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Quality of life of patients with primary open-angle glaucoma based on EQ-5D in Wenzhou

Zhonghua Yan Ke Za Zhi. 2021 Mar 11;57(3):207-214. doi: 10.3760/cma.j.cn112142-20201020-00693.

ABSTRACT

Objective: To evaluate the quality of life of patients with primary open-angle glaucoma (POAG) and its related factors in Wenzhou. Methods: Cross-sectional analysis. A total of 339 POAG patients diagnosed in the Wenzhou glaucoma progression study conducted in the Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University from March 2014 to October 2019 were included. Quality of life of POAG patients was assessed by EQ-5D including the visual analogue scale (VAS). The effects of gender, age, visual field loss (VFL), family history of glaucoma, hypertension, diabetes, migraine, sleep quality, and amateur exercise on the quality of life were analyzed. The utility value (UV) and VAS score were expressed as the median (P25, P75), and Mann-Whitney U was used for the comparison between two groups. Kruskal-Wallis H was performed to compare the differences among multiple groups. Results: A total of 339 POAG patients were included in the study; 164 were males (48.4%), and 175 were females (51.6%). The mean age was (63±10) years. Thirty-four patients (10.0%) had received medication (including one with combined surgical treatment), while the remaining 305 patients (90.0%) had received no anti-glaucoma treatment. Among the patients, 10.5% (32/305) had no VFL, 68.9% (210/305) had mild VFL, 17.0% (52/305) had moderate VFL, and 3.6% (11/305) had severe VFL. In all patients, the median of UV was 1.000 (1.000, 1.000), the mean of UV was 0.964, and the median of VAS score was 80 (75, 90), the mean of VAS score was 81.58. Anxiety or depression and pain or discomfort occurred in 45.7% (43/94) and 34.1% (32/94), respectively, of POAG patients with decreased UVs, as well as mobility constraints in 13.8 % (13/94) and usual activity constraints in 6.4% (6/94). The median of UV of the eye with a better visual field in the group without VFL or with mild or moderate VFL was 1.000 (1.000, 1.000), and in the group with severe VFL was 1.000 (0.862, 1.000), but there was no significant difference in the UV and the VAS score of the eye with a better visual field among groups with different degrees of VFL (both P>0.05). There was statistically significant difference in the UV among groups with different sleep qualities (H=17.465; P<0.01). Using pairwise comparison, the median of UV of the very good sleep group was 1.000 (1.000, 1.000), significantly different to the slightly poor sleep group 1.000 (0.866, 1.000) (z=3.613; P<0.05). The median of UV in patients with migraine was 1.000 (0.875, 1.000), without migraine 1.000 (1.000, 1.000), and in patients with hypertension was 1.000 (0.875, 1.000), without hypertension 1.000 (1.000, 1.000), and in patients with diabetes was 1.000 (0.875, 1.000), without diabetes was 1.000 (1.000, 1.000), the difference was statistically significant (Z=-2.189, -3.864, -2.417; all P<0.05). The UV was not related to age, gender, family history of glaucoma, amateur exercise, alcohol and tobacco, and history of anti-glaucoma medication (all P>0.05). Conclusions: VFL is related to the UV of POAG patients in Wenzhou. Quality of life in mild POAG patients is good but decrease in advanced POAG patients. Sleep quality, systemic complications and physical or psychological discomfort impact on quality of life in POAG patients. (Chin J Ophthalmol, 2021, 57: 207-214).

PMID:33721960 | DOI:10.3760/cma.j.cn112142-20201020-00693

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Correlation between systemic inflammation level and emphysema degree and bone mineral density in chronic obstructive pulmonary disease patients and its mechanism

Zhonghua Jie He He Hu Xi Za Zhi. 2021 Mar 12;44(3):213-217. doi: 10.3760/cma.j.cn112147-20200721-00824.

ABSTRACT

Objective: To study the correlation between systemic inflammation level and emphysema degree and bone mineral density in chronic obstructive pulmonary disease (COPD) patients and its possible mechanism. Methods: 90 patients with stable COPD who met the inclusion criteria and 50 controls in the physical examination center during the same period were recruited. All the enrolled objects have collected general clinical data, analyzed peripheral blood samples, measuring the Low-attenuation area of lung and CT value of lumbar 1 vertebra (L1-CT) by chest spiral CT. According to LAA%, COPD patients were divided into 36 cases of the non-emphysema group, 32cases of mild to moderate emphysema group, and 22 cases of severe emphysema group. The correlation between L1-CT value, LAA%, peripheral blood inflammatory factors, and pulmonary function indices in each group was analyzed and compared. Results: The HU value of L1-CT (107±32) in the COPD group was significantly lower than that in the control group (153±30), and the difference was statistically significant (P<0.05). The higher the LAA% in COPD patients was, the lower the value of L1-CT was, and the difference between groups was statistically significant. Compared with COPD patients in the non-emphysema group, peripheral blood neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and C-reactive protein (CRP) were all increased in the emphysema group, and the differences were statistically significant (P<0.05). L1-CT was negatively correlated with LAA, PLR, NLR, and CRP while uncorrelated with serum concentration of calcium and phosphorus. Conclusion: The decrease in bone density in COPD patients is closely related to the degree of emphysema. It is associated with increased levels of systemic inflammation caused by COPD itself. Early and timely broad-spectrum anti-inflammatory treatment may have certain clinical significance for the prevention and treatment of comorbidity with osteoporosis.

PMID:33721934 | DOI:10.3760/cma.j.cn112147-20200721-00824

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The distribution of blood eosinophils and the related clinical characteristics in chronic obCOPD patients

Zhonghua Jie He He Hu Xi Za Zhi. 2021 Mar 12;44(3):218-224. doi: 10.3760/cma.j.cn112147-20200617-00715.

ABSTRACT

Objective: To analyze the distribution of blood eosinophils (EOS) in COPD patients in the community and outpatient clinics, and to study the clinical characteristics and influencing factors of COPD patients with high EOS counts. Methods: This study included 237 patients with stable COPD, of which the median age was 68 years and males accounted for 81.2%. There were 45 community patients from the China Pulmonary Health study conducted in 2012-2013 and another 192 outpatients who attended the Respiratory Department of Peking University Third Hospital from August 2013 to November 2014 or from September 2015 to May 2018. Taking 100 cells/μl as the cut-off value, it was divided into high EOS group (146 people, 61.6%) and low EOS group (91 people, 38.4%). We compared demographic characteristics, respiratory symptoms, acute exacerbation, lung function, inflammation, imaging and other indicators. Results: The median EOS count of community patients was 110.4 cells/μl, and that of outpatients was 110.0 cells/μl. There was no statistically significant difference in the distribution of blood EOS among community and outpatients. The median EOS count of the general population was 110.0 cells/μl, and the median percentage was 1.8%. EOS≥300 cells/μl accounted for 11.4%. In the high EOS group, the percentage of male gender was higher (85.6% vs 74.7%), the GOLD grade was more severe, and the percentage of neutrophils was lower (61.70% vs 64.70%) (P<0.05 for these three characteristics). After multivariate analysis, the high EOS group was closely related to older age (OR=1.035, 95%CI:1.004-1.067, P=0.029), heavier GOLD grade (P=0.015) and lower percentage of neutrophils (OR=0.956, 95%CI:0.923-0.991, P=0.015). Conclusion: The distribution of blood EOS of COPD patients between the community and the outpatient clinics is not significantly different. About 60% of COPD patients have blood EOS≥100 cells/μl, which is associated with advanced age, male, severe airflow limitation, and low neutrophils.

PMID:33721935 | DOI:10.3760/cma.j.cn112147-20200617-00715

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Analysis of resistance to clofazimine in tuberculosis patients

Zhonghua Jie He He Hu Xi Za Zhi. 2021 Mar 12;44(3):225-229. doi: 10.3760/cma.j.cn112147-20210108-00021.

ABSTRACT

Objective: To analyze the drug resistance of tuberculosis patients to clofazimine. Methods: Retrospective analysis was conducted on the case data of 1 770 tuberculosis patients in Department of tuberculosis, Beijing Chest Hospital affiliated to Capital Medical University from January 2015 to June 2018, including 1 225 males and 545 females, aged 8-92 (43.2±15.2) years old. Drug sensitivity tests using proportion method (hereinafter referred to as drug susceptibility test) for TB strains anti-tb drug resistance test. Using χ2 test or Fisher’s exact test. Results: 1 770 cases of tuberculosis patients, 1 713 cases of patients with clofazimine sensitive, of 57 patients with drug resistance, and resistant rate was 3.2% (57/1 770), including patients with recurrent clofazimine, significantly higher than the initial percentages of patients [5.8% (38/656), 1.7% (19/1 114), χ²= 22.129, P = 0.000, P<0.01]; The drug resistance rates of poly-resistant, multi-drug resistant and extensively resistant patients to clofazimine were 1.0% (17/1 770), 1.2% (21/1 770) and 1.1% (19/1 770), respectively. Has a history of hospitalization of clofazimine resistance of multidrug-resistant and extensively drug-resistant patients resistant rate 2.4% (14/594), 2.7% (16/594), respectively, higher than 0.6% (7/1 176) with no history of hospitalized patients, 0.3% (3/1 176), the differences were statistically significant (χ²=10.447,22.099,P=0.001,<0.001). Conclusion: Clofazimine has a low resistance rate, which can improve the treatment success rate of patients with drug-resistant tuberculosis and has important value.

PMID:33721936 | DOI:10.3760/cma.j.cn112147-20210108-00021

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The efficacy of balloon dilatation in clinical improving period for patients who suffered from actively caseating endobronchial tuberculosis and central airway stenosis

Zhonghua Jie He He Hu Xi Za Zhi. 2021 Mar 12;44(3):237-242. doi: 10.3760/cma.j.cn112147-20210108-00022.

ABSTRACT

Objective: To investigate the efficacy of balloon dilatation performed for patients who suffered from actively caseating endobronchial tuberculosis (EBTB) and central airway stenosis in clinical improving period who’s bronchus has not formed mature scar tissue. Methods: A total of 152 tuberculous unilateral main bronchus stenosis patients (23 male and 129 female) who received treatment in Hunan Chest Hospital from January 1st 2014 to December 31st 2018 were included in this retrospective analysis. The age was 15-66 (33.3±11.9) years old. All patients received routine anti-tuberculosis chemotherapy. Sixty-four of them who suffered from actively caseating EBTB and unilateral main bronchus stenosis received cryotherapy and endobronchial isoniazid (INH) administration till the caseating necrosis in stenotic bronchus was disappeared and ulcers were recovered, and then received balloon dilatation combined with cryotherapy, were test group. Eighty-eight of them who suffered from fibrostenotic EBTB received balloon dilatation combined with cryotherapy were control group. We analyzed the efficacy and complications after treatments. Results: The lung re-expansion rate after treatment in test group was higher than the control group, and the differences were statistically significant [74.0%(37/50) vs. 37.9%(22/58), χ²=14.094, P<0.001]. The 6-month re-stenosis rate in test group was lower than control group, and the differences were statistically significant [10.9%(7/64) vs. 30.7% (27/88), χ²=8.318, P=0.004]. The differences of diameter and diameter variation after balloon dilatation, immediate effective rates, average times of balloon dilatation and procedure-related bleeding (<10 ml) rates, chest pain rates had no statistical signification in two groups. Severe complications including fatal bleeding (>100 ml) and mediastinal emphysema did not occur during our procedures. Conclusions: Performing balloon dilatation for patients who suffered from actively caseating EBTB and central airway stenosis in the clinical improvement period, when caseous necrosis tissue disappeared and ulcers were recovered, not only helps to perform interventional procedures on distal bronchus in time, increase the rate of lung re-expansion, can also reduce the rate of re-stenosis after 6 months, so it is effective and safe.

PMID:33721938 | DOI:10.3760/cma.j.cn112147-20210108-00022

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Exploring the variability of radiomic features of lung cancer lesions on unenhanced and contrast-enhanced chest CT imaging

Phys Med. 2021 Mar 12;82:321-331. doi: 10.1016/j.ejmp.2021.02.014. Online ahead of print.

ABSTRACT

PURPOSE: The aim of this methods work is to explore the different behavior of radiomic features resulting by using or not the contrast medium in chest CT imaging of non-small cell lung cancer.

METHODS: Chest CT scans, unenhanced and contrast-enhanced, of 17 patients were selected from images collected as part of the staging process. The major T1-T3 lesion was contoured through a semi-automatic approach. These lesions formed the lesion phantoms to study features behavior. The stability of 94 features of the 3D-Slicer package Radiomics was analyzed. Feature discrimination power was quantified by means of Gini’s coefficient. Correlation between distance matrices was evaluated through Mantel statistic. Heatmap, cluster and silhouette plots were applied to find well-structured partitions of lesions.

RESULTS: The Gini’s coefficient evidenced a low discrimination power, <0.05, for four features and a large discrimination power, around 0.8, for five features. About 90% of features was affected by the contrast medium, masking tumor lesions variability; thirteen features only were found stable. On 8178 combinations of stable features, only one group of four features produced the same partition of lesions with the silhouette width greater than 0.51, both on unenhanced and contrast-enhanced images.

CONCLUSIONS: Gini’s coefficient highlighted the features discrimination power in both CT series. Many features were sensitive to the use of the contrast medium, masking the lesions intrinsic variability. Four stable features produced, on both series, the same partition of cancer lesions with reasonable structure; this may merit being objects of further validation studies and interpretative investigations.

PMID:33721791 | DOI:10.1016/j.ejmp.2021.02.014

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Quantify Point Defects in Monolayer Tungsten Diselenide

Nanotechnology. 2021 Mar 15. doi: 10.1088/1361-6528/abeeb2. Online ahead of print.

ABSTRACT

Point defects may significantly influence the electrical and optoelectronic properties of two-dimensional tungsten diselenide (WSe2), while precise information about point defects distribution (e.g., species and concentration) in monolayer (ML-) WSe2 are hard to obtain. In this letter, we tried to partly fill this knowledge gap via performing quantitative and statistical analysis of intrinsic point defects in WSe2 monolayers prepared by three so-called main-stream approaches i.e., mechanical exfoliation (ME), chemical vapor deposition (CVD), and molecular beam epitaxy (MBE), which are promising for providing high-quality samples. Via a conjunction of statistic atomic-resolution annular dark-field scanning transmission electron microscopy (ADF-STEM) imaging, software-based automated defect identification and counting, together with image simulations, defect species and concentrations were quantitatively determined. Seven types of intrinsic point defects were identified in ML-WSe2 and the most dominant one is selenium mono-vacancy (VSe) (corresponding to one Se atom missing), irrespective of the synthetic route and growth conditions. Exact contents and diversity of point defects depend on the specific preparation method: CVD grown ML-WSe2 is the most defective (for example, the density of VSe reaches 1.40% in atomic ratio), followed by ME (~ 0.79 at% for VSe) and MBE grown samples (~ 0.42 at% for VSe). Our results, though still with limited sampling, provide preliminary quantitative information of point defects in ML-WSe2, which can serve as a reference to achieve the precisely controlled large-scale sample growth and establish the structure-property relationship of two-dimensional transition-metal dichalcogenides (2D TMDCs) materials.

PMID:33721843 | DOI:10.1088/1361-6528/abeeb2

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Radiation risks of lymphoma and multiple myeloma incidence in the updated NRRW-3 cohort in the UK: 1950-2011

J Radiol Prot. 2021 Mar 15. doi: 10.1088/1361-6498/abee96. Online ahead of print.

ABSTRACT

The effect of external radiation on lymphoma, including non-Hodgkin lymphoma (NHL), Hodgkin lymphoma (HL) and multiple myeloma (MM) incidence was evaluated in the National Registry for Radiation Workers (NRRW) based upon the 3rd analysis cohort but with an additional 10 years of follow-up. The study includes 172,452 workers, of whom (90%) were men with 3.6 million person-years of follow-up from 1950 through to the end of 2011. A total of 711 cases of NHL, 113 cases of HL and 279 cases of MM were registered. Poisson regression was used to estimate the excess relative risk (ERR) per unit of cumulative exposure to ionising radiation. A statistically significant association was found between radiation dose and the incidence of NHL and MM. There was no evidence of radiation associated excess risk for HL. The reported associations are based on a very small proportion of exposed workers, in particular among workers with cumulative doses above 0.5 Sv so should be treated with caution, further investigations are necessary to confirm our results.

PMID:33721859 | DOI:10.1088/1361-6498/abee96

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Statistical Note: Confounding and Causality in Observational Studies

Pediatr Crit Care Med. 2021 Mar 16. doi: 10.1097/PCC.0000000000002702. Online ahead of print.

NO ABSTRACT

PMID:33721879 | DOI:10.1097/PCC.0000000000002702

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Antiviral activity of oleandrin and a defined extract of Nerium oleander against SARS-CoV-2

Biomed Pharmacother. 2021 Mar 3;138:111457. doi: 10.1016/j.biopha.2021.111457. Online ahead of print.

ABSTRACT

With continued expansion of the coronavirus disease (COVID-19) pandemic, caused by severe acute respiratory syndrome 2 (SARS-CoV-2), both antiviral drugs as well as effective vaccines are desperately needed to treat patients at high risk of life-threatening disease. Here, we present in vitro evidence for significant inhibition of SARS-CoV-2 by oleandrin and a defined extract of N. oleander (designated as PBI-06150). Using Vero cells, we found that prophylactic (pre-infection) oleandrin (as either the pure compound or as the active principal ingredient in PBI-06150) administration at concentrations as low as 0.05 µg/ml exhibited potent antiviral activity against SARS-CoV-2, with an 800-fold reduction in virus production, and a 0.1 µg/ml concentration resulted in a greater than 3000-fold reduction in infectious virus production. The half maximal effective concentration (EC50) values were 11.98 ng/ml when virus output was measured at 24 h post-infection, and 7.07 ng/ml measured at 48 h post-infection. Therapeutic (post-infection) treatment up to 24 h after SARS-CoV-2 infection of Vero cells also reduced viral titers, with 0.1 µg/ml and 0.05 µg/ml concentrations causing greater than 100-fold reduction as measured at 48 h, and the 0.05 µg/ml concentration resulting in a 78-fold reduction. Concentrations of oleandrin up to 10 µg/ml were well tolerated in Vero cells. We also present in vivo evidence of the safety and efficacy of defined N. oleander extract (PBI-06150), which was administered to golden Syrian hamsters in a preparation containing as high as 130 µg/ml of oleandrin. In comparison to administration of control vehicle, PBI-06150 provided a statistically significant reduction of the viral titer in the nasal turbinates (nasal conchae). The potent prophylactic and therapeutic antiviral activities demonstrated here, together with initial evidence of its safety and efficacy in a relevant hamster model of COVID-19, support the further development of oleandrin and/or defined extracts containing this molecule for the treatment of SARS-CoV-2 and associated COVID-19 disease and potentially also for reduction of virus spread by persons diagnosed early after infection.

PMID:33721754 | DOI:10.1016/j.biopha.2021.111457