Objective: The association of the triglyceride-glucose (TyG) index with severe consciousness disturbance and in-hospital mortality in patients with cerebrovascular disease in the intensive care unit (ICU) is unclear. This study aimed to investigate the TyG index’s predictive ability on the severity of impaired consciousness and in-hospital mortality in patients with cerebrovascular disease in the ICU. Method: Patients diagnosed with non-traumatic cerebral hemorrhage and cerebral infarction were extracted from the MIMIC-IV database and analyzed as two cohorts. The association between the TyG index and the severity of patients’ impairment of consciousness and in-hospital mortality was analyzed using logistic regression models. Using restricted cubic spline curves, we analyzed potential nonlinear relationships between TyG indices and outcome indicators. receiver operating characteristic (ROC) curves were utilized to evaluate the predictive ability of the TyG index for outcome indicators. Result: The study’s last two cohorts comprised 537 patients with traumatic cerebral hemorrhage and 872 patients with cerebral infarction. TyG index was a significant predictor of the severity of impaired consciousness and in-hospital mortality in patients with cerebrovascular disease, as determined by logistic regression. The risk of severe consciousness impairment and in-hospital mortality increased roughly linearly with increasing TyG index. Conclusion: The TyG index was found to be a significant predictor for severe impairment of consciousness and in-hospital death in patients with cerebrovascular disease in the ICU, and it provides some predictive value for the severity of consciousness disturbances and in-hospital mortality in cerebrovascular disease patients.
BACKGROUND:Dialysis frequency and dose are controversial prognostic factors of hemodialysis morbidity and mortality. The aim of this study was to find out the effect of frequency and dosage of dialysis on mortality and survival in a group of Chinese ...
Background: Although the incidence and clinical manifestations of pituitary apoplexy were reported by a few researches, the results are not consistent. This study aimed to explore the risk factors associated with an incidence of apoplexy in pituitary adenomas.Methods: The clinical information of 843 patients with pituitary adenoma from the Department of Neurological Surgery, 1st Affiliated Hospital of Kunming Medical University, was reviewed. The incidence, clinical manifestation, and potential risk factors for pituitary apoplexy were analyzed by a case-control study.Results: In total, 121 patients (14.4%) with macroadenoma were suffered from pituitary apoplexy. Headache, vomiting, and visual impairment are the top 3 symptoms for the pituitary apoplexy.Logistic regression results showed that the hypertension(hypertension vs non-hypertension OR = 2.765, 95%CI:1.41~5.416), tumor type (negative staining vs. positive staining, OR = 1.501, 95%CI:1.248~5.235), and tumor size (diameter > 2 cm vs. diameter ≤ 2 cm, OR = 3.952, 95%CI:2.211~7.053) are independent factors associated with pituitary apoplexy.Conclusion: Our results indicate that the risk factors for the incidence of pituitary apoplexy depend mainly on properties of the tumor itself (tumor size and pathologic type) and the blood pressure of patients.
Gut microbiota is symbiotic and interdependent with human body. Intestinal probiotics are colonized in the human gastrointestinal tract, which can improve the host intestinal microenvironment and enhance the intestinal function and immune function of the human body. A small number of opportunistic pathogens exist in the intestinal tract. Once the number of pathogens exceeds the threshold of intestinal tolerance, the intestinal micro-ecological balance can be destroyed, and various diseases may thus develop. Pregnancy is a special status with different physiologic changing stages. In the meanwhile, alterations in the gut microbiome populations occur, which can promote the differentiation, development, and maturation of fetal organs by affecting maternal metabolism. Compared with normal pregnant women, great changes in the gastrointestinal function and gut microbiome may take place in pregnant women with pregnancy-related complications, in which these changes include the number, species, and intestinal translocation. The composition of the maternal gut microbiome could contribute to pregnancy and obstetric outcomes, and long-term health of mother and child. The relationships of pregnancy to gut microbiome have attracted an increasing attention in recent years. This article will provide a summary review of the research studies of gut microbiome in normal pregnant women versus abnormal pregnancy women with complications.
1 July 2018 in Journal of the Chinese Medical Association
DNA methylation is the most extensively studied epigenetic modification which had been suspected to be involved in the progress of gestational diabetes mellitus(GDM). It is vital to investigate the expression profile and methylation profile in the GDM adipose tissue samples to learn more about the relationship between the two profiles. Illumina Human Methylation 450 k DNA Analysis Beadchip and whole Human Gene Expression Array were selected to screen for methylation and gene expression in the omental visceral adipose tissue of pregnant women. Validation of methylation of DMGs was conducted by bisulfate pyrosequencing and expression of DEGs by q RT-PCR. Global gene methylation profiling and whole genome expression profiling were conducted in visceral omental adipose tissue (VOAT) between GDM and normal pregnancies. Compared with controls, 935 genes were commonly dysregulated in the GDM group, including 450 down-regulated DEGs and 485 up-regulated DEGs. The Seven overlapping genes between DEGs and DMGs were extracted, including C10orf10, FSTL1, GSTT1, HLA-DPB1, HLA-DRB5, HSPA6 and MSLN. Among them, C10orf10, FSTL1, GSTT1, HLA-DPB1, HLA-DRB5 showed hypermethylation and up-regulated expression, while HSPA6 show hypomethylation and down-regulated expression. Typical negative correlation between gene expression and DNA methylation level was only found in MSLN with significant hypermethylation in the CpG island and downregulated transcription. No gene was found to be significantly hypomethylated in the CpG islands and unregulated transcription. We found that antigen processing and presentation pathway and immune-related genes were closely associated with gestational diabetes mellitus in the visceral omental adipose tissue of Chinese pregnant women, based on the integration analysis of expression and methylation profiles. These results may be valuable for the prognostic biomarkers and future therapeutic targets.
Increasing evidence has shown that insulin resistance in omental visceral adipose tissue (OVAT) is a characteristic of gestational diabetes mellitus (GDM). The present study aimed to identify differentially expressed genes (DEGs) and their associated functions and pathways involved in the pathogenesis of GDM by comparing the expression profiles of OVATs obtained from pregnant Chinese women with and without GDM during caesarian section. A total of 935 DEGs were identified, including 450 downregulated and 485 upregulated genes. In the gene ontology category cellular components, the DEGs were predominantly associated with functions of the extracellular region, while receptor binding was predominant in the molecular function category and biological process terms included antigen processing and presentation, extracellular matrix organization, positive regulation of cell-substrate adhesion, response to nutrients and response to dietary excess. Functional enrichment and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment were performed and a functional interaction network was constructed. Functions of downregulated genes included antigen processing and presentation as well as cell adhesion molecules, while those of upregulated genes included transforming growth factor (TGF)-β-signaling, focal adhesion, phosphoinositide-3 kinase-Akt-signaling, P53 signaling, extracellular matrix-receptor interaction and regulation of actin cytoskeleton pathway. The five main pathways associated with GDM were antigen processing and presentation, cell adhesion molecules, Type 1 diabetes mellitus, natural killer cell-mediated cytotoxicity and TGF-β signaling. These pathways were included in the KEGG pathway categories of ‘signaling molecules and interaction’, ‘immune system’ and ‘inflammatory response’, suggesting that these processes are involved in GDM. The results of the present study enhanced the present understanding of the mechanisms associated with insulin resistance in OVATs of GDM.