Objective To evaluate associations betweenMTHFD1 gene G1958A polymorphism and the risk of neural tube defects (NTDs). Methods We electronically searched databases including PubMed, The Cochrane Library, Web of Science, CNKI, VIP, and WanFang Data from inception to June 2016 to collect case-control studies of the correlation between the G1958A polymorphism inMTHFD1 and the risk of NTDs. Two reviewers independently screened the studies, extracted data and assessed the risk of bias of included studies, and then, meta-analysis was performed using Stata 12.0 software. Results Thirteen case-control studies were included, involving 1 724 NTDs infants, 1 485 mothers and 774 fathers with NTDs offspring. The results of meta-analysis showed that there was significant association betweenMTHFD1 gene G1958A polymorphism and increased risk of NTDs in infants (AAvs. GG: OR=1.437, 95%CI 1.100 to 1.878,P=0.008; AA+AGvs. GG: OR=1.187, 95%CI 1.031 to 1.367,P=0.017; Avs. G: OR=1.210, 95%CI 1.050 to 1.394,P=0.008). However, there was no association between biparentalMTHFD1 gene G1958A polymorphism and NTDs in the offspring. Conclusion The current evidence shows thatMTHFD1 gene G1958A polymorphism may be a genetic risk factor for NTDs. Due to the limited quantity and quality of the included studies, more high quality studies are needed to verify the above conclusion.
Objective To investigated the early risk factors of AIDS severe pneumonia complicated with acute respiratory distress syndrome in order to carry out early recognition and intervention of ARDS and improve the prognosis of patients. Methods The clinical data of 232 patients with severe AIDS pneumonia admitted to Chengdu Public Health Clinical Medical Center from January 2017 to December 2020 were retrospectively analyzed, including general data, vital signs, laboratory examination indexes, basic diseases, etc. Firstly influential indexes for complicated with ARDS were screened by single factor logistic regression analysis, then the multicollinearity assessment indicators were filtered out in multi-factor logistic stepwise regression analysis, finally the receiver operating characteristic (ROC) curves were drawn and the predictive value of the indicators were assessed. Results Thirty-three of 232 AIDS patients with severe pneumonia were complicated with ARDS. The mortality rate in ARDS group was 81.8%. The intra-group mortality of non-ARDS group was 33.7%. Single factor logistic regression analysis showed that pH, acute physiology and chronic health evaluation Ⅱ grade, sequential organ failure assessment grade, white blood cell count, lactate dehydrogenase, α-hydroxybutyric acid dehydrogenase (α-HBDH), alanine aminotransferase (ALT), aspartic acid aminotransferase (AST), calcium, fibrinogen degradation produc (FDP) and D-dimer, total 11 indicators were associated with the incidence of ARDS. The multicollinearity analysis of the 11 indicators showed that there was no multicollinearity problem among the other 9 indicators except the variance inflation factor of ALT and AST which was greater than 10. Multivariate logistic stepwise regression analysis showed α-HBDH (OR=1.001, 95% confidence interval 1.000 - 1.002, P=0.045) and D-dimer (OR=1.044, 95% confidence interval 1.006 - 1.083, P=0.024) were independent factors. ROC curve indicated the following: alpha hydroxy butyric acid dehydrogenase (the area under ROC curve=0.667, P=0.002, the optimal threshold was 391 U/L, the corresponding sensitivity and specificity was 78.8% and 61.8%, respectively), D-dimer (the area under ROC curve=0.602, P=0.062, the optimal threshold was 4.855 µg/mL, the corresponding sensitivity and specificity was 42.4% and 82.9%, respectively). Conclusion AIDS severe pneumonia complicated with ARDS is associated with many factors, among whichα-HBDH (≥391 U/L) and D-dimer (≥ 4.855 µg/mL) on admission are independent risk factors, which have great early predictive value and can provide reference for early clinical identification of ARDS high-risk patients.
ObjectiveTo observe the ultra-wide-angle fundus imaging characteristics of acquired immunodeficiency syndrome (AIDS) combined with cytomegalovirus retinitis (CMVR).MethodsThis study was a retrospective study. From July 2017 to November 2019, 124 eyes of 86 patients diagnosed with AIDS and CMVR at the Department of Ophthalmology, Beijing You'an Hospital, Capital Medical University, were included in the study. Among them, 80 patients were males (93.0%) and 6 patients were females (7.0%) with 17-58 years old. The average age was (36.86±8.82) years old. There were 48 cases (55.8%) in one eye and 38 cases (44.2%) in both eyes. All the affected eyes underwent indirect ophthalmoscope fundus examination and Aalborg ultra-wide-angle fundus photography examination. According to the characteristics of CMVR in ultra-wide-angle fundus images, it can be divided into classic type, granular type, frost-like dendritic vasculitis and optic neuroretinitis. We observed and analyzed the type of fundus of the affected eye. According to the position of the vortex vein in the fundus image and record of the lesion as the posterior pole or peripheral part, the scope of the lesion was divided into ≤1 quadrant, ＞1 quadrant and ≤2 quadrants (1-2 quadrants), ＞2 quadrants and ≤3 quadrants (2-3 quadrants), ＞3 and ≤4 quadrants (3-4 quadrants). The upper and lower vascular arches or disc edges of the macula were used as boundaries to record whether the macular area or optic disc was involved. At the same time, we recorded whether the vitreous body had obvious turbidity. The comparison of CD4+ T lymphocyte count between patients of different types was performed by one-way analysis of variance, and the comparison of the positive rate of blood CMV-DNA was performed by the χ2 test; pairwise comparisons between groups were performed by the least significant difference method.ResultsAmong the 124 eyes, CMVR was classified into 35 eyes (28.2%) with classic type, 68 eyes with granular type (54.8%), 3 eyes with frost-like dendritic vasculitis (2.4%), and 18 eyes with optic neuroretinitis (14.5%). The lesion involved 83 eyes (66.9%) at both the posterior pole and the periphery, 22 eyes (17.7%) confined to the posterior pole, and 19 eyes (15.3%) confined to the periphery; the extent of the lesion was ≤1 quadrant in 76 eyes (61.3%), 23 eyes (18.5%) in 1-2 quadrants, 7 eyes (5.6%) in 2-3 quadrants, and 18 eyes (14.5%) in 3-4 quadrants. 54 eyes (43.5%) showed lesions involving the macular area; 52 eyes (41.9%) had lesions involving the optic disc; 33 eyes (26.6%) showed obvious vitreous inflammatory opacities. Among 86 patients, the average number of CD4+ T lymphocytes in 82 patients was 1 to 168 cells/μl, with an average of 33.60±40.02 cells/μl; the remaining 4 patients (4.7%) were unknown. There was no statistically significant difference in the positive rate of CD4+ T lymphocyte count and blood CMV-DNA load between patients in different subtypes groups (F=0.863, 0.926; P=0.462, 0.431).ConclusionThe ultra-wide-angle fundus images of AIDS combined with CMVR have certain characteristics, which can manifest as classic, granular, frost-like dendritic vasculitis and optic neuroretinitis.
Acquired Immunodeficiency Syndrome (AIDS) is a severe infectious disease induced by human immuno deficiency virus (HIV). Laboratory testing plays an important role in the diagnosis of HIV/AIDS. In general, laboratory testing includes detection of virus antibodies and antigens, virus RNA, immune cells (CD4+, CD8+) and anti-HIV drug resistance. During the past twenty years, great progress has been made in laboratory testing. As research on HIV/AIDS has advanced and biotechnology has developed rapidly, different methods of testing have been discovered. In recent years, the application of molecular biotechnology and immunology has led to important advances for epidemiological surveys, clinical diagnosis and treatment of HIV. The existence of a testing method with high sensitivity and specificity is not only helpful for early diagnosis and prediction, monitoring and evaluation of therapeutic efficacy, but can also reduce the risk of false-negative results. HIV laboratory testing is now developing towards a simple, rapid, sensitive, accurate and automatic way of diagnosing this condition.
Objective To explore the white matter microstructural abnormalities in patients with different subtypes of attention-deficit/hyperactivity disorder (ADHD) and establish a diagnostic classification model. Methods Patients with ADHD admitted to West China Hospital of Sichuan University between January 2019 and September 2021 and healthy controls recruited through advertisement were prospectively selected. All participants underwent diffusion tensor imaging scanning. The whole brain voxel-based analysis was used to compare the diffusion parameter maps of fractional anisotropy (FA) among patients with combined subtype of ADHD (ADHD-C), patients with inattentive subtype of ADHD (ADHD-I) and healthy controls. The support vector machine classifier and feature selection method were used to construct the individual ADHD diagnostic classification model and efficiency was evaluated between each two groups of the ADHD patients and healthy controls. Results A total of 26 ADHD-C patients, 24 ADHD-I patients and 26 healthy controls were included. The three groups showed significant differences in FA values in the bilateral sagittal stratum of temporal lobe (ADHD-C<ADHD-I<healthy controls) and the isthmus of corpus callosum (ADHD-C>ADHD-I>healthy controls) (P<0.005). The direct comparison between the two subtypes of ADHD showed that ADHD-C had higher FA than ADHD-I in the right middle frontal gyrus. The classification model differentiating ADHD-C and ADHD-I showed the highest efficiency, with a total accuracy of 76.0%, sensitivity of 88.5%, and specificity of 70.8%. Conclusions There is both commonality and heterogeneity in white matter microstructural alterations in the two subtypes of patients with ADHD. The white matter damage of the sagittal stratum of temporal lobe and the corpus callosum may be the intrinsic pathophysiological basis of ADHD, while the anomalies of frontal brain region may be the differential point between different subtypes of patients.
ObjectiveTo observe the effect of sensory integration training combined with methylphenidate hydrochloride on attention deficit hyperactivity disorder (ADHD). MethodsThe clinical data of 96 patients with ADHD diagnosed between January 2009 and March 2013 were retrospectively analyzed. The patients were divided into two groups by the table of random number. The trail group (n=48) received the combination therapy of sensory integration training combined with methylphenidate hydrochloride; while the control group (n=48) only received the medication of methylphenidate hydrochloride. The scores of sensory integration ability rating scale, integrated visual and auditory continuous performance test (IVA-CPT), Conner's behavior rating scale, Chinese Wechsler Intelligence Scale for Children (C-WISC) and adverse reactions were observed and compared between the two groups. ResultsThe scores of the sensory integration ability rating scale, FRCQ, FAQ (IVA-CPT), PIQ, VIQ, FIQ, C factor (C-WISC) in both of the two groups were significantly higher after the therapy; while the scores of the study, behavior, somatopsychic disturbance, impulsion, hyperactivity index and anxiety factor significantly decreased after the treatment (P<0.05). Compared with the control group, the trial group's scores of sensory integration ability rating scale, IVA-CPT, Conner's behavior rating scale, C-WISC were improved obviously, and the adverse reactions were significantly less (P<0.05). ConclusionThe sensory integration training combined with methylphenidate hydrochloride is sage and effective on children with attention deficit hyperactivity disorder.
【摘要】 目的 掌握德昌县艾滋病流行趋势，为制订防控措施提供准确依据。 方法 利用描述流行病学方法分析德昌县1995年以来艾滋病疫情资料。 结果 自1995年德昌县报告首例艾滋病感染者至2011年8月共报告艾滋病感染者/患者262例，年均报告发病率18.95/10万，2008年-2010年报告发病率呈快速增长趋势；男性年均发病率26.57/10万，女性11.05/10万，差异有统计学意义（χ2=43.94，P=0.002），男女性别比为2.49︰1；年龄分布以20~45岁和55~75岁高发为特征，两个年龄段合计占病例报告总数93.49%；农民、不详2项职业的艾滋病病例数占全部病例的82.4%，职业高峰明显；异性传播及注射毒品是德昌县艾滋病的主要传播途径，分别占病例总数的64.89%、32.82%。异性传播中有29例为夫妻间家庭式感染病例，另外还有3例为母婴传播病例。 结论 德昌县艾滋病疫情快速增长，形势严峻，须加强艾滋病防治知识宣传，提高全民预防艾滋病的意识；各部门互相合作，对娱乐场所进行监管；加强对流动人口的管理；进一步完善咨询检测网络，提高艾滋病的发现率，以有效控制艾滋病的蔓延。【Abstract】 Objective To understand the epidemiological trend of acquired immune deficiency syndrome (AIDS) in Dechang County so as to provide a scientific base for prevention and control of AIDS. Methods Descriptive epidemiological analysis was conducted on the AIDS epidemic data in Dechang county. Results From 1995 when the first case of HIV infection was confirmed to August 2011, a total of 262 cases of HIV/AIDS were reported with a total infection rate of 18.95/100 000. From 2008 to 2010, the reported infections showed rapid growth. The annual infection rate of male was 26.57/100 000 and female 11.05/100 000 with a significant difference (χ2＝43.94, P＝0.002). The ratio of male to female infections was 2.49∶1. Most of the AIDS cases were young adults aged between 20 and 45 years and old people aged between 55 and 75 years old who occupied 93.49% of the total infectious cases. The number of reported AIDS cases of farmer and unknown occupations accounted for 82.4% and there was an obvious occupations peak. Most patients in the county were infected by heterosexual sexual contact and injecting drugs, which accounted for 64.89% and 32.82% of the total respectively. The AIDS cases of 29 infected couples and 3 mother-to-child transmission. Conclusions AIDS epidemic growth is rapid in Dechang county with the situation being quite grim. We should enhance the AIDS prevention propaganda in the publicity, to raise national awareness of AIDS prevention. The related departments should cooperate to regulate the illegal entertainment and strengthen the management of migrant workers. The counseling and testing network should be improved so as to raise the detection rate and control the spread of AIDS.