Background: Before the COVID-19 pandemic, tuberculosis is the leading cause of death from a single infectious agent worldwide for the past 30 years. Progress in the control of tuberculosis has been undermined by the emergence of multidrug-resistant tuberculosis. The aim of the study is to reveal the trends of research on medications for multidrug-resistant pulmonary tuberculosis (MDR-PTB) through a novel method of bibliometrics that co-occurs specific semantic Medical Subject Headings (MeSH). Methods: PubMed was used to identify the original publications related to medications for MDR-PTB. An R package for text mining of PubMed, pubMR, was adopted to extract data and construct the co-occurrence matrix-specific semantic types. Biclustering analysis of high-frequency MeSH term co-occurrence matrix was performed by gCLUTO. Scientific knowledge maps were constructed by VOSviewer to create overlay visualization and density visualization. Burst detection was performed by CiteSpace to identify the future research hotspots. Results: Two hundred and eight substances (chemical, drug, protein) and 147 diseases related to MDR-PTB were extracted to form a specific semantic co-occurrence matrix. MeSH terms with frequency greater than or equal to six were selected to construct high-frequency co-occurrence matrix (42 × 20) of specific semantic types contains 42 substances and 20 diseases. Biclustering analysis divided the medications for MDR-PTB into five clusters and reflected the characteristics of drug composition. The overlay map indicated the average age gradients of 42 high-frequency drugs. Fifteen top keywords and 37 top terms with the strongest citation bursts were detected. Conclusion: This study evaluated the literatures related to MDR-PTB drug therapy, providing a co-occurrence matrix model based on the specific semantic types and a new attempt for text knowledge mining. Compared with the macro knowledge structure or hot spot analysis, this method may have a wider scope of application and a more in-depth degree of analysis. Keywords: multidrug-resistant tuberculosis, pulmonary tuberculosis, medication trends, specific semantic types, MeSH tree, pubMR
Background Insulin resistance (IR) is recognized as a potential modifiable risk factor for cognitive decline, but findings within Asian populations have been inconsistent. Given the high prevalence of dementia and its substantial economic burden in China, large-scale longitudinal studies are essential to elucidate the complex relationship between IR and cognitive function. Methods This longitudinal cohort study included 8,734 middle-aged and older adults (median age: 58 years; 53.6% females) from the China Health and Retirement Longitudinal Study (CHARLS), followed from 2011 to 2018. Estimated glucose disposal rate (eGDR) was used to assess IR and was calculated using waist circumference, hypertension status, and HbA1c levels. Participants were categorized into tertiles based on eGDR levels (Tertile 1: lowest; Tertile 3: highest). Cognitive function was calculated as the sum of episodic memory and executive function scores, which was then standardized to a Z -score. Linear mixed-effects models and dose-response analyses were performed to evaluate the association between baseline eGDR and cognitive changes in the total population and stratified by sex. Results Higher eGDR levels were significantly associated with slower global cognitive decline (Tertile 3 vs. Tertile 1: β = 0.007; 95% CI: 0.000–0.014; P = 0.047). This association was stronger in females (Tertile 3 vs. Tertile 1: β = 0.011; 95% CI: 0.002–0.021; P = 0.021), while no significant association was observed in males. Dose-response analyses indicated a linear positive relationship between baseline eGDR and global cognitive function in the total population and in females, but not in males. Similar patterns were found for episodic memory and executive function, with significant associations predominantly in females. Conclusion Higher eGDR was significantly associated with slower cognitive decline, particularly among women. These findings underscore the potential of eGDR as a marker for identifying and mitigating cognitive decline and highlight the importance of sex-specific strategies to address insulin resistance and promote cognitive health.
Objective
To compare the perioperative incidence of deep venous thrombosis (DVT) and level of plasma D-dimer between different ages in patients with lower limb fracture in Northwest China.
Methods
The data were retrospectively analyzed of the 1,185 patients with lower limb fracture in 5 provinces in Northwest China from July 2014 to March 2017. They were 583 males and 602 femals, with an average of 60.3 years(from 18 to 102 years). Of them, 723 were from Shaanxi Province, 148 from Gansu Province, 137 from Qinghai Province, 128 from Ningxia Hui Nationality Autonomous Regions and 49 from Xinjiang Uygur Autonomous Region. They were divided into a young group (≤44 years old) (n=288), a middle-aged group (from 45 to 59 years old) (n=256), a junior elderly group (from 60 to 74 years old) (n=263), and a senior elderly group (≥75 years old) (n=378). The incidences of perioperative deep venous thrombosis (DVT) and levels of plasma D-dimer were compared between the 4 age groups.
Results
The DVT incidences before and after operation in the young group were significantly lower than in the other 3 groups (P<0.05); the DVT incidence after operation in the middle-aged group was significantly lower than that in the junior elderly group (P<0.05). The pre- and post-operative levels of plasma D-dimer increased with the age of the patients; the pre- and post-operative levels of plasma D-dimer in the senior elderly group were significantly higher than in the other 3 groups (P<0.05).
Conclusions
The perioperative incidence of DVT was high in the elderly patients with lower limb fracture in Northwest China, peaking in the age range from 60 to 74 years old. The pre- and post-operative levels of plasma D-dimer increased with the age of the patients.
Key words:
Bones of lower extremity; Fractures, bone; Thrombosis; Age distribution
Background . Primary biliary cirrhosis (PBC) is a chronic and progressive cholestasis liver disease. Bile salt export pump (BSEP) is the predominant bile salt efflux system of hepatocytes. BSEP gene has been attached great importance in the susceptibility of PBC and the response rate of ursodeoxycholic acid (UDCA) treatment of PBC patients. Methods . In this study, TaqMan assay was used to genotype four variants of BSEP, and the Barcelona criteria were used for evaluating the response rate of UDCA treatment. Results . Variant A allele of BSEP rs473351 (dominant model, OR = 2.063; 95% CI, 1.254–3.393;P=0.004) was highly associated with PBC susceptibility. On the contrary, variant A allele of BSEP rs2287618 (dominant model, OR = 0.617; 95% CI, 0.411–0.928;P=0.020) provided a protective role and Barcelona evaluation criterion indicated that the frequency of variant allele at BSEP rs2287618 was significantly decreased in UDCA-responsive PBC patients (P=0.021). Conclusion . These results suggested that BSEP rs473351 was closely associated with the susceptibility of PBC and if people with BSEP rs2287618 were diagnosed as PBC, the UDCA treatment was not satisfactory. Larger studies with mixed ethnicity subjects and stratified by clinical and subclinical characteristics are needed to validate our findings.
Objective
To explore the application of Doppler ultrasound to assess the stability of pelvic ring in treatment of lateral-compression-1 (LC-1) pelvic fractures.
Methods
For this prospective study 38 patients with LC-1 pelvic fracture were enrolled who had been admitted to the Department of Orthopedic Trauma, Honghui Hospital from July 2016 to November 2017. They were 22 men and 16 women with an age of 55.2±16.1 years. After the patient's condition was stable, they underwent a Doppler ultrasound examination in the pelvic compression separation test. According to the criteria preset: those with a left-right mobility ≥ 0.3 cm were assigned as an unstable group (16 cases) and those with a mobility<0.3 cm as a stable group (22 cases). The stable group received conservative treatment while the unstable group surgical treatment. The 2 groups were compared in terms of mobility of fracture ends, follow-up time, weight-bearing time, fracture healing time, and the Majeed scores of pelvic function at the last follow-up.
Results
The 2 groups were compatible due to their insignificant differences in baseline data(P>0.05). The mobility of fracture ends (left-right distance: 0.45±0.22 cm; anterior-posterior distance: 0.26±0.16 cm; oblique distance: 0.50±0.23 cm) in the unstable group was all significantly greater than in the stable group (left-right distance: 0.11±0.03 cm; anterior-posterior distance: 0.05±0.04 cm; oblique distance: 0.11±0.07 cm) (P 0.05).
Conclusions
Since ultrasonography is helpful in assessment of the stability of LC-1 pelvic fractures, a proper treatment strategy can be decided. Stable ones can be treated conservatively and unstable ones surgically.
Key words:
Pelvis; Fractures, bone; Lateral compression; Ultrasonography, doppler; Stability
Background: Patients with dementia might have higher risk for hemorrhagic complications with anticoagulant therapy prescribed for atrial fibrillation (AF). Objective: This study assesses the risks and benefits of warfarin, antiplatelets, and no treatment in patients with dementia and AF. Methods: Of 49,792 patients registered in the Swedish Dementia Registry 2007–2014, 8,096 (16%) had a previous diagnosis of AF. Cox proportional hazards models were used to calculate the risk for ischemic stroke (IS), nontraumatic intracranial hemorrhage, any-cause hemorrhage, and death. Results: Out of the 8,096 dementia patients with AF, 2,143 (26%) received warfarin treatment, 2,975 (37%) antiplatelet treatment, and 2,978 (37%) had no antithrombotic treatment at the time of dementia diagnosis. Patients on warfarin had fewer IS than those without treatment (5.2% versus 8.7%; p < 0.001) with no differences compared to antiplatelets. In adjusted analyses, warfarin was associated with a lower risk for IS (HR 0.76, CI 0.59–0.98), while antiplatelets were associated with increased risk (HR 1.25, CI 1.01–1.54) compared to no treatment. For any-cause hemorrhage, there was a higher risk with warfarin (HR 1.28, CI 1.03–1.59) compared to antiplatelets. Warfarin and antiplatelets were associated with a lower risk for death compared to no treatment. Conclusions: Warfarin treatment in Swedish patients with dementia is associated with lower risk of IS and mortality, and a small increase in any-cause hemorrhage. This study supports the use of warfarin in appropriate cases in patients with dementia. The low percentage of patients on warfarin treatment indicates that further gains in stroke prevention are possible.
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