ObjectiveTo assess the mortality, acute exacerbations, exercise capacity, symptoms and significant physiological parameters (lung function, respiratory muscle function and gas exchange) of patients with severe stable chronic obstructive pulmonary disease (COPD) with respiratory failure treated by noninvasive positive pressure ventilation (NPPV).MethodsA meta-analysis of randomized controlled trials was carried out by searching PubMed, Cochrane library, Embase, OVID, Chinese Biomedical Literature Database and the bibliographies of the retrieved articles up to February 2017. Studies of patients with severe stable COPD with respiratory failure receiving long-term noninvasive positive pressure ventilation and comparison with oxygen therapy were conducted, and at least one of the following parameters were reviewed: frequency of acute exacerbations, mortality, lung function, respiratory muscle function, gas exchange, 6-minute walk test.ResultsSix studies with 695 subjects met the inclusion criteria and were analyzed. The PaCO2 was significantly decreased in patients who received long-term NPPV. No significant difference was found between long-term NPPV and oxygen therapy in mortality, frequency of acute exacerbations, gas exchange, lung function, respiratory muscle function and exercise capacity. The subgroup analysis showed that NPPV improves survival of patients when it is targeted at greatly reducing hypercapnia.ConclusionCurrent evidence suggests that there is no significant improvement by application of NPPV on severe stable COPD with respiratory failure patients, but NPPV may reduce patients’ mortality with the aim of reducing hypercapnia.
ObjectiveTo perform a meta-analysis on the positive rate of hepatitis C virus (HCV) antibody among pregnant females in China from 2008 to 2018, so as to provide scientific references for the prevention and treatment of HCV infection among pregnant females.MethodsDatabases including PubMed, Web of Science, SinoMed, CNKI, VIP, and WanFang Data were electronically searched to collect observational studies on the positive rate of HCV antibody among pregnant females in China from January, 2008 to December, 2018. Two reviewers independently screened literature, extracted data and evaluated risk of bias of included studies. Meta-analysis was then performed using Stata 15.0 software.ResultsA total of 108 studies involving 657 765 individuals were included. Results of meta-analysis showed that the overall positive rate of HCV antibody among pregnant females in Chinese was 0.235% (95%CI 0.189% to 0.286%). Subgroup analysis showed that the positive rate of HCV antibody among pregnant females in western China to be the highest 0.291% (95%CI 0.221% to 0.378%), the northeast China to be 0.240% (95%CI 0.099% to 0.442%), the central China to be 0.235% (95%CI 0.016% to 0.319%), and the east China to be the lowest 0.193 % (95%CI 0.119% to 0.281%). The HCV antibody positive rate of pregnant females from hospital was 0.291% (95%CI 0.221% to 0.372%) and was higher than that from AIDS surveillance site which was 0.164% (95%CI 0.122% to 0.207%).ConclusionsThe prevalence of HCV antibody among pregnant females maintains at a low level in China.
Objective To analyze the trends and influencing factors of rheumatoid arthritis disease burden in mainland China from 1990 to 2021 and predict its disease burden over the next 15 years. MethodsData on RA incidence, prevalence, mortality, and disability-adjusted life years (DALYs) in mainland China were extracted from the Global Burden of Disease Study 2021 (GBD 2021). Joinpoint regression was used to analyze temporal trends, while an age-period-cohort model assessed age, period, and birth cohort effects. Decomposition analysis explored the contributions of population aging, population growth, and epidemiological changes. An ARIMA model was applied to predict future disease burden. ResultsFrom 1990 to 2021, the number of RA cases in mainland China increased by 93.5% (incidence), 133% (prevalence), 115% (deaths), and 107% (DALYs), though age-standardized rates showed smaller changes. The disease burden was significantly higher in women than in men, with sex-specific peaks in onset and prevalence. Joinpoint regression revealed rising age-standardized incidence and prevalence rates (AAPC=0.54% and 0.51%, respectively) but declining mortality (AAPC=−0.78%). Cohort effects indicated higher RA risk in later-born populations (RR=1.53 for the 2012 cohort). Decomposition analysis identified population growth as the primary driver of increased burden. Projections suggested that by 2036, the age-standardized incidence and prevalence would rise to 13.92/100 000 and 248.84/100 000, respectively, while DALYs rates might decline to 42.09/100 000. ConclusionThe RA disease burden in mainland China is driven by both population aging and epidemiological factors, with notable sex disparities and cohort effects. Targeted interventions for high-risk populations, optimized healthcare resource allocation, and further research on influencing factors are needed to develop precise prevention and control strategies.
Objective To investigate the expression and clinicopathological features of fumarate hydratase (FH) in multiple leiomyoma of the uterus. Methods Relevant clinicopathological data of patients with multiple leiomyoma of the uterus diagnosed pathologically between September 1, 2018 and August 31, 2019 were collected from the Department of Pathology of West China Second University Hospital. The morphology, FH protein expression and prognosis of FH negative patients were observed. Results A total of 900 patients were included. Among them, there were 825 cases of nonatypical leiomyomas, 36 cases of leiomyoma with bizarre nuclei, 34 cases of cellular leiomyoma and 5 cases of mitotically active leiomyoma. A total of 69 patients with negative FH expression were included, with an average age of (37.28±8.22) years. Among them, there were 43 cases of nonatypical leiomyomas, 19 cases of leiomyoma with bizarre nuclei, 6 cases of cellular leiomyoma, and 1 cases of mitotically active leiomyoma. At low magnification, staghorn shaped blood vessels, alveolar pattern edema, palisade distribution of smooth muscle cells and bizarre nuclei smooth muscle cells could be seen in patients with negative FH expression. At high magnification, cytoplasmic eosinophilicglobules andeosinophilic nucleolus surrounded by a halo could be seen in patients with negative FH expression. Among the 69 cases with negative FH expression, 60 cases (86.96%, 60/69) were followed up. All patients survived, of which 24 cases (40%, 24/60) recurred. Conclusion Immunohistochemically, the marker FH for multiple leiomyoma of the uterus is helpful to improve the identification of FH deficient leiomyoma in clinical work as well as early diagnosis in hereditary leiomyomatosis renal cell cancer syndrome.
Objective To evaluate the mental status of survivors after Wenchuan earthquake, so as to provide relevant information for psychological and medical intervention. Methods Demographic data was recorded and the post-traumatic stress disorder (PTSD) Checklist-Civilian Version (PCL-C) was evaluated. The acute stress disorder (ASD) were assessed with the DSM-IV criteria in the survivors from the central earthquake area who are now living in two shelters in Chengdu. Results Among the 780 retrieved questionnaires, 729 baseline registration forms and 450 PCL-C were valid. In the 729 baseline registration forms, male to female ratio was 1:1.31 and the mean age was 36.73±20.82. 9.5% of subjects suffered from physical diseases, 9.7% needed assistance in daily activities, 70.7% were passive and didn’t participate in community activities, 9.1% suffered from severe psychological problems. In the present study, 30.9% of subjects were found to meet the DSM-IV criteria for ASD. 41.3%, 22.2% and 18.4% of subjects had a PCL-C score ≥ 38, ≥ 45 and ≥50, respectively. Consistency check showed there was no significant difference between the screening result of PCL-C score ≥45 and clinical diagnosis (Kappa=0.780, P=0.033). There was significant difference in the age of subjects between ASD and non-ASD groups (Plt;0.05). Conclusion The earthquake survivors suffered from psychological problems after the disaster in the early stage. Thus, in addition to life rescue, we should pay more attention to psychological intervention.