Tag: statistics

Zhonghua Jie He He Hu Xi Za Zhi. 2021 Jun 12;44(6):525-530. doi: 10.3760/cma.j.cn112147-20210329-00208.

ABSTRACT

Objective: To understanding the clinical characteristics of the patients of pneumonia concomitant with acute pulmonary embolism, and the early identification of high-risk patients. Methods: Retrospective analysis of hospitalized patients with confirmed diagnosis of community acquired pneumonia (CAP) with concomitant pulmonary embolism (PE) within a period of 5 years. Patients hospitalized with CAP alone in the same period were included in the control group in a ratio of 1∶2 according to the principle of gender and age. The demographic characteristics, clinical feature, laboratory examination, radiographic and other clinical data of these 2 groups of patients were studied. Statistical analysis was performed by Chi-square test, Kruskal-Wallis test and logistic regression. Results: Thirty-nine patients with CAP combined with PE and 78 patients with CAP alone were included. Compared to patients with CAP alone, dyspnea (21/39 vs 21/78, P=0.004), a history of heart disease (10/39 vs 8/78, P=0.031), and a history of connective tissue diseases (3/39 vs 0/78, P=0.035) were more common to seen in patients with CAP combined with PE. D-dimer [2 222(854, 3 539) ng/ml vs 295(168, 707) ng/ml, P=0.000], arterial PH value (7.5±0.5 vs 7.4±0.4, P=0.022), BNP [103.9(48.7, 236.8) pg/ml vs 98.4(44.8, 246.3) pg/ml, P=0.028] and incidence of lower extremity venous thrombosis (18/39 vs 3/41, P=0.000) were higher in patients with CAP combined with PE, while arterial partial pressure of CO₂ [(35.3±6.2) mmHg vs (38.4±4.4) mmHg, P=0.009, 1 mmHg=0.133 kPa] was lower. Logistic regression analysis showed that D-dimer (P=0.000) and dyspnea (P=0.033) were associated with the risk of PE. Conclusion: When patients with CAP represent dyspnea or have a history of heart disease or connective tissue diseases concomitant PE should be considered for differential diagnosis. Determination of D-dimer, arterial PH value, arterial partial pressure of CO₂, BNP and ultrasonography of lower extremities had important implications for the diagnosis of pneumonia complicated with acute pulmonary embolism.

PMID:34102713 | DOI:10.3760/cma.j.cn112147-20210329-00208

Zhonghua Jie He He Hu Xi Za Zhi. 2021 Jun 12;44(6):537-542. doi: 10.3760/cma.j.cn112147-20200722-00830.

ABSTRACT

Objective: To investigate the effect of VDR gene silencing on proliferation of airway smooth muscle cells (ASMCs) and elucidate the role of NF-κB. Methods: A recombinant lentiviral vector specifically targeting VDR gene in rat was constructed by RNA interference. Rat ASMCs were divided into blank group, empty vector group and interference group. ASM cell line model stably silencing the VDR gene RNA expressing was selected by puromycin. Then MTT colorimetric assay and cell cycle analysis by flow cytometry were used to examine cell proliferation. The activation of nuclear factor-κB was determined by immunofluorescence double label method. Moreover, NF-κB-dependent transcription activity was tested through luciferase reporter gene assay. Western blotting was used for IκBα and phospho-IκBα protein levels and actinomycin D treatment was used to determine IκBα mRNA stability. All statistical analyses were performed using SPSS version 23.0 software. Differences between groups were analyzed using one-way ANOVA analysis. Multiple comparisons among groups were made by Student-Newman-Keuls test. Results: (1) As compared with those in the blank group and the empty vector group, the cell proliferation index (PI) and the percent of ASMCs at G₂/M phase in the interference group were markedly increased (P<0.05), but their percent at G_0/1 phase was decreased (P<0.05).(2) In the interference group, the nuclear translocation of NF-κB p65 in ASMCs was obviously induced. And its level of receptor gene NF-κB p65 (1.37±0.28) was significantly higher than that in the blank group (1.00±0.19,P=0.031) and in the empty vector group (0.96±0.18,P=0.027).(3) In the interference group, the IκBα protein level in ASMCs (0.13±0.04) was obviously less than that in the blank group (0.29±0.05, P=0.023) and in the empty vector group (0.32±0.07, P=0.014). Oppositely, the p-IκBα/IκBα level in the interference group (0.86±0.04) was much more than that in the blank control group (0.41±0.07, P=0.026) and in the empty vector group (0.37±0.05, P=0.017). (4) In the interference group, IκBα mRNA showed a shorter half-life, (171.31±9.67) min, compared to that in the blank group [(224.69±7.95) min,P=0.032] and in the empty vector group [(230.41±6.37) min,P=0.035]. Conclusion: VDR gene silencing could promote ASMC proliferation and the underlying mechanism may involve the activation of NF-κB signaling pathway.

PMID:34102715 | DOI:10.3760/cma.j.cn112147-20200722-00830

Zhonghua Jie He He Hu Xi Za Zhi. 2021 Jun 12;44(6):543-549. doi: 10.3760/cma.j.cn112147-20201009-01027.

ABSTRACT

Objective: To analyze the diversity, abundance and structural composition of intestinal microflora in patients with different severity of OSAHS, and to explore their potential role in the occurrence and development of OSAHS. Methods: A total of 27 healthy volunteers(N) [male 19, female 8, age 22-78(44.4±2.7)years old] of Health Examination Center of the Second Hospital of Shanxi Medical University and 100 patients with OSAHS [male 86, female 14, age 19-78(49.1±1.3) years old] of Sleep Medicine Center of the Second Hospital of Shanxi Medical University were enrolled from December 2018 to September 2019, and patient-related sleep monitoring data and medical history data were collected.According to the AHI classification and whether there were complications, OSAHS patients were divided into mild group (L), moderate group (M), severe group (S) and severe complication group (SC).Using 16S rRNA high-throughput sequencing technology to analyze the intestinal flora of all people, bioinformatics related statistics were analyzed by QIIME2 software, and clinical data were analyzed by SPSS 25.0 software. Results: There was no significant difference in intestinal flora Alpha and Beta diversity among all groups (P>0.05). At phylum level, the relative abundance of Bacteroides in OSAHS group was lower than that in normal group (N group: 24.96%, L group: 18.31%, M group: 12.95%, S group: 15.78%, Sc group: 16.48%). At genus level, the relative abundance of Bacteroides (N group:16.03%, L group: 10.82%, M group: 9.79%, S group: 9.29%, Sc group: 8.25%) and Faecalibacterium (N group: 11.21%, L group: 10.42%, M group: 10.21%, S group: 8.54%, Sc group: 6.27%) were negatively correlated with the severity of OSAHS (the values of r respectively were -0.887, -0.945) while the relative abundance of Bifidobacterium (N group: 3.20%, L group: 2.47%, M group: 4.10%, S group: 4.93%, Sc group: 6.27%) and Blautia (N group: 2.52%, L group: 3.59%, M group: 3.81%, S group: 4.11%, Sc group: 5.86%) were positively correlated with the severity of OSAHS (the values of r respectively were 0.916, 0.940) Compared with the S group, the relative abundance of Roseburia (S group: 10.22%, Sc group: 6.65%) in the Sc is lower and the relative abundance of Shigella(S group: 4.64%, Sc group: 10.01%) is higher. Redundancy analysis (RDA) showed that Apnea hypopnea index (AHI), The lowest oxygen saturation (SpO₂min), The average saturation of blood oxygen (SpO₂mean) and The longest time of apnea (Tmax) were not significantly correlated with the overall abundance of intestinal flora (P>0.05), However, there was a significant correlation between the abundance of different flora and sleep monitoring indicators. Conclusion: There is an intestinal microecological imbalance in patients with OSAHS, mainly due to the reduction of the relative abundance of probiotics producing short-chain fatty acids and the increase of pathogenic bacteria, suggesting that the disturbance of intestinal flora may be related to the occurrence and development of OSAHS.

PMID:34102716 | DOI:10.3760/cma.j.cn112147-20201009-01027

J Hypertens. 2021 Jun 4. doi: 10.1097/HJH.0000000000002903. Online ahead of print.

ABSTRACT

OBJECTIVES: Turner syndrome (TS) is associated with increased cardiovascular risk. We investigated whether hormone replacement therapy (HRT) affects endothelial function, arterial stiffness and myocardial deformation in women with TS.

METHODS: Twenty-five women with TS were studied in the estrogen phase of the HRT and two months after discontinuation of HRT. The following measurements were made: flow-mediated dilation (FMD) of the brachial artery, pulse wave velocity (PWV-Complior) and central systolic blood pressure (cSBP), carotid intima-media thickness (cIMT), aortic (Ao) elastic indexes – namely Ao strain, distensibility, stiffness index and pressure strain modulus (Ep) – and left ventricular (LV) global longitudinal strain (GLS) using speckle-tracking echocardiography. Ten healthy female of similar age and BMI served as a control group.

RESULTS: Compared to controls, women with TS on HRT had higher PWV (9.1 ± 2.4 vs. 7.5 ± 0.5 m/s), cSBP (130 ± 15 vs. 121 ± 6 mmHg), cIMT (0.66 ± 0.06 vs. 0.55 ± 0.05 mm), aortic stiffness index, Ep and LA strain, and lower FMD (7.2 ± 4 vs. 10.5 ± 2.3%), Ao strain, Ao distensibility and GLS (-18.8 ± 2.7 vs. -21.9 ± 1.5%) (P < 0.05 for all comparisons). Two months after discontinuation of HRT, all women increased FMD (11.7 ± 6 vs. 7.2 ± 4%) and reduced PWV (7.8 ± 1.7 vs. 9.1 ± 2.4 m/s) and cSBP (123 ± 14 vs. 130 ± 15 mmHg). There were no statistically significant changes in BMI, cIMT and GLS (P > 0.05 for all comparisons). The percentage decrease of cSBP was associated with the percentage decrease of PWV (r = 0.54) and reversely related with the percentage increase of FMD (r = -0.57; P < 0.05 for all comparisons).

CONCLUSIONS: HRT in women with TS may deteriorate endothelial function contributing to increased arterial stiffness and central arterial blood pressure.

PMID:34102661 | DOI:10.1097/HJH.0000000000002903

J Hypertens. 2021 Jun 4. doi: 10.1097/HJH.0000000000002902. Online ahead of print.

ABSTRACT

OBJECTIVES: Blood pressure has decreased in the general population. We aimed to examine whether this is true also among the very old, and among persons with and without dementia. Further, we aimed to investigate how common undetected and untreated hypertension is in the very old, both among people with and without dementia.

METHOD: Blood pressure was measured in representative population samples of 85-year-olds living in Gothenburg, Sweden, examined 1986-1987 (n = 484) and 2008-2010 (n = 571). Dementia was diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, edition 3 revised, by the same medical doctor at both examinations.

RESULTS: Both systolic and diastolic blood pressure were lower in 85-year-olds examined 2008-2010 than in those examined 1986-1987, both among those with and without dementia. Participants with dementia had lower systolic blood pressure than those without dementia in both cohorts, and blood pressure levels related to dementia severity. Despite this, hypertension (≥140/90 mmHg) was found in almost half (46.5%) of those with dementia in 2008-2010.

CONCLUSION: Our findings show that time-trends of lower blood pressure in western populations also applies to the very old, and that individuals with dementia continue to have lower blood pressure compared to the rest of the population. The latter finding suggests that the pathophysiological processes in dementia affect blood pressure regulating regions in the brain independent of time trends. Still, hypertension is common in dementia and needs to be detected and treated.

PMID:34102663 | DOI:10.1097/HJH.0000000000002902

Ultraschall Med. 2021 Jun 8. doi: 10.1055/a-1493-2367. Online ahead of print.

ABSTRACT

PURPOSE: To describe the perinatal outcome of a prospective cohort of late-onset small-for-gestational-age (SGA) fetuses and to test adverse perinatal outcome (APO) prediction using Doppler measurements.

METHODS: Singleton pregnancies from 32 weeks with suspicion of SGA (followed-up each 2 weeks) and randomly selected healthy controls at a university hospital were included. The whole SGA group was divided into the FGR subgroup or SGA percentile 3-10 subgroup. The following Doppler measurements were evaluated prospectively: umbilical artery (UA) pulsatility index (PI), middle cerebral artery (MCA) PI, cerebro-placental ratio (CPR), and mean uterine artery (mUtA) PI. APO was defined as arterial cord blood pH ≤ 7.15 and/or 5-minute Apgar ≤ 7 and/or emergency operative delivery and/or admission to the neonatal unit. Induction of labor was indicated according to a stage-based protocol.

RESULTS: A total of 149 SGA and 143 control fetuses were included. The number of operative deliveries was similar between both groups (control: 29 %, SGA: 28 %), especially the cesarean delivery rate after the onset of labor (11 % vs. 10 %). Most SGA cases ended up in induction of labor (61 % vs. 31 %, p < 0.001). The areas under the curve (AUC) for APO prediction were similar using the last UA PI, MCA PI, CPR, and mUtA PI and barely reached 0.60. The AUC was best for the FGR subgroup, using the minimal CPR or maximum mUtA PI z-score of all longitudinal measurements (AUC = 0.63).

CONCLUSION: SGA fetuses do not have a higher rate of operative delivery if managed according to a risk stratification protocol. Prediction of APO is best for SGA and FGR using the “worst” CPR or mUtA PI but it remains moderate.

PMID:34102686 | DOI:10.1055/a-1493-2367

Blood Coagul Fibrinolysis. 2021 Jun 7. doi: 10.1097/MBC.0000000000001039. Online ahead of print.

ABSTRACT

Congenital factor XIII (FXIII) deficiency is one of the rarest bleeding disorders, with an incidence of one per 2 million persons. Intracranial hemorrhage (ICH), a major cause of mortality in FXIII deficiency, is reported to be associated with vascular endothelial growth factor (VEGF) and thrombospondin-1 (TSP-1). Therefore, we investigated the association of VEGF and TSP-1 expression and methylation patterns with ICH in congenital FXIII deficiency patients. This study was conducted on 40 participants with FXIII, 20 of whom experienced ICH (cases), and 20 who did not (controls). Methylation pattern, gene expression, and plasma protein level were assessed using bisulfite sequencing PCR, quantitative real-time PCR, and ELISA. We found a partially methylated pattern for both VEGF and TSP-1 (P > 0.05). VEGF mRNA levels of the case group were significantly higher than those of the control group (P < 0.05), whereas TSP-1 mRNA levels did not show significant upregulation (P > 0.05). Plasma VEGF and TSP-1 concentrations in the case group were higher, but not statistically significant (P > 0.05). Our findings showed no obvious correlation between VEGF or TSP-1 methylation patterns and expression, suggesting that their expression in FXIII deficiency may not solely be controlled by gene methylation.

PMID:34102652 | DOI:10.1097/MBC.0000000000001039

Environ Int. 2021 Jun 5;155:106669. doi: 10.1016/j.envint.2021.106669. Online ahead of print.

ABSTRACT

BACKGROUND: Residential airborne fungi may present obvious risk to human health. However, many countries do not recognize the necessarily need to control residential airborne culturable fungi (RAF). In China, few systemic investigations have been conducted to illustrate the distribution of residential airborne fungi and identify the association between indoor influencing variables and RAF under general living scenario in China.

OBJECTIVE: This study aimed to investigate RAF with the on-site research of 12 typical cities in China, and provided the latest characteristics and potential influencing factors of RAF under general living scenario.

METHODS: We measured RAF and investigated residential characteristics in 12 typical cities in China, 2018. At least 50 resident families were randomly selected both from downwind and upwind districts in each city with pre-proposed requirements. The RAF were sampled by the six-stage Anderson impactor. PM_2.5 and PM₁₀ were monitored by calibrated light-scattering dust meters. CO and CO₂ were monitored by non-dispersive infrared analyzer method. NO₂ was determined by Saltzman method. General linear model was used to evaluate the association between RAF exposure and residential characteristics with adjustment for potential confounders.

RESULTS: The RAF concentrations ranged from 0 to 9371 CFU/m³ with a median concentration of 396 CFU/m³. The median concentrations of RAF in the warm season were statistically higher than the cold season in Panjin, Qingdao, Lanzhou and Luoyang, but lower than the cold season in Shijiazhuang, Ningbo and Nanning. RAF in the bedrooms were more than the living rooms in all cities except Xi’an. Temperature and humidity had an interactive effect on the RAF (OR = 1.0006, 95% CI: 1.0005, 1.0006). Some residential environmental pollutants, including PM_2.5 (OR = 0.9989, 95% CI: 0.9988, 0.9989), PM₁₀ (OR = 0.9993, 95% CI: 0.9993, 0.9993), and CO₂ (OR = 0.0236, 95% CI: 0.0230, 0.0243), were negatively correlated with RAF. CO (OR = 1.1450, 95% CI: 1.1433, 1.1467) and NO₂ (OR = 1.0026, 95% CI: 1.0024, 1.0028) were positively correlated with RAF. Architectural characteristics (sunlight exposure, building history, longitude, latitude, total living area, living floor, distance from the road, house type, the layers of window glass and decoration), family-related information (income) and lifestyle behaviors (keeping pets, growing plants, cooking, using insecticide, burning incense, heating, using air conditioner and cleaning frequencies) were also significantly related with RAF.

CONCLUSIONS: This study reported nation-wide baseline condition of RAF and related influencing factors under general living scenario with quantitative details, which are exceedingly promising for evidence-driven standard and reasonable control strategy of residential airborne culturable in China.

PMID:34102580 | DOI:10.1016/j.envint.2021.106669

J Clin Psychopharmacol. 2021 Jun 7. doi: 10.1097/JCP.0000000000001417. Online ahead of print.

ABSTRACT

BACKGROUND: Given the relative lack of psychiatric information and data on the perpetrators of US mass shootings, the aim of our study was to understand who these “mass shooters” were and whether they had a psychiatric illness. If so, were they competently diagnosed, and if so, were they treated with appropriate medication for their diagnoses before the violence?

METHODS: Because a prospective study of diagnosis and treatment could not, for obvious reasons, be carried out, we designed a retrospective, observational study of mass shooters, defined as those who killed 4 or more people with firearms between 1982 and 2012 or who killed 3 or more people with firearms between 2013 and 2019 in the United States. We used the Mother Jones database-a database of 115 persons identified as committing a mass shooting in the United States between January 1982 and September 2019. In the vast majority of the incidents identified in the database, the perpetrator died either during or shortly after the crime, leaving little reliable information about their history-especially psychiatric history. We focused on the 35 mass shooters who survived and for which legal proceedings were instituted because these cases presented the most reliable psychiatric information. For each of these 35 mass shootings, we interviewed forensic psychiatrists and forensic psychologists who examined the perpetrator after the crime and/or collected the testimony and reports by psychiatrist(s) at trial or in the postconviction proceedings contained in the court record. In addition, we reviewed available information from the court proceedings, public records, a videotaped interview of assailant by law enforcement, social media postings of the assailant, and writings of the assailant. After collecting the clinical information from multiple sources on each case to make a Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, diagnosis, we also completed a Sheehan Diagnostic Scale. After this, 20 additional cases where the assailant died at the crime were randomly selected form the remaining 80, to determine whether there were differences in psychiatric diagnoses and treatment between such assailants and those who survived.

RESULTS: Twenty-eight of 35 cases in which the assailant survived had a psychiatric diagnosis-18 with schizophrenia, 3 with bipolar I disorders, 2 with delusional disorders, persecutory type, 2 with personality disorders (1 paranoid and 1 borderline), 2 with substance-related disorders without other psychiatric diagnoses, and 1 with posttraumatic stress disorder. Four had no psychiatric diagnosis, and in 3, we did not have enough information to make a diagnosis.Of 15 of 20 cases in which the assailant died, 8 had schizophrenia. None of those diagnosed with psychiatric illnesses were treated with medication.

CONCLUSIONS: A significant proportion of mass shooters experienced unmedicated and untreated psychiatric disorder.

PMID:34102649 | DOI:10.1097/JCP.0000000000001417

J Environ Manage. 2021 Jun 5;294:112973. doi: 10.1016/j.jenvman.2021.112973. Online ahead of print.

ABSTRACT

The dramatic increase in world population underpins current escalating food demand, which requires increased productivity in the available arable land through agricultural intensification. Agricultural intensification involves increased agrochemicals use to increase land productivity. Increased uses of agrochemicals pose environmental and ecological risks such as contamination and water eutrophication. Consequently, toxic metals accumulate in plant products, thus entering the food chain leading to health concerns. To achieve this study, secondary data from peer-reviewed papers, universities, and government authorities were collected from a public database using Tanzania as a case study. Data from Science Direct, Web of Science, and other internet sources were gathered using specific keywords such as nutrient saturation and losses, water eutrophication, potentially toxic metal (PTEs), and impact of toxic metals on soils, water, and food safety. The reported toxic metal concentrations in agro-ecosystem worldwide are linked to agricultural intensification, mining, and urbanization. Statistical analysis of secondary data collected from East African agro-ecosystem had wide range of toxic metals concentration such as; mercury (0.001-11.0 mg Hg/kg), copper (0.14-312 mg Cu/kg), cadmium (0.02-13.8 mg Cd/kg), zinc (0.27-19.30 mg Zn/kg), lead (0.75-51.7 mg Pb/kg) and chromium (19.14-34.9 mg Cr/kg). In some cases, metal concentrations were above the FAO/WHO maximum permissible limits for soil health. To achieve high agricultural productivity and environmental safety, key research-informed policy needs are proposed: (i) development of regulatory guidelines for agrochemicals uses, (ii) establishment of agro-environmental quality indicators for soils and water assessment to monitor agro-ecosystem quality changes, and (iii) adoption of best farming practices such as split fertilization, cover cropping, reduced tillage, drip irrigation to ensure crop productivity and agro-ecosystem sustainability. Therefore, robust and representative evaluation of current soil contamination status, sources, and processes leading to pollution are paramount. To achieve safe and sustainable food production, management of potential toxic metal in agro-ecosystems is vital.

PMID:34102465 | DOI:10.1016/j.jenvman.2021.112973