Relationship between different healing degree and C peptide in elderly patients with diabetic foot ulcers

Objective:To explore the relationship between different healing degree and C peptide in elderly patients with diabetic foot ulcers.Methods:Totally, two hundred and forty-one DFU patients were selected into our research from September 2nd, 2011 to September 2nd, 2012. After admission, the patients' sex, age, the course of diabetes, the days of hospitalization, and BMI were recorded. After examination, blood routine and blood biochemistry, urine routine, hepatorenal work were recorded. Follow up 5 years, patients with unhealed ulcers were selected into bad prognosis group during follow-up, and patients with ulcerative healing into good prognosis group. Single factor analysis showed factors affecting the healing of DFU patients;Cox proportional risk model was further evaluated the effect of all factors with statistical significance on the healing of DFU patients. Using the ROC curve to analyze the statistically significant factors and to calculate the area under the curve to evaluate the predictive ability of the healing of the patients with DFU.Results: At the end of the follow-up, 6 patients were lost, 177 had the end point, and the healing rate was 73.44%. Single factor and multifactor analysis showed that the course of diabetes and HbA1C were independent risk factors affecting the prognosis. FCP was an independent protective factor affecting the prognosis. In ROC, the AUC of diabetes course was 0.754 under the ROC curve. The AUC of HbA1C under the line is 0.791, while the AUC of FCP level is 0.581 under the ROC curve.Conclusion: Low FCP is an independent risk factor for DFU healing, but FCP has little predictive effect on patient healing.

Seroprevalence of human enterovirus A71 in Guangzhou,China,2019-2021

Enterovirus A71 (EV-A71) is a significant hand-foot-mouth disease (HFMD) etiology. The inactivated EV-A71 vaccines were approved in China in 2016. However, the seroprevalence of EV-A71 after the vaccine application and its potential association with the EV-A71 epidemic in the population are rarely studied. In this study, we analyzed the incidence of EV-A71 infection and seroepidemiology in Guangzhou City, China. From 2019 to 2021, 167,920 clinically confirmed HFMD cases were reported in Guangzhou. In 6,868 enterovirus-positive samples, Coxsackievirus A6 and Coxsackievirus A16 were dominant genotypes, and only 3 EV-A71-positive samples were detected, highlighting the deficient epidemic activity of EV-A71. Microneutralization assay was performed on 1,000 representative serum samples. Notably, the seroprevalence and geometric mean titer (GMT) decreased significantly in 2020, and that in the < 3-year age group were increased and even higher than that in 3–5-year age group in 2019 and 2021, which was contrary to our previous surveillance result and other studies in Guangzhou. Furthermore, a moderate decline of GMT level was observed following the vaccination, but the seropositive serums were still detected for 49 months after second immunization, suggesting the long-term persistence of the immunity. Our seroepidemiology study revealed relatively higher neutralizing antibody activity in the susceptible population after the EV-A71 vaccine was adopted in 2016 in Guangzhou. It may be one of the reasons for the lower epidemic activity of EV-A71 in Guangzhou from 2019 to 2021.

多学科联合微创手术在晚期肾盂输尿管移行细胞癌中的应用

目的晚期肾盂输尿管移行细胞癌常并发转移和输尿管壁间段肿瘤侵犯。本文报告4例肾盂输尿管移行细胞癌合并肺或输尿管旁淋巴结转移及患侧输尿管壁间段肿瘤侵犯,术前组织多学科讨论,按照多学科治疗模式联合微创手术治疗。方法收治本院晚期上尿路移行细胞癌4例,男性3例,女性1例;平均年龄73岁;平均血尿病史10个月;3例肾盂输尿管全程侵犯,4例均有患侧输尿管壁间段肿瘤侵犯,3例肾盂输尿管周围淋巴结侵犯,1例肺转移。4例患者均行多学科联合治疗,所有患者接受新辅助治疗后均接受微创手术治疗(3例机器人辅助、1例腹腔镜辅助)。选择1例肺转移和肾盂及输尿管周围淋巴结侵犯做多学科病例分析汇报。结果4例手术均顺利完成,术后予辅助治疗,中位随访时间为33个月,4位患者健侧肾功能正常,且无肿瘤复发。结论晚期上尿路移行细胞癌多学科治疗模式中,选择合适病例切除病灶(包括输尿管壁间段肿瘤)能有效延长患者肿瘤特异性生存率。

Screening disease-associated proteins from sera of patients with rheumatoid arthritis： a comparative proteomic study

Background Rheumatoid arthritis （RA） is an autoimmune disease characterized by chronic inflammation at the synovial membrane. Although great progress has been made recently in exploring the etiology and pathogenesis of RA, its molecular pathological mechanism remains to be further defined and it is still a great challenge in determining the diagnosis and in choosing the appropriate therapy in early patients. This study was performed to screen candidate RA-associated serum proteins by comparative proteomics to provide research clues to early diagnosis and treatment of RA. Methods Sera isolated from 6 RA patients and 6 healthy volunteers were pooled respectively and high-abundance proteins were depleted by Plasma 7 Multiple Affinity Removal System. The protein expression profiles between the two groups were then compared by two-dimensional gel electrophoresis （2-DE） and the proteins over/under-expressed by more than 3-fold were identified by mass spectrometry analysis. To validate the differential expression levels of the identified proteins between the two groups, ELISA was performed in two of the identified proteins in individual sera from 32 RA patients and 32 volunteers. Results Eight proteins which over/under-expressed in sera of RA patients were identified. Among them, chain A of transthyretin （TTR） was under-expressed, while serum amyloid A protein, apolipoprotein A （ApoA）-IV, ApoA-IV precursor, haptoglobin 2, ceruloplasmin （Cp）, immunoglobulin superfamily 22 and HT016 were over-expressed. ELISA test confirmed that Cp expressed remarkably higher while TTR obviously lower in RA group compared with volunteer group. Conclusion There were 8 identified proteins differentially expressed between RA group and volunteer group, which might be candidate RA-associated proteins and might be promising diagnostic indicators or therapeutic targets for RA.

Dynamic characteristics of a shrouded blade with impact and friction

A simplified computational model of a twisted shrouded blade with impact and friction is established.In this model,the shrouded blade is simulated by a flexible Timoshenko beam with a tip-mass,and the effects of centrifugal stiffening,spin softening,and Coriolis force are considered.Impact force is simulated using a linear spring model,and friction force is generated by a tangential spring model under sticking state and a Coulomb friction model under sliding state.The proposed model is validated by a finite element model.Then,the effects of initial gap and normal preload,coefficient of friction,and contact stiffness ratio(the ratio of tangential contact stiffness to normal contact stiffness)on system vibration responses are analyzed.Results show that resonant peaks become inconspicuous and impact plays a dominant role when initial gaps are large between adjacent shrouds.By contrast,in small initial gaps or initial normal preloads condition,resonant speed increases sharply,and the optimal initial normal preloads that can minimize resonant amplitude becomes apparent.Coefficient of friction affects the optimal initial normal preload,but it does not affect vibration responses when the contact between shrouds is under full stick.System resonant amplitude decreases with the increase of contact stiffness ratio,but the optimal initial normal preload is unaffected.