Association of serum pepsinogen with degree of gastric mucosal atrophy in an asymptomatic population

BACKGROUNDAtrophic gastritis is a precancerous lesion of the stomach. It has been reported that pepsinogen (PG) can reflect the morphology and function of the gastric mucosa, and it is therefore used as a marker for the early diagnosis of atrophic gastritis.AIMTo evaluate the diagnostic value of serum PG for degree of gastric mucosal atrophy in asymptomatic Chinese upon physical examination.METHODSMedical data were collected from subjects who underwent transnasal gastroscopy between October 2016 and October 2018. For each study subject, serum PG levels and presence of Helicobacter pylori (H. pylori) infection were investigated. Pathology was evaluated using the Operative Link for Gastritis Assessment (OLGA) classification and Operative Link on Gastric Intestinal Metaplasia Assessment (OLGIM) systems. All statistical analyses were carried out using SPSS statistical software.RESULTSA total of 2256 subjects were enrolled and 1922 cases were finally included in the study. Based on the OLGA grading system, the levels of PGI were slightly decreased, while those of PGII were slightly increased. The PGI/PGII ratio (PGR) was reduced with increasing atrophy. The association between PG and OLGA grading was higher compared with that between PG and the OLGIM grading system. Compared with the OLGA-0 group, a statistically significant difference was observed in the mean age of OLGA-I, III, and IV groups (P < 0.05). In the H. pylori-positive subjects, the PGR levels were notably lower in the OLGA-I, II, and III groups compared with the OLGA-0 group (P < 0.05). H. pylori-positive subjects exhibited significantly higher PGI and PGII serum levels and a significantly lower PGR compared with H. pylori-negative patients in different OLGA groups (P < 0.05). CONCLUSIONSerum PG levels may represent a non-invasive screening marker for gastric mucosal atrophy in asymptomatic subjects.     

Celiac disease may be rare among children in South China

ObjectiveThe prevalence of celiac disease (CD) varies geographically and ethnically; however, the prevalence among children in South China remains unknown. We therefore determined the occurrence of CD among Chinese children in South China.MethodsSerum samples were collected from children and assessed for anti-tissue transglutaminase IgA antibodies (anti-tTG-IgA) and total IgA. Anti-tTG-IgA+ participants underwent human leukocyte antigen (HLA) DQ2/DQ8 determination. Samples with serum total IgA <0.05 g/L were also analyzed for anti-tTG-IgG, and for HLA-DQ2/DQ8 if the values were above borderline. Participants who were anti-tTG-IgA/IgG+ and HLA-DQ2+ and/or HLA-DQ8+ underwent small bowel biopsy.ResultsA total of 8794 children were enrolled, of whom 479 had chronic unexplained abdominal symptoms. Three (0.034%) children were anti-tTG-IgA+ and ten (0.114%) had serum total IgA <0.05 g/L, all of whom were anti-tTG-IgG−. The three positive children were all HLA-DQ2+ and/or HLA-DQ8+. Two underwent gastroscopy, and histopathology of small intestinal biopsy showed duodenal villous blunting in one and increased intraepithelial lymphocytes in the other, neither consistent with a diagnosis of CD.ConclusionOur study showed a prevalence of CD autoimmunity of 0.034% and failed to identify any cases of CD, suggesting a low prevalence of CD among children in South China.     

醋酸染色联合窄带成像对胃黏膜肠上皮化生的诊断价值

目的:探讨内镜醋酸染色联合窄带成像模式对幽门螺杆菌阳性患者胃黏膜肠上皮化生(gastric intestinal metaplasia,GIM)病灶的诊断效果以及在筛查中的价值。方法:对93例幽门螺旋杆菌感染患者进行胃镜检查,分别在常规白光(esophagogastroduodenoscopy,EGD)、醋酸染色(acetic acid chromoendoscopy,ACC)、ACC联合窄带成像(narrow band imaging,NBI)3种模式下进行观察诊断并活检,比较3种模式下对GIM的诊断效果。结果:ACC+NBI模式的灵敏度为92.06%,远高于ACC模式的74.60%及EGD模式的30.16%,差别有统计学意义(P<0.05),3种模式的特异度差别无统计学意义(P>0.05)。EGD、ACC、ACC+NBI模式的ROC曲线AUC分别为0.584、0.790、0.860。结论:ACC联合NBI模式能明显提高内镜下胃黏膜GIM的诊断,是胃黏膜GIM筛查的良好工具。     

Different disease characteristics in young patients with colorectal cancer: a large retrospective study in a city in Romania

ObjectiveIn 2018, colorectal cancer (CRC) was the second most frequent malignancy in Romania after lung cancer. Although CRC is typically encountered in patients >50 years old, CRC''s global incidence among younger adults has been increasing. We aimed to compare the disease characteristics of patients with CRC aged ≤50 years with those >50 years old.MethodsWe retrospectively evaluated data from patients with CRC who underwent standard surgery at “Pius Brinzeu” Emergency County Hospital, Timisoara, Romania. Patients were divided into two groups: Group 1 (patients ≤50 years old) and Group 2 (patients >50 years old). Six parameters were analyzed (sex, residence location, age, tumor localization, microscopic findings, pathological staging).ResultsData on age-related CRC were available for 1380 patients treated from January 2012 to December 2018. Group 1 included 120 patients while group 2 included 1260 patients. Significantly more Group 1 patients presented with advanced CRC compared with Group 2 patients (94.2% vs. 87.4%). Furthermore, CRC in younger adults was more likely to be diagnosed at an advanced stage.ConclusionsMonitoring the CRC incidence in younger adults is essential to assess whether screening practices require changes and to raise awareness among clinicians of the increasing CRC incidence among younger patients.     

Red blood cell distribution width and serum CA-125 level as prognostic markers in acute exacerbation of chronic obstructive pulmonary disease

ObjectiveAcute exacerbation of chronic obstructive pulmonary disease (AECOPD) is a primary cause of hospitalization and death in COPD. Serum CA-125 and red blood cell distribution width (RDW) are related to AECOPD. We investigated correlations between serum markers and AECOPD.MethodsIn total, 132 patients with AECOPD were included from January 2017 to December 2019. Participants were followed for 1 year. Patients were assigned to the poor prognosis (n = 40) or good prognosis (n = 92) group. We collected serum samples and general clinical information and conducted routine blood tests. We used logistic regression, receiver operating characteristic (ROC), and area under the ROC curve (AUC) analyses to assess differences between groups.ResultsWe found significant differences between groups (odds ratio, 95% confidence interval) for age (1.046, 1.005–1.09), RDW (2.012, 1.339–3.023), and cancer antigen 125 (CA-125; 1.022, 1.006–1.039); these remained risk factors for AECOPD prognosis in multivariate analyses. RDW and CA-125 in combination was significant in ROC curve analysis. The AUC of RDW, CA-125, and these combined were 0.691, 0.779, and 0.772, respectively. Patients with RDW >12.75% and CA-125 >15.65 U/mL were predicted to have poor prognosis.ConclusionsWe found that RDW and CA-125 are potential prognostic indicators for AECOPD.     

不同血清肿瘤标志物对胃癌诊断价值的临床研究

目的：探讨血清肿瘤标志物癌胚抗原（CEA）、糖类抗原724（CA724）、铁蛋白（SF）、胃蛋白酶原Ⅰ（PGⅠ）、胃蛋白酶原Ⅱ（PGⅡ）及其比值（PGI／PGII）对胃癌的诊断价值。方法对46例健康对照者（健康对照组）,45例慢性萎缩性胃炎患者和39例胃癌患者,分别进行血清CEA,CA724,PGⅠ,PGⅡ及 SF含量的检测。CEA,CA724采用电化学发光法进行检测;PGⅠ和PGⅡ采用化学发光法进行检测;SF采用散射比浊法进行检测。计算 PGI／PGII比值,并对检测结果进行统计分析。结果①与正常对照组相比,胃癌组除 SF差异无统计学意义外,其余指标差异均具有统计学意义（P＜0.05）,萎缩性胃炎组PGⅠ,PGⅡ和 SF差异有统计学意义（P＜0.05）;与萎缩性胃炎组相比,胃癌组的 CEA,CA724显著升高,PGⅠ显著下降,并且差异具有统计学意义（P＜0.05）。②用于评价胃癌的 ROC 曲线下面积由大到小依次为 CEA,SF, CA724,PGI／PGII,PGⅡ,PGⅠ;CEA,CA724,PGI／PGII和 SF曲线下面积差异无统计学意义（P＞0．05）,PGⅠ,PGⅡ差异有统计学意义（P＜0.05）。③不同肿瘤标志物单项与联合检测对胃癌诊断的敏感度、特异度、阳性预测值及阴性预测值存在差异。结论血清肿瘤标志物CEA,CA724,PGⅠ,PGⅡ和 SF对胃癌的诊断具有重要的参考价值但各指标单独及联合检测对胃癌的诊断价值各不相同;血清PG含量及其比值与胃黏膜病变密切相关。     

血清抗幽门螺杆菌IgG抗体、胃蛋白酶原水平与胃癌发病的相关性分析

目的研究长春地区人群血清抗幽门螺杆菌(Helicobacter pylori,Hp)IgG抗体、胃蛋白酶原水平和胃癌发病的相关性,为胃癌的防治研究提供依据和流行病学资料。方法选择2008年10月至2011年2月吉林大学第一医院明确诊断的450例原发性胃癌患者作为病例组,选择同时期体检中心1072例健康体检者作为对照组。采用酶联免疫吸附(ELISA)法检测血清中Hp IgG抗体、胃蛋白酶原Ⅰ(PGI)和Ⅱ(PGII)的水平,确定Hp菌感染和萎缩性胃炎的发生状况。以PGI≤82.3μg/L,同时PGI/PGII≤6.05作为萎缩性胃炎的诊断标准。结果胃癌组与对照组相比,Hp感染阳性率明显增高(69.1%vs.52.4%,χ2=36.1,P<0.001)。胃癌组中血清PGI水平与对照组比较无显著差异(93.2vs.88.9μg/L,P<0.001),而PGII浓度显著升高(15.9vs.11.3μg/L,P<0.001),同时PGI/PGII比值明显降低(5.4vs.7.8,P<0.001)。胃癌组中患萎缩性胃炎的比例明显高于对照组(31.4%vs.10.4%,P<0.001)。多因素回归分析显示:在调整年龄和性别因素后,Hp感染和萎缩性胃炎均为胃癌发病的独立危险因素。结论本研究对象人群中Hp感染率,尤其是青年胃癌患者中Hp感染率仍然较高,Hp感染和萎缩性胃炎是胃癌发病的危险因素。与PGI相比,血清PGII浓度和PGI/PGII比值可能成为胃癌筛选的潜在血清学标志物。     

Frailty assessment of older adults,first-time applicants of public home care service in Norway

ObjectiveEarly detection of frailty is essential to prevent or delay disability. The most appropriate screening tool for frailty among home-dwelling older adults is under debate. The present study estimates the prevalence of frailty among older adults, first-time applicants of public home care service in Norway, and investigates the appropriateness of gait speed and Short Physical Performance Battery as screening-tools for frailty.Design and settingWe conducted a cross-sectional study of 116 older adults >65 years applying for public home care service for the first time. Frailty was assessed by an adapted version of the Fried Frailty Phenotype. The test accuracies of gait speed and Short Physical Performance Battery to detect frailty were calculated for a general population >70 years in Norway.Results62.1% of the participants were frail, 29.3% were prefrail, and 8.6% were robust. Mean gait speed and Short Physical Performance Battery-scores were significantly lower in frail compared to prefrail individuals, and significantly lower in prefrail compared to robust individuals. The sensitivity and specificity of gait speed at a cut point of 0.8 m/s to detect physical frailty phenotype was 99% and 68%, respectively.Conclusions The high prevalence of frailty in the present study indicates that screening for frailty should be considered at an earlier time point than when older adults apply for public home care service for the first time. Gait speed may be an appropriate screening tool for frailty in a general population >70 years in Norway.

KEY POINTS

• The prevalence of frailty among older adults, first-time applicants of public home care services in Norway is major.
• Screening for frailty should be considered before older adults apply for public home care service for the first time.
• Gait speed at a cut point at 0.8 m/s may be an appropriate screening tool for frailty in a general population >70 years in Norway.

     

Sex-related Anthropometrics in a Lower-Body Mobility Assessment Among Professional Soccer Athletes

BackgroundThe functional movement screen (FMS™) and Y-balance test (YBT) are commonly used to evaluate mobility in athletes.PurposeThe primary aim of this investigation was to determine the relationship between demographic and anthropometric factors such as sex, body composition, and skeletal dimension and scoring on YBT and FMS™ in male and female professional soccer athletes.Study DesignCross SectionalMethodsDuring pre-season assessments, athletes from two professional soccer clubs were recruited and underwent body composition and skeletal dimension analysis via dual-energy X-ray absorptiometry (DEXA) scans. Balance and mobility were assessed using the YBT and FMS™. A two-tailed t-test was used to compare YBT between sexes. Chi-square was used for sex comparisons of FMS™ scores. Correlation analysis was used to determine if body composition and/or skeletal dimensions correlated with YBT or FMS™ measures. Type-I error; α=0.05.Results40 Participants were successfully recruited: (24 males: 27±5yr, 79±9kg; |16 females: 25±3yr, 63±4kg). YBT: Correlations were found between anterior reach and height (r=-0.36), total lean mass (LM)(r=-0.39), and trunk LM(r=-0.39) as well as between posterolateral reach and pelvic width (PW)(r=0.42), femur length (r=0.44), and tibia length (r=0.51)(all p<0.05). FMS™: The deep squat score was correlated with height(r=-0.40), PW(r=0.40), LM(r=-0.43), and trunk LM (r =-0.40)(p<0.05). Inline lunge scores were correlated with height(r=-0.63), PW(r=0.60), LM(r=-0.77), trunk LM(r=-0.73), and leg LM(r=0.70)(all p<0.05). Straight leg raise scores were correlated with PW (r=0.45, p<0.05). Females scored higher for the three lower body FMS™ measures where correlations were observed (p<0.05).ConclusionsLower body FMS™ scores differ between male and female professional soccer athletes and are related to anthropometric factors that may influence screening and outcomes for the FMS™ and YBT, respectively. Thus, these anatomical factors likely need to be taken into account when assessing baseline performance and risk of injury to improve screening efficacy.Level of EvidenceLevel 3b     

Higher blood urea nitrogen level is independently linked with the presence and severity of neonatal sepsis

BackgroundPrevious studies have demonstrated that blood urea nitrogen (BUN) is strongly associated with sepsis. However, no data are currently available regarding the association of BUN levels and neonatal sepsis. Thus, this study aimed to investigate the role of BUN in predicting the presence and severity of neonatal sepsis.MethodsIn this study, we enrolled 925 neonates. Among them, 737 neonates were diagnosed with sepsis, including 426 neonates with severe sepsis. Neonates with hyperbilirubinemia (n = 188) served as controls. We collected complete clinical and laboratory data were collected. Multivariate logistic regression analysis was performed to identify the potential independent risk factor for neonatal sepsis. Receiver operating characteristic (ROC) curve analysis was used to evaluate the prediction accuracy of BUN in predicting neonatal sepsis. All statistical analyses were performed using the statistical package SPSS 24.0.ResultsNeonates with sepsis and severe sepsis had a higher level of BUN. The prevalence of neonates with severe sepsis was dramatically increased according to BUN tertiles. Correlation analysis showed that BUN levels were positively correlated with the levels of infection marker procalcitonin (PCT) and high-sensitivity C-reactive protein (hsCRP). Multiple logistic regression analysis showed that BUN was an independent risk factor for the presence and severity of neonatal sepsis. ROC curve analysis showed that BUN had a well discriminatory power in predicting sepsis (area under curve (AUC) = 0.69, 95% CI, 0.66–0.74, p < .001) and severe sepsis (AUC = 0.72, 95% CI, 0.67–0.78, p < .001).ConclusionHigher BUN level is independently linked with the presence and severity of neonatal sepsis.     

Assessment of Clinical Characteristics and Mortality-Associated Factors in COVID-19 Critical Cases in Kuwait

ObjectiveThe objective of this study was to assess the clinical characteristics and identify mortality risk factors in intensive care unit (ICU)-admitted COVID-19 patients.MethodsWe recruited and analyzed SARS-CoV-2-infected adult patients (age ≥18 years) who were admitted to the ICU at Jaber Al-Ahmad Al Sabah Hospital, Kuwait, between March 1, 2020, and April 30, 2020. The risk factors associated with in-hospital mortality were assessed using multiple regression analysis.ResultsWe recruited a total of 103 ICU patients in this retrospective cohort. The median age of the patients was 53 years and the fatality rate was 45.6%; majority (85.5%) were males and 37% patients had more than 2 comorbidities. Preexisting hypertension, moderate/severe acute respiratory distress syndrome, lymphocyte count <0.5 × 10⁹, serum albumin <22 g/L, procalcitonin >0.2 ng/mL, D-dimer >1,200 ng/mL, and the need for continuous renal replacement therapy were significantly associated with mortality.ConclusionThis study describes the clinical characteristics and risk factors for mortality among ICU patients with CO­VID-19. Early identification of risk factors for mortality might help improve outcomes.     

RUMA and RUPCR in children with Henoch–Schonlein purpura

ObjectiveThe aim of this study was to compare the qualitative and quantitative targets in the detection of proteinuria in children with HSP.MethodsThree hundred and forty children were taken as the research subjects. Qualitative and a series of quantitative indicators of urine protein were tested.ResultsThe qualitative and quantitative of protein in 340 children were analyzed retrospectively. Correlation analysis found that 24hUTP had a strong correlation with age, RUMA, RUPCR, and qualitative urine occult blood (p < 0.01, for all). After regression analysis, RUMA and RUPCR were still significantly correlated with 24hUTP (p < 0.01). At the same time, RUMA and RUPCR had good diagnostic accuracy for proteinuria. When the RUPCR ratio was set as 0.415, the diagnostic sensitivity was 83%, and the specificity was 98.7%. When RUMA was set as 68.215, the sensitivity was 94.3% and the specificity was 96.2%.ConclusionCompared with 24hUTP, RUMA and RUPCR had high sensitivity and specificity for monitoring proteinuria in children with HSP.     

Epidemiological investigation of hospitalized patients with traumatic fractures: a cross-sectional study

ObjectiveThis study was performed to explore major risk factors for traumatic fracture by comparing related data of hospitalized patients with traumatic fracture and patients with lumbar disc herniation.MethodsPatients with traumatic fracture and patients with lumbar disc herniation requiring surgical treatment in the orthopedics department of our hospital from March to May 2018 were divided into a fracture group and a non-fracture group. Clinical data were collected from the two groups by questionnaires. Major risk factors for traumatic fracture were analyzed using multivariate logistic regression.ResultsUnivariate analysis showed statistically significant differences in family history of fracture, smoking history, drinking history, sex, sleep duration, chronic disease history, osteoporosis history, age, body mass index, occupation, and education level between the two groups. Multivariate logistic regression analysis showed that patients aged 25 to 44 years were more prone to traumatic fracture than patients aged ≥65 years, male patients were more prone to fracture than female patients, drinking alcohol was a risk factor for traumatic fracture, and sufficient sleep duration (>7 hours/night) was a protective factor for traumatic fracture.ConclusionYoung age, male sex, and drinking are risk factors for traumatic fracture, whereas sufficient sleep duration is a protective factor.     

Seroprevalence of CMV IgG and IgM in Korean women of childbearing age

BackgroundThe aim of this study was to investigate the seroprevalence of cytomegalovirus (CMV) infection using the serologic status of CMV IgG and IgM antibodies in Korean women of childbearing age.MethodsWe retrospectively reviewed CMV IgG and IgM test results from Korean women aged 15–49 years who underwent testing between January 2009 and December 2019. Seroprevalence of CMV IgG and IgM by year and age was investigated.ResultsThe study period was 11 years, and among 6837 samples tested, 95.8% were CMV IgG–positive. The seropositivity in women aged 15‐ <20 years was significantly lower (77.5%) than older age groups. Among 6837 total CMV IgG tests, 75.9% (5186) had concurrently measured CMV IgM results among which 2.4% were IgM‐positive.ConclusionConsidering the low CMV seropositivity of women younger than 20 years, they may need prenatal education for CMV infection.     

Kinematic and Kinetic Predictors of Y-Balance Test Performance

BackgroundThe Y-Balance Test (YBT) assesses dynamic stability and neuromuscular control of the lower extremity. Several authors have analyzed kinematic predictors of YBT performance with conflicting results, but the influence of kinetic factors is not well understood.PurposeTo examine kinematic predictors of YBT performance and determine the joint kinetics which predict YBT performance.Study DesignCross-sectional study.MethodsThirty-one physically active individuals performed YBT trials on a force plate while whole body kinematics were recorded using a motion capture system. Sagittal, frontal, and transverse plane joint kinematics and joint moments were calculated at maximum reach in each YBT reach direction. Variables correlated with reach distances at the p < 0.2 level were entered into a stepwise linear regression.ResultsIn the anterior direction, knee flexion and torso rotation (R²=0.458, p<0.001) and knee extensor and hip abductor moments (R²=0.461, p<0.001) were the best kinematic and kinetic predictors of reach distance. In the posterior medial direction, hip flexion, ankle dorsiflexion, and ankle rotation accounted for 45.8% of the variance in reach direction (p<0.001) while hip and knee extensor, and hip abductor moments explained 72.6% of the variance in reach distance (p<0.001). In the posterior lateral direction, hip flexion and pelvic rotation (R²=0.696, p<.001) and hip extensor moments (R²=0.433, p=0.001) were the best kinematic and kinetic predictors of reach distance.ConclusionThe ability to generate large hip and knee joint moments in the sagittal and frontal plane are critical for YBT performance.Level of Evidence3.     

Application of bone metabolic parameters in the diagnosis of growing pains

ObjectiveThe present study aimed to assess the diagnostic significance of serum bone metabolic parameters in children with growing pains (GPs).MethodsAll patients diagnosed with GP and healthy controls matched with age and gender were recruited at the outpatient clinic of Children''s Hospital at Zhejiang University School of Medicine from August 2016 to August 2021. In all subjects, serum levels of calcium (Ca), phosphorus (P), procollagen type‐I N‐terminal (PINP), parathormone (PTH), 25‐hydroxyvitamin D (25‐(OH)D), osteocalcin (OC), N‐terminal cross‐linked telopeptides of type‐I collagen (CTX), and tartrate‐resistant acid phosphatase type 5b (TRACP5b) were investigated. The univariate analysis, multivariate logistic regression analysis, and receiver operating characteristic (ROC) curve were used to identify the bone metabolic parameters factors for diagnosing GP.ResultsWe enrolled 386 children with GP and 399 healthy controls in present study. The mean age of GP group was 5.319 years, and, primarily, the subjects were preschool‐age children. The gender ratio (male‐to‐female) was 1.27 in GP group. After adjusting for age and gender, we identified that the serum levels of Ca (p < 0.001, OR: 25.039), P (p = 0.018, OR: 2.681), PINP (p < 0.001, OR: 1.002), and PTH (p = 0.036, OR: 0.988) were independent diagnostic factors associated with GP. Area under curve (AUC) of the ROC curves was in the order: PINP (0.612) > Ca (0.599) > P (0.583) > PTH (0.541). A combination of independent diagnostic factors and multivariable logistic regression analysis provided a refined logistic regression model to improve the diagnostic potential, of which the AUC had reached 0.655.ConclusionsSerum levels of Ca, P, PINP, and PTH could be independent diagnostic factors associated with GP. The logistic model was significantly superior to bone metabolic parameters for diagnosing GP.     

A high value of fibrinogen in immunoglobulin A nephropathy patients is associated with a worse renal tubular atrophy/interstitial fibrosis score

PurposeThe purpose of our study was to investigate the relationship between serum fibrinogen value and renal tubular atrophy/interstitial fibrosis in immunoglobulin A nephropathy patients with eGFR ≥90 ml/min/1.73 m².Patients and MethodsOf 359 patients diagnosed with immunoglobulin A nephropathy after renal biopsy were enrolled in this retrospective study. Demographic, histopathological features, and clinical data were collected. The relationships among these factors were analyzed by using Student''s t test, Mann‐Whitney U test, Kruskal‐Wallis test, Chi‐square test, or Fisher''s exact test, where appropriate. The logistic regression analysis was performed to examine the independent risk factors.ResultsOf 176 immunoglobulin A nephropathy patients with eGFR ≥90 ml/min/1.73 m² were included in this study, and patients were classified into low fibrinogen (fibrinogen <304.6 mg/dl) and high fibrinogen (fibrinogen ≥304.6 mg/dl) groups, respectively. High fibrinogen groups had advanced age, a higher classification of renal tubular atrophy/interstitial fibrosis, and higher levels of systolic pressure, D‐dimer, 24 h urine protein quantitation, nag enzyme. Multivariate logistic analysis showed that fibrinogen (OR = 1.018) was significantly associated with tubular atrophy/interstitial fibrosis.ConclusionAmong patients with immunoglobulin A nephropathy, the higher levels of fibrinogen and uric acid may mean a higher score of tubular atrophy/interstitial fibrosis, which suggests the renal biopsy should be performed for these patients as early as possible to defined pathological classification, even though there is no obvious abnormal change in the test of renal function.     

Associations of serum amyloid A and 25‐hydroxyvitamin D with diabetic nephropathy: A cross‐sectional study

BackgroundThe present study investigated the relationships between serum amyloid A (SAA), 25‐hydroxyvitamin D (25(OH)VD) and diabetic nephropathy (DN) to provide evidence for the prevention and management of DN.MethodsA total of 182 patients with type 2 diabetes mellitus (T2DM) were enrolled in this study. The levels of SAA, 25(OH)VD, and other conventional indicators were measured and analyzed. Receiver operating characteristic curve analysis was applied for the combined measurement of SAA and 25(OH)VD, and risk factors for DN were evaluated using binary logistic regression analysis.ResultsThe levels of SAA in T2DM patients were significantly higher than those in healthy subjects, and the level significantly increased with the progression of DN (p < 0.05). In contrast, the level of 25(OH)VD in T2DM patients was significantly lower than that in healthy subjects, and the level significantly decreased with the progression of DN (p < 0.05). The combined measurement of SAA and 25(OH)VD distinguished DN patients from T2DM patients better than the measurement of SAA or 25(OH)VD alone. SAA was an independent risk factor for DN, and 25(OH)VD was an independent protective factor for DN.ConclusionSAA and 25(OH)VD might be used as potential markers to identify patients at increased risk of developing DN.     

食管胃黏膜异位内镜检出率的影响因素分析

目的 探讨影响食管胃黏膜异位（HGME）内镜检出率的影响因素，以提高HGME的内镜检出率。方法 回顾性分析2018年1月－2018年12月在柳州市人民医院行胃镜检查的患者19 948例。记录患者年龄、性别、胃镜检查方式、胃镜检查模式和胃镜医师级别等，分析HGME检出率的影响因素。结果 检出HGME 282例，总检出率为1.41%（282/19 948）。不同组别发现的HGME病例数如下：无痛胃镜组226例（1.53%），普通胃镜组56例（1.07%）；NBI组89例（3.06%），普通白光组193例（1.13%）；按胃镜医师级别分组，住院医师及低年资主治医师组37例（0.89%），高年资主治医师组93例（1.48%），副主任医师及以上组152例（1.59%）。经统计学分析，胃镜检查方式、胃镜检查模式和医师分级对HGME检查率均有影响（P < 0.05），而患者年龄和性别对HGME检出率无明显影响。结论 HGME检出率与胃镜检查方式、胃镜检查模式和医师分级相关，无痛胃镜、NBI模式、内镜医师经验的积累均能明显提高HGME的检出率。     

健康人群血清PG定量检测和Hp感染的临床意义

目的 探讨健康体检人群的血清胃蛋白酶原(PG)与幽门螺杆菌(Hp)现症感染状况的关系。评估年龄、性别和幽门螺杆菌状态对胃蛋白酶原检测的影响以及建立胃蛋白酶原检测结果和幽门螺杆菌血清学检测在健康体检人群中的临床应用。方法 采用胶体金法对800例查体者进行Hp感染检测。采用化学发光微粒子免疫检测法进行血清PGI和PGII测定并计算PGI/II比值,定量检测人血清或血浆中的PG水平。结果 体检人群Hp感染率为50.63%; 性别与Hp感染率差异无统计学显著性意义(P>0.05); 年龄段与Hp感染率差异有统计学显著性意义(P<0.05),40～60岁Hp阳性率最高; 血清PGI和PGII水平在Hp阳性者中高于Hp阴性者(P<0.05)。PGI/II比值在Hp阳性者中低于Hp阴性者(P<0.05)。结论 健康体检人群中,年龄、性别和Hp感染状态与血清PG水平有一定关联。 其中Hp感染状况与血清PG水平及PG异常率密切相关,因此Hp与PG水平检测相结合可用于健康体检人群的普查筛选。