Predictors for attending annual eye screening for diabetic retinopathy amongst patients with diabetes in an urban community of Beijing

AIM： To gain a better understanding of possible factors that may influence the decision of diabetes persons to participate in annual eye screening in an urban community setting of China.METHODS： A structured interview including questions on attendance of eye screening, knowledge and awareness of diabetic retinopathy was conducted. The presence and degree of retinopathy were assessed using two field nonmydriatic retinal photography. RESULTS： Totally 720 diabetes persons were recruited and 519 were enrolled in this cross-sectional study. In this urban setting of Beijing, among diabetes patients of average of 10 y duration, 77% confirmed having undergone at least one eye examination and 61% reported having at least one eye examination with dilated pupil. As for the last 12 mo, the number decreased to 210（47%） and 131（30%） separately. Most of the participants（95%） were aware that diabetes could affect their vision and that regular eye examination was necessary. Very few of them（12%） however were aware that the early stages of diabetic retinopathy presented without symptoms of vision loss. Having attended patient education on diabetes was effective in building awareness about diabetic eye disease and was a significant positive predictor for attending eye screening [education in a year, Adj. OR=0.47（0.29-0.74）, P〈0.001, education years ago, Adj. OR=0.56（0.33-0.96）, P=0.036]. The duration of disease also increasedthe likelihood of having undergone eye screening（Adj. OR=0.96, P〈0.05）. CONCLUSION： Being exposed to education about the complications of diabetes increases the probability of attending diabetic eye screening. An appropriate patient knowledge building strategy should be made available to patients from the time of diagnosis.

Hemodynamic analysis of intracranial aneurysms using phase-contrast magnetic resonance imaging and computational fluid dynamics

Additional hemodynamic parameters are highly desirable in the clinical management of intracranial aneurysm rupture as static medical images cannot demonstrate the blood flow within aneurysms. There are two ways of obtaining the hemodynamic information-by phase-contrast magnetic resonance imaging (PCMRI) and computational fluid dynamics (CFD). In this paper, we compared PCMRI and CFD in the analysis of a stable patient's specific aneurysm. The results showed that PCMRI and CFD are in good agreement with each other. An additional CFD study of two stable and two ruptured aneurysms revealed that ruptured aneurysms have a higher statistical average blood velocity, wall shear stress, and oscillatory shear index (OSI) within the aneurysm sac compared to those of stable aneurysms. Furthermore, for ruptured aneurysms, the OSI divides the positive and negative wall shear stress divergence at the aneurysm sac.

Nursing Care of Patients With Transcatheter Closure of Atrial Septal Defect via Femoral Vein

Objective:To explore the operative nursing coordination method for the treatment of congenital atrial septal defect(ASD)by transcatheter closure of atrial septal defect via femoral vein.It provides useful experience for the treatment of congenital heart disease.Methods a total of 12 patients undergoing minimally invasive atrial septal defect closure via femoral vein from January 2017 to November 2017 in our department of cardiac surgery were selected as the subjects.All patients received transesophageal ultrasound guided ASD occlusion by femoral vein.The operation and nursing contents include preoperative care,the cooperation of the itinerant nurses,the coordination of the instrument nurses and the postoperative nursing.Results the operation of 12 patients in this group was successful.The diameter of the occluder was 17.1+4.5 mm during the operation.The time of tracheal intubation was 2.4+0.7 h,from the femoral vein to the sheath tube time was 38.7+9.4 min,the occupancy of ICU was 12.5+2.6 h after the operation.The average time of hospitalization was 4.5+1.8 D.There were 2 cases of shunt 1mm immediately after operation.After 24h reexamination,the shunt disappeared,the heart murmur disappeared in the rest of the patients.No residual shunt and other complications occurred.

Upregulation of GLT25D1 in Hepatic Stellate Cells Promotes Liver Fibrosis via the TGF-β1/SMAD3 Pathway In Vivo and In vitro

Background and Aims:Collagenβ(1-O)galactosyltransferase 25 domain 1(GLT25D1)is associated with collagen production and glycosylation,and its knockout in mice results in embryonic death.However,its role in liver fibrosis remains elusive,particularly in hepatic stellate cells(HSCs),the primary collagen-producing cells associated with liver fibrogenesis.Herein,we aimed to elucidate the role of GLT25D1 in HSCs.Methods:Bile duct ligation(BDL)-induced mouse liver fibrosis models,primary mouse HSCs(mHSCs),and transforming growth factor beta 1(TGF-β1)-stimulated LX-2 human hepatic stellate cells were used in in vivo and in vitro studies.Stable LX-2 cell lines with either GLT25D1 overexpression or knockdown were established using lentiviral transfection.RNA-seq was performed to investigate the genomic differences.HPLCMS/MS were used to identify glycosylation sites.Scanning electronic microscopy(SEM)and second-harmonic generation/two-photon excited fluorescence(SHG/TPEF)were used to image collagen fibril morphology.Results:GLT25D1 expression was upregulated in nonparenchymal cells in human cirrhotic liver tissues.Meanwhile,its knockdown attenuated collagen deposition in BDL-induced mouse liver fibrosis and inhibited mHSC activation.GLT25D1 was overexpressed in activated versus quiescence LX-2 cells and regulated in vitro LX-2 cell activation,including proliferation,contraction,and migration.GLT25D1 also significantly increased liver fibrogenic gene and protein expression.GLT25D1 upregulation promoted HSC activation and enhanced collagen expression through the TGF-β1/SMAD signaling pathway.Mass spectrometry showed that GLT25D1 regulated the glycosylation of collagen in HSCs,affecting the diameter of collagen fibers.Conclusions:Collectively,the upregulation of GLT25D1 in HSCs promoted the progression of liver fibrosis by affecting HSCs activation and collagen stability.

Investigation of Catecholaminergic Polymorphic Ventricular Tachycardia Children in China:Clinical Characteristics,Delay to Diagnosis,and Misdiagnosis

To the Editor:Catecholaminergic polymorphic ventricular tachycardia (CPVT)often occurs in children or adolescents without organic heart diseases.It is a rare malignant arrhythmic disorder with hereditary features characterized by exercise-or emotional stress-induced ventricular arrhythmias,especially bidirectional/ polymorphic ventricular tachycardia (VT),syncope,or sudden death.[1]

Evaluation value of lung ultrasound combined with CRP and PCT on the efficacy and prognosis of HAP

Objective To investigate the efficacy of lung ultrasound combined with serum C-reactive protein(CRP)and procalcitonin(PCT)in evaluating the efficacy and prognosis of hospital-acquired pneumonia(HAP).Methods A total of 308 HAP patients admitted to the emergency department and intensive care unit(ICU)of First Affiliated Hospital of Tsinghua University from January 2018 to December 2021 were selected and divided into effective group(n=276)and ineffective group(n=32)according to different treatment effects.The baseline data and the dynamic changes of lung ultrasound score(LUS),CRP and PCT were compared between the two groups before treatment,3 days and 7 days after treatment.Pearson correlation analysis was used to evaluate the correlation between LUS,CRP,PCT and Clinical Pulmonary Infection Score(CPIS)after 3 days and 7 days of treatment.Logistic regression equation was used to analyze the related influencing factors of curative effect.Receiver operating characteristic(ROC)curve and area under ROC(AUC)were used to analyze the efficacy of LUS,CPR,PCT and the combination of the three in predicting curative effect.Kaplan-Meier(K-M)survival curve was used to analyze the survival rate of patients with high-risk and low-risk LUS,CPR and PCT.Results In the effective group,the LUS,CPR and PCT after 3 days and 7 days of treatment were lower than those of the ineffective group.Pearson linear correlation analysis showed that LUS,CPR and PCT after 7 days of treatment were positively correlated with CPIS score(P<0.05),among which LUS after 7 days of treatment had the strongest correlation with CPIS(r=0.635).Logistic regression analysis showed that LUS,CPR and PCT were correlated with the efficacy of HAP after 3 days and 7 days of treatment(P<0.05).ROC curve analysis showed that the AUC of LUS,CPR and PCT predicting invalid HAP after 7 days of treatment was higher than that after 3 days of treatment.The AUC of LUS combined with CPR and PCT after 7 days of treatment to predict the efficacy is the largest(AUC=0.947).K-M curve analysis showed that there were statistically significant differences in LUS,CPR and PCT survival rates between high-risk and low-risk patients after 7 days of treatment(P<0.05).Conclusions There is a certain reference value for the dynamic monitoring of lung ultrasound combined with CPR and PCT in the evaluation of the efficacy and prognosis of HAP.