Associated Factors to Poor Blood Pressure Control in Hypertensives Followed Up at the Campus University Hospital of Lome (Togo)

Introduction: Hypertension is a real public health issue and its control is very difficult. We aim to determine the frequency of uncontrolled hypertension in hypertensive patients followed up as an outpatient at the campus university hospital of Lome (Togo) and to search for the associated factors. Methodology: The study was cross-sectional, descriptive and analytical, carried out from February (2022) to August 2022 in 260 hypertensive patients aged 22 years old, followed up (on an) as an outpatient for at least 3 months at the Lome University Hospital campus. A univariate then multivariate analysis were conducted in order to highlight the most common factors significantly linked to uncontrolled. Results: The mean age of hypertensives was 56.4 ± 12.7 years, the sex ratio (M/F) was 0.59. Prevalence of uncontrolled blood pressure was 42%. Associated Factors to poor blood pressure control in our study were age > 60 years (OR = 1.6 CI [1.17 - 2.50]), low socio-economic level (OR = 2.2 CI [1.96 - 4.33]), high cardiovascular risk level (OR = 3.1 CI [2.18 - 4.52]), non-adherence to regular blood pressure monitoring (OR = 3.3 CI [2.21 - 5.55]), low compliance to treatment (OR = 4.1 CI [2.33 - 6.76]) and a chronic renal failure (OR = 2.1 CI [1.21 - 3.10]). Conclusion: Nearly half of the hypertensives in our study had poorly controlled blood pressure by antihypertensive treatment medication. The factors of this poor control were age > 60 years, low socio-economic level, high or very high level of cardiovascular risk, low compliance to treatment, and renal failure.

Gallbladder carcinosarcoma with a poor prognosis: A case report

BACKGROUND Carcinosarcoma of the gallbladder is a rare malignant tumor with a very poor prognosis.To date,only approximately 100 patients have been reported in the English literature.The prognosis of this tumor type is poor,the preoperative diagnosis is difficult,and there is a possibility of a misdiagnosis.We present an unsuccessful case of carcinosarcoma of the gallbladder with a preoperative misdiagnosis and rapid early postoperative recurrence.Therefore,we have a deeper understanding of the poor prognosis of gallbladder carcinosarcoma(GBC)patients.CASE SUMMARY The patient is a 65-year-old male.He was admitted to the hospital because of right upper abdomen distending pain and discomfort for half a month.Abdominal magnetic resonance imaging revealed a polycystic mass in the right lobe of the liver and the fossa of the gallbladder.After admission,the patient was diagnosed with a liver abscess,which was treated by abscess puncture drainage.Obviously,this treatment was unsuccessful.Hepatectomy and cholecystectomy were performed one month after the puncture.Postoperative pathologic examination revealed carcinosarcoma of the gallbladder,and the resected specimen contained two tumor components.One month after surgery,the patient's tumor recurred in situ and started to compress the duodenum,resulting in duodenal obstruction and bleeding.The treatment was not effective.The patient died of gastrointestinal hemorrhage and hypovolemic shock.CONCLUSION Carcinosarcoma of the gallbladder is a rare malignant tumor that is easily misdiagnosed preoperatively and has a poor prognosis.

Autosomal Dominant Polycystic Kidney Disease: Epidemiological, Clinical Aspects and Predictive Factors of Poor Renal Prognosis (About 300 Cases)

Introduction: Autosomal dominant polycystic kidney disease (ADPKD) is a common, multisystemic, and progressive hereditary disease. It accounts for 6 to 8% of incident cases of end-stage chronic renal disease (ESRD) in developed countries. The aim of this study is to describe the predictive factors for the development of end-stage chronic kidney disease (CKD) in the course of this disease. Material and Methods: This is a retrospective, descriptive, and analytical study including 300 cases of ADPKD collected at the Nephrology Department of Ibn-Sina Hospital in Rabat over a period of 30 years (1993 to 2023). Included in the study are all patients with ADPKD meeting the ultrasound diagnostic criteria. The analysis focused on demographic, clinical, paraclinical, evolutionary data, as well as prognostic factors associated with renal function deterioration. Results: The mean age of patients at diagnosis is 51.53 +/− 17 years [16 - 93] with a male predominance. The median serum creatinine at diagnosis is 15.5 mg/l [10 - 34]. 21% of patients had ESRD (eGFR 300 mg/24h (21%). The most common cystic complication is hemorrhage (12.3%). 21.3% of patients had hepatorenal polycystic disease. In adjusted analysis, the predictive risk factors for the occurrence of ESRD were smoking (p = 0.019), anemia (p Conclusion: ADPKD can progress insidiously to ESRD. Identification and early treatment of predictive factors for poor renal prognosis could contribute to a better outcome for this disease.

Diagnosis of poorly differentiated adenocarcinoma of the stomach by confocal laser endomicroscopy:A case report

BACKGROUND In recent years,confocal laser endomicroscopy(CLE)has become a new endoscopic imaging technology at the microscopic level,which is extensively performed for real-time in vivo histological examination.CLE can be performed to distinguish benign from malignant lesions.In this study,we diagnosed using CLE an asymptomatic patient with poorly differentiated gastric adenocarcinoma.CASE SUMMARY A 63-year-old woman was diagnosed with gastric mucosal lesions,which may be gastric cancer,in the small curvature of the stomach by gastroscopy.She consented to undergo CLE for morphological observation of the gastric mucosa.Through the combination of CLE diagnosis and postoperative pathology,the intraoperative CLE diagnosis was considered to be reliable.According to our experience,CLE can be performed as the first choice for the diagnosis of gastric cancer.CONCLUSION CLE has several advantages over pathological diagnosis.We believe that CLE has great potential in the diagnosis of benign and malignant gastric lesions.

Turning Dreams Into Reality China is committed to helping African countries to build their space capability

An important feature of China developing its aerospace industry is its insistence on self-reliance and independent innovation,because China firmly believes that aerospace is a hi-tech industry and high core technologies cannot be bought.Only by mastering core technologies can China firmly grasp the initiative in development.

Discussion on the Ideological and Political Education for Poor College Students

At present,ideological and political education is significant for poor college students.The focus of funding for poor students has gradually transformed from providing economic support for them to ideological and spiritual help,which puts forward higher requirements on how to carry out ideological and political work.It also requires us to advance the work of ideological and moral education and put it in the most important position in the ideological and educational work for poor college students.Combined with the reality of poor college students,we will adhere to the idea of being student-oriented and endeavor to enhance the effectiveness,pertinence,and relevance of the work of ideological and political education.This paper analyzes the significance and problems of ideological and political education for poor college students and puts forward effective ways to solve the problems from the levels of ideology,cognition,and teaching staff.

Causes and Countermeasures of Helping Poor Students to Learn English

In English teaching, there is a common phenomenon: at the beginning of English learning, students are enthusiastic and full of interest; then polarization appears after a period of study. Some of the students become discouraged and lose confidence in learning English, and gradually become the so-called poor learners. Therefore, teachers should make careful analysis, find out the causes and regulate countermeasures to improve teaching methods, so that every student can get a comprehensive and healthy development.

Human mesenchymal stem cells exhibit altered mitochondrial dynamics and poor survival in high glucose microenvironment

BACKGROUND Mesenchymal stem cells(MSCs)are a type of stem cells that possess relevant regenerative abilities and can be used to treat many chronic diseases.Diabetes mellitus(DM)is a frequently diagnosed chronic disease characterized by hyperglycemia which initiates many multisystem complications in the long-run.DM patients can benefit from MSCs transplantation to curb down the pathological consequences associated with hyperglycemia persistence and restore the function of damaged tissues.MSCs therapeutic outcomes are found to last for short period of time and ultimately these regenerative cells are eradicated and died in DM disease model.AIM To investigate the impact of high glucose or hyperglycemia on the cellular and molecular characteristics of MSCs.METHODS Human adipose tissue-derived MSCs(hAD-MSCs)were seeded in low(5.6 mmol/L of glucose)and high glucose(25 mmol/L of glucose)for 7 d.Cytotoxicity,viability,mitochondrial dynamics,and apoptosis were deplored using specific kits.Western blotting was performed to measure the protein expression of phosphatidylinositol 3-kinase(PI3K),TSC1,and mammalian target of rapamycin(mTOR)in these cells.RESULTS hAD-MSCs cultured in high glucose for 7 d demonstrated marked decrease in their viability,as shown by a significant increase in lactate dehydrogenase(P<0.01)and a significant decrease in Trypan blue(P<0.05)in these cells compared to low glucose control.Mitochondrial membrane potential,indicated by tetramethylrhodamine ethyl ester(TMRE)fluorescence intensity,and nicotinamide adenine dinucleotide(NAD+)/NADH ratio were significantly dropped(P<0.05 for TMRE and P<0.01 for NAD+/NADH)in high glucose exposed hAD-MSCs,indicating disturbed mitochondrial function.PI3K protein expression significantly decreased in high glucose culture MSCs(P<0.05 compared to low glucose)and it was coupled with significant upregulation in TSC1(P<0.05)and downregulation in mTOR protein expression(P<0.05).Mitochondrial complexes I,IV,and V were downregulated profoundly in high glucose(P<0.05 compared to low glucose).Apoptosis was induced as a result of mitochondrial impairment and explained the poor survival of MSCs in high glucose.CONCLUSION High glucose impaired the mitochondrial dynamics and regulatory proteins in hAD-MSCs ensuing their poor survival and high apoptosis rate in hyperglycemic microenvironment.

“The Source of Flowing Water”:How Targeted Poverty Alleviation Helps China’s Rural Poor Access Credit

Based on the China Household Finance Survey(CHFS)data of 2011-2017,this paper investigated the effects of China’s targeted poverty alleviation policy on rural credit access and amount using the“difference-in-differences”methodology.This study found that the targeted poverty alleviation policy increased the availability and amount of formal credit to poor households and reduced the proportion and amount of their borrowing through informal channels,and that the effects increased amid the policy’s implementation over time.This paper further found that the policy effects were more significant for China’s western regions,reflecting a positive role of targeted poverty alleviation in coordinating pro-poor finance across regions.Compared with poor counties,poor households from non-poor counties experienced a greater increase in their probability and amount of formal credit access,reflecting China’s approach of reducing regional poverty before targeting more precisely at individual poor households.This paper also uncovered that no significant“elite capture”effect had existed in the allocation of formal agricultural credit under targeted poverty alleviation,but extremely poor households experienced no significant change in their access to formal credit.While the targeted poverty alleviation policy has helped create a sound rural credit market,it should further improve access to formal finance for extremely poor households.

The Rich Help the Poor

ＴｈｅＲｉｃｈＨｅｌｐｔｈｅＰｏｏｒＭｏｒｅａｎｄｍｏｒｅｗｅａｌｔｈｙｒｅｇｉｏｎｓａｎｄｂｕｓｉｎｅｓｓｐｅｏｐｌｅａｒｅｐａｒｔｉｃｉｐａｔｉｎｇｉｎｔｈｅｃａｍｐａｉｇｎａｇａｉｎｓｔｐｏｖｅｒｔｙ，ａｎｄｈａｖｅｍａｄｅｃｏｎｓｉｄｅｒａｂ...

Increased MAD2L2 expression predicts poor clinical outcome in Colon Adenocarcinoma

Background:Colon adenocarcinoma(COAD)is the second leading cause of cancer death worldwide thus,identification of COAD biomarkers is critical.Mitotic Arrest Deficient 2 Like 2(MAD2L2)is a key factor in mammalian DNA damage repair and is highly expressed in many malignant tumors.This is a comprehensive study of MAD2L2 expression,its diagnostic value,prognostic analysis,potential biological function,and impact on the immune system of patients with COAD.Methods:Gene expression,clinical relevance,prognostic analysis,diagnostic value,GO/KEGG cluster analysis,data obtained from TCGA,and bioinformatics statistical analysis were performed using the R package.Immune responses to MAD2L2 expression in COAD were analyzed using TIMER.The expression of MAD2L2 in HCT116 cells induced by the inflammatory factor TNF-αwas detected using Western blot.Results:Our results underscore the clinical diagnostic value and potential biological significance of MAD2L2 in patients with COAD.A high level of MAD2L2 expression has been found in COAD and correlated with tumor status and colon polyps.ROC curve analysis showed that MAD2L2 expression has high diagnostic value in COAD.Analysis of immune infiltration results showed that MAD2L2 expression was positively correlated with neutrophil levels.The western blot results demonstrated that MAD2L2 was dose-dependently present with TNF-α.GO/KEGG revealed that MAD2L2 overexpressed and coexpressed genes were mostly involved in biological functions,including hypoxia response,response to reduced oxygen levels,mitochondrial translation elongation,and other processes.Conclusion:MAD2L2 as a new COAD biomarker contributes to our understanding of how alterations in gene expression and the immunological environment contribute to the development of colon cancer.Following further investigation,MAD2L2 may prove to be a viable target factor for clinical diagnosis and therapy of COAD.

Long term outcomes of Cohen’s cross trigonal reimplantation for primary vesicoureteral reflux in poorly functioning kidney

BACKGROUND Open ureteric reimplantation by cross trigonal technique described by Cohen is considered a common surgical option for correction of vesicoureteral reflux(VUR). There is a lack of evidence in literature though for what happens to such kidneys, in the long run, particularly those which are poorly functioning.AIM To assess the long-term outcomes of ureteric reimplantation in poorly functioning kidneys in children with unilateral primary VUR.METHODS Children with unilateral primary VUR and a relative renal function of less than 35% who underwent open or laparoscopic ureteric reimplantation between January 2005 and January 2017 were included in the study. Patients who had a follow up of less than five years were excluded. Preoperative evaluation consisted of a voiding cystourethrogram and Dimercaptosuccinic acid(DMSA) scan. In the follow-up period, patients underwent a diuretic scan at 6 weeks and 6 months.Follow up ultrasound was done for change in grade of hydronephrosis and retrovesical ureteric diameter. Subsequent follow up was done at 6 monthly intervals with evaluation for proteinuria and hypertension and any recurrent urinary tract infection(UTI). For assessment of cortical function, DMSA was repeated annually for 5 years after surgery. A paired-samples t-test was used to test the mean difference of DMSA between pre-post observations.RESULTS During this period, 36 children underwent ureteric reimplantation for unilateral primary VUR. After excluding those with insufficient follow-up, 31 were included in the analysis. Most of the patients were males(n = 26/31, 83.8%). Patient’s age(mean ± SD, range) was 5.21 ± 3.71, 1-18 years. The grades of VUR were grade Ⅱ(1patient), grade Ⅲ(8 patients), grade Ⅳ(10 patients), and grade Ⅴ(12 patients). The pre and postoperative DMSA was 24.064 ± 12.02 and 24.06 ± 10.93, which was almost the same(statistically equal, paired-samples t-test: P = 0.873). The median(range) follow-up duration was 82(60-120)mo. One patient had persistent reflux after surgery(preoperative: grade Ⅳ, postoperative: grade Ⅲ), and the very same patient developed recurrent UTI. The difference in the preoperative and postoperative DRF was less than 10% in 29 patients. In one patient, the DRF decreased by 17%(22% to 05%) while in another patient, the DRF increased by 12%(25% to 37%) after surgery. None of the patients had an increase in scarring after surgery. 15% of patients were hypertensive before surgery and all of them continued to be hypertensive after surgery while none developed hypertension after surgery. None of the patients had significant proteinuria(> 150 mg/d) during the follow-up period.CONCLUSION Children with unilateral primary VUR and poorly functioning kidney maintain the renal function over the long term in most cases. Hypertension and proteinuria do not progress over time in these patients.

Comparison of Self-Strength, Seeking Help and Happiness between Pakistani and Chinese Adolescents: A Positive Psychology Inquiry

Adolescents’emotions and preferences are influenced by their childhood experiences.In today’s world,there is a pervasive eagerness for happiness.Happiness has been linked to feelings of self-strength,seeking help,and psy-chological health.The current quantitative research was designed with a positive psychological perspective to compare Pakistani and Chines adolescents’self-strength,seeking help,and happiness.The research design of the study was causal-comparative.The study population consisted of 400 Pakistani and 409 Chinese adolescents studying in the elementary grades of both countries.The sample was selected by using a simple random sampling technique.It consisted of 413 boys(51%)and 396 girls(49%),319(39)of them were from the age group of 13–14 years,386(48%)of them were from the age group of 15–16 years,and 104(12.9%)were from the age group of 17–18 years.Three different scales were developed to collect study data.Independent sample t-test and simple linear regression were used to test study hypotheses.The analysis revealed that Pakistani adolescents have signifi-cantly higher self-strength,seeking help and happiness than their counterparts.It was also found that adolescents’self-strength and seeking help significant affect their happiness.Based on thefindings,it was suggested to inves-tigate the factors contributing to the improved self-strength,seeking help,and happiness of Pakistani adolescents.It was also recommended to investigate the mediating effect of adolescents’self-strength on the relationship between their happiness and seeking help.

Four ways blue foods can help achieve food system ambitions across nations

Blue foods,sourced in aquatic environments,are important for the economies,livelihoods,nutritional security and cultures of people in many nations.They are often nutrient rich1,generate lower emissions and impacts on land and water than many terrestrial meats2,and contribute to the health3,wellbeing and livelihoods of many rural communities4.

Could chatbots help devise the next pandemic virus

An MIT class exercise suggests AI tools can be used to order a bioweapon,but some are skeptical.Science.2023 Jun 23;380(6651):1211.doi:10.1126/science.adj3377.Epub 2023 Jun 22.

Poor hygienic conditions of butcheries and high level of microbiological contamination of meat sold in Nampula city,Mozambique

The present study aimed to evaluate the hygiene practices and the quality of meat sold in butcheries in the city of Nampula,Mozambique.Of the twelve butcheries in the city,only seven participated in the study,which was divided into four categories:hygienic conditions of buildings and facilities,equipment,furniture and utensils,good handling practices for handlers,and microbiological quality of meat products.Results showed that most of the butcheries(71%)had poor hygiene conditions,such as walls with cracks and holes and lack of washbasins in the production area.In addition,the majority(71%)of butcheries used a reusable dirty cloth to clean equipment and utensils,and only 43%had a cold room or refrigerated chamber for meat conservation.Regarding personal hygiene,100%of the handlers washed and changed their clothes daily,but 71%did not properly wash their hands before handling food.Microbiological analysis revealed that 86%of the cutting tables swabs and 43%of the hand blades had E.coli counts above 4 Log,and the presence of Salmonella was observed in 71%of meat samples.Overall,the study highlights the need for improvement in hygiene practices and the quality of meat sold in butcheries in Nampula.

基于HELP模式的骨科老年病人术后谵妄中医联合干预方案的构建与应用

目的:构建基于住院老年病人生活项目干预(HELP)模式的骨科老年病人术后谵妄中医联合干预方案,以降低老年病人术后谵妄的发生。方法:选取2021年7月—2022年9月于河南省洛阳正骨医院(河南省骨科医院)首次拟行全身麻醉骨科手术的213例老年病人为研究对象。采用随机数字表法将其随机分为对照组106例及观察组107例。对照组实施骨科围术期常规护理,观察组在对照组基础上构建并给予基于HELP模式的骨科老年病人术后谵妄中医联合干预方案。比较两组术后谵妄发生情况、相关不良事件发生情况、睡眠情况及住院时间。结果:术后5 d内观察组病人谵妄发生率低于对照组,持续时间短于对照组,严重程度轻于对照组,术后谵妄所致不良事件发生率低于对照组,每日睡眠时间长于对照组,睡眠障碍指数(ISI)得分低于对照组,住院时间短于对照组,差异均有统计学意义(P<0.05)。结论:基于HELP模式的骨科老年病人术后谵妄中医联合干预能降低老年病人术后谵妄发生率,减轻谵妄严重程度,延长睡眠时间,改善睡眠质量,缩短病人住院时间。

帮助信息网络犯罪活动罪定性之探讨

现有帮信罪定性观点均以共犯理论为依托,但无论正犯说、共犯说抑或并合说,均无法对司法解释中通常属于共犯、例外属于正犯的双重属性界定予以兼顾,因此唯有摆脱共犯理论方能实现帮信罪的准确定性。误用共犯理论的原因在于帮信罪共犯型的犯罪构成,而为帮信罪赋予独立的犯罪构成资格即可在理论纠偏的同时实现其准确定性。“他人利用信息网络实施犯罪”作为帮信罪条文中共犯特征的标志性表述,为其给予独立的构成要件要素定位即可赋予帮信罪独立的犯罪构成资格,且“他人利用信息网络实施犯罪”只得视为帮信罪客观情状。由此,帮信罪得以实现当然的正犯定性。

低温弱光处理对茄子不同时期花青素含量及果实品质的影响

【目的】探究低温、弱光、低温弱光处理对茄子幼苗期、花期、果期花青素含量的影响,以及对茄子品质的影响,为茄子的优质培育以及高产栽培奠定理论基础。【方法】以紫黑茄秀娘为试验材料,分别在幼苗期、花期、果期进行低温(18℃/13℃,250μmol·m^(-2)·s^(-1))、弱光(25℃/20℃,120μmol·m^(-2)·s^(-1))、低温弱光(18℃/13℃,120μmol·m^(-2)·s^(-1))、CK(25℃/20℃,250μmol·m^(-2)·s^(-1))等4个处理,测定幼苗期形态及生理特性,不同时期、不同部位的花青素,以及果期果实的品质。【结果】低温弱光胁迫对幼苗生长存在显著影响,在幼苗期低温对幼苗生长及生理影响显著大于弱光及低温弱光,花青素含量均表现为根<叶片<叶脉<茎;在花期,花青素含量依次为花萼<花瓣;在果期,花青素含量依次为果肉<果柄<果皮。茄子不同时期受到胁迫后,不同部位的花青素含量均呈现弱光<CK<低温弱光<低温,各胁迫下果实色泽指数依次为弱光<CK<低温弱光<低温,可溶性糖含量、可溶性蛋白含量、类黄酮含量、总酚含量均呈现低温<低温弱光<弱光<CK。【结论】低温促进花青素合成;弱光抑制花青素合成;在低温弱光双因素互作下,低温因素对花青素含量的影响起主导作用,花青素的合成大于降解,花青素含量增加。低温、弱光、低温弱光胁迫下茄子品质均下降,其中,低温胁迫对茄子的品质影响最大。