Sepsis is a lethal condition characterized by multiple organ dysfunction due to disrupted host responses to severe infections.[1]Aff ected patients often have a Sequential Organ Failure Assessment(SOFA)score≥2.[2]Pat...Sepsis is a lethal condition characterized by multiple organ dysfunction due to disrupted host responses to severe infections.[1]Aff ected patients often have a Sequential Organ Failure Assessment(SOFA)score≥2.[2]Patients with a SOFA score<2 and at least one of the following were considered as“suspected sepsis”:(1)quick SOFA(qSOFA)score≥2;(2)SOFA score=1;or(3)National Early Warning Score(NEWS)4-6.[3]Compared with studies on fluid resuscitation in sepsis patients,there are few studies on fluid management in patients with suspected sepsis.Therefore,we conducted a retrospective cohort study to evaluate the relationship between fluid management and disease progression in suspected sepsis patients.展开更多
INTRODUCTION Chest pain is a common chief complaint and encompasses nearly 5.2% of all patients seen in emergency departments(ED). In the United States, this accounts for approximately six million annual visits.[1-4]T...INTRODUCTION Chest pain is a common chief complaint and encompasses nearly 5.2% of all patients seen in emergency departments(ED). In the United States, this accounts for approximately six million annual visits.[1-4]The evaluation of patients with chest pain in the ED is a time-consuming and challenging process because the physician must identify those with life-threatening cardiac chest pain, while avoiding unnecessary and costly evaluations of those with non-cardiac chest pain.展开更多
Dear editor,After sustaining severe traumatic brain injury(TBI),patients frequently require invasive mechanical ventilation(MV).However,up to 26%of patients require tracheostomy due to failure to wean from the ventila...Dear editor,After sustaining severe traumatic brain injury(TBI),patients frequently require invasive mechanical ventilation(MV).However,up to 26%of patients require tracheostomy due to failure to wean from the ventilator.[1]The decision of when to perform tracheostomy is important as it balances the risk between avoiding prolonged MV and avoiding risk of tracheostomy.Early predictors for tracheostomy,i.e.,clinical factors when patients first present to an Emergency Department after trauma or when patient fi rst arrive at a regional trauma center,can help clinicians’medical decision-making process.展开更多
Limbic encephalitis represents a cluster of autoimmune disorders,with inflammation in the medial temporal lobe characterised by subacute onset of neuropsychiatric symptoms such as anxiety,affective symptoms,psychosis,...Limbic encephalitis represents a cluster of autoimmune disorders,with inflammation in the medial temporal lobe characterised by subacute onset of neuropsychiatric symptoms such as anxiety,affective symptoms,psychosis,short-term memory impairment as well as faciobrachial and grand mal seizures.We aim to present a case of a 53-year-old man with positive anti-voltage-gated potassium channel(VGKC)complex antibodies who initially presented with symptoms of psychotic mania.Six weeks post-psychiatric symptomatology,he presented with neurological symptoms such as faciobrachial jerking and tonic-clonic seizure.The patient had no previous psychiatric history and was initially treated with psychotropic medications.Our experience emphasises the fact that limbic encephalitis is not easy to identify as most patients initially present with psychiatric symptomatology than neurological symptoms.Furthermore,immunological and laboratory testing takes a rather long time to determine the diagnosis.What is more,few psychiatrists consider autoimmune nature of the neuropsychiatric presentation.Therefore,it is important to consider autoimmune encephalitis in patients with new-onset psychosis or mania who also present with neurological symptoms at some stage of their illness.Characteristic indicators of autoimmune encephalitis include neurological symptoms such as facial twitching,seizures,confusion and cognitive decline.展开更多
In this paper, we have considered some properties of quasi-umbilical hypersurfaces of a Riemannian space and obtained a characteristic of Riemannian spaces admitting quasi-concircular transformation.
COVID-19 has led to an increase in psychiatric disorders,stress,trauma and suicidal behaviour.Study published in the Lancet in 2021 have identified anxiety disorder as the most frequently diagnosed psychiatric disorde...COVID-19 has led to an increase in psychiatric disorders,stress,trauma and suicidal behaviour.Study published in the Lancet in 2021 have identified anxiety disorder as the most frequently diagnosed psychiatric disorder in COVID-19 survivors[1].Fear conditioning and hyper-vigilance towards abnormal breathing patterns attributable to COVID-19 or not,can act as etiological and maintenance factors of panic,and hence we should expect an onset or aggravation of panic disorder in COVID-19[2].展开更多
Heart failure(HF)is a devastating condi-tion characterized by a high rate of mor-tality.[1]About 6.2 million individuals are grappling with the burden of HF in the United States(U.S).[2]Of this over 6 million individu...Heart failure(HF)is a devastating condi-tion characterized by a high rate of mor-tality.[1]About 6.2 million individuals are grappling with the burden of HF in the United States(U.S).[2]Of this over 6 million individuals af-fected with HF,a higher proportion is made up of people older than 65 years.[3,4]More than 50%of pa-tients hospitalized due HF are older than 75 years.[5]Seniors do not just account for the greater propor-tion of individuals affected by HF but also have a worse outcome compared to younger individuals with HF.[6−14]In the light of the above,we aim to address racial disparities as they affect seniors with HF in terms of mortality in addition to other potential prognostic indices.展开更多
Background: Delirium is one of the most common medical emergencies and is associated with poor outcomes including: mortality, prolonged length of stay and poor functional outcome. The more severe delirium is the worst...Background: Delirium is one of the most common medical emergencies and is associated with poor outcomes including: mortality, prolonged length of stay and poor functional outcome. The more severe delirium is the worst the clinical outcomes of medical illness. Despite the obvious, not much has been documented on delirium severity and its associated factors among medical inpatients in low income countries including Nigeria. Objectives: This study was conducted to examine the severity of delirium among medical inpatients admitted through the Accident and Emergency unit of Jos University Teaching Hospital as well as to assess its associated Sociodemographic and Clinical characteristics. Method: This was a cross-sectional study that employed a consecutive sampling technique to select 290 eligible subjects from medical inpatients that presented to Accident and Emergency unit of Jos University Teaching Hospital. On admission, patients were assessed for delirium using Confusion Assessment Method and severity of delirium was evaluated using Delirium Rating Scale-Revised-98. Results: Of the 105 delirious medical inpatients, 48 (45.7%) had severe delirium, 41 (39.1%) developed less severe delirium while 16 (15.2) presented with no severe delirium. Sociodemographic characteristics found to be significantly associated with less to more severe delirium include male gender (P = 0.001), nonprofessionals (P = 0.003), income range of N20,000 - N49,000 (P Conclusion: This study demonstrates that delirium is often associated with higher severity in Accident and Emergency unit admission and there are strongly associated clinical characteristics to watch out for in high risk medical inpatients.展开更多
In the mid-1980’s researchers at Cleveland State University made a startling discovery. They conducted an experiment by creating two fictitious job candidates—David and John.Thecandidates had identical resumes and l...In the mid-1980’s researchers at Cleveland State University made a startling discovery. They conducted an experiment by creating two fictitious job candidates—David and John.Thecandidates had identical resumes and letters of reference.The only difference was that John’s letterincluded the sentence“Sometimes,John can be difficult to get along with.”They showed the re-展开更多
Objective Most patients with sepsis were diagnosed in the emergency department when admitted to the hospital. This study aimed to explore independent factors for hospital mortality in sepsis patients in the emergency ...Objective Most patients with sepsis were diagnosed in the emergency department when admitted to the hospital. This study aimed to explore independent factors for hospital mortality in sepsis patients in the emergency department.Methods It was a retrospective study. All patients with sepsis admitted to the emergency department of Changsha Central Hospital between 1 July 2020 and 1 July 2021 were included. Variables that showed significant differences between the survivor group and the non-survivor group were caculated in multivariate logistic regression analysis. Independent factors associated with in-hospital mortality in sepsis were identified.Results A total of 194 patients were included in this study. In-hospital mortality was 17.01%(n=33). Two independent risk factors including albumin(ALB) and urea nitrogen were identified by multivariate logistic regression analysis. The optimal cut-off values of ALB and urea nitrogen were 26.5g/L and 8.03mmol/L. While combined ALB and urea nitrogen, the area under the ROC curve(AUC) was 0.790, which was superior to the SOFA, qSOFA, and APACHEⅡscores.Conclusions Independent factors including ALB and urea nitrogen for in-hospital mortality in sepsis in the emergency department were identified. It could help physicians identify those patients with a higher risk of a poor prognosis early and easily, so intervention and management could be performed quickly.展开更多
OBJECTIVES Stress-related glycemic indicators,including admission blood glucose(ABG),stress-hyperglycemia ratio(SHR),and glycemic gap(GG),have been associated with worse outcomes after acute myocardial infarction(AMI)...OBJECTIVES Stress-related glycemic indicators,including admission blood glucose(ABG),stress-hyperglycemia ratio(SHR),and glycemic gap(GG),have been associated with worse outcomes after acute myocardial infarction(AMI).However,data regarding their prognostic value in the oldest old with AMI are unavailable.Therefore,this study aimed to investigate the association of stress-related glycemic indicators with short-and long-term cardiovascular mortality(CVM)in the oldest old(≥80 years)with AMI.METHODS In this prospective study,a total of 933 consecutive old patients with AMI admitted to FuWai hospital(Beijing,China)were enrolled.On admission,ABG,SHR,and GG were assessed and all participants were classified according to their quartiles.Kaplan-Meier,restricted cubic splines(RCS),and multivariate Cox regression analyses were performed to evaluate the association between these glycemic indicators and CVM within 30 days and long-term follow-up.RESULTS During an average of 1954 patient-years of follow-up,a total of 250 cardiovascular deaths were recorded.Kaplan-Meier analyses showed the lowest CVM in quartile 1 of ABG and in quartile 2 of SHR and GG.After adjusting for potential covariates,patients in quartile 4 of ABG,SHR,and GG had a respective 1.67-fold(95%CI:1.03-2.69;P=0.036),1.80-fold(95%CI:1.16-2.79;P=0.009),and 1.78-fold(95%CI:1.14-2.79;P=0.011)higher risk of long-term CVM risk compared to those in the reference groups(quartile 1 of ABG and quartile 2 of SHR and GG).Furthermore,RCS suggested a J-shaped relationship of ABG and a Ushaped association of SHR and GG with long-term CVM.Additionally,we observed similar associations of these acute glycemic parameters with 30-day CVM.CONCLUSIONS Our data first indicated that SHR and GG consistently had a U-shaped association with both 30-day and longterm CVM among the oldest old with AMI,suggesting that they may be useful for risk stratification in this special population.展开更多
Editorial Professor Juejun Hu was admitted by Tsinghua University as top scorer in the science college entrance examination of Fujian Province.After graduating,he went to MIT to pursue further studies,where he continu...Editorial Professor Juejun Hu was admitted by Tsinghua University as top scorer in the science college entrance examination of Fujian Province.After graduating,he went to MIT to pursue further studies,where he continued to excel and became a faculty member.Each step of his journey has been marked by extraordinary achievements,setting a standard that few can match.Today,Prof.Hu is recognized as a leading expert in integrated photonics and optical materials.His pioneering research has not only advanced the frontiers of academia but also made significant impacts on industrial applications.In this interview,we invite you to delve into Prof.Hu's research world,exploring his unique insights into technological innovation and how he uses the power of science to shape the future.展开更多
Subdiaphragmatic abscess is uncommon in patients who undergo resection for hepatocellular carcinoma.The identifi cation of pathogens and appropriate treatment can be challenging.[1]Herein,we present a case of subdiaph...Subdiaphragmatic abscess is uncommon in patients who undergo resection for hepatocellular carcinoma.The identifi cation of pathogens and appropriate treatment can be challenging.[1]Herein,we present a case of subdiaphragmatic abscess caused by Cutibacterium modestum.A 66-year-old man was admitted to our hospital with fever,cough,and persistent,dull pain in the right upper quadrant for two days.The patient’s medical history included liver cirrhosis,radical resection of hepatocellular carcinoma three months prior to admission,and type 2 diabetes mellitus.Physical examination revealed tachycardia with small moist rales in the right lower chest.Abdominal examination revealed an L-shaped,well-healed surgical incision in the right upper quadrant without intra-abdominal mass or tenderness.展开更多
A 77-year-old female presented with shortness of breath and tightness of chest was admitted.Her past medical history included hypertension and she has been taking nifedipine regularly.Two years before,she was diagnose...A 77-year-old female presented with shortness of breath and tightness of chest was admitted.Her past medical history included hypertension and she has been taking nifedipine regularly.Two years before,she was diagnosed with pericardial effusion(Figure 1)and had pericardiocentesis drainage.On physical examination,her blood pressure was 151/100 mm-Hg and her pulse rate was 91 beats/min.展开更多
Prof.Yun Zhang was born on 9 July 1963 in Kunming,Yunnan,China,during a tumultuous period which he often referenced.Throughout his life,he harbored a steadfast belief in using knowledge to unravel the mysteries of hum...Prof.Yun Zhang was born on 9 July 1963 in Kunming,Yunnan,China,during a tumultuous period which he often referenced.Throughout his life,he harbored a steadfast belief in using knowledge to unravel the mysteries of human diseases.His educational journey was marked by frequent changes in schools due to his parents’occupational relocations.However,despite these challenges,he consistently displayed diligence and was admitted to the East China University of Science and Technology,Shanghai,after completing high school in 1980.He remained an active and loyal member of the School of Biotechnology at the university.展开更多
BACKGROUND Prealbumin is considered to be a useful indicator of nutritional status. Furthermore, it has been found to be associated with severities and prognosis of a range of diseases. However, limited data on the as...BACKGROUND Prealbumin is considered to be a useful indicator of nutritional status. Furthermore, it has been found to be associated with severities and prognosis of a range of diseases. However, limited data on the association of baseline prealbumin level with outcomes of patients with acute ST-segment elevation myocardial infarction(STEMI) are available.METHODS We analyzed 2313 patients admitted for acute STEMI between October 2013 and December 2020. In-hospital outcomes and mortality during the 49 months(interquartile range: 26–73 months) follow-up period were compared between patients with the low prealbumin level(< 170 mg/L) and those with the high prealbumin level(≥ 170 mg/L).RESULTS A total of 114 patients(4.9%) died during hospitalization. After propensity score matching, patients with the low prealbumin level than those with the high prealbumin level experienced higher incidences of heart failure with Killip class Ⅲ(9.9%vs. 4.4%, P = 0.034), cardiovascular death(8.4% vs. 3.4%, P = 0.035) and the composite of major adverse cardiovascular events(19.2%vs. 10.3%, P = 0.012). Multivariate logistic regression analysis identified that the low prealbumin level(< 170 mg/L) was an independent predictor of in-hospital major adverse cardiovascular events(odds ratio = 1.918, 95% CI: 1.250–2.942, P = 0.003). The cutoff value of prealbumin level for predicting in-hospital death was 170 mg/L(area under the curve = 0.703, 95% CI: 0.651–0.754, P< 0.001;sensitivity = 0.544, specificity = 0.794). However, after multivariate adjustment of possible confounders, baseline prealbumin level(170 mg/L) was no longer independently associated with 49-month cardiovascular death. After propensity score matching, Kaplan-Meier survival curves revealed consistent results.CONCLUSIONS Decreased prealbumin level closely related to unfavorable short-term outcomes. However, after multivariate adjustment and controlling for baseline differences, baseline prealbumin level was not independently associated with an increased risk of long-term cardiovascular mortality in STEMI patients.展开更多
Dear Editor,We present a case of ruptured renal angiomyolipoma(AML)and bilateral renal staghorn calculi.We discuss about the management of this patient by angioembolization,partial nephrectomy,and pyelolithotomy,follo...Dear Editor,We present a case of ruptured renal angiomyolipoma(AML)and bilateral renal staghorn calculi.We discuss about the management of this patient by angioembolization,partial nephrectomy,and pyelolithotomy,followed by contralateral interval percutaneous nephrolithotomy(PCNL).Our case is a 40-year-old male who presented with history of dull aching and dragging sensation in bilateral flanks of 6-month duration.He was admitted and evaluated at other hospital for dizziness,sweating,and loss of consciousness.He was found to have bilateral staghorn calculi and left AML and was referred to our institute for further management after initial stabilization.The proper written and informed consent was taken from the patient for management as well as publication of the report and images,maintaining the patient’s anonymity.展开更多
Dear Editor,We present a case of dacryocystitis and canaliculitis secondary to residual of epidural catheter remaining in lacrimal duct for 25y.A 56-year-old male patient was admitted to our medical center on February...Dear Editor,We present a case of dacryocystitis and canaliculitis secondary to residual of epidural catheter remaining in lacrimal duct for 25y.A 56-year-old male patient was admitted to our medical center on February 16,2023.We obtained the written informed consent from the patient,and this case study was in accordance with the tenets of the Declaration of Helsinki.The main complaint was that the right eye had suffered from persistent tears for more than 25y and discharge for more than 1y.展开更多
文摘Sepsis is a lethal condition characterized by multiple organ dysfunction due to disrupted host responses to severe infections.[1]Aff ected patients often have a Sequential Organ Failure Assessment(SOFA)score≥2.[2]Patients with a SOFA score<2 and at least one of the following were considered as“suspected sepsis”:(1)quick SOFA(qSOFA)score≥2;(2)SOFA score=1;or(3)National Early Warning Score(NEWS)4-6.[3]Compared with studies on fluid resuscitation in sepsis patients,there are few studies on fluid management in patients with suspected sepsis.Therefore,we conducted a retrospective cohort study to evaluate the relationship between fluid management and disease progression in suspected sepsis patients.
文摘INTRODUCTION Chest pain is a common chief complaint and encompasses nearly 5.2% of all patients seen in emergency departments(ED). In the United States, this accounts for approximately six million annual visits.[1-4]The evaluation of patients with chest pain in the ED is a time-consuming and challenging process because the physician must identify those with life-threatening cardiac chest pain, while avoiding unnecessary and costly evaluations of those with non-cardiac chest pain.
文摘Dear editor,After sustaining severe traumatic brain injury(TBI),patients frequently require invasive mechanical ventilation(MV).However,up to 26%of patients require tracheostomy due to failure to wean from the ventilator.[1]The decision of when to perform tracheostomy is important as it balances the risk between avoiding prolonged MV and avoiding risk of tracheostomy.Early predictors for tracheostomy,i.e.,clinical factors when patients first present to an Emergency Department after trauma or when patient fi rst arrive at a regional trauma center,can help clinicians’medical decision-making process.
文摘Limbic encephalitis represents a cluster of autoimmune disorders,with inflammation in the medial temporal lobe characterised by subacute onset of neuropsychiatric symptoms such as anxiety,affective symptoms,psychosis,short-term memory impairment as well as faciobrachial and grand mal seizures.We aim to present a case of a 53-year-old man with positive anti-voltage-gated potassium channel(VGKC)complex antibodies who initially presented with symptoms of psychotic mania.Six weeks post-psychiatric symptomatology,he presented with neurological symptoms such as faciobrachial jerking and tonic-clonic seizure.The patient had no previous psychiatric history and was initially treated with psychotropic medications.Our experience emphasises the fact that limbic encephalitis is not easy to identify as most patients initially present with psychiatric symptomatology than neurological symptoms.Furthermore,immunological and laboratory testing takes a rather long time to determine the diagnosis.What is more,few psychiatrists consider autoimmune nature of the neuropsychiatric presentation.Therefore,it is important to consider autoimmune encephalitis in patients with new-onset psychosis or mania who also present with neurological symptoms at some stage of their illness.Characteristic indicators of autoimmune encephalitis include neurological symptoms such as facial twitching,seizures,confusion and cognitive decline.
文摘In this paper, we have considered some properties of quasi-umbilical hypersurfaces of a Riemannian space and obtained a characteristic of Riemannian spaces admitting quasi-concircular transformation.
文摘COVID-19 has led to an increase in psychiatric disorders,stress,trauma and suicidal behaviour.Study published in the Lancet in 2021 have identified anxiety disorder as the most frequently diagnosed psychiatric disorder in COVID-19 survivors[1].Fear conditioning and hyper-vigilance towards abnormal breathing patterns attributable to COVID-19 or not,can act as etiological and maintenance factors of panic,and hence we should expect an onset or aggravation of panic disorder in COVID-19[2].
文摘Heart failure(HF)is a devastating condi-tion characterized by a high rate of mor-tality.[1]About 6.2 million individuals are grappling with the burden of HF in the United States(U.S).[2]Of this over 6 million individuals af-fected with HF,a higher proportion is made up of people older than 65 years.[3,4]More than 50%of pa-tients hospitalized due HF are older than 75 years.[5]Seniors do not just account for the greater propor-tion of individuals affected by HF but also have a worse outcome compared to younger individuals with HF.[6−14]In the light of the above,we aim to address racial disparities as they affect seniors with HF in terms of mortality in addition to other potential prognostic indices.
文摘Background: Delirium is one of the most common medical emergencies and is associated with poor outcomes including: mortality, prolonged length of stay and poor functional outcome. The more severe delirium is the worst the clinical outcomes of medical illness. Despite the obvious, not much has been documented on delirium severity and its associated factors among medical inpatients in low income countries including Nigeria. Objectives: This study was conducted to examine the severity of delirium among medical inpatients admitted through the Accident and Emergency unit of Jos University Teaching Hospital as well as to assess its associated Sociodemographic and Clinical characteristics. Method: This was a cross-sectional study that employed a consecutive sampling technique to select 290 eligible subjects from medical inpatients that presented to Accident and Emergency unit of Jos University Teaching Hospital. On admission, patients were assessed for delirium using Confusion Assessment Method and severity of delirium was evaluated using Delirium Rating Scale-Revised-98. Results: Of the 105 delirious medical inpatients, 48 (45.7%) had severe delirium, 41 (39.1%) developed less severe delirium while 16 (15.2) presented with no severe delirium. Sociodemographic characteristics found to be significantly associated with less to more severe delirium include male gender (P = 0.001), nonprofessionals (P = 0.003), income range of N20,000 - N49,000 (P Conclusion: This study demonstrates that delirium is often associated with higher severity in Accident and Emergency unit admission and there are strongly associated clinical characteristics to watch out for in high risk medical inpatients.
文摘In the mid-1980’s researchers at Cleveland State University made a startling discovery. They conducted an experiment by creating two fictitious job candidates—David and John.Thecandidates had identical resumes and letters of reference.The only difference was that John’s letterincluded the sentence“Sometimes,John can be difficult to get along with.”They showed the re-
基金Changsha Natural Science Foundation(NO.kq2208445)Changsha Central Hospital (NO.YNKY202306)Changsha Science and Technology Bureau(NO.kzd21084, kzd22074, kzd22075)。
文摘Objective Most patients with sepsis were diagnosed in the emergency department when admitted to the hospital. This study aimed to explore independent factors for hospital mortality in sepsis patients in the emergency department.Methods It was a retrospective study. All patients with sepsis admitted to the emergency department of Changsha Central Hospital between 1 July 2020 and 1 July 2021 were included. Variables that showed significant differences between the survivor group and the non-survivor group were caculated in multivariate logistic regression analysis. Independent factors associated with in-hospital mortality in sepsis were identified.Results A total of 194 patients were included in this study. In-hospital mortality was 17.01%(n=33). Two independent risk factors including albumin(ALB) and urea nitrogen were identified by multivariate logistic regression analysis. The optimal cut-off values of ALB and urea nitrogen were 26.5g/L and 8.03mmol/L. While combined ALB and urea nitrogen, the area under the ROC curve(AUC) was 0.790, which was superior to the SOFA, qSOFA, and APACHEⅡscores.Conclusions Independent factors including ALB and urea nitrogen for in-hospital mortality in sepsis in the emergency department were identified. It could help physicians identify those patients with a higher risk of a poor prognosis early and easily, so intervention and management could be performed quickly.
基金supported by the Capital Health Development Fund[201614035],the CAMS Innovation Fund for Medical Sciences[2021-I2M-1-008]the National High-level Hospital Clinical Research Funding[2023-GSP-RC-09,2023-GSP-QN-8].
文摘OBJECTIVES Stress-related glycemic indicators,including admission blood glucose(ABG),stress-hyperglycemia ratio(SHR),and glycemic gap(GG),have been associated with worse outcomes after acute myocardial infarction(AMI).However,data regarding their prognostic value in the oldest old with AMI are unavailable.Therefore,this study aimed to investigate the association of stress-related glycemic indicators with short-and long-term cardiovascular mortality(CVM)in the oldest old(≥80 years)with AMI.METHODS In this prospective study,a total of 933 consecutive old patients with AMI admitted to FuWai hospital(Beijing,China)were enrolled.On admission,ABG,SHR,and GG were assessed and all participants were classified according to their quartiles.Kaplan-Meier,restricted cubic splines(RCS),and multivariate Cox regression analyses were performed to evaluate the association between these glycemic indicators and CVM within 30 days and long-term follow-up.RESULTS During an average of 1954 patient-years of follow-up,a total of 250 cardiovascular deaths were recorded.Kaplan-Meier analyses showed the lowest CVM in quartile 1 of ABG and in quartile 2 of SHR and GG.After adjusting for potential covariates,patients in quartile 4 of ABG,SHR,and GG had a respective 1.67-fold(95%CI:1.03-2.69;P=0.036),1.80-fold(95%CI:1.16-2.79;P=0.009),and 1.78-fold(95%CI:1.14-2.79;P=0.011)higher risk of long-term CVM risk compared to those in the reference groups(quartile 1 of ABG and quartile 2 of SHR and GG).Furthermore,RCS suggested a J-shaped relationship of ABG and a Ushaped association of SHR and GG with long-term CVM.Additionally,we observed similar associations of these acute glycemic parameters with 30-day CVM.CONCLUSIONS Our data first indicated that SHR and GG consistently had a U-shaped association with both 30-day and longterm CVM among the oldest old with AMI,suggesting that they may be useful for risk stratification in this special population.
文摘Editorial Professor Juejun Hu was admitted by Tsinghua University as top scorer in the science college entrance examination of Fujian Province.After graduating,he went to MIT to pursue further studies,where he continued to excel and became a faculty member.Each step of his journey has been marked by extraordinary achievements,setting a standard that few can match.Today,Prof.Hu is recognized as a leading expert in integrated photonics and optical materials.His pioneering research has not only advanced the frontiers of academia but also made significant impacts on industrial applications.In this interview,we invite you to delve into Prof.Hu's research world,exploring his unique insights into technological innovation and how he uses the power of science to shape the future.
基金This research did not receive any specific grant from funding agencies in the publiccommercialor not-for-profit sectors
文摘Subdiaphragmatic abscess is uncommon in patients who undergo resection for hepatocellular carcinoma.The identifi cation of pathogens and appropriate treatment can be challenging.[1]Herein,we present a case of subdiaphragmatic abscess caused by Cutibacterium modestum.A 66-year-old man was admitted to our hospital with fever,cough,and persistent,dull pain in the right upper quadrant for two days.The patient’s medical history included liver cirrhosis,radical resection of hepatocellular carcinoma three months prior to admission,and type 2 diabetes mellitus.Physical examination revealed tachycardia with small moist rales in the right lower chest.Abdominal examination revealed an L-shaped,well-healed surgical incision in the right upper quadrant without intra-abdominal mass or tenderness.
基金funded by the Tianjin Natural Science Foundation (No. 21JCYBJC01740 and 21JCYBJC01460)the Tianjin Key Medical Discipline (Specialty) Construction Project+1 种基金the Tianjin Key Medical Discipline (Specialty) Construction Project(TJYXZDXK-029A)Science Foundation of The Tianjin Education Commission (No.2023ZD007)
文摘A 77-year-old female presented with shortness of breath and tightness of chest was admitted.Her past medical history included hypertension and she has been taking nifedipine regularly.Two years before,she was diagnosed with pericardial effusion(Figure 1)and had pericardiocentesis drainage.On physical examination,her blood pressure was 151/100 mm-Hg and her pulse rate was 91 beats/min.
文摘Prof.Yun Zhang was born on 9 July 1963 in Kunming,Yunnan,China,during a tumultuous period which he often referenced.Throughout his life,he harbored a steadfast belief in using knowledge to unravel the mysteries of human diseases.His educational journey was marked by frequent changes in schools due to his parents’occupational relocations.However,despite these challenges,he consistently displayed diligence and was admitted to the East China University of Science and Technology,Shanghai,after completing high school in 1980.He remained an active and loyal member of the School of Biotechnology at the university.
文摘BACKGROUND Prealbumin is considered to be a useful indicator of nutritional status. Furthermore, it has been found to be associated with severities and prognosis of a range of diseases. However, limited data on the association of baseline prealbumin level with outcomes of patients with acute ST-segment elevation myocardial infarction(STEMI) are available.METHODS We analyzed 2313 patients admitted for acute STEMI between October 2013 and December 2020. In-hospital outcomes and mortality during the 49 months(interquartile range: 26–73 months) follow-up period were compared between patients with the low prealbumin level(< 170 mg/L) and those with the high prealbumin level(≥ 170 mg/L).RESULTS A total of 114 patients(4.9%) died during hospitalization. After propensity score matching, patients with the low prealbumin level than those with the high prealbumin level experienced higher incidences of heart failure with Killip class Ⅲ(9.9%vs. 4.4%, P = 0.034), cardiovascular death(8.4% vs. 3.4%, P = 0.035) and the composite of major adverse cardiovascular events(19.2%vs. 10.3%, P = 0.012). Multivariate logistic regression analysis identified that the low prealbumin level(< 170 mg/L) was an independent predictor of in-hospital major adverse cardiovascular events(odds ratio = 1.918, 95% CI: 1.250–2.942, P = 0.003). The cutoff value of prealbumin level for predicting in-hospital death was 170 mg/L(area under the curve = 0.703, 95% CI: 0.651–0.754, P< 0.001;sensitivity = 0.544, specificity = 0.794). However, after multivariate adjustment of possible confounders, baseline prealbumin level(170 mg/L) was no longer independently associated with 49-month cardiovascular death. After propensity score matching, Kaplan-Meier survival curves revealed consistent results.CONCLUSIONS Decreased prealbumin level closely related to unfavorable short-term outcomes. However, after multivariate adjustment and controlling for baseline differences, baseline prealbumin level was not independently associated with an increased risk of long-term cardiovascular mortality in STEMI patients.
文摘Dear Editor,We present a case of ruptured renal angiomyolipoma(AML)and bilateral renal staghorn calculi.We discuss about the management of this patient by angioembolization,partial nephrectomy,and pyelolithotomy,followed by contralateral interval percutaneous nephrolithotomy(PCNL).Our case is a 40-year-old male who presented with history of dull aching and dragging sensation in bilateral flanks of 6-month duration.He was admitted and evaluated at other hospital for dizziness,sweating,and loss of consciousness.He was found to have bilateral staghorn calculi and left AML and was referred to our institute for further management after initial stabilization.The proper written and informed consent was taken from the patient for management as well as publication of the report and images,maintaining the patient’s anonymity.
文摘Dear Editor,We present a case of dacryocystitis and canaliculitis secondary to residual of epidural catheter remaining in lacrimal duct for 25y.A 56-year-old male patient was admitted to our medical center on February 16,2023.We obtained the written informed consent from the patient,and this case study was in accordance with the tenets of the Declaration of Helsinki.The main complaint was that the right eye had suffered from persistent tears for more than 25y and discharge for more than 1y.
