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Background: The lipid accumulation product (LAP) and the visceral adiposity index (VAI) are suggested as dependable measures for assessing visceral fat levels. Prediabetes is recognized as a condition that precedes the potential onset of diabetes. The objective of this research is to investigate how VAI and LAP are related to prediabetes among the adult population in the United States. Methods: Information from the 2007–2020 National Health and Nutrition Examination Survey (NHANES) was scrutinized in a cross-sectional study. To evaluate the connection between VAI or LAP and the presence of prediabetes, both univariate analysis and multivariate logistic regression were utilized. Threshold effect analysis and fitted smoothing curves were used to delve into the non-linear association between VAI or LAP and prediabetes. Additional analyses were performed on specific subgroups, along with tests to explore potential interactions. Results: In general, 12,564 American adults were included. After full adjustment, prediabetes with VAI (OR: 1.128, 95% CI: 1.073–1.185) or LAP (OR: 1.006, 95% CI: 1.004–1.008) showed a positive correlation. Individuals in the 4th VAI quartile group faced a significant 61.9% elevated risk for prediabetes (OR: 1.619, 95% CI: 1.354–1.937) when contrasted to those in the 1st VAI quartile. Participants in the 4th LAP quartile group had a significant 116.4% elevated risk for prediabetes (OR: 2.164, 95% CI: 1.747–2.681) when contrasted to individuals of the 1st LAP quartile. Smooth curve fitting analysis revealed a nonlinear correlation of VAI or LAP and prediabetes, and threshold effect analysis was used to determine an inflection point of 4.090 for VAI and 68.168 for LAP. Conclusions: The values of VAI and LAP are positively associated with the prevalence of prediabetes. The VAI and LAP indices may be used as predictors of prediabetes. [ABSTRACT FROM AUTHOR]

Introduction: The Surviving Sepsis Campaign guidelines recommend early goal-directed therapy (EGDT) for the resuscitation of patients with sepsis; however, the recent evidences quickly evolve and convey conflicting results. We performed a meta-analysis to evaluate the effect of EGDT on mortality in adults with severe sepsis and septic shock. Methods: We searched electronic databases to identify randomized controlled trials that compared EGDT with usual care or lactate-guided therapy in adults with severe sepsis and septic shock. Predefined primary outcome was all-cause mortality at final follow-up. Results: We included 13 trials enrolling 5268 patients. Compared with usual care, EGDT was associated with decreased mortality (risk ratio [RR]: 0.87, 95% CI: 0.77-0.98; 4664 patients, 8 trials; Grading of Recommendations Assessment, Development, and Evaluation [GRADE] quality of evidence was moderate). Compared with lactate clearance–guided therapy, EGDT was associated with increased mortality (RR: 1.60, 95% CI: 1.24-2.06; 604 patients, 5 trials; GRADE quality of evidence was low). Patients assigned to EGDT received more intravenous fluid, red cell transfusion, vasopressor infusion, and dobutamine use within the first 6 hours than those assigned to usual care (all P values < .00001). Conclusion: Adults with severe sepsis and septic shock who received EGDT had a lower mortality than those given usual care, the benefit may mainly be attributed to treatments administered within the first 6 hours. However, the underlying mechanisms by which lactate clearance–guided therapy benefits these patients are yet to be investigated. [ABSTRACT FROM AUTHOR]

Objective To observe the changes of metabolomics in the evolution process of blockade of heart vessel syndrome (BHVS). Methods The formation of BHVS in three stages were sim- ulated by using high-fat forage and ligating the left anterior descending coronary artery. Increased blood lipid was in the early stage of blood stasis syndrome (BSS) group. Atherosclerosis (AS) was formed in the middle stage of BSS group (sub-BSS). Coronary artery was ligated on the basis of AS was the 3rd stage of BSS (BHVS group). There were 8 rats in each group. Totally 24 rats was used as the blank con- trol group and each stage had 8 rats. The changes of metabolite contents were analyzed using principal component analysis (PCA) and partial least squares method (PLS) with gas chromatography-mass spectrometer (GC-MS) among different groups. Results (1) In the 32 kinds of identified metabolites, citric acid was closest associated with the evolution process of BHVS, followed by cholesterol, inositol, ornithine, proline, isoleucine, octadecanoic acid, lactic acid, urea, leucine, linoleic acid, mannose. (2) Metabolic markers in the three stages: octadecanoic acid, lactic acid (positively correlated) , and mannose (negatively correlated) in the early stage of BSS. Ornithine, proline, inositol (positively correla- ted) , and isoleucine (negatively correlated) in the middle stage of BSS (sub-BSS). Leucine, isoleucine, citric acid (positively correlated) , and lactic acid (negatively correlated) in the BHVS stage. Conclusions High fat diet causes disordered in vivo lipid metabolism in pre-stage BSS, and the organism initiates anti- inflammation. Continued high fat diet leads to disordered urea cycle, imbalanced intestinal flora, changed vascular morphology, and liver dysfunction in the sub-BSS stage. Acute myocardial ischemia leads to glucose metabolism disorder in the BHVS stage.

Objective: To study the possible relationship between serum zinc levels and attention deficit hyperactivity disorder (ADHD) in Chinese children., Methods: Following a systematic search for case-control studies on the serum zinc levels in Chinese children with ADHD published between 2000 and 2015, a Meta analysis was conducted using Stata 12.0 software., Results: A total of 17 studies, including 2 177 children with ADHD and 2 900 normal children, were enrolled. The Meta analysis showed that serum zinc levels in children with ADHD were lower than normal children (SMD= -1.33; 95%CI: -2.22, -0.44; P=0.003). The sensitivity analysis indicated that the results were reliable. Eggerγs test did not find the existence of publication bias., Conclusions: Serum zinc levels may be associated with susceptibility to ADHD in children.

Objective: To investigate the risk factors for attention deficit hyperactivity disorder (ADHD) and to provide a basis for future prevention and treatment of this disease., Methods: Following a systematic search for case-control studies on the risk factors for ADHD in China between 2000 and 2014, relevant family risk factors were extracted accordingly. The quality of selected studies was evaluated according to the NOS scale. A Meta analysis on the selected studies was conducted using Stata 12.0 software., Results: A total of 16 studies were selected, involving 2 167 children with ADHD and 2 148 normal controls. Results of Meta analysis showed that good parenting (OR=0.32, 95% CI: 0.26-0.40), nuclear family (OR=0.56, 95% CI: 0.41-0.76), high education level of father (OR=0.56, 95% CI: 0.41-0.76), high education level of mother (OR=0.65, 95% CI: 0.47-0.89), and extroversion of mother (OR=0.33, 95% CI: 0.18-0.61) are favorable factors for ADHD. Poor parental relationship (OR=1.90, 95% CI: 1.17-3.06) and family history of ADHD (OR=5.86, 95% CI: 3.67-9.35) are risk factors for ADHD., Conclusions: Good parenting, nuclear family, high education level of parents, and mother with extroversion are protective factors for ADHD, whereas poor parental relationship and family history of ADHD are associated with an increased risk for ADHD.

To introduce a method of classification with high precision--the artificial neural network (ANN), and to compare the results using logistic regression method. Using data from 1070 landless peasants' mental health survey, the artificial neural network models and logistic regression model were built and compared on their advantages and disadvantages of the two models. The prediction accuracy for artificial neural network was 94.229% and for logistic regression it was 51.028%. ANN appeared to have had good ability on generalization. ANN displayed advantages when conditions of classical statistical techniques could not be met or the predictive effect appeared to be unsatisfactory. Hence, ANN would make a better fracture of its application in medical research.

This study was aimed to explore changes of platelet function in vitro during storage by thrombelastography (TEG). 12 units plateletpheresis were randomly selected and stored at 20 to 24 degrees C with agitation. Thrombelastography variable parameters R, K values and maximal amplitude (MA) were measured on 1, 2, 3, 4, 5 days of platelet storage. Platelet concentration, mean platelet volume (MPV), hypotonic shock response (HSR), CD62p expression and CD62p reexpression on platelet surface were detected at the same time. Changes of platelet function in virto were systematically evaluated by above-mentioned indexes. The results showed that MPV augmented slightly with prolongation of preserved time (p > 0.05), and CD62p expression on platelet surface increased remarkably (p < 0.01), while CD62p reexpression decreased gradually (p < 0.01). There were no significant differences in HSR level of platelets during storage (p > 0.05). R value increased with prolongation of preserved time (p < 0.01). There were no obvious changes on K value and alpha Angle during storage (p > 0.05). There were no obvious changes in MA from 1 to 4 days, and MA decreased slightly on day 5 (p < 0.05). It is concluded that there was no significant change in MA and HSR which reflects comprehensive coagulation of platelets during storage. Platelets on the end of storage have excellent function of hemostasis; Thrombelastography parameter MA value can be used as a valuable indicator for evaluation of platelet function in vitro during storage.

The study was purposed to explore the suitable platelet activators to be used in slide platelet aggregation test. Experiments were as follows: (1) to detect the intensity and time in 15 healthy donors' platelet aggregation tests induced by cationic propyl gallate (c-PG) and the usual platelet activators: ADP, collagen, epinephrine, arachidonic acid and ristocentin, respectively; (2) to detect the time in platelet aggregation tests of 15 healthy donors induced by c-PG and the above usual platelet activators respectively after addition of PGI2, cAMP or EDTA; (3) to detect the time in 15 healthy donors' platelet aggregation tests induced by c-PG after addition of heparin; (4) to detect the intensity and time of platelet aggregation induced by c-PG at the platelet count of (240-15) x 10(9)/L, (5) to detect the time of platelet aggregation induced by c-PG in eight patients each of whom had taken 100 mg aspirin per day for five days. The results showed that (1) c-PG reduced the strongest intensity of platelet aggregation and the time taken was appropriate, (2) c-PG was the most effective activator to reveal the inhibitive effect on platelet by PGI2, cAMP or EDTA, (3) 0.5 - 3 U/ml heparin did not significantly change the platelet aggregation induced by c-PG, (4) 15 healthy donors' platelet aggregation induced by c-PG displayed clearly on the slide until the platelet count below 30 x 10(9)/L, (5) The platelet aggregation time induced by c-PG was significantly prolonged in eight patients who had taken aspirin. In conclusion, compared to the usual platelet activators, c-PG has remarkable potential advantages when used in slide platelet aggregation test.

The purpose of this study was to establish a set of techniques for cryopreservation of platelets with dimethylsulphoxide (DMSO) to insure high quality of cryopreserved platelet. The methods were as following: (1) DMSO was filtered in stead of being sterilized before infusion into the bag with platelets. (2) The whole blood was centrifuged immediately after blood collection and the attached tube was tied on the top of the bucket. (3) The related centrifugal force was 480 x g, the accelerating and braking grades of the centrifuge for acceleration and deceleration were 9 and 4 respectively. (4) The flow rate of platelet rich plasma (PRP) could not be too high, 80 - 100 ml PRP should be harvested at 1 minute or so. The infusion rate of DMSO into the PRP was 1 ml/min. After the infusion of DMSO, the PRP bag must be put into the -80 degrees C ultra low freezer at once to make the product to be freezed as soon as possible. The cryopreserved platelet should be thawed in the cycling warm water at the temperature of 38 - 40 degrees C. (5) After thawing of platelet, the platelet, red blood cell and white blood cell were counted, and the bacteria culturing, tests for HBsAg, anti-HCV, anti-HIV, TP and ALT were carried out. The results showed that altogether 14 800 units of cryopreserved platelets were prepared including 80 units collected with blood cell separator, of which quality control was accomplished in 300 units. The manually collected platelet mean count >/= 2.4 x 10(10)/unit, while the apheresis platelet count >/= 2.5 x 10(11)/unit. The yield was over 70%. The contaminated red and white blood cells were

Objective: To investigate the prevalence of sleep apnea-hypopnea syndrome (SAHS) among adults aged over 30 yr in Chengde city of Hebei province., Methods: 1 168 subjects (over 30 yr) were derived from a random sample of the population among the Shuangqiao district in Chengde city. All subjects were asked at home to answer questions about their snoring, daytime sleepiness, and habits of smoking and drinking. According to the degree of snoring, 127 moderate and severe snorers were measured by portable PSG for a whole night and the prevalence of SAHS was estimated according to AHI and ESS scores., Results: 1 168 subjects (95.42%) answered the questions. The prevalence of snoring was 53.76%. The prevalence of moderate and severe snoring (>or= second degree) was 28.25%. The prevalence of snoring increased with age before the age of 70. The prevalence of snoring in males was significantly higher than that in females. Smoking and drinking groups were associated with a higher prevalence of snoring. The prevalence of snoring was higher in drivers (42.00%) than that in other populations. The estimated prevalence of SAHS according to both the AHI > 5 and the ESS >or= 9 was 4.63%., Conclusions: The estimated prevalence of SAHS among adults aged over 30 yr in Chengde city was 4.63%. It means that SAHS needs better understanding and more study.