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At present, percutaneous nephrolithotomy has become an option for hospitals increasingly to treat calculus. However, due to the certain risk of percutaneous nephrolithotomy, it may lead to postoperative complications. Analyzing the preoperative factors of septic shock after percutaneous nephrolithotomy can provide guidance for reducing the incidence of septic shock after PCNL. This article establishes a logistic regression model based on preoperative factors, uses statistical methods, and uses the professional statistical software SPSS to create a database and analyze the data. The method of classification data analysis was used to determine various influencing factors including patient factors, stone factor, and preoperative factors and combined B-ultrasound guidance and percutaneous nephrolithotomy to reduce the risk of surgery. The experimental results found that the percutaneous nephroscope laser lithotripsy guided by the smart Internet of Things can effectively perform lithotripsy; in this paper, the preoperative data of different complications are obtained, and the risk of surgery is closely related to the operation time. The operation time exceeds 90 minutes and causes the risk of severe bleeding after PCNL. It is twice the operation time of less than 90 minutes and 5 times the operation time of less than 60 minutes. [ABSTRACT FROM AUTHOR]

Objective. The rise of zoonotic diseases has become a global health issue around the world. The present study is aimed at assessing the global status and the trends in scrub typhus (ST) research. Methods. Publications related to ST studies from 1945 to 21st July 2020 were retrieved from the Scopus database. The search for the ST literature was conducted using the entry terms of the MeSH (Medical Subject Headings) database. Full research articles and reviews were included in the analysis, and no limitation to the language was specified. Key bibliometric indicator analysis was performed using Microsoft Excel, Bibliometrix (an R package), GraphPad Prism 5, and VOSviewer (version 1.6.6). Results. A total of 1567 publications were retrieved. The results revealed a significant increase in the number of ST publications over time. The documents received an average of 11.22 citations per document. Mahidol University in Thailand (258, 16.46%) was the most productive institution, while the American Journal of Tropical Medicine and Hygiene published the most ST articles (88, 5.62%). Korea (195, 12.44%) was the most productive country, followed by India (178, 11.36%) and China (106, 6.76%). Richards AL was the most productive author with 36 articles. Conclusions. The study findings provide useful insights into the global efforts and works related to the progress of ST research, which can be used to identify future research areas, such as vaccine development. [ABSTRACT FROM AUTHOR]

In this retrospective study, charts of inpatients with spinal tuberculosis (STB) treated in large-scale general hospitals in Changsha, Hunan, China, between 2007 and 2016 were reviewed to investigate their clinical characteristics. Demographic, epidemiological and clinical features, imaging findings, treatment methods, and prognosis were summarized and analyzed. There were 1378 patients, 805 males and 573 females, with a mean age of 43.7 years. The mean interval between symptom onset and diagnosis was 16.0 months (range 15 days–240 months). The incidence of back pain, radicular pain and symptoms of systemic toxicity was 92.5%, 40.1%, and 32.1%, respectively. The rate of neurological impairment was 49.9 %. STB was present in two or more vertebrae in 91.1% of patients, with two adjacent vertebrae being involved in 67.9% of them. The lumbar segment (38.2%) was the most frequently affected, followed by the thoracic spine (35.7%). The sacrococcygeal area was the least frequently involved (0.8%). Abscesses were detected in 65.5% of patients. One thousand patients (72.6%) were managed with surgery and 378 (27.4%) with anti-TB drugs only. Cure was achieved in 1215 patients (88.2%), whereas 49 (3.5 %) had relapses. Concomitant pulmonary TB (PTB) was diagnosed in 366 patients (26.6%) and 63 (4.6%) had concomitant diabetes. Compared with the previous five years, the number of older patients, urban patients, and medical staff with STB had increased by 6.1%, 5.2%, and 1.3%, respectively in the five years studied. STB remains a severe public health problem that cannot be ignored. Most of the patients ignored early symptoms and therefore received untimely treatment. Thus, surveillance for and treatment of STB in South-central China requires strengthening. In addition to the current China-wide database of patients with PTB, a China-wide database of patients with STB should also be set up. [ABSTRACT FROM AUTHOR]

Lynch syndrome is a genetically and clinically heterogeneous disorder; it is caused by a germline mutation in DNA mismatch repair (MMR) genes. Individuals with a heterozygous mutation in MLH1 have an increased risk for developing colorectal cancer. Here we described a 5-generation Chinese Lynch syndrome family with different severity and onset age. A novel heterozygous germline mutation (c.3G>T, p.Met1Ile) in MLH1 gene was discovered by next generation sequencing. Our study also revealed by qPCR that the MLH1 mRNA expression in peripheral blood of patients in this family was remarkably lower than that of the unaffected carriers and non-carriers. The research results indicated that the mRNA expression level may provide predictive suggestions of treatment and management for carriers with the initiation codon mutation of MLH1 in this family. Further studies are undertaken in this family as well as other families with Lynch syndrome to interrogate the exact reasons affecting the MLH1 mRNA expression level and whether mRNA expression in peripheral blood could be a significant factor for early diagnosis and surveillance of Lynch syndrome. [ABSTRACT FROM AUTHOR]

Objective. To evaluate the feasibility, safety, and efficacy of a new surgical method of U-shaped myometrial excavation and modified suture approach with uterus preservation for diffuse adenomyosis. Methods. From January 2012 to December 2014, 198 patients with diffuse adenomyosis were surgically treated using this novel procedure in Zhengzhou Hua-Shan Hospital. Degree of dysmenorrhea, menstrual blood volume, serum CA 125, and uterine size before and at 1 month, 3 months, 6 months, 12 months, and 24 months after surgery were compared. Results. Postoperatively, VAS score of dysmenorrhea, menstrual blood volume, serum CA 125 level, and uterine size significantly decreased at 1 month, 3 months, 6 months, 12 months, and 24 months from presurgical levels (all p < .001), but there were no differences at the follow-up time points. Two patients recurred at 18 months and 23 months after surgery, but both recovered after repeat surgery. Interestingly, 2 other patients recrudesced at 10 months and 12 months after surgery. In addition, only one patient was found to have a postoperative anaemia with fever, conservatively managed without surgery. Conclusion. U-shaped myometrial excavation and modified suture approach with uterus preservation is a safe and feasible surgical approach to treat diffuse adenomyosis, with favourable outcomes. [ABSTRACT FROM AUTHOR]

Colorectal cancer (CRC) is the fifth leading cause of cancer death and the fifth most commonly diagnosed cancer in China. Approximately, 25% of CRC was in the advanced stage as diagnosed, and 40% of patients with CRC progress to metastatic colorectal cancer (mCRC). RAS mutation status is now routinely used to select their therapy. But it is still a question whether RAS mutation status is a prognostic marker. In our study, we detected RAS mutation, immunoscore (IS), and PD-L1 expression in 60 Chinese mCRC patients who received palliative operation. The Kaplan-Meier survival analysis showed that the overall survival (OS) in patients with RAS wild type was better than those with RAS mutated type. Moreover, in multivariate analysis, RAS mutation and PD-L1 expression were demonstrated to be the independent negative prognostic factors for OS (P=0.044, HR: 0.258, and 95% CI: 0.069–0.967; P=0.048, HR: 0.276, and 95% CI: 0.077–0,988). All results suggested that, combined with IS, PD-L1 expression and RAS status may be the prognostic indicators for mCRC patients with palliative operation. [ABSTRACT FROM AUTHOR]

Objective. To examine the relative impact of maternal prepregnancy body mass index (BMI) and glucose level at 24–28 gestational weeks on offspring’s overweight status from birth to 3 years of age in China. Methods. Health care records of 21,354 mother-child pairs were collected. The single and joint associations of maternal prepregnancy BMI and glucose level at 24–28 gestational weeks with 0–3-year-old offspring’s overweight status were assessed. Results. The odds ratios (95% confidence intervals) of offspring’s macrosomia at birth and overweight/obesity at the 12th month, 24th month, and 36th month were 1.12 (1.11–1.13), 1.05 (1.04–1.06), 1.07 (1.06–1.08), and 1.11 (1.10–1.12) for each 1-unit increase (km/m2) in maternal prepregnancy BMI and 1.13 (1.10–1.17), 1.01 (0.99–1.03), 0.99 (0.96–1.01), and 1.00 (0.97–1.02) for each 1-unit increase (mmol/L) in maternal glucose level at 24–28 gestational weeks, respectively. The positive association of maternal glucose level with macrosomia at birth was similar between prepregnancy normal weight (BMI < 24 kg/m2) and overweight (BMI ≥ 24 kg/m2); however, the positive association of high maternal glucose level with childhood overweight was only seen among prepregnancy normal weight mothers but not among overweight mothers. Conclusions. The impact of maternal gestational hyperglycemia on offspring’s overweight before 3 years of age can be modified by prepregnancy BMI. [ABSTRACT FROM AUTHOR]

Aims. To measure plasma levels of superoxide dismutases 1, 2, and 3 (SOD1, 2, 3) and determine whether SODs can function as biomarkers for coronary artery disease (CAD). Patients & Methods. Patient groups were as follows: patients with stable angina pectoris (SAP, n=33), patients with acute coronary syndrome (ACS, n=49), and controls (n=42). Protein quantification was done using ELISA. Results. The concentrations of plasma SOD1 and SOD2 were higher in CAD than in healthy controls. No difference in SOD3 levels between CAD and control groups was found. Limited correlations were found between SODs and gender, age, and severity of coronary artery stenosis. Conclusions. Plasma levels of SOD1 and SOD2 were elevated in patients with CAD and might serve as surrogate biomarkers for CAD. [ABSTRACT FROM AUTHOR]

Acute burn injuries are among the most devastating forms of trauma and lead to significant morbidity and mortality. Appropriate fluid resuscitation after severe burn, specifically during the first 48 hours following injury, is considered as the single most important therapeutic intervention in burn treatment. Although many formulas have been developed to estimate the required fluid amount in severe burn patients, many lines of evidence showed that patients still receive far more fluid than formulas recommend. Overresuscitation, which is known as “fluid creep,” has emerged as one of the most important problems during the initial period of burn care. If fluid titration can be personalized and automated during the resuscitation phase, more efficient burn care and outcome will be anticipated. In the present study, a dynamic urine output based infusion rate prediction model was developed and validated during the initial 48 hours in severe thermal burn adult patients. The experimental results demonstrated that the developed dynamic fluid resuscitation model might significantly reduce the total fluid volume by accurately predicting hourly urine output and has the potential to aid fluid administration in severe burn patients. [ABSTRACT FROM AUTHOR]

Although HAD is now rare due to HAART, the milder forms of HAND persist in HIV-infected patients. HIV-induced systemic and localized inflammation is considered to be one of the mechanisms of HAND. The levels of cytokines in CSF were associated with neurocognitive impairment in HIV infection. However, the changes of cytokines involved in cognition impairment in plasma have not been shown, and their relationships between CSF and plasma require to be addressed. We compared cytokine levels in paired CSF and plasma samples from HIV-infected individuals with or without neurocognitive impairment. Cytokine concentrations were measured by Luminex xMAP. In comparing the expression levels of cytokines in plasma and CSF, IFN-α2, IL-8, IP-10, and MCP-1 were significantly higher in CSF. Eotaxin was significantly higher in plasma, whereas G-CSF showed no difference between plasma and CSF. G-CSF (P=0.0079), IL-8 (P=0.0223), IP-10 (P=0.0109), and MCP-1 (P=0.0497) in CSF showed significant difference between HIV-CI and HIV-NC group, which may indicate their relationship to HIV associated neurocognitive impairment. In addition, G-CSF (P=0.0191) and IP-10 (P=0.0377) in plasma were significantly higher in HIV-CI than HIV-NC. The consistent changes of G-CSF and IP-10 in paired plasma and CSF samples might enhance their potential for predicting HAND. [ABSTRACT FROM AUTHOR]

The recent sporadic infections of humans in China with previously unrecognized avian influenza A virus of the H7N9 subtype (A(H7N9)) have caused concern. The aim is to find out the epidemiological and molecular analysis of the PB1-F2 proteins in H7N9 influenza viruses, in Jiangsu province. Sequences were obtained from GISAID database. Data were analyzed by using Molecular Evolutionary Genetics Analysis software and Bayesian Markov chain Monte Carlo method. From March 1, 2013, to May 31, 2014, 53 patients were confirmed to be infected with the H7N9 virus; one was a retrospective case in Jiangsu province. 38 sequences of PB1 in H7N9 of Jiangsu were obtained from the GISAID online and were then divided into three lineages. Of these sequences, 4 sequences and 3 sequences encode an N-terminally truncated PB1-F2 (52aa)polypeptide and C-terminally truncated PB1-F2 (76aa) polypeptide, respectively. The remaining sequences encode a full-length PB1-F2 (90aa). We estimated a mean evolutionary rate of 3.053 × 10−3 subs/site/year (95% HPD: 2.021 × 10−3–4.051 × 10−3). The site-by-site analysis of selection pressure analysis revealed positively and negatively (12, 3), respectively, selected sites. Influenza A (H7N9) virus adapting into new host, PB1-F2 of H7N9, might be faced with higher selection pressures. [ABSTRACT FROM AUTHOR]

This study involved a death which occurred in four Himalayan griffons housed in Beijing zoo, China. Based on pathogen identification and the pathological changes observed, we did characterize the fungi and Hepatitis E virus (HEV) in four dead Himalayan griffons. Pathological changes were severe. Membranous-like material was observed on the surface of the internal organs. Spleen was necrotic. Focal lymphocyte infiltration in the liver and many sunflower-like fungi nodules were evident in the tissues, especially in the kidney. PCR was used to identify the pathogen. Based on the 18SrRNA genomic sequence of known fungi, the results confirmed that all four dead Himalayan griffons were infected with Aspergillus. At the same time the detection of HEV also showed positive results. To the best of our knowledge, this work appears to be the first report of concurrent presence of Aspergillosis and Hepatitis E virus in rare avian species.

Background: To investigate whether one or more SAMHD1 gene mutations are associated with cerebrovascular disease in the general population using a Chinese stroke cohort., Methods: Patients with a Chinese Han background (N = 300) diagnosed with either cerebral large-artery atherosclerosis (LAA, n = 100), cerebral small vessel disease (SVD, n = 100), or other stroke-free neurological disorders (control, n = 100) were recruited. Genomic DNA from the whole blood of each patient was isolated, and direct sequencing of the SAMHD1 gene was performed. Both wild type and mutant SAMHD1 proteins identified from the patients were expressed in E. coli and purified; then their dNTPase activities and ability to form stable tetramers were analysed in vitro., Results: Three heterozygous mutations, including two missense mutations c.64C>T (P22S) and c.841G>A (p.E281K) and one splice site mutation c.696+2T>A, were identified in the LAA group with a prevalence of 3%. No mutations were found in the patients with SVD or the controls (p = 0.05). The mutant SAMHD1 proteins were functionally impaired in terms of their catalytic activity as a dNTPase and ability to assemble stable tetramers., Conclusions: Heterozygous SAMHD1 gene mutations might cause genetic predispositions that interact with other risk factors, resulting in increased vulnerability to stroke.