between the two groups (P>0.05). In the Full Analysis Set (FAS), the mean age of the experimental group was (34.9±14.4) years old, with 83 males (42.78%). The mean age of the control group was (33.3±13.5) years old, with 78 males (39.59%). There were no statistically significant differences between the two groups in demographic data, physical examination, viral pathogen detection, total score of TCM syndromes and scores of each symptom at baseline (P>0.05). In the FAS, the remission time M (Q₁, Q₃) of major clinical symptoms was 3.0 (3.0, 4.0) days in the experimental group and 3.0 (3.0, 4.0) days in the control group, and the difference was not statistically significant (P>0.05). The time M (Q₁, Q₃) of complete defervescence was 34.0 (20.3, 49.0) hours in the experimental group and 36.5 (19.6, 48.8) hours in the control group, and the difference was not statistically significant (P>0.05). KBD granules had the same effect as Oseltamivir phosphate capsule (P>0.05) in terms of acetaminophen dosage, TCM syndrome effect and disappearance rate of most important clinical symptoms. Meanwhile, the disappearance rate of dizziness and chest distress on day 3 in the KBD granules group was better than that of oseltamivir phosphate capsule (P<0.05). Conclusion: KBD granules have the same efficacy as Oseltamivir Phosphate capsule in the treatment of influenza and the drug safety is good.

BMI modifies the association between serum HDL cholesterol and stroke in a hypertensive population without atrial fibrillation

PURPOSE

Both high-density lipoprotein cholesterol (HDL-C) and body mass index (BMI) have an impact on the prevalence of stroke. However, it is unclear whether BMI can modify the relationship between HDL-C and stroke. Therefore, we aimed to assess the effect of the BMI on the association between HDL-C and stroke in a hypertensive population without atrial fibrillation (AF).

METHODS

We analyzed data of 10,925 hypertensive patients without AF from the Chinese Hypertension Registry Study. BMI was categorized as < 24 and ≥ 24 kg/m². Multivariate logistic regression and smooth curve fitting (penalized spline method) were used to analyze the association between HDL-C and stroke in different BMI groups. Subgroup analysis and interaction tests were used to explore the effect of other variables on this relationship.

RESULTS

The results showed a negative association between HDL-C and stroke in the BMI < 24 kg/m² group, but HDL-C was not associated with stroke in the BMI ≥ 24 kg/m² group. In the BMI < 24 kg/m² group, each 1 mmol/L increase in HDL-C was associated with a 50% decreased risk of stroke [odds ratio (OR) 0.50, 95% confidence interval (CI) 0.38-0.66]. No significant relationship between HDL-C and stroke was observed in the BMI ≥ 24 kg/m² group (OR 0.73, 95% CI 0.49-1.10). There was a significant interaction between BMI and HDL-C in regard to the prevalence of stroke in the hypertensive population without AF (P_Interaction = 0.027).

CONCLUSIONS

We found an inverse association between HDL-C and stroke only in the BMI < 24 kg/m² group. The finding suggested that BMI could modify the association between HDL-C and stroke in hypertensive populations without AF.

[Risk factors for surgical site infection after emergency abdominal surgery: a multicenter cross-sectional study in China]

Objective: Surgical site infection (SSI) is the most common infectious complication after emergency abdominal surgery (EAS). To a large extent, most SSI can be prevented, but there are few relevant studies in China. This study mainly investigated the current situation of SSI occurrence after EAS in China, and further explored risk factors for SSI occurrence. Methods: Multi-center cross-sectional study was conducted. Clinical data of patients undergoing EAS in 33 hospitals across China between May 1, 2019 and June 7, 2019 were prospectively collected, including perioperative data and microbial culture results from infected incisions. The primary outcome was the incidence of SSI after EAS, while the secondary outcomes were postoperative hospital stay, ICU occupancy rate, length of ICU stay, hospitalization cost, and mortality within postoperative 30 days. Univariate and multivariate logistic regression models were used to analyze the risk factors of SSI after EAS. Results: A total of 660 EAS patients aged (47.9±18.3) years were enrolled in this study, including 56.5% of males (373/660). Forty-nine (7.4%) patients developed postoperative SSI. The main pathogen of SSI was Escherichia coli [culture positive rate was 32.7% (16/49)]. As compared to patients without SSI, those with SSI were more likely to be older (median 56 years vs. 46 years, U=19 973.5, P<0.001), male [71.4% (35/49) vs. 56.1% (343/611), χ(2)=4.334, P=0.037] and diabetes [14.3% (7/49) vs. 5.1% (31/611), χ(2)=5.498, P=0.015]; with-lower preoperative hemoglobin (median: 122.0 g/L vs. 143.5 g/L, U=11 471.5, P=0.006) and albumin (median: 35.5 g/L vs. 40.8 g/L, U=9452.0, P<0.001), with higher blood glucose (median: 6.9 mmol/L vs. 6.0 mmol/L, U=17 754.5, P<0.001); with intestinal obstruction [32.7% (16/49) vs. 9.2% (56/611), χ(2)=25.749, P<0.001], with ASA score 3-4 [42.9% (21/49) vs. 13.9% (85/611), χ(2)=25.563, P<0.001] and with high surgical risk [49.0% (24/49) vs. 7.0% (43/611), χ(2)=105.301, P<0.001]. The main operative procedure resulting in SSI was laparotomy [81.6%(40/49) vs. 35.7%(218/611), χ(2)=40.232, P<0.001]. Patients with SSI experienced significantly longer operation time (median: 150 minutes vs. 75 minutes, U=25 183.5, P<0.001). In terms of clinical outcome, higher ICU occupancy rate [51.0% (25/49) vs. 19.5% (119/611), χ(2)=26.461, P<0.001], more hospitalization costs (median: 44 000 yuan vs. 15 000 yuan, U=24 660.0, P<0.001), longer postoperative hospital stay (median: 10 days vs. 5 days, U=23 100.0, P<0.001) and longer ICU occupancy time (median: 0 days vs. 0 days, U=19 541.5, P<0.001) were found in the SSI group. Multivariate logistic regression analysis showed that the elderly (OR=3.253, 95% CI: 1.178-8.985, P=0.023), colorectal surgery (OR=9.156, 95% CI: 3.655-22.937, P<0.001) and longer operation time (OR=15.912, 95% CI:6.858-36.916, P<0.001) were independent risk factors of SSI, while the laparoscopic surgery (OR=0.288, 95% CI: 0.119-0.694, P=0.006) was an independent protective factor for SSI. Conclusions: For patients undergoing EAS, attention should be paid to middle-aged and elderly patients and those of colorectal surgery. Laparoscopic surgery should be adopted when feasible and the operation time should be minimized, so as to reduce the incidence of SSI and to reduce the burden on patients and medical institutions.