The balanced crystalloids have become a substitute for saline for fluid resuscitation. Some studies have investigated the clinical effect and adverse event of differently balanced crystalloids, but they have no consistent conclusions. This study aims to assess and compare the effect of differently balanced crystalloids for intravenous fluid therapy in critically ill and non-critically ill patients using network meta-analysis (NMA).

We attempted to investigate the mechanism and susceptibility genes for diabetes in Han and Kazak ethnic individuals.The abdominal omental adipose tissues were obtained from diabetic cases and healthy controls. The gene expression and methylation data were produced for Kazak and Han individuals, respectively, and analyzed by bioinformatics analysis.We obtained 921 differentially expressed genes (DEGs) in Han group and 1772 in Kazak group. DEGs in Han group were significantly related with type 2 diabetes mellitus, and biosynthesis of amino acids, while the DEGs specific to Kazak patients were significantly enriched in metabolism-related pathways such as carbon metabolism, propanoate metabolism, and 2-oxocarboxylic acid metabolism. Major facilitator superfamily domain containing 1 (MFSD1) was found to be a methylation associated gene at hypermethylation site of cg16289538 in Han group. Rho guanine nucleotide exchange factor 1 (ARHGEF1) was the susceptible gene corresponding to the methylation sites of cg18800192 and cg00759295 in Kazak group. ARHGEF1 was also a node in protein-protein interaction network and significantly enriched in hsa04270: vascular smooth muscle contraction pathways.The molecular mechanism of diabetes may be different in Han and Kazak patients. MFSD1 and ARHGEF1 may be the diabetes susceptible genes.

Intraoperative dexemdetomidine (DEX) with or without loading dose is well-established to improve postoperative pain control in patient-controlled analgesia (PCA). This study was designed to compare the pro-analgesia effect between the 2 in patients received general anesthesia.Seventy patients shceduced abdominal surgery under general anesthesia were randomly assigned into 3 groups which were maintained using propofol/remifentanil/Ringer solution (PRR), propofol/remifentanil/dexmedetomidine with (PRDw) or without (PRDo) a loading dose of dexmedetomidine before induction.PRDw/o patients displayed a greater Romsay sedation score measured immediately after surgery. When compared with PRR patients, those from the PRDw/o group had an increased time to first request of postoperative morphine and decreased 24 hours total morphine consumption. No significant difference was observed between patients from the PRDw and PRDo groups with respect to these parameters.The present study suggests that the administration of a DEX loading dose does not affect the pro-analgesic effect of intraoperative use of DEX on morphine-based PCA.

The aim of this study was to evaluate the effect of acupuncture injection therapy for the patients with nonspecific chronic low back pain (CLBP) systematically.

Aim of this study was to determine if surface electromyography (sEMG) could provide objective data in monitoring the alteration of signal amplitude of myoelectric activity of the paraspinal muscles in the patients with acute nonspecific lower back pain (ANLBP), and to explore the correlation between sEMG data and symptom relief in the ANLBP patients before and after massage therapy.Forty-five ANLBP patients and 20 healthy subjects were enrolled into this study. Patients were given massage therapy for 1 week. The average electromyography (AEMG), visual analogue scale (VAS), and distance of finger to floor (DFTF) were measured before and after treatment.AEMG at flexion and maintained flexion positions were significantly higher in the ANLBP group compared to that in the control group. At extension position, in contrast, AEMG was significantly lower in the ANLBP patients than that of control group, and there was no significant difference between the 2 groups at upright position. After massage therapy for the ANLBP patients, AEMG was significantly reduced at flexion and maintained flexion positions, but significantly increased at extension position than that before treatment. VAS and DFTF were also significantly reduced after treatment. In addition, AEMG alteration at maintained flexion position was significantly correlated with improvement of VAS or DFTF.Myoelectric activity of the paraspinal muscles in the ANLBP patients was different from that of healthy subjects. Massage therapy not only relived patients' symptoms, but also normalized myoelectric activity of the paraspinal muscles in the ANLBP patients.

This study will aim to evaluate the diagnostic accuracy of digital X-ray radiogrammetry (DXR) on hand bone loss (HBL) for rheumatoid arthritis (RA).

This study aimed to establish a comprehensive prognostic system for osteosarcoma based on a large population database with high quality.The Surveillance, Epidemiology, and End Results (SEER) Program database was used to identify patients with osteosarcoma from 1973 to 2015. Multivariate analysis was performed to screen statistically significant variables. A nomogram was constructed by R software to predict the 3-, 5- and 10-year survival rates. Predictive abilities were compared by C-indexes, calibration plots, integrated discrimination improvement (IDI), net reclassification improvement (NRI), as well as decision curve analysis (DCA).In total, 4505 osteosarcoma patients were identified. They were divided into training (70%, n = 3153) and validating (30%, n = 1352) groups. Multivariate analyses identified independent predictors. Subsequently, the nomogram system of a new model was established, which comprised 7 variables as age, sex, site, decade of diagnosis (DOD), extent of disease (EOD), tumor size and patients undergoing tri-modality therapy (surgery, radiotherapy and chemotherapy). It provided better C-indexes than the model without therapies (0.727, 0.712 vs 0.705, 0.668) in the 2 cohort, respectively. As well, the new model had good performances in the calibration plots. Moreover, both IDI and NRI improved for 3-, 5- and 10-year follow-up of C-indexes. Finally, DCA demonstrated that the nomogram of new model was clinically meaningful.We developed a reliable nomogram for prognostic determinants and treatment outcome analysis of osteosarcoma, thus helping better choose medical examinations and optimize therapeutic regimen under the cooperation among oncologists and surgeons.

Although previous studies have utilized narrow band imaging endoscopy diagnosis (NBIED) in detection of patients with early gastric cancer (EGC), there are still inconsistent results. Thus, this study will explore the accuracy of NBIED in detection of patients with EGC.

Although fetal cardiac rhabdomyoma can be the initial finding in patients with tuberous sclerosis complex (TSC), the challenges of precise genetic diagnosis of TSC can now be potentially overcome by new whole or targeted genomic sequencing. The goals of this study were to investigate the correlation between suspected cardiac rhabdomyoma and TSC to provide the information for a prenatal diagnosis of TSC and to validate the TSC genotype in this cohort of fetuses with suspected prenatal cardiac rhabdomyoma.We retrospectively analyzed 10,728 fetal echocardiograms from January 2013 to March 2016 in our institution. A total of 32 fetuses were suspected of having cardiac rhabdomyomas. Among them, 15 subjects met the inclusion criteria and provided written consent. Samples from fetuses (n = 13 after terminations) and newborns (n = 2) were available for targeted genomic sequencing of the exons and introns of the TSC1 and TSC2 genes and the adjacent 10 base pairs and for validated studies using Sanger sequencing.Among the 15 subjects with suspected cardiac rhabdomyoma and TSC genomic sequencing data, 7 subjects were familial and 8 subjects were sporadic cases. Fetal echocardiography showed a single tumor in 2 fetuses and multiple tumors in 13 fetuses. Gene sequencing analysis showed no mutation of the TSC1 or TSC2 gene in 2 subjects with a single tumor but positive mutations in all 13 subjects with multiple tumors. Among the latter, 5 mutations were "pathogenic" and have been previously reported (4 familial and 1 sporadic). Six new mutations were "likely pathogenic" and had not been previously reported (3 familial and 3 sporadic); 1 was of "uncertain significance" (sporadic), and 1 was suspected of being "likely benign" (sporadic).Prenatal suspected cardiac rhabdomyoma detected by fetal echocardiography should raise the suspicion of TSC. In fetuses with multiple tumors, especially the familial cases, genomic sequencing has a high yield of detecting TSC-causing genes. Patient history, prenatal fetal echocardiography, and targeted genomic sequencing may facilitate screening for, diagnosis of, and counseling for TSC.

Chronic heart failure has become one of the main diseases endangering human health in the 21st century. It is characterized by high morbidity and high mortality. With the continuous in-depth study of Traditional Chinese medicine, the treatment of heart failure by Tradional Chinese medicine has made significant progress, especially in improving the clinical symptoms of patients, controlling the development of the disease, and improving the quality of life of patients.

The study aimed to explore the value of ultrasound (US) texture analysis in the differential diagnosis of triple-negative breast cancer (TNBC) and non-TNBC.Retrospective analysis was done on 93 patients with breast cancer (35 patients with TNBC and 38 patients with non-TNBC) who were admitted to Taizhou people's hospital from July 2015 to June 2019. All lesions were pathologically proven at surgery. US images of all patients were collected. Texture analysis of US images was performed using MaZda software package. The differences between textural features in TNBC and non-TNBC were assessed. Receiver operating characteristic curve analysis was used to compare the diagnostic performance of textural parameters showing significant difference.Five optimal texture feature parameters were extracted from gray level run-length matrix, including gray level non-uniformity (GLNU) in horizontal direction, vertical gray level non-uniformity, GLNU in the 45 degree direction, run length non-uniformity in 135 degree direction, GLNU in the 135 degree direction. All these texture parameters were statistically higher in TNBC than in non-TNBC (P <.05). Receiver operating characteristic curve analysis indicated that at a threshold of 268.9068, GLNU in horizontal direction exhibited best diagnostic performance for differentiating TNBC from non-TNBC. Logistic regression model established based on all these parameters showed a sensitivity of 69.3%, specificity of 91.4% and area under the curve of 0.834.US texture features were significantly different between TNBC and non-TNBC, US texture analysis can be used for preliminary differentiation of TNBC from non-TNBC.

This meta-analysis aimed to explore the diagnostic value of diffusion kurtosis imaging (DKI) compared to mono-exponential diffusion weighted imaging (DWI) in the diagnosis of breast cancer.

Atelectasis is the most occurring postoperative complication after cardiac surgeries. Postoperative respiratory exercises and incentive spirometry led to decrease in postoperative complications, especially atelectasis and hospital stay. The objectives of the study were to evaluate postoperative complications and length of hospital stay of patients who received pre and postoperative nurse-guided incentive spirometry against those of patients who received pre and postoperative breathing exercises by the physiotherapist in patients who underwent cardiac surgery. Data of patients who received 2 days preoperative and 2 days postoperative nurse-guided incentive spirometry with a spirometer (PPN cohort, n = 102) or received 2 days preoperative and 2 days postoperative breathing exercises by physiotherapist without spirometer (PPP cohort, n = 105), or 2 days postoperative physiotherapist-guided breathing exercises only without spirometer (PPB cohort, n = 114) were collected and analyzed. The acute or chronic collapse of part or entire lung was defined as atelectasis. The length of stay in the hospital was from the day of admission to discharge. Patients of the PPN cohort had fewer numbers of incidences of atelectasis, dyspnea, and sweating >1 day after operations compared to those of the PPB and the PPP cohorts (P < .05 for all). The partial pressure of oxygen and oxygen saturation of arterial blood ≥6 hours after operations reported higher, the duration of ventilation was shorter, and numbers of re-intubation processes reported fewer for patients of the PPN cohort than those of the PPB and the PPP cohorts (P < .05 for all). The hospital length of the stay of patients in the PPN cohort was fewer than those of the PPB and the PPP (P < .0001 for both) cohorts. Pre and postoperative nurse-guided incentive spirometry with a spirometer following cardiac surgeries would have better postoperative pulmonary outcomes and fewer hospital stays than those of postoperative-only or pre and postoperative physiotherapist-guided breathing exercises (level of evidence: IV; technical efficacy stage: 5).

The purpose of the study was to conduct a meta-analysis about the effect of the combined application of orthokeratology and single-vision spectacles on slowing the progression of high myopia.

Cancer stem cells (CSCs) are thought to be responsible for tumor relapse and metastasis due to their abilities to self-renew, differentiate, and give rise to new tumors. Cyclooxygenase-2 (COX-2) is highly expressed in several kinds of CSCs, and it helps promote stem cell renewal, proliferation, and radioresistance. Whether and how COX-2 contributes to CSC migration and invasion is unclear. In this study, COX-2 was overexpressed in the CSC-like side population (SP) of the human hepatocellular carcinoma (HCC) cell line HCCLM3. COX-2 overexpression significantly enhanced migration and invasion of SP cells, while reducing expression of metastasis-related proteins PDCD4 and PTEN. Treating SP cells with the selective COX-2 inhibitor celecoxib down-regulated COX-2 and caused a dose-dependent reduction in cell migration and invasion, which was associated with up-regulation of PDCD4 and PTEN. These results suggest that COX-2 exerts pro-metastatic effects on SP cells, and that these effects are mediated at least partly through regulation of PDCD4 and PTEN expression. These results further suggest that celecoxib may be a promising anti-metastatic agent to reduce migration and invasion by hepatic CSCs.

Supernumerary teeth are those that teeth in excess number than the normal count. It is usually associated with genetic syndromes when present in more numbers. Several causal genes, such as APC, NHS, TRPS1, EVC and RUNX2, have been identified. However, etiology of supernumerary teeth remains largely unclear.

The purpose of this study was to investigate the relationship between glioma-associated oncogene homolog 1 (GLI1) rs2228226 and rs10783826 polymorphisms and congenital heart disease (CHD) risk in a Chinese Han population.Genotyping for our interested polymorphisms was performed using polymerase chain reaction-restriction fragment length polymorphism in 106 CHD patients and 112 healthy controls. Hardy-Weinberg equilibrium status in the control group was also checked via χ test. Differences in genotype and allele frequencies between the case and control groups were analyzed adopting Chi-Squared test as well, and the relative risk of CHD resulting from GLI1 genetic variants was checked via calculating odds ratio (OR) and 95% confidence interval (95%CI).CC genotype of rs2228226 showed significantly higher frequency in CHD patients than in controls (P = .011), indicating that it increased the disease risk (OR = 3.257, 95%CI = 1.280-8.287). Similarly, C allele of the polymorphism elevated CHD incidence by 1.609 folds, compared with G allele (OR = 1.609, 95%CI = 1.089-2.376). However, rs10783826 was not correlated with the occurrence of CHD.GLI1 rs2228226 polymorphism may be a risk factor for CHD in Chinese Han population, but not rs10783826.

Homocysteine (Hcy) is a risk factor for the presence of atherosclerotic vascular disease and hypercoagulability states, which is associated with increased risk of cardiovascular events in cardiovascular disease patients. Whereas the role of Hcy in premature acute coronary syndrome (ACS) female patients is still obscure. Hence, we aimed to explore the relationship of Hcy with clinical features, and more importantly, to probe its predictive value for major adverse cardiovascular events (MACE) risk in premature ACS female patients.By retrospectively reviewing the medical charts of 1441 premature ACS female patients, we collected patients' Hcy level (at diagnosis) and other clinical data. According to the follow-up records, the accumulating MACE occurrence was calculated.Hcy presented with a skewed distribution with median value 11.3 μmol/L (range: 4.4-64.0 μmol/L, inter quartile: 9.2-14.1 μmol/L). Hcy was associated with older age, heavy body mass index, dysregulated liver/renal/cardiac indexes, hypertension history, and old myocardial infarction history. The 1-year, 3-year, 5-year MACE incidence was 2.9%, 10.7%, and 12.6%, respectively. Interestingly, Hcy was increased in 1-year MACE patients compared with 1-year non-MACE patients, in 3-year MACE patients compared with 3-year non-MACE patients, in 5-year MACE patients compared with 5-year non-MACE patients, and it had a good value for predicting 1-year/3-year/5-year MACE risk. Furthermore, Hcy was also correlated with increased accumulating MACE occurrence.Hcy associates with increased age and body mass index, dysregulated liver, renal, and cardiac indexes; more interestingly, it predicts increased MACE risk in premature ACS female patients.

The stimulator of interferon genes (STING) plays a crucial role in the recognition of a viral infection and subsequent stimulation of an immune response. However, it is unclear whether methylation of the STING promoter affects STING transcription and response to antiviral therapy. The present study determined the methylation status of the STING promoter in patients with chronic hepatitis B (CHB).This study included 198 participants, of which 159 participants had CHB and 39 were healthy controls (HCs). Methylation-specific polymerase chain reaction was performed to detect the methylation status of the STING promoter. Reverse transcription-quantitative polymerase chain reaction was performed to determine STING mRNA level in peripheral blood mononuclear cells.The methylation frequency of the STING promoter was significantly higher and STING mRNA level was lower in the patients with CHB than in the HCs. Presence of hepatitis B virus (HBV) DNA was independently correlated with an increased risk of STING promoter methylation. Virological response frequency was higher in the patients with CHB receiving entecavir (ETV) than in those receiving adefovir (ADV). In the ETV group, the virological response frequency was evidently lower in the patients with CHB having methylated STING promoters than in those having unmethylated STING promoters. However, there was no significant difference in the virological response frequency between ADV-treated patients having methylated and unmethylated STING promoters.These results indicate that the hypermethylation of the STING promoter and thus the transcriptional repression of STING weaken the effect of STING in inhibiting HBV replication and decreases the effectiveness of antiviral therapy.

Low-iodine intake has historically been an issue in China, causing widespread iodine deficiency diseases (IDD). China started to introduce universal salt iodization in 1995, but reports of increased thyroid disease are a concern and appropriate levels of iodine intake must be considered.