bluuebunny/crossref_metadata_2025 huggingface dataset:
The Influence of Motivation Leadership and Work Discipline on Employees Work Spirit at Astagina Resort Villa and Spa Kuta Bali
Authors: Wartana I Made Hedy , Sumerta I Ketut Eli
Published: January 2024

This research aims to determine the effect of motivation (X1) leadership (X2) and work discipline (X3) onemployee morale (Y) at Astagina Resort Villa and Spa Kuta Bali. The respondents used in this research were allemployees of Astagina Resort Villa and Spa Kuta Bali with a total of 89 respondents. The data used in theresearch is primary data, namely from the results of questionnaire answers, then the results of thequestionnaire answers are tested using validity and reliability tests followed by classical assumption tests andmultiple linear regression analysis. The research results show that motivation (X1) has a positive andsignificant effect on employee morale at Astagina Resort Villa and Spa Kuta Bali. This is proven by the t-count= 2.783 > t-table = 1.66 and the Sig. = 0.007<0.05. This means that motivation has a positive and significantinfluence on employee morale. Leadership (X2) has a positive and significant effect on employee morale atAstagina Resort Villa and Spa Legian Bali. This is proven by the t-count = 4.097 > t-table = 1.66 and the Sig. =0.000<0.05. This means that leadership has a positive and significant effect on employee morale. Workdiscipline (X3) has a positive and significant effect on employee morale at Astagina Resort Villa and Spa KutaBali. This is proven by the t-count value = 4.286 > t-table = 1.66 and the Sig value. = 0.000<0.05. This meansthat work discipline has a positive and significant effect on employee performance.Keywords: Motivation, Leadership, Work Discipline, Employee Work Spirit.
Traditional Market Development Strategy as a Shopping Tourism Attraction in West Lombok Regency, West Nusa Tenggara: Case Study of Tenten Golong Traditional Market
Authors: Widiantara I Gusti Agung Bagus , Wirya I Made Suwitra , Dwi Putranto Isa Wahyoedi
Published: January 2024

Markets play an important role in the economy of a rural community. The market not only functions as ameeting place for sellers and buyers to carry out transactions, but also increases its function as a center forvarious community activities ranging from selling artistic, agricultural, handicraft, culinary, cultural, religiousproducts with the existence of the Melanting Temple for Hindus, especially those earn their living as traders inthe market. So it is very appropriate for the market to be called the center of the economy and also a touristattraction, especially shopping tourism. The existence of this market, some of which are global, some aredeveloping on a regional scale or traditional markets are found in every village in Indonesia, including onLombok Island, West Nusa Tenggara Province. In 2023, West Nusa Tenggara Province targets 2 million touriststo visit and spend their free time and money on holidays, whether they come in groups or independently. Forthe arrival of tourists, it is necessary to provide adequate tourist accommodation and tourist attractions, interms of quality and quantity. One of the tourist attractions offered to tourists visiting West Nusa TenggaraProvince is the Tenten Traditional Market with its various unique potentials which is not yet widely known andthere is a need for a development strategy in this qualitative descriptive research which is analyzed using SWOTAnalysis. With this SWOT analysis, the strengths, weaknesses, opportunities and threats that occur inconnection with the existence of the Tenten Golong Traditional Market as a tourist attraction in West NusaTenggara Regency are known. After knowing the elements of this SWOT, it is concluded that the TentenTraditional Market has the potential to be developed into a shopping tourist attraction by implementing severalgood strategies to improve the internal environmental conditions of the market, the quality of human resourcesmanaging the market, product quality, marketing and the external environment in outside that market.Keywords: Traditional Market, Development Strategy, SWOT Analysis
An Analysis of Room Reservation Practice Learning Obstacle for Students in The Second Diploma of Accommodation at The Community Academy of MAPINDO
Authors: Agustina Riski Gusti Ayu
Published: January 2024

Room Reservation practice is one of the courses that aims to prepare students so that they have the competenceto handle room requests, process bookings, and archive the history of room bookings. Learning in the practiceof booking rooms uses the role play method, where students act as reservation agents and others as guestswith the material being Room Reservation procedures via telephone operator. However, in the learningprocess, there are several obstacles in learning that hinder the achievement of the objectives of the learningoutcomes. The purpose of this research is to analyze the types of difficulties experienced by students along withthe factors that cause them as well as the efforts made by students to overcome these obstacles so that learningabout the practice of booking rooms can run in accordance with the stated objectives. The research methodused is a qualitative method, collecting data through observation, distributing questionnaires, interviews anddocumentation. Respondents in this study were 29 students, selected purposively (purposive sampling),namely students who had experiences in practical learning process for booking rooms. Analysis techniques usequalitative data. The research results show that students have difficulty recording guest payment methods,allocating rooms, providing room rates, and filling in reservation charts. The causal factors are divided intointernal factor (such us: lack pf confidence, and language barriers) and external factor (lak of facilities and timeallocating). The efforts made by students are to study again and practice a lot of role plays, as well as lookingfor references from other sources.Keywords: Barriers, Learning, Front Office Practice, Front Office Practice
Using Games: Role Play and Kahoot in English Language Teaching and Learning for Tourism Students
Authors: Tari Nirmala , Safitri Ni Putu Dianita
Published: January 2024

To improve students' language learning and overall learning experience, the incorporation of games intoEnglish Language Teaching (ELT) has emerged as a potential pedagogical method. This abstract explores theuse of two types of game, namely role play and kahoot as a creative and successful teaching and learningEnglish, focusing on the effects on language proficiency, motivation, and engagement. Games are used in ELTas a dynamic and engaging platform that promotes a learner-centered atmosphere and stimulates studentparticipation and teamwork. The variety of possibilities accommodates to various learning styles and interests,combining conventional board games and digital kahoot language learning programs. Games establish anemotionally safe environment for language learners to explore with the target language without worryingabout making mistakes by incorporating aspects of enjoyment, competition, and challenge. This encouragingenvironment makes a big contribution to increasing students' self-assurance and lowering their anxiety, whichfosters a happy learning environment. Additionally, games can be altered to fit with particular language goals,allowing teachers to focus on different linguistic abilities like vocabulary, grammar, speaking, listening, andreading comprehension. The abstract also explains how games encourage situational learning and real-worldlanguage use. Role-playing games and simulations, for instance, let students put their language abilities incontext while immersing them in real-world situations. Meanwhile, kahoot can help students to enjoy thelearning process digitally. In conclusion, games present an effective and adaptable instrument to transformEnglish Language Teaching and Learning.Keywords: Games, Role Play, Kahoot, English Language Teaching, Learning
Identify Industrial Work Practices in the Food and Beverage Product Department of Kayumas Seminyak Resort
Authors: Antara I Made Kusuma , Anggayana I Wayan Agus , Dwiyanti Ni Made Christine , Sengkey Fenny
Published: January 2024

This research Identify Industrial Work Practices in the Food and Beverage Product Department of Kayumas Seminyak Resort. It can be used as a guide to improve the quality of work and creativity in entering the tourism industry. Increasing student knowledge in the Food and Beverage products field and implementing training will be helpful later when facing the industrial world. This research is descriptive qualitative research. The document used in this research is taken from Industrial Work Practices in the Food and Beverage Product Department of Kayumas Seminyak Resort Students' report. After carrying out industrial work practices, the researcher gained a lot of useful work experience in the form of theories and practical knowledge regarding the Food and Beverage Product field and the ability to work together. In addition, the author has carried out one of the requirements for completing the Food and Beverage Product Study program by carrying out industrial work practices.

Keywords: Industrial Work Practices, Food and Beverage Product Department, Quality of work, Tourism Industry, Kayumas Seminyak Resort.
Identify Industrial Work Practices in the Food and Beverage Product Department of Quest Hotel Kuta
Authors: Ditya Adi Putra I Made Marianto , Anggayana I Wayan Agus
Published: January 2024

This research identifies industrial Work Practices in the Food and Beverage Product Department of Quest Hotel Kuta. It can be used as a guide to improve the quality of work and creativity in entering the tourism industry. Increasing student knowledge in the Food and Beverage products field and implementing training will be helpful later when facing the industrial world. This research is descriptive qualitative research. The document used in this research is taken from Industrial Work Practices in the Food and Beverage Product Department of Quest Hotel Kuta Students' report. After carrying out industrial work practices, the researcher gained a lot of useful work experience in the form of theories and practical knowledge regarding the Food and Beverage Product field and the ability to work together. In addition, the author has carried out one of the requirements for completing the Food and Beverage Product Study program by carrying out industrial work practices.

Keywords: Industrial Work Practices, Food and Beverage Products, Tourism Industry, Quest Hotel Kuta.
A new study on diffusion tensor imaging of the whole visual pathway fiber bundle and clinical application
Authors: TAO Xiao-feng , WANG Zhong-qiu , GONG Wan-qing , JIANG Qing-jun , SHI Zeng-ru
Published: January 2024

Background

With conventional imaging methods only the morphous of the visual nerve fiber bundles can be demonstrated, while the earlier period functional changes can not be demonstrated. We hypothesized that diffusion tensor imaging (DTI) would demonstrated the whole optic never fiber bundle and visual pathway and the earlier period functional changes. The purpose of the present study was to evaluate the application of DTI technique in the demonstration of the whole optic never fiber bundle and visual pathway, and the influence of orbital tumors on them.

Methods

GE 1.5T signa HD MR System, and the software package DTV2 were adopted. The total 45 subjects were enrolled, including 15 volunteers and 30 patients. All patients had ocular proptosis from minor to major. Seven patients had visual acuity decrescence.

Results

The nerve fiber bundles, e.g. optic chiasma, optic tract and optic radiation in posterior visual pathway were well demonstrated in all cases. Wherein, the intact whole visual pathway fiber bundles were clearly revealed in 10 volunteers and 17 patients, and optic nerve was not wholly revealed in the rest of the subjects. Shift of optic nerve caused by compression and partial deformation were seen in 7 patients with orbital tumor. In 6 of 7 patients, DTI displayed significant abscise and deformation of visual nerve. Chi-square test indicated significant correlation between visual acuity decrescence and DTI visual nerve non-display.

Conclusions

Visual nerve fiber bundles and the whole visual pathway were visualized in most of patients with DTI. It might be an effective method of providing imaging evidence for visual nerve fiber earlier period functional changes, and laid a foundation for the study in other cranial nerves.
Blood purification therapy in treatment of acute renal failure in infants with melamine-induced stones
Authors: SHEN Ying , LIU Xiao-rong , ZHANG Gui-ju , ZHOU Nan
Published: January 2024

Background

In 2008, infants in some areas of China suffered from stones of the urinary system which were caused by melamine-contaminated milk formula. Most of the infants were asymptomatic, and a few suffered from acute renal failure induced by urinary obstruction by stones. This study aimed to assess the significance of blood purification therapy in treatment of infants with acute obstructive oligo-anuric renal failure. Corrective perception, timely diagnosis, and active treatment of this complex disease are critical factors that guarantee a quick recovery of renal function of infants and help them to prevent multiple organ system failure.

Methods

Thirteen infants with acute renal failure induced by urinary multiple obstruction caused by melamine-containing stones who had been admitted to Beijing Children's Hospital Affiliated to Capital Medical University in 2008 were investigated for the epidemiological characteristics, image features and indications of dialysis. All these infants were treated with dialysis. The efficacy of dialysis was compared with that of two control groups treated with cystoscopic retrograde catheterization into the ureter and medical treatment for the recovery of renal function.

Results

The 13 infants with life-threatening complications treated with dialysis showed a blood urea nitrogen (BUN) level of (30.9±7.9) mmol/L and a creatinine (Cr) level of (572±173) μmol/L. Of these infants, 8 were treated with peritoneal dialysis (PD), and 5 with hemodialysis (HD). Ten infants recovered to urinate 24–72 hours after dialysis and 3 infants with persistent ureteral obstruction were further treated with cystoscopic retrograde catheterization into the ureter for drainage, and urination resumed soon after the operation. The average time of PD and HD were (2.1±0.8) days and (1.2±0.4) days, respectively. The total average time of PD and HD dialysis was (1.77±0.83) days. The recovery time of renal function of infants after dialysis was (3.08±1.20) days, comparable to that of the two control groups treated with catheterization with a cystoscope or by medication. There was no significant difference in the recovery time of renal function among the three groups (P>0.05).

Conclusions

Melamine-contaminated milk formula may cause urinary stones and obstructive acute renal failure in infants. Dialysis is suggested to treat life-threatening complications such as hyperkalemia, oliguria or anuria if surgical intervention fails. If possible, hemodialysis or peritoneal dialysis can be performed early. Blood purification is feasible to help the infants overcome the critical stage of acute renal failure. Surgical measures can be taken to remove the obstruction if necessary.
Mutation of plakophilin-2 gene in arrhythmogenic right ventricular cardiomyopathy
Authors: WU Shu-lin , WANG Pei-ning , HOU Yue-shuang , ZHANG Xu-chao , SHAN Zhi-xin , YU Xi-yong , DENG Mei
Published: January 2024

Background

Arrhythmogenic right ventricular cardiomyopathy (ARVC) is one of the leading causes of sudden cardiac death. Recent studies have shown that ARVC, which is an inheritable genetic change, results from mutations in genes encoding desmosomal proteins. Plakophilin-2 is an important component of the desmosome. Because the full range of genetic variations related to ARVC is unknown and no related studies of the Chinese population have been reported, we aimed to investigate the genetic variation of plakophilin-2 in ARVC patients from the Southern Region of China.

Methods

Genomic DNA was isolated from peripheral blood samples of all 34 ARVC patients, who were screened through a clinical evaluation. They were used to detect variations in the sequences of the plakophilin-2 genes by polymerase chain reaction amplification in combination with direct sequencing.

Results

In exon-1 of the plakophilin-2 gene, a deletion mutation (c.145_148 del GACA) was found in one family pedigree. The mutation was also found in exon-2, 4, and 11 of the plakophilin-2 gene. The QT interval dispersion of the ECG was considerably longer in the mutation group than in the non-mutation group of ARVC patients, and this result was statistically significant (P <0.05).

Conclusion

We discovered a plakophilin-2 mutation that prolongs the QT interval dispersion in the southern Chinese ARVC population.
Expression of CD133, PAX2, ESA, and GPR30 in invasive ductal breast carcinomas
Authors: LIU Qun , LI Ji-guang , ZHENG Xin-yu , JIN Feng , DONG Hui-ting
Published: January 2024

Background

Biomarkers in breast neoplasms provide invaluable information regarding prognosis and help determining the optimal treatment. We have examined the possible correlation between cancer stem cell (CSC)-like markers (CD133, paired box gene 2 protein (PAX2), epithelial specific antigen (ESA)), and a new membrane estrogen receptor (G-protein coupled receptor 30 (GPR30)) in invasive ductal breast carcinomas with known clinicopathological parameters, tumor recurrence, and expression of some known biomarkers.

Methods

In 74 invasive ductal breast carcinomas, we investigated the protein expression of these molecular markers by immunohistochemistry, and their associations with known clinicopathological parameters, tumor recurrence, and expression of some known biomarkers. We studied the interrelationship between the expressions of these proteins.

Results

CD133, a putative CSC marker, was positively related to tumor size, tumor stage, and lymph node metastasis.

PAX2 was negatively correlated with tumor recurrence. ESA, one of the breast CSC markers, was an indicator of tumor recurrence. GPR30 was associated with hormone receptors. Despite the correlation between GPR30 and the nuclear estrogen receptor, the expression was dependent. Positive staining of GPR30 in tumors displayed a significant association with high C-erbB2 expression and a tendency for tumor recurrence. A positive relationship between GPR30 and CD133 existed.

Conclusion

Detecting the expression of CD133, PAX2, ESA, and GPR30 in invasive ductal breast carcinomas may be of help in more accurately predicting the aggressive properties of breast cancer and determining the optimal treatment.
Development of a novel two color tracer perfusion technique for the hydrodynamic study of aqueous outflow in bovine eyes
Authors: ZHU Jing-yin , YE Wen , GONG Hai-yan
Published: January 2024

Background

Elevation of intraocular pressure is usually associated with primary open angle glaucoma and caused by increased outflow resistance. A two-color fluorescent tracer technique was developed to investigate the hydrodynamics of aqueous humor outflow with changing intraocular pressure within the same eye, to better understand the relationship between outflow facility and effective filtration area.

Methods

Eighteen enucleated bovine eyes were first perfused at 30 mmHg with Dulbecco's phosphate-buffered saline containing 5.5 mmol/L D-glucose. After a stable baseline facility, red fluorescent microspheres (0.5 μm, 0.002% v/v) were exchanged and perfused. Eyes in the one-color control group (n=6) were immediately perfused with fixative. In the experimental group (n=6), eyes were perfused with green tracer after intraocular pressure reduced to 7 mmHg, while in the two-color control group (n=6), eyes were perfused with green tracer with intraocular pressure remaining at 30 mmHg. All 12 eyes were then perfusion-fixed. Outflow facility was continuously recorded in all eyes. Confocal images were taken along the inner wall of the aqueous plexus and the percent of the effective filtration length (PEFL; length of inner wall exhibiting tracer labeling/total length of inner wall) was measured. The relationships between outflow facility and PEFL were analyzed statistically.

Results

No significant differences were found in baseline facilities (μl·min-1·mmHg-1) among the three groups (the experimental group: 0.93±0.12; the two-color control group: 0.90±0.19; the one-color control group: 0.98±0.13). In the experimental group, the outflow facility was significantly higher at 7 mmHg (4.29±1.01) than that at 30 mmHg (1.90±0.67, P <0.001), which corresponded to a significant increase in the PEFL at 7 mmHg (54.70±8.42) from that at 30 mmHg ((11.76±4.56)%, P <0.001). The PEFL labeled by red fluorescent microspheres in the experimental group ((11.76±4.56)%) showed no significant difference from that of the one-color control group ((13.39±2.19)%, P=0.473) or the two-color control group ((11.49±4.95)%, P=0.930). The PEFL labeled by green fluorescent microspheres in the experimental group ((54.70±8.42)%) was significantly higher than that of the two color control group ((37.34±8.17)%, P=0.010). A positive correlation was found between outflow facility and PEFL(t=0.897, R
2=0.804) in the experimental group.

Conclusions

Changes in aqueous humor outflow patterns before and after a change in intraocular pressure can be successfully distinguished within the same eye using our newly developed two-color tracer perfusion technique. The PEFL showed positive correlation with the outflow facility.
Influence of insulin resistance on long-term outcomes in patients with coronary artery disease after sirolimus-eluting stent implantation
Authors: ZHAO Liang-ping , LÜ An-kang , SHEN Wei-feng , LIU Hai-feng , MA Xiao-ye , FAN Xiao-ming , ZHANG Qi
Published: January 2024

Background

Insulin resistance (IR) is significantly associated with coronary artery disease and cardiovascular events in patients with or without type 2 diabetes mellitus. This study aimed to evaluate the influence of IR on long-term outcomes of patients undergoing percutaneous coronary intervention (PCI) with sirolimus-eluting stent (SES) implantation.

Methods

A total of 467 consecutive patients undergoing SES-based PCI were divided into IR group (n=104) and non-IR group (n=363). The patients were followed up for one year. The rate of major adverse cardiac events (MACEs) including death, non-fatal myocardial infarction and recurrent angina pectoris was compared by the log-rank test, and the independent risk factors were identified by the Cox regression analysis.

Results

MACEs occurred more frequently, and cumulative survival rate was lower in the IR group than in the non-IR group during the follow-up (all P <0.05). IR was an independent risk factor for the occurrence of cardiac death and non-fatal myocardial infarction (OR=2.76, 95% CI=1.35-5.47, P=0.034). Old age, diabetes, and multi-vessel disease were determinants for recurrent angina pectoris after PCI (P <0.05). Subgroup analysis revealed that IR (OR=3.35, 95% CI=1.07-13.59, P=0.013) and multi-vessel disease (OR=2.19, 95% CI=1.01-5.14, P=0.044) were independent risk predictors for recurrent angina pectoris in patients with diabetes after PCI.

Conclusions

IR is associated with reduced MACE-free survival and remains an independent predictor for recurrent angina pectoris after PCI with SES implantation.
Pre-hospital care-seeking in patients with acute myocardial infarction and subsequent quality of care in Beijing
Authors: SONG Li , YAN Hong-bing , HU Da-yi , YANG Jin-gang , SUN Yi-hong
Published: January 2024

Background

Cumulative evidence demonstrates that primary percutaneous coronary intervention (PCI) is a reperfusion strategy for ST-elevation myocardial infarction (STEMI). This study was undertaken to evaluate the pre-hospital care-seeking pathway and subsequent care quality in patients with STEMI in the Beijing health care system, which offers patients a choice between seeking care in a small community hospital (SH group) or a large hospital (LH group).

Methods

Between January 1 and December 31, 2006, a cross-sectional and multicenter survey was conducted in 11 hospitals qualified as tertiary centers in Beijing and included consecutive patients with STEMI admitted within 24 hours after onset of symptoms.

Results

Among the 566 patients interviewed, 28.3% first arrived at a small community hospital and were transferred to large hospitals with the ability to perform primary PCI. The median total pre-hospital delay in the SH group (n=160) was significantly longer than in the LH group (n=406) (225 vs. 120 minutes, P <0.001). Multivariate analysis showed that interpreting symptoms to non-cardiac origin (OR, 1.996; 95% CI: 1.264-3.155), absence of history of myocardial infarction (OR, 1.595; 95% CI: 1.086-3.347), non-health insurance coverage (OR, 1.931; 95% CI: 1.079-3.012) and absence of sense of impending doom (OR, 4.367; 95% CI: 1.279-14.925) were independent predictors for choosing small hospitals. After adjusting for demographics and medical history, patients in the SH group were 1.698 times (95% CI: 1.182-3.661) less likely to receive primary PCI compared with those in the LH group.

Conclusions

Above one fourth of the STEMI patients in Beijing experienced inter-hospital transfer. Factors including symptoms interpretation, symptoms, history of myocardial infarction, and insurance coverage were associated with the patients’ pre-hospital care-seeking pathway. The patients who were transferred had longer pre-hospital delays and were less likely to receive primary PCI.
Diagnostic accuracy of various glomerular filtration rates estimating equations in patients with chronic kidney disease and diabetes
Authors: LI Hai-xia , XU Guo-bin , WANG Xue-jing , ZHANG Xu-chu , YANG Jian-mei
Published: January 2024

Background

The equations for estimating glomerular filtration rate (GFR) based on creatinine have been found to have limitations and have not been generalizable across all populations. Equations based on cystatin C provide an alternative method to estimate GFR. Whether the equation based on cystatin C alone or combined creatinine would improve GFR estimates has not been validated among Chinese patients with chronic kidney disease (CKD) and diabetes. The aim of this study was to compare the performance of the modification of diet in renal disease (MDRD) equation based on creatinine with the five cystatin C-based formulae for estimation of GFR in patients with CKD and diabetes.

Methods

A total of 166 patients with CKD and 91 patients with type 2 diabetes were enrolled in this study. Cystatin C was measured by using the particle-enhanced immunonephelometric method and estimated formulae proposed by five different investigator teams (Stevens, Ma, Rule, Macisaac and Perkins). The plasma clearance of 99mTc-DTPA was determined as measured GFR (mGFR).

Results

For CKD patients, the bias and accuracy for the Ma and Macisaac equations were superior compared with the MDRD, and the mean results for the Ma formula were closer to mGFR than the other equations in CKD stages 2-5. The differences between Macisaac and mGFR in CKD stages 2-4 were significantly less than those in CKD stage 1 or 5. Stevens and Rule's formulae revealed a similar bias and accuracy compared with the MDRD equation. The MDRD formula had a higher accuracy in CKD stages 3-5 as compared with the results in other stages. For diabetic patients, the mean results between Macisaac and mGFR were closer than those of other equations in mGFR ≥90 ml·min-1·1.73 m-2 stage. In GFR 60-89 ml·min-1·1.73 m-2 stage, the MDRD formula showed the smallest difference compared with other equations. All equations overestimated GFR in the cases with GFR <60 ml·min-1·1.73 m-2 stages. The MDRD formula had a greater accuracy within 50% of mGFR than the equations based on cystatin C in diabetic patients. Perkins formula showed a large positive bias and low accuracy, therefore it may not be suitable for assessing GFR in patients with CKD and diabetes.

Conclusions

The formulae for estimating GFR based on cystatin C or creatinine have different trends and accuracies in patients with CKD and diabetes, especially in patients with various GFR levels. The equations based on cystatin C provide less accurate results than MDRD formulae, at least in the diabetic patients. Therefore, whether the formulae based on cystatin C are superior to MDRD formula requires further investigation in large diverse populations.
Ningbo thyroid dysfunction prevalence study: a cross-sectional survey in an employees-cohort
Authors: MAO Yu-shan , LIU Zhi-min , CHEN Chang-xi , ZHU Zhong-wei , HONG Zhong-li
Published: January 2024

Background

The prevalence and the spectrum of thyroid dysfunction in the mainland of China are not adequately understood. We performed a population-based study to determine the prevalence of major thyroid dysfunctions including overt and subclinical hyper- and hypothyroidism in a stable cohort.

Methods

All active and retired employees aged 20 years and older (11 067) of Sinopec Zhenhai Refining & Chemical Company in Ningbo participated in the cross-sectional survey with a questionnaire and blood samples.

Results

A total of 10 405 individuals attended for screening. Using biochemical definitions 95.5% were euthyroid. The prevalence of former diagnosed hyperthyroidism was 1.1% in females and 0.4% in males, hypothyroidism 1.7% and 0.3%, and thyroid surgery 1.2% and 0.3%, respectively. In both sex the prevalence increased with age. Twenty-four percent of individuals with thyroid surgery or medications had abnormal thyroid-stimulating hormone (TSH) levels. In individuals without a history of thyroid disease, the prevalence of pathological TSH values in females and males were TSH ≥10 mU/L 0.60% and 0.29%; TSH 4.8–9.9 mU/L 5.71% and 2.25%; TSH <0.3 mU/L 0.87% and 0.41%, respectively. Overt hyper- and hypothyroidism were uncommon (0.2%, 0.3%, respectively). The prevalence of subclinical hyper- and hypothyroidism was 0.4% and 3.4%, respectively. Subclinical hypothyroidism was more common in females (male 2.4% vs. female 5.8%, P <0.001) and with increasing age (P <0.001).

Conclusions

The prevalence of thyroid dysfunction is 4.5% in the cohort. Among individuals with thyroid medications or surgery, only 75.7% were within the normal range of TSH. These results indicate that thyroid dysfunction is common in Chinese adults.
Role of extracellular signal-regulated kinase in regulating expression of interleukin 13 in lymphocytes from an asthmatic rat model
Authors: LI Yuan-yuan , LIU Xian-sheng , LIU Chang , XU Yong-jian , XIONG Wei-ning
Published: January 2024

Background

The extracellular signal-regulated kinase (ERK) is widely expressed in mammal cells and involved in airway proliferation and remodeling in asthma. In this study, we intend to explore the role of ERK in the expression of the Th2 cytokine, interleukin 13 (IL-13) in lymphocytes in asthma.

Methods

Forty Sprague-Dawley rats were randomly divided into two groups: normal control and asthmatic groups. Peripheral blood lymphocytes were isolated and purified from the blood of each rat and divided into five groups: control, asthmatic lymphocytes, asthmatic cells stimulated with ERK activator epidermal growth factor (EGF), or with ERK inhibitor PD98059, or with EGF and PD98059 together. The expression of phosphorylated-ERK (p-ERK) was observed by immunocytochemical staining, the expression of ERK mRNA was determined by reverse transcriptase-PCR, IL-13 protein in supernatants was measured by ELISA.

Results

(1) The ERK mRNA level and the percentage of cells with p-ERK in lymphocytes from asthmatic rats were significantly higher than those in normal controls, and were significantly increased by EGF administration. This effect of EGF was significantly inhibited by PD98059 pretreatment. (2) IL-13 protein in supernatants of asthmatic lymphocytes was higher than that produced by normal control lymphocytes, and was significantly increased by EGF treatment. This EGF effect was partly blocked by PD98059 pretreatment. (3) There was a significant positive correlation between the percentage of cells with p-ERK in peripheral blood lymphocytes and IL-13 protein in supernatants of lymphocytes from asthmatic rats.

Conclusions

In asthma the ERK expression and activation levels were increased, as was the protein level of IL-13. The ERK signaling pathway may be involved in the increased expression of the Th2 cytokine IL-13 in asthma.
Changes in immunological function after treatment with transarterial chemoembolization plus radiofrequency ablation in hepatocellular carcinoma patients
Authors: Guan Hai-tao , Wang Jian , Yang Ming , Song Li , Tong Xiao-qiang , Zou Ying-hua
Published: January 2024

Background

Different strategies for hepatocellular carcinoma (HCC) may have distinct effects on the immune system. The aim of this research was to investigate changes in the immunological function after transcatheter arterial chemoembolization (TACE) plus radiofrequency ablation (RFA) in HCC patients.

Methods

A total of 51 consecutive HCC treatment-naïve patients was enrolled in this study and 20 healthy subjects served as controls. The therapeutic strategy was selected according to the tumor stage and general conditions. TACE was performed in 25 cases, TACE plus RFA in 17 and RFA in nine. All the patients underwent routine examinations and peripheral blood was harvested for the detection of lymphocyte subset by flow cytometry 1 day before, and 2 and 4 weeks after the treatment. The serum levels of alpha-fetoprotein (AFP), ALT and AST were also measured before and 4 weeks after treatment for the evaluation of therapeutic efficacy and liver function impairment.

Results

When compared with healthy controls, the CD4/CD8 ratio and the number of B cells and natural killer (NK) cells were significantly decreased in HCC patients before treatment (P <0.05). When compared with before treatment, the CD4+ cells and CD4/CD8 ratio decreased but CD8+ cells increased in the TACE group (P <0.05); the CD4/CD8 ratio and NK cells decreased but CD8+ cells increased in the TACE-RFA group (P <0.05); the CD3+ cells, CD4+ cells, CD4/CD8 ratio and NK cells increased in the RFA group (P <0.05). Significant differences in the CD3+ cells, CD8+ cells, CD4/CD8 ratio and NK cells were observed among groups (P <0.05). Moreover, the AFP level decreased and transaminase level increased in all groups (P <0.05). Differences of pre and post treatment between groups were statistically significant (P =0.016, 0.025, 0.018 respectively).

Conclusions

Immunity was compromised in HCC patients; TACE and TACE plus RFA lowered immunologic function to a certain extent. RFA improved it accompanied by a protective effect on liver function.
Comparison of the effect of posterior lumbar interbody fusion with pedicle screw fixation and interspinous fixation on the stiffness of adjacent segments
Authors: LI Chun-de , SUN Hao-lin , LU Hong-zhang
Published: January 2024

Background

Adjacent segment degeneration could seriously affect the long-term prognosis of lumbar fusion. Dynamic fixation such as the interspinous fixation, which is characterized by retaining the motion function of the spinal segment, has obtained satisfactory short-term effects in the clinical setting. But there are few reports about the biomechanical experiments on whether dynamic fixation could prevent adjacent segment degeneration.

Methods

The surgical segments of all 23 patients were L4/5. Thirteen patients with disc herniation of L4/5 underwent Wallis implantation surgery, and 10 patients with spinal stenosis of L4/5 underwent posterior lumbar interbody fusion (PLIF). L3-S1 segmental stiffness and displacement were measured by a spine stiffness gauge (SSG) device during surgery when the vertebral plate was exposed or during spinal decompression or internal fixation. Five fresh, frozen cadavers were used in the self control experiment, which was carried out in four steps: exposure of the vertebral plate, decompression of the spinal canal, implantation of a Wallis fixing device, and PLIF of L4/5 after removing the Wallis fixing device. Then, L3-S1 segment stiffness was measured by an SSG device.

Results

The experiments showed that the average stiffness of the L4/5 segment was (37.1±8.9) N/mm after exposure of the vertebral plate, while after spinal decompression, the average stiffness fell to (26.2±7.1) N/mm, decreasing by 25.8% (P <0.05). For the adjacent segments L3/4 and L5/S1, their stiffness showed no significant difference between the L4/5 segment decompression and the exposure of the vertebral plate (P >0.05). After Wallis implantation of L4/5, the stiffness of the cephalic adjacent segment L3/4 was (45.8±10.7) N/mm, which was 20.5% more than that after the exposure of the vertebral plate (P <0.05); after L4/5 PLIF surgery, the stiffness of L3/4 was (35.3±10.7) N/mm and was decreased by 12.4% more than that after the exposure of the vertebral plate (P <0.05). The stiffness of the cephalic adjacent segment L3/4 after fixation in the Wallis group was significantly higher than that of the PLIF group (P <0.05). Cadaver experiments showed that the stiffness of the cephalic adjacent segment in the Wallis group was significantly higher than that of the PLIF group after L4/5 segment fixation (P <0.05); the stiffness of the L5/S1 segment showed no significant difference between PLIF surgery and Wallis implantation (P >0.05).

Conclusions

After interspinous (Wallis) fixation, the stiffness of the cephalic adjacent segment increased. After PLIF with pedicle screw fixation, the stiffness of the cephalic adjacent segment decreased. An interspinous fixation system (Wallis) has a protective effect for cephalic adjacent segments for the immediate post-operative state.
Outcome of contralateral C7 nerve transferring to median nerve
Authors: GAO Kai-ming , LAO Jie , ZHAO Xin , GU Yu-dong
Published: January 2024

Background

Contralateral C7 (cC7) transfer had been widely used in many organizations in the world, but the outcomes were significantly different. So the purpose of the study was to evaluate the outcome of patients treated with cC7 transferring to median nerve and to determine the factors affecting the outcome of this procedure.

Methods

A retrospective review of 51 patients with total root avulsion brachial plexus injuries who underwent cC7 transfer was conducted. All of the surgeries were performed with two surgery stages and median nerve was the recipient nerve. The cC7 nerve was used in three different ways. The entire C7 root was used in 11 patients; the posterior division together with the lateral part of the anterior division was used in 15 patients; the anterior or the posterior division alone was used in 25 patients. The mean follow-up period was 6.9 years.

Results

The efficiency of the surgery in these 51 patients was 49.02% in motor and 62.75% in sensory function. The patients with entire C7 root transfer obtained significantly better recovery in both motor and sensory function than the patients with partial C7 transfer. The best function recovery could be induced if the interval between the two surgery stages was 4-8 months.

Conclusions

cC7 transfer is an effective procedure in repairing median nerve. But using the entire C7 root transfer can obtain better recovery; so we emphasize using the entire root as the donor. The optimal interval between two surgery stages is 4-8 months.
Comparison between Doppler echocardiography and hot-film anemometry in measuring the turbulent shear stress downstream of artificial mitral valves: a methodological study
Authors: SUN Yi , LI Rui-jie , LI Gan-niu , LI Bin , WANG Yu , MA Run-wei , YANG Bai-hui , LU Sen-lin , ZHANG Gui-min
Published: January 2024

Background

Turbulent shear stress (TSS) plays an important role in the research of fluid dynamics of heart valves. This study aimed to perform a quantitative study of TSS downstream of porcine artificial mitral valves in order to verify the correlation of hot-film anemometry (HFA) and Doppler echocardiography combined with computer-aided image analysis for the detection of TSS.

Methods

A porcine model of mitral valve replacement was established. HFA and Doppler ultrasound techniques were used to directly and indirectly measure TSS-relevant parameters of the artificial mitral valve following different mitral valve replacements: different approaches were used to reserve the subvalvular apparatus of the mitral valve. A correlation analysis was then carried out.

Results

There was a significant correlation between the HFA and Doppler ultrasound combined with computer-aided image analysis of the TSS at the same time and at the same site. No significant difference was found in the TSS measured by the two methods.

Conclusions

Compared with HFA, Doppler echocardiography combined with computer-aided image analysis is a safe, non-invasive, and real-time method that enables accurate and quantitative detection of TSS downstream in vivo, objectively reflecting the flow field downstream of the artificial mitral valve. Doppler ultrasound combined with computer-aided image analysis can be employed for quantitatively evaluating the downstream hemodynamic performance of the mitral valve.
Association of NFATc1 gene polymorphism with ventricular septal defect in the Chinese Han population
Authors: SHEN Lei , LI Zhong-zhi , SHEN A-dong , LIU Hui , BAI Song , GUO Jian , YUAN Feng , LI Xiao-feng
Published: January 2024

Background

Congenital heart disease (CHD) is a diverse group of diseases determined by genetic and environmental factors. Considerable research has been done on genes associated with the development of the heart. Recently, focus is on the role of transcription factor NFATc1 in the development of proper valve and septa. As part of a larger study, high density single nucleotide polymorphism (SNP) scanning was used to explore the relationship between NFATc1 gene polymorphism and susceptibility to ventricular septal defect (VSD) in the Chinese Han population.

Methods

One hundred and ninety-two pediatric patients with congenital VSD and 192 matching healthy control subjects were studied. The haplotype reconstructions were calculated by PHASE2.0 software. Haploview software was used to perform linkage disequilibrium assessment and define haplotype blocks. The algorithm used for defining the blocks was the confidence interval method.

Results

The NFATc1 gene region can be divided into 11 haplotype blocks. Strong linkage disequilibrium existed within blocks 6, 8, 9, and 11. Three SNPs (rs7240256, rs11665469, and rs754505) within the NFATc1 gene had significant correlation with VSD by single marker association analysis. In addition, two haplotypes correlated with VSD.

Conclusions

NFATc1 is associated with the occurrence of VSD and it may be a predisposing gene to CHD in Han Chinese. This finding has set a direction for further genetic and functional studies.
Prevalence and clinical prognosis of heteroresistant vancomycin-intermediate Staphylococcus aureus in a tertiary care center in China
Authors: WANG Yan , HU Yun-jian , AI Xiao-man , XU Hong-tao , SUN Tie-ying
Published: January 2024

Background

The emergence of heteroresistant vancomycin-intermediate Staphylococcus aureus (hVISA) is increasingly challenging the methods for detection in diagnostic microbiology laboratories. However, the report of hVISA is rare in China. This study summarizes the prevalence and clinical features associated with hVISA infections at our institution and the local impact they have on clinical outcome.

Methods

A total of 122 methicillin-resistant Staphylococcus aureus (MRSA) isolates which were of the causative pathogens were collected. One hundred and two patients for whom we had full information of MRSA pneumonia were included. Isolates of MRSA were collected using PCR to detect the mecA gene. Both Etest and macro Etest were performed to screen for hVISA. The Staphylococcal chromosome cassette mec (SCCmec) types were determined by multiplex PCR strategy. Logistic regression analysis was used to determine the risk factors.

Results

Among the 122 MRSA isolates collected, 25 (20.5%) strains were identified as hVISA. There were 119 (97.5%) SCCmec III isolates, two (1.6%) SCCmec II isolates, and one (0.8%) SCCmec V isolate. The 30-day mortality of MRSAhospital acquired pneumonia (HAP) was 37.3%, and 62.5% for hVISA-HAP. Vancomycin treatment was the independent risk factor of hVISA. Factors independently associated with 30-day mortality in all patients were acute physiology and Chronic Health Evaluation (APACHE) II score >20, multiple lobe lesions, and creatinine clearance rate (CCR) <15 ml/min.

Conclusions

The prevalence of hVISA is 20.5% at our institution. hVISA-HAP patients had a poor clinical outcome. Vancomycin treatment was the independent predictors for hVISA infection. Factors independently associated with 30-day mortality in all patients were APACHE II score >20, multiple lobe lesions and CCR <15 ml/min.
Comparison of immunohistochemistry with fluorescence in situ hybridization in determining the human epidermal growth factor receptor 2 status of breast cancer specimens: a multicenter study of 3 149 Chinese patients
Authors: Han Xiaohong , Shi Yuankai , Ma Li , Lyu Zheng , Yang Hongying , Yao Jiarui , Li Jian , Li Bo , Qin Yan
Published: January 2024

Background

Accurate detection of human epidermal growth factor receptor 2 (HER2) expression and gene amplification is crucial for the application of HER2-specific therapy and for evaluating the response of patients with breast cancer. A uniform and standard procedure of immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH) needs to be established for evaluating the HER2 status in breast cancer tissues for the treatment of patients with real HER2-positive tumors. The present multicenter study was aimed to examine the HER2 status in breast cancer specimens from Chinese patients using both IHC and FISH methods.

Methods

A multicenter study was performed on the HER2 status in 3 149 breast cancer specimens from different ethnic populations and areas in China by IHC and FISH assays. The potential association of HER2 status with demographic and clinical characteristics was analyzed.

Results

The positive rates for HER2 over-expression and HER2 amplification were 23.3% and 27.5% in this study, respectively. The concordance between IHC and FISH was 71.2% (κ=0.494, P <0.001). Furthermore, 72.9% of specimens with IHC 2+ were negative to FISH. The discordance rates among laboratories were from 5% to 28% for IHC and 1% to 16% for FISH. HER2 amplification was associated significantly with advanced tumor stage (III or IV, P=0.002), large tumor size (>5 cm, P=0.002), moderate and poor histological grades (P <0.0001), post-menopause (P <0.0001), ER-PR- (P=0.002), and having ≥4 lymph nodes affected (P <0.0001) in this population. The positive rates of HER2 amplification in specimens from Man and Hui Chinese were significantly higher than that in other Chinese populations. There are slightly higher positive rates of HER2 expression and amplification in Chinese patients with breast cancer.

Conclusion

These findings may provide new insights into understanding the epidemiological features of HER2 expression and amplification, and may be valuable for clinical practice.