Exploring the potential mechanisms of impairment on genitourinary system associated with coronavirus disease 2019 infection:Bioinformatics and molecular simulation analyses

Objective:The novel coronavirus(severe acute respiratory syndrome coronavirus 2)has been spreading worldwide since December 2019,posing a serious danger to human health and socioeconomic development.A large number of clinical trials have revealed that coronavirus disease 2019(COVID-19)results in multi-organ damage including the urogenital system.This study aimed to explore the potential mechanisms of genitourinary damage associated with COVID-19 infection through bioinformatics and molecular simulation analysis.Methods:We used multiple publicly available databases to explore the expression patterns of angiotensin-converting enzyme 2(ACE2),transmembrane serine protease 2(TMPRSS2),and CD147 in major organs in the healthy and disease-specific populations,particularly the genitourinary organs.Single-cell RNA sequencing was used to analyze the cell-specific expression patterns of ACE2,TMPRSS2,CD147,cytokine receptors,and cytokine interacting proteins in genitourinary organs,such as the bladder,kidney,prostate,and testis.Additionally,gene set enrichmentanalysis was used to investigate the relationship between testosterone levels and COVID-19 vulnerability in patients with prostate cancer.Results:The results revealed that ACE2,TMPRSS2,and CD147 were highly expressed in normal urogenital organs.Then,they were also highly expressed in multiple tumors and chronic kidney diseases.Additionally,ACE2,TMPRSS2,and CD147 were significantly expressed in a range of cells in urogenital organs according to single-cell RNA sequencing.Cytokine receptors and cytokine interacting proteins,especially CCL2,JUN,and TIMP1,were commonly highly expressed in urogenital organs.Finally,gene set enrichment analysis results showed that high testosterone levels in prostate cancer patients were significantly related to the JAK-STAT signaling pathway and the Toll-like receptor signaling pathway which were associated with COVID-19.Conclusion:Our study provides new insights into the potential mechanisms of severe acute respiratory syndrome coronavirus 2 damage to urogenital organs from multiple perspectives,which may draw the attention of urologists to COVID-19 and contribute to the development of targeted drugs.

Histone H1/MBP hydrolysing antibodies - novel potential marker in diagnosis of disease severity in systematic lupus erythematosus patients

Recently we have shown the presence of catalytically active IgGs, capable to cleave histone H1 and bovine myelin basic protein (MBP), in blood serum of SLE patients. Here we present data that demonstrate the correlation between a) proteolytic activity towards histone H1 and MBP of IgG-antibodies from blood serum of SLE patients and b) disease severity level in these patients. IgGs were isolated from blood serum by chromatography on protein G-sepharose. Commercial preparations of bovine myelin basic proteins (MBP) and calf thymus histone H1 were used as substrates. Analysis of the proteolytic activity showed that 16 of 38 lgG-preparations (42,1%) obtained from blood serum of SLE patients were capable of cleaving both histone H1 and MBP with different efficiency. It was revealed that the presence in blood serum of lgGs possessing proteolytic activity towards both histone H1 and bMBP closely correlates with manifestation of the disease severity in SLE patients.

Chronic Diseases of Childhood and the International Classification of Functioning, Disability, and Health: A Systematic Review

The increase in chronic diseases in childhood highlights the need for a biopsychosocial approach to deal with the complexity of these health conditions. The International Classification of Functioning, Disability, and Health (ICF) results from the need to implement new explanatory evaluative and therapeutic models. Thus, the present systematic review aims to identify published studies on the use of the ICF in chronic childhood diseases. As a secondary objective, to map the themes that have already been studied in the area to support the discussion on the expansion of the use of this classification in health services. The systematic review followed the PRISMA protocol, and the model was the PICO acronym, where Population was children and adolescents with chronic diseases, Intervention/Exposure was evaluation based on ICF concepts, Comparator was any tool, instrument, or intervention, and outcome was direct or indirect use of the ICF. We selected eight articles, five of which used the ICF as a conceptual tool and three as a classification system, divided into the following themes: quality of life, evaluation of patients (without using coding) and mapping the inclusion of the activity’s results and participation in clinical trials. Thus, use of the ICF in clinical practice is still incipient, although it has been recommended in guidelines. Further studies are necessary to expand the number of contributions by the ICF and to develop the necessary approaches for understanding the classification’s use.

Orchard Sports Injury and Illness Classification System (OSIICS) Version 15

Background:Sports medicine(injury and illnesses)requires distinct coding systems because the International Classification of Diseases is insuf-ficient for sports medicine coding.The Orchard Sports Injury and Illness Classification System(OSIICS)is one of two sports medicine coding systems recommended by the International Olympic Committee.Regular updates of coding systems are required.Methods:For Version 15,updates for mental health conditions in athletes,sports cardiology,concussion sub-types,infectious diseases,and skin and eye conditions were considered particularly important.Results:Recommended codes were added from a recent International Olympic Committee consensus statement on mental health conditions in athletes.Two landmark sports cardiology papers were used to update a more comprehensive list of sports cardiology codes.Rugby union protocols on head injury assessment were used to create additional concussion codes.Conclusion:It is planned that OSIICS Version 15 will be translated into multiple new languages in a timely fashion to facilitate international accessibility.The large number of recently published sport-specific and discipline-specific consensus statements on athlete surveillance warrant regular updating of OSIICS.

Relationship between nutritional therapy and beneficial bacteria ratio in severe disease

Objective:To evaluate relationship between changes in the beneficial bacteria in intensive care unit(ICU)patients and nutritional therapy type.Methods:Ten patients aged≥18 years admitted to the ICU between January and December 2020,were included.Good enteral nutrition was defined as early achievement of target calorie intake through enteral feeding.The ratio of beneficial bacteria at the first and second bowel movements after each patient’s admission was calculated and the patients were classified into the increase or decrease group.Among all patients,five each were in the increase and decrease groups.We investigated patient background,changes in sequential organ failure assessment(SOFA)and acute physiology and chronic health evaluation(APACHE)Ⅱscores,nutritional doses or methods,and clinical outcomes.Results:No relationship was found between changes in the ratio of beneficial bacteria and changes in SOFA/APACHEⅡscores at the time of admission.The rate of good enteral nutrition was significantly higher in the increase group than in the decrease group(4/5 vs.0/5,P=0.01).Conclusions:An increase in beneficial bacteria may be significantly related to the early establishment of enteral nutrition.In the future,accumulating cases may make it possible to establish a new nutritional strategy for critically ill patients from an intestinal microbiota perspective.

Towards Intelligent Detection and Classification of Rice Plant Diseases Based on Leaf Image Dataset

The detection of rice leaf disease is significant because,as an agricultural and rice exporter country,Pakistan needs to advance in production and lower the risk of diseases.In this rapid globalization era,information technology has increased.A sensing system is mandatory to detect rice diseases using Artificial Intelligence(AI).It is being adopted in all medical and plant sciences fields to access and measure the accuracy of results and detection while lowering the risk of diseases.Deep Neural Network(DNN)is a novel technique that will help detect disease present on a rice leave because DNN is also considered a state-of-the-art solution in image detection using sensing nodes.Further in this paper,the adoption of the mixed-method approach Deep Convolutional Neural Network(Deep CNN)has assisted the research in increasing the effectiveness of the proposed method.Deep CNN is used for image recognition and is a class of deep-learning neural networks.CNN is popular and mostly used in the field of image recognition.A dataset of images with three main leaf diseases is selected for training and testing the proposed model.After the image acquisition and preprocessing process,the Deep CNN model was trained to detect and classify three rice diseases(Brown spot,bacterial blight,and blast disease).The proposed model achieved 98.3%accuracy in comparison with similar state-of-the-art techniques.

Clinical value of the Toronto inflammatory bowel disease global endoscopic reporting score in ulcerative colitis

BACKGROUND Endoscopic evaluation in diagnosing and managing ulcerative colitis(UC)is becoming increasingly important.Several endoscopic scoring systems have been established,including the Ulcerative Colitis Endoscopic Index of Severity(UCEIS)score and Mayo Endoscopic Subscore(MES).Furthermore,the Toronto Inflammatory Bowel Disease Global Endoscopic Reporting(TIGER)score for UC has recently been proposed;however,its clinical value remains unclear.AIM To investigate the clinical value of the TIGER score in UC by comparing it with the UCEIS score and MES.METHODS This retrospective study included 166 patients with UC who underwent total colonoscopy between January 2017 and March 2023 at the Affiliated Hospital of Qingdao University(Qingdao,China).We retrospectively analysed endoscopic scores,laboratory and clinical data,treatment,and readmissions within 1 year.Spearman’s rank correlation coefficient,receiver operating characteristic curve,and univariate and multivariable logistic regression analyses were performed using IBM SPSS Statistics for Windows,version 26.0(IBM Corp.,Armonk,NY,United States)and GraphPad Prism version 9.0.0 for Windows(GraphPad Software,Boston,Massachusetts,United States).RESULTS The TIGER score significantly correlated with the UCEIS score and MES(r=0.721,0.626,both P<0.001),showed good differentiating values for clinical severity among mild,moderate,and severe UC[8(4-112.75)vs 210(109–219)vs 328(219–426),all P<0.001],and exhibited predictive value in diagnosing patients with severe UC[area under the curve(AUC)=0.897,P<0.001].Additionally,the TIGER(r=0.639,0,551,0.488,0.376,all P<0.001)and UCEIS scores(r=0.622,0,540,0.494,and 0.375,all P<0.001)showed stronger correlations with laboratory and clinical parameters,including C-reactive protein,erythrocyte sedimentation rate,length of hospitalisation,and hospitalisation costs,than MES(r=0.509,0,351,0.339,and 0.270,all P<0.001).The TIGER score showed the best predictability for patients'recent advanced treatment,including systemic corticosteroids,biologics,or immunomodulators(AUC=0.848,P<0.001)and 1-year readmission(AUC=0.700,P<0.001)compared with the UCEIS score(AUC=0.762,P<0.001;0.627,P<0.05)and MES(AUC=0.684,P<0.001;0.578,P=0.132).Furthermore,a TIGER score of≥317 was identified as an independent risk factor for advanced UC treatment(P=0.011).CONCLUSION The TIGER score may be superior to the UCIES score and MES in improving the accuracy of clinical disease severity assessment,guiding therapeutic decision-making,and predicting short-term prognosis.

Classification of metabolic-associated fatty liver disease subtypes based on TCM clinical phenotype

Objective:To classify the subtypes of metabolic-associated fatty liver disease(MAFLD)and provide new insights into the heterogeneity of MAFLD.Methods:Electronic medical records(EMR)of MAFLD diagnosed in accordance with the diagnostic criteria of Hubei Provincial Hospital of Traditional Chinese Medicine from 2016-2020 were included in the study.for physical annotation,and the data on each clinical phenotype was normalized according to corresponding aspirational standards.The MAFLD heterogeneous medical record network(HEMnet)was constructed using sex,age,disease diagnosis,symptoms,and Western medicine prescriptions as nodes and the co-occurrence times between phenotypes as edges.K-means clustering was used for disease classification.Relative risk(RR)was used to assess the specificity of each phenotype.Statistical methods were used to compare differences in laboratory indicators among subtypes.Results:A total of patients(12,626)with a mean age of 55.02(±14.21)years were included in the study.MAFLD can be divided into five subtypes:digestive diseases(C0),mental disorders and gynecological diseases(C1),chronic liver diseases and decompensated complications(C2),diabetes mellitus and its complications(C3),and immune joint system diseases(C4).Conclusions:Patients with MAFLD experience various symptoms and complications.The classification of MAFLD based on the HEMnet method is highly reliable.

A Survey of the Major Sorghum Production Regions for Foliar and Panicle Diseases during the 2022 Growing Season in Senegal, West Africa

Sorghum is a vital commodity and greatly contributes to the daily calorie needs for millions of the inhabitants in Senegal, West Africa. Yet, sorghum productivity and profitability are impacted by diseases. In the 2022 growing season, 122 farmers’ fields across 7 regions, notably Diourbel, Fatick, Kaffrine, Kaolack, Kolda, Tambacounda, and Thies were surveyed for foliar and panicle diseases. During the survey, stops were made at 30 km intervals and at each stop, 2 - 5 fields were evaluated. In each field, 40 plants mostly at soft to early hard dough stages of development were assessed using a W-shaped pattern to cover the whole field. A total of 13 diseases, including leaf blight, anthracnose, Zonate leaf spot, Sooty stripe, rough leaf spot, oval leaf spot, long smut, grain mold, and covered kernel smut were documented. The most predominant diseases were leaf blight, anthracnose, and zonate leaf spot. The prevalence of leaf blight was 100%, while anthracnose and zonate leaf spot were found in 93 out of the 122 fields surveyed, indicating a 76% prevalence, respectively. Across the regions, the prevalence of rough leaf spot was 47%, covered kernel smut (32%), oval leaf spot (19%) and target leaf spot (19%). Mean incidence of leaf blight was high in all regions, ranging from 94% (Kaolack) to 100% (Fatick and Tambacounda). The highest mean incidence of anthracnose (62%) and covered kernel smut (16%) was noted in Tambacounda region. In the region of Thies, the highest mean incidence of zonate leaf spot (49%) was recorded. The mean severity of leaf blight (37%) was highest on plants assessed in the region of Kaffrine, followed by those in the regions of Kaolack, Tambacounda, and Kolda. Anthracnose infection was most intense on plants evaluated in Kolda, while zonate leaf spot was most severe in the region of Tambacounda. Fields with incidences of 85% and above were considered as “hotspots” to evaluate sorghum germplasm for disease resistance. This survey is significant because the information obtained will be beneficial to plant pathologists, sorghum producers, government officials, and funding agencies to prioritize research projects that ensure productivity and food security.

Brain Functional Networks with Dynamic Hypergraph Manifold Regularization for Classification of End-Stage Renal Disease Associated with Mild Cognitive Impairment

The structure and function of brain networks have been altered in patients with end-stage renal disease(ESRD).Manifold regularization(MR)only considers the pairing relationship between two brain regions and cannot represent functional interactions or higher-order relationships between multiple brain regions.To solve this issue,we developed a method to construct a dynamic brain functional network(DBFN)based on dynamic hypergraph MR(DHMR)and applied it to the classification of ESRD associated with mild cognitive impairment(ESRDaMCI).The construction of DBFN with Pearson’s correlation(PC)was transformed into an optimization model.Node convolution and hyperedge convolution superposition were adopted to dynamically modify the hypergraph structure,and then got the dynamic hypergraph to form the manifold regular terms of the dynamic hypergraph.The DHMR and L_(1) norm regularization were introduced into the PC-based optimization model to obtain the final DHMR-based DBFN(DDBFN).Experiment results demonstrated the validity of the DDBFN method by comparing the classification results with several related brain functional network construction methods.Our work not only improves better classification performance but also reveals the discriminative regions of ESRDaMCI,providing a reference for clinical research and auxiliary diagnosis of concomitant cognitive impairments.

Deep Transfer Learning Based Detection and Classification of Citrus Plant Diseases

Citrus fruit crops are among the world’s most important agricultural products,but pests and diseases impact their cultivation,resulting in yield and quality losses.Computer vision and machine learning have been widely used to detect and classify plant diseases over the last decade,allowing for early disease detection and improving agricultural production.This paper presented an automatic system for the early detection and classification of citrus plant diseases based on a deep learning(DL)model,which improved accuracy while decreasing computational complexity.The most recent transfer learning-based models were applied to the Citrus Plant Dataset to improve classification accuracy.Using transfer learning,this study successfully proposed a Convolutional Neural Network(CNN)-based pre-trained model(EfficientNetB3,ResNet50,MobiNetV2,and InceptionV3)for the identification and categorization of citrus plant diseases.To evaluate the architecture’s performance,this study discovered that transferring an EfficientNetb3 model resulted in the highest training,validating,and testing accuracies,which were 99.43%,99.48%,and 99.58%,respectively.In identifying and categorizing citrus plant diseases,the proposed CNN model outperforms other cuttingedge CNN model architectures developed previously in the literature.

Convolutional Neural Network-Based Classificationof Multiple Retinal Diseases Using Fundus Images

Use of deep learning algorithms for the investigation and analysis of medical images has emerged as a powerful technique.The increase in retinal dis-eases is alarming as it may lead to permanent blindness if left untreated.Automa-tion of the diagnosis process of retinal diseases not only assists ophthalmologists in correct decision-making but saves time also.Several researchers have worked on automated retinal disease classification but restricted either to hand-crafted fea-ture selection or binary classification.This paper presents a deep learning-based approach for the automated classification of multiple retinal diseases using fundus images.For this research,the data has been collected and combined from three distinct sources.The images are preprocessed for enhancing the details.Six layers of the convolutional neural network(CNN)are used for the automated feature extraction and classification of 20 retinal diseases.It is observed that the results are reliant on the number of classes.For binary classification(healthy vs.unhealthy),up to 100%accuracy has been achieved.When 16 classes are used(treating stages of a disease as a single class),93.3%accuracy,92%sensitivity and 93%specificity have been obtained respectively.For 20 classes(treating stages of the disease as separate classes),the accuracy,sensitivity and specificity have dropped to 92.4%,92%and 92%respectively.

APACHE system is better than Ranson system in the prediction of severity of acute pancreatitis

BACKGROUND: It has been suggested that addition of obesity score to the APACHE-Ⅱ system can lead to more accurate prediction of severity of acute pancreatitis. However there is scanty information on the usefulness of the combined APACHE-O scoring system in Asian patients. This study aimed to compare the accuracy of Ranson, APACHE-Ⅱ and APACHE-O systems in assessing severity of acute pancreatitis in a local Chinese population. METHODS: One hundred and one consecutive patients with acute pancreatitis were prospectively studied. Body mass index (BMI) was measured on admission. Ranson score, APACHE-Ⅱ and APACHE-O scores were recorded on admission and at 48 hours. By adopting the cut-off levels and definitions advocated in the Atlanta consensus for severe disease, the diagnostic accuracy of the three scoring systems was compared by the area under the curve (AUC) under the receiver operator characteristic curve. RESULTS: Of the 101 patients, 12 (11.9%) patients suffered from severe pancreatitis. Obesity was uncommon and only two patients (2.0%) had BMI >30. Eighty-two (81.2%) patients were normal weight (BMI≤25) whereas 17 (16.8%) were overweight ( BMI 25-30 ). Overweight or obesity (BMI >25) was not associated with severe pancreatitis (P= 0.40). The AUC for admission scores of Ranson, APACHE-Ⅱ, and APACHE-O systems was 0. 549, 0. 904 and 0. 904, respectively. The AUC for 48-hour scores of Ranson, APACHE-Ⅱ and APACHE-O systems was 0.808, 0.955 and 0.951, respectively. CONCLUSIONS: The APACHE-Ⅱ scoring system is more accurate than the Ranson scoring system of the prediction of severity in acute pancreatitis. Addition of obesity score does not significantly improve the predictive accuracy of the APACHE-Ⅱ system in our local population with a low prevalence of obesity.

Quantitative computed tomography analysis for stratifying the severity of Coronavirus Disease 2019

To examine the feasibility of using a computer tool for stratifying the severity of Coronavirus Disease 2019(COVID-19)based on computed tomography(CT)images.We retrospectively examined 44 confirmed COVID-19 cases.All cases were evaluated separately by radiologists(visually)and through an in-house computer software.The degree of lesions was visually scored by the radiologist,as follows,for each of the 5 lung lobes:0,no lesion present;1,<1/3 involvement;2,>1/3 and<2/3 involvement;and 3,>2/3 involvement.Lesion density was assessed based on the proportion of ground-glass opacity(GGO),consolidation and fibrosis of the lesions.The parameters obtained using the computer tool included lung volume(mL),lesion volume(mL),lesion percentage(%),and mean lesion density(HU)of the whole lung,right lung,left lung,and each lobe.The scores obtained by the radiologists and quantitative results generated by the computer software were tested for correlation.A Chi-square test was used to test the consistency of radiologist-and computer-derived lesion percentage in the right/left lung,upper/lower lobe,and each of the 5 lobes.The results showed a strong to moderate correlation between lesion percentage scores obtained by radiologists and the computer software(r ranged from 0.7679 to 0.8373,P<0.05),and a moderate correlation between the proportion of GGO and mean lesion density(r=-0.5894,P<0.05),and proportion of consolidation and mean lesion density(r=0.6282,P<0.05).Computer-aided quantification showed a statistical significant higher lesion percentage for lower lobes than that assessed by the radiologists(x^2=8.160,P=0.004).Our experiments demonstrated that the computer tool could reliably and accurately assess the severity and distribution of pneumonia on CT scans.

Evaluation of the Sensitivity and Specificity of the New Clinical Diagnostic and Classification Criteria for Kashin-Beck Disease,an Endemic Osteoarthritis,in China

This study aimed to evaluate the sensitivity and specificity of the new clinical diagnostic and classification criteria for Kashin-Beck disease （KBD） using six clinical markers： flexion of the distal part of fingers, deformed fingers, enlarged finger joints, shortened fingers, squat down, and dwarfism. One-third of the total population in Linyou County was sampled by stratified random sampling.

miR-125b, miR-200c Are Correlated with the Severity of Interstitial Lung Disease in Dermatomyositis/Polymyositis

Objective: To explore the correlations between miR-125b, miR-200c, and the severity of interstitial lung disease associated with dermatomyositis/polymyositis (DM/PM-ILD). Methods: 30 consecutive patients with DM/PM and 23 healthy controls were recruited into current study. Anti-JO-1, anti-SSA, muscle enzymes, the data of chest HRCT and pulmonary function test were collected. 9 consecutive DM/PM-ILD patients underwent bronchoalveolar lavage (BAL). TGF-β1 and surfactant protein D (SP-D) in BAL fluid (BALF) and plasma were detected by ELISA. miR-125b and miR-200c in PBMCs and bronchoalveolar cells were detected by QRT-PCR. All patients were classified into three groups: Mild or non-ILD group, moderate ILD group, and severe ILD group. The correlations between miRNAs and the severity of ILD, the lung damage markers, auto-antibodies, were analyzed. Results: The levels of miR-125b and miR-200c in bronchoalveolar cells were higher than in PBMCs, and the levels of TGF-β1 and SP-D were higher in BALF than in plasma in DM/PM-ILD patients. There were positive correlations between miR-125b, miR-200c in bronchoalveolar cells and SP-D in BALF. The levels of miR-125b and miR-200c in severe ILD group were higher than in mild or non-ILD and moderate ILD groups. There were negative correlations between miR-125b, miR-200c, and FEV1, and between miR-200c and DLCO. The patients with anti-JO-1 antibody had higher levels of miR-125b and miR-200c, and had more severe condition of ILD. Conclusion: miR-125b and miR-200c were positively correlated with the lung damage and severity of ILD in DM/PM, which could be important markers for judgement of disease condition in clinic.

Performance of the Montreal classification for inflammatory bowel diseases

AIM:To validate the Montreal classification system for Crohn's disease(CD) and ulcerative colitis(UC) within the Netherlands.METHODS:A selection of 20 de-identified medical records with an appropriate representation of the inflammatory bowel disease(IBD) sub phenotypes were scored by 30 observers with different professions(gastroenterologist specialist in IBD,gastroenterologist in training and IBD-nurses) and experience level with IBD patient care.Patients were classified according to the Montreal classification.In addition,participants were asked to score extra-intestinal manifestations(EIM) and disease severity in CD based on their clinical judgment.The inter-observer agreement was calculated by percentages of correct answers(answers identical to the "expert evaluation") and Fleiss-kappa(k).Kappa cutoffs:< 0.4-poor; 0.41-0.6-moderate; 0.61-0.8-good; > 0.8 excellent.RESULTS:The inter-observer agreement was excellent for diagnosis(k = 0.96),perianal disease(k = 0.92) and disease location in CD(k = 0.82) and good for age of onset(k = 0.67),upper gastrointestinal disease(k = 0.62),disease behaviour in CD(k = 0.79) and disease extent in UC(k = 0.65).Disease severity in UC was scored poor(k = 0.23).The additional items resulted in a good inter-observer agreement for EIM(k = 0.68) and a moderate agreement for disease severity in CD(k = 0.44).Percentages of correct answers over all Montreal items give a good reflection of the inter-observer agreement(> 80%),except for disease severity(48%-74%).IBD-nurses were significantly worse in scoring upper gastrointestinal disease in CD compared to gastroenterologists(P = 0.008) and gastroenterologists in training(P = 0.040).Observers with less than 10 years of experience were significantly better at scoring UC severity than observers with 10-20 years(P = 0.003) and more than 20 years(P = 0.003) of experience with IBD patient care.Observers with 10-20 years of experience with IBD patient care were significantly better at scoring upper gastrointestinal disease in CD than observers with less than 10 years(P = 0.007) and more than 20 years(P = 0.007) of experience with IBD patient care.CONCLUSION:We found a good to excellent interobserver agreement for all Montreal items except for disease severity in UC(poor).

Ultrasound features of carotid atherosclerosis in patients with coronary heart disease and their correlation with disease severity

Objective:To study the ultrasound features of carotid atherosclerosis in patients with coronary heart disease and their correlation with disease severity. Methods:180 patients with coronary heart disease treated in our hospital between December 2010 and December 2015 were collected as observation group and divided into single-vessel disease group (n=50), double-vessel disease group (n=72) and triple-vessel disease group (n=58) according to the degree of coronary artery stenosis;50 healthy subjects receiving physical examination in our hospital during the same period were selected as control group. Carotid ultrasound was used to measure carotid atherosclerosis parameters, cardiac color Doppler ultrasound was used to detect cardiac function parameters, enzyme-linked immunosorbent assay (ELISA) was used to detect serum endothelial function indexes, and Pearson test was used to analyze the correlation between carotid ultrasound parameters and the cardiac function as well as endothelial function. Results:Carotid ultrasound parameters stiffness (β), elastic modulus (Ep), arterial compliance (AC) and pulse wave velocity (PWVβ) value of observation group were higher than those of control group, and with the increase of coronary artery lesion severity, the changes ofβ, Ep, AC and PWVβvalue increased (P<0.05);cardiac function parameters left ventricular end-diastolic diameter (LVEDD) and left ventricular end-systolic diameter (LVESD) value of observation group were higher than those of control group while left ventricular ejection fraction (LVEF) value was lower than that of control group, and with the increase of coronary artery lesion severity, the changes of LVEDD, LVESD and LVEF value increased (P<0.05);endothelial function indexes endothelin-1 (ET-1) and von willebrand factor (vWF) levels of observation group were higher than those of control group while nitric oxide (NO) level was lower than that of control group, and with the increase of coronary artery lesion severity, the changes of ET-1, vWF and NO levels increased (P<0.05). Carotid ultrasound parameterβ, Ep, AC and PWVβvalue in patients with coronary heart disease were directly correlated with the levels of cardiac function parameters and endothelial function indexes. Conclusions:The ultrasound parameter levels of carotid atherosclerosis in patients with coronary heart disease are directly correlated with the disease severity and can be used as the noninvasive and reliable means for early judgment of the disease.

The Prevalence and Severity of Gallstones in Sickle Cell Disease in Kuwait

Introduction: Sickle cell disease (SCD) is a genetic disease affecting hemoglobin development. Complications may occur in all organs due to sickle cell hemoglobin. Gallstones may develop as the complication of the biliary system in SCD. Aim: To calculate the prevalence and severity of the biliary system complications in SCD. Method: A total of 220 patients with homozygous SCD were recruited. The prevalence of gallstones was estimated, and the severity of the biliary system complications was classified according to the condition of the gallstones;it was classified as grade 0 when no gallstones were detected, grade 1 when gallstones were present only in the gallbladder, grade 2 when gallstones were present in both the gallbladder and the common bile duct, and grade 3 when the patient had cholecystectomy due to gallstones. Results: The overall prevalence of gallstones and cholecystectomy was 51%;it was 22% in females and 29% in males. The prevalence of the severity of grade 0 was 49%, grade 1 was 14%, and grade 3 was 37%. Grade 2 prevalence was not calculated because this study was based on abdominal ultrasound only. Conclusion: The prevalence of gallstones in SCD is much higher than in the normal population, and more in males than in females. It begins at an early age during childhood due to several underlying etiological factors related to SCD. This study provided a simple grading of severity for the biliary system based on the gallbladder stone complication. The severity calculation in the biliary system is a part of the assessment of the severity in other systems in this multisystem chronic disorder.

Determination of serum inflammatory factors in different pathogenic bloodstream infections and judgment value on the degree of disease severity and prognosis

Objective: To investigate the serum inflammatory cytokines expression in different pathogens and to explore the value of serum inflammatory cytokines in judging the severity of disease and assessing prognosis. Methods: We retrospectively analyzed 90 cases of bloodstream infections admitted to our hospital from October 2016 to November 2017 and regarded it as observation group, while the control group was 80 patients with negative blood cultures over the same period. Serum inflammatory factors PCT, C-reactive protein (CRP), white blood cell count (WBC), neutrophil percentage (NEUT) and Endotoxin levels were compared between the two groups.The levels of serum inflammatory factors PCT, CRP, WBC, NEUT and Endotoxin in patients with Gram-positive(G+), Gram-negative (G-), treatment improvement and treatment ineffective group were compared. Result: The levels of PCT, CRP, WBC, NEUT and Endotoxin in patients with positive blood flow culture were significantly higher than those with negative blood culture. Compared with the G+ group, the levels of PCT, CRP, WBC and Endotoxin in the G- group were significantly higher. There was no significant difference in the level of NEUT in two groups. Compared with the treatment-ineffective group, the therapeutic improvement group PCT, CRP, WBC, NEUT and Endotoxin levels decreased significantly. The levels of PCT, CRP, WBC,NEUT and endotoxin in patients with moderate and severe bloodstream infections were significantly higher than those with mild infections;the levels of PCT, CRP, WBC, NEUT and endotoxin in patients with moderate infection were significantly higher than those with mild infections, and all has statistical significance. Conclusion:PCT, CRP, WBC, NEUT and Endotoxin can be used as auxiliary diagnostic indicators of bloodstream infections, which can be used to judge the severity of bloodstream infection and evaluate the prognosis.