A Bayesian Network to Predict the Risk of Post Influenza Vaccination Guillain-Barré Syndrome: Development and Validation Study

BackgroundIdentifying the key factors of Guillain-Barré syndrome (GBS) and predicting its occurrence are vital for improving the prognosis of patients with GBS. However, there are scarcely any publications on a forewarning model of GBS. A Bayesian network (BN) model, which is known to be an accurate, interpretable, and interaction-sensitive graph model in many similar domains, is worth trying in GBS risk prediction.ObjectiveThe aim of this study is to determine the most significant factors of GBS and further develop and validate a BN model for predicting GBS risk.MethodsLarge-scale influenza vaccine postmarketing surveillance data, including 79,165 US (obtained from the Vaccine Adverse Event Reporting System between 1990 and 2017) and 12,495 European (obtained from the EudraVigilance system between 2003 and 2016) adverse events (AEs) reports, were extracted for model development and validation. GBS, age, gender, and the top 50 prevalent AEs were included for initial BN construction using the R package bnlearn.ResultsAge, gender, and 10 AEs were identified as the most significant factors of GBS. The posttest probability of GBS suggested that male vaccinees aged 50-64 years and without erythema should be on the alert or be warned by clinicians about an increased risk of GBS, especially when they also experience symptoms of asthenia, hypesthesia, muscular weakness, or paresthesia. The established BN model achieved an area under the receiver operating characteristic curve of 0.866 (95% CI 0.865-0.867), sensitivity of 0.752 (95% CI 0.749-0.756), specificity of 0.882 (95% CI 0.879-0.885), and accuracy of 0.882 (95% CI 0.879-0.884) for predicting GBS risk during the internal validation and obtained values of 0.829, 0.673, 0.854, and 0.843 for area under the receiver operating characteristic curve, sensitivity, specificity, and accuracy, respectively, during the external validation.ConclusionsThe findings of this study illustrated that a BN model can effectively identify the most significant factors of GBS, improve understanding of the complex interactions among different postvaccination symptoms through its graphical representation, and accurately predict the risk of GBS. The established BN model could further assist clinical decision-making by providing an estimated risk of GBS for a specific vaccinee or be developed into an open-access platform for vaccinees’ self-monitoring.     

心血管系统常用药物对新型冠状病毒肺炎感染风险及不良预后的影响

心血管疾病是新型冠状病毒肺炎(新冠肺炎)最为常见的合并症,在新冠肺炎大流行期间降压、降脂、抗血小板、抗凝、降糖及抗心律失常等心血管系统常用药物的安全性和有效性尚未形成统一明确的认识,相关指南也有待进一步完善。随着全球新冠肺炎病例数量的增加和第二波感染的发生,更好地了解这些药物对新冠肺炎患者的影响是当务之急。本文旨在总结心血管系统常用药物对新冠肺炎感染风险以及不良预后的关联,并对合并心血管疾病的新冠肺炎患者用药提出建议。     

血管紧张素受体拮抗剂对粮尿病肾病患者肾小管功能的作用

目的 探讨肾小管间质损伤作为糖尿病患者肾损害早期的一项重要特征,评价血管紧张素受体拮抗剂对该指标的作用.方法 予对照组患者口服双嘧达莫100mg,一日3次,治疗组患者在此基础上加用口服缬沙坦80mg,一日1次,观察两组患者的肾小管功能.结果 治疗组患者经治疗后尿系列蛋白均明显降低.结论 缬沙坦具有肾小管保护功能.     

Improved Anti-Vulcanization and Bonding Performance of a Silver Alloy Bonding Wire by a Cathodic Passivation Treatment with Palladium

As a traditional interconnect material, silver alloy bonding wires are widely used in electronic packaging, but their propensity to vulcanize quickly has not been sufficiently addressed. The current surface anti-oxidation and anti-sulfidation treatments are often accompanied by a decline in bonding performance, which hinders the use of silver alloy bonding wires in new applications. In the present paper, we develop a new cathodic passivation treatment in a Pd-containing solution for silver bonding wires, which not only significantly improves their vulcanization resistance, but also maintains their bonding performance. The surface of the treated wires remains unaffected after vulcanization in 0.3 μg/m³ of ammonium sulfide for 60 min. Compared to a Pd-free passivation treatment, the bonding strength of the wire passivated with the Pd-containing solution improves from 0.20 to 0.27 N. XPS analysis confirms the existence of Pd on the surface of the wire. The solder ball formed an obtuse angle instead of a sharp angle on the pad, which is beneficial for bonding strength.     

Design and Preparation of Imidazole Ionic Liquid-Based Magnetic Polymers and Its Adsorption on Sunset Yellow Dye

Magnetic polymers are often used as loading materials for ionic liquids because of their excellent magnetic separation properties. In this study, a novel imidazolium-based ionic liquid-modified magnetic polymer was synthesized by suspension polymerization and grafting, denoted as γ-Fe₂O₃@GMA@IM, and this magnetic polymer was used for the adsorption of the acid dye FCF. The magnetic polymer was characterized by SEM, FTIR, XRD, VSM and TGA. These techniques were used to reveal the overall physical properties of magnetic polymers, including the presence of morphology, functional groups, crystalline properties, magnetism and thermal stability. Studies have shown that γ-Fe₂O₃@GMA@IM can adsorb FCF in a wide pH range (2–10), with a maximum adsorption capacity of 445 mg/g. The adsorption data were more in line with the pseudo-second-order kinetic model and the Freundlich isotherm. In order to investigate its reusability, this study used 10% NaCl as the desorption solution, and carried out five batches of adsorption–desorption cycles. After five cycles, the adsorption effect was maintained at 98.3%, which showed a good recycling performance.     

Efficacy and safety of low-dose corticosteroids for acute respiratory distress syndrome: A systematic review and meta-analysis

BACKGROUND: There are conflicting results regarding whether corticosteroids have better efficacy than placebo in acute respiratory distress syndrome (ARDS) patients. Therefore, we aim to further evaluate the efficacy and safety of corticosteroids in adult ARDS patients.     

高龄肺癌围手术期呼吸指导与护理

198 9～ 1996年对 45例 70岁以上高龄肺癌患者围手术期进行呼吸指导与护理 ,获得良好效果。术前做好心理护理、积极控制呼吸道感染、改善肺功能、在护士指导下进行适量的体能训练。术后尽早开始呼吸指导。本组均按期进行手术 ,术前未出现严重呼吸系统感染。术后呼吸指导显示指端经皮血氧饱和度均有明显改善 ,由指导前88± 1.2 %上升至 95± 2 .1% ,P <0 .0 1。对于不能配合呼吸指导者行纤维支气管镜吸痰。全部患者顺利渡过手术后恢复期。对高龄患者围手术期的呼吸指导与护理能够提高手术的成功率 ,减少手术并发症。术前心理护理、体能训练、术后呼吸指导与护理是保证病人以最佳状态接受手术并早日康复的重要环节     

左炔诺孕酮宫内节育系统预防子宫内膜异位症复发的临床疗效

目的探讨左炔诺孕酮宫内节育系统(LNG-IUD)用于卵巢子宫内膜异位症保守性手术后的疗效、安全性以及复发情况。方法选取72例进行卵巢子宫内膜异位症保守性手术的患者作为研究对象,其中36例于术后第1次月经来潮予以放置LNG-IUD,另36例术后应用促性腺激素释放激素激动剂(GnRH-a)、中成药或未采取任何措施,于术后第3、6、12月观察其卵巢大小、卵巢功能、内膜厚度、糖类抗原125(CA125)、人附睾蛋白4(HE4)以及其痛经等情况的变化。结果 LNG-IUD可有效的预防卵巢子宫内膜异位囊肿腹腔镜保守性手术后的术后复发,同时可以缓解痛经、减少月经量、降低CA125水平,且对卵巢功能无影响。结论 LNG-IUD适用于预防卵巢子宫内膜异位症复发且患者依从性好。     

糖尿病大鼠肾小管骨调素表达上调

目的观察骨调素(OPN)在糖尿病(DM)大鼠肾小管的表达,探讨其与血管紧张素Ⅱ(AngⅡ)、核转录因子-κB(NF-κB)及肾损害之间的关系。方法雄性SD大鼠70只,注射链尿佐菌素(STZ)诱导DM,随机分为5组,每组分别设鼠龄匹配的对照组。免疫组化检测肾小管OPN、AngⅡ、NF-κB及纤连蛋白(FN)的表达;Western blot检测肾皮质OPN和I-κB蛋白水平;生化测定血糖、血肌酐及24h尿蛋白量;光镜观察肾组织形态。结果DM大鼠肾小管AngⅡ和NF-κB表达从第3天、OPN从第7天、FN从第2周开始随病程发展而增多;肾皮质I-κB从第3天开始减少;4周时,OPN与AngⅡ、NF-κB、FN及蛋白尿呈显著正相关。结论DM大鼠肾小管OPN表达增加可能受AngⅡ和NF-κB调控,并参与肾小管间质病变的发病机制。