A Risk Prediction Model for Ischemic Stroke in Southern Chinese Population: Impact of Multiple Genetic Variants and Clinical/Lifestyle Factors

With a global prevalence of 7.7 million, ischemic stroke (IS) is one of the leading causes of death and disability worldwide. In China, IS alone contributed to 69.6％? of stroke events and accounted for 37.1％? of the mortality/disability rate[1]. IS is a complex disease that is known to be associated?with?various?genetic?variants?and?clinical and lifestyle risk factors[2]. Genome -wide association studies (GWAS) provided evidence for the?occurrence?of?more?than?160?IS-associated?single nucleotide?polymorphisms?(SNPs).?In?terms?of?clinical risk factors, patients with a history of chronic diseases like hypertension, dyslipidemia, and diabetes mellitus, display a higher risk of developing IS. Among the various lifestyle components, leading a sedentary lifestyle, smoking, and having an unhealthy diet are known to be associated with the risk of IS. Thus, integration of various genetic, clinical, and lifestyle variables might prove to be highly beneficial in the prediction and prevention of IS?at?the?individual?level[3].     

抚触对减低白内障患者局麻手术中焦虑水平的实验研究

目的 评价抚触对白内障患者在局麻下实施手术过程中焦虑情绪的影响。方法 实验前后建立抚触组与对照组，在手术过程中抚触组接受抚触安慰；利用视觉相似测量和交谈测量2组患者紧张度，脉率、收缩压和舒张压用于测量其生理性应激反应，同时分析血中肾上腺素、去甲肾上腺素、可的松、嗜中性粒细胞、淋巴细胞的含量水平。结果 对照组比照，抚触组中有利于减少焦虑的因子含量明显高于非抚触组，抚触组患者的肾上腺素水平明显低于对照组。结论 患者于局麻下行白内障手术过程中，非损伤性护理介入可以减低其焦虑情绪。     

风电项目光影影响分析方法

风电作为一种清洁能源,是近年来国家鼓励发展的能源项目,以往主要分布在人烟稀少地区,但随着规模的发展,部分风电场区已经涉及到零星居民居住地,随之而来的光影影响不可忽视。     

运动对小肠铁吸收及一氧化氮的调节作用

目的:运动性低铁状态在运动员中发生率明显高于一般人群,但补铁效果很不理想。运动时一氧化氮对铁代谢的调节活动以及功能关系已成为近年研究的热点,对了解运动导致铁缺乏的原因以及运动对铁代谢影响的生理或病理生理机制尤为关键,且有利于运动员铁状态的改善。资料来源:应用计算机检索PUBMED1994-01/2005-10期间的相关文章,检索词为“exercise,iron,nitricoxide”,并限定文章语言种类为“English”。同时计算机检索万方数据库2000-01/2005-10期间的相关文章,检索词为“运动,铁,一氧化氮”,并限定文章语言种类为中文。资料选择:对资料进行初审,并查看每篇文献后的引文。纳入标准:文章所述内容应与运动时一氧化氮对铁代谢的调节活动以及功能关系的研究相关。排除标准:重复研究或Meta分析类文章。资料提炼:共收集到60篇相关文献,28篇文献符合纳入标准,排除的32篇文献为内容陈旧或重复。符合纳入标准的28篇文献中,4篇涉及铁代谢与一氧化氮的联系,8篇涉及运动过程中铁代谢与一氧化氮的关系,8篇涉及一氧化氮对小肠生理和病理研究的意义,7篇涉及小肠黏膜细胞对铁的吸收情况。资料综合:铁是生命体中不可缺少的过渡金属,在对运动员及动物运动模型的铁代谢研究中发现,运动可导致运动性铁缺乏,甚至发生铁缺乏性贫血。小肠黏膜是机体铁转运的第一步,弄清楚铁在小肠黏膜处的吸收机制是解决这个问题的关键,几个与铁吸收有关的大分子蛋白的结构的掌握,为研究运动状态下小肠黏膜铁吸收情况奠定了理论基础。虽然运动性低铁状态在运动员中发生率明显高于一般人群,但运动员补铁效果不理想,耐力运动员体内铁储存量是否趋向于低水平仍有争议。运动对铁代谢的影响,一方面认为是很多原因引起的铁负平衡的结果,若是这种缺铁状况,对机体进行补铁应是有效的,应对运动员进行常规补铁。另一方面认为是机体正常的铁调节结果,应当尽量减少补铁,以免增加铁毒性。结论:血清中的铁含量与一氧化氮水平呈负相关,补充一氧化氮合成酶抑制剂L-NAME可明显改善低铁状态,由此假设一氧化氮可能是改善铁代谢的因素之一。小肠黏膜上皮是机体铁转运的第一步,一氧化氮是否影响此处铁的转运有待于进一步分析。     

Should Stage T2 Esophageal Squamous Cell Carcinoma Be Subclassified?

Background

In patients with esophageal squamous cell carcinoma (ESCC), pathologic examination allows T2 tumors to be further subclassified according to whether the circular or longitudinal muscle layers are invaded. Therefore, we aimed to investigate whether subclassifying the T2 stages can aid in determining the prognosis for patients with ESCC.

Methods

The clinical and pathologic characteristics of 85 ESCC patients with T2 tumors who underwent thoracoscopic esophagectomy between 2008 and 2013 were retrospectively analyzed. Univariate and multivariate analyses were performed to identify prognostic factors. The Kaplan–Meier method was used to compare survival differences with respect to each prognostic factor.

Results

Thirty-nine patients had tumors invading the circular muscle layer and were designated as having T2a disease. The remaining 46 patients had T2b disease, with tumors invading the longitudinal muscle layer. The overall 1-, 3-, and 5-year survival rates were 96.1, 53.8, and 36.4 %, respectively, with a median survival of 39.0 months. Univariate analysis indicated that sex, smoking history, grade, location, and tumor length did not significantly influence on survival. Only T stage (P = 0.017) and N stage (P = 0.003) were associated with survival. The results of multivariate Cox proportional hazard regression analysis showed that T stage (P = 0.045) and N stage (P = 0.003) were independent prognostic factors.

Conclusions

N stage and subclassified T stage are independent prognostic factors in patients with T2 tumors. Therefore, we concluded that T2 tumors can be subclassified further into T2a and T2b stages, and patients with different T2 stages may have different prognoses.     

Prognostic Factors of Patients with Spinal Chondrosarcoma: A Retrospective Analysis of 98 Consecutive Patients in a Single Center

Purpose

Chondrosarcoma (CHS) in the spine is relatively rare and minimal information has been published in the literature regarding this subject. The objective of our study was to discuss the factors that may affect outcomes of patients with spinal CHS.

Methods

Univariate and multivariate analyses were performed to identify prognostic factors for recurrence, distant metastasis, and survival of spinal CHS. T test, χ ² test and rank sum test were used to analyze a single factor for recurrence and metastasis, while survival rate was estimated using the Kaplan–Meier method. Factors with p values of ≤0.1 were subjected to multivariate analyses by binary logistic regression analyses or Cox regression analyses. p Values of ≤0.05 were considered statistically significant.

Results

A total of 98 patients with spinal CHS were included in the study. The mean follow-up period was 49.7 months (range 6–178). Recurrence was detected in 42 patients after initial surgery in our center, while distant metastasis and death occurred in 24 and 32 cases, respectively. The statistical analyses suggested that pathology grade III was closely related with distant metastasis which was an independent prognostic factor for overall survival. Total en bloc spondylectomy could significantly decrease the risk of recurrence, distant metastasis, and death of patients with spinal CHS.

Conclusions

Total en bloc spondylectomy could significantly decrease the risk of recurrence and distant metastasis, and meanwhile improve overall survival of spinal CHS. Distant metastasis which was closely associated with pathology grade III was an adverse prognostic factor for overall survival of spinal CHS.