Biomechanics-mediated endocytosis in atherosclerosis.

Biomechanical forces, including vascular shear stress, cyclic stretching, and extracellular matrix stiffness, which influence mechanosensitive channels in the plasma membrane, determine cell function in atherosclerosis. Being highly associated with the formation of atherosclerotic plaques, endocytosis is the key point in molecule and macromolecule trafficking, which plays an important role in lipid transportation. The process of endocytosis relies on the mobility and tension of the plasma membrane, which is sensitive to biomechanical forces. Several studies have advanced the signal transduction between endocytosis and biomechanics to elaborate the developmental role of atherosclerosis. Meanwhile, increased plaque growth also results in changes in the structure, composition and morphology of the coronary artery that contribute to the alteration of arterial biomechanics. These cross-links of biomechanics and endocytosis in atherosclerotic plaques play an important role in cell function, such as cell phenotype switching, foam cell formation, and lipoprotein transportation. We propose that biomechanical force activates the endocytosis of vascular cells and plays an important role in the development of atherosclerosis.

Time series analysis of using the PDCA method combined with the Teach-back method to improve spontaneous reports of adverse drug reactions in a grade IIIA hospital in China.

BACKGROUND: Spontaneous reporting of adverse drug reactions (ADRs) is essential for the post-marketing safety evaluation of drugs. Therefore, good monitoring of ADRs is vital for strengthening drug supervision, management, and guiding rational drug use. Chinese medical institutions are the primary source of ADR case reports, but the proportion of the reports in grade IIIA hospitals is still low due to serious under-reporting. The 3rd Affiliated Hospital of Chengdu Medical College, Chengdu Pidu District People's Hospital, also has such a problem. OBJECTIVE: To improve the quantity and quality of ADR reports and enhance the level of pharmacovigilance in hospitals, the Third Affiliated Hospital of Chengdu Medical College, People's Hospital of Chengdu Pidu District experienced 10 years to gradually establish a management model to improve the medical staff's reporting rate of spontaneous reporting of ADRs. The management model is led by clinical pharmacists and combines the PDCA with Teach-back methods. The purpose of this paper is to introduce the management model and discuss its advantages and shortcomings of this model. METHODS: This study was conducted at the Third Affiliated Hospital of Chengdu Medical College-Chengdu Pidu District People's Hospital. From 2016, the daily management of reporting, auditing, and data improvement of adverse drug reactions in the hospital was carried out by clinical pharmacists, who used the PDCA method combined with the Teach-back method to continuously improve the reporting program of ADRs in the hospital during 2016-2021. Then, the proportion of spontaneous reports of total, new, and serious ADRs was compared before and after the intervention. Also, we performed a time series analysis using an autoregressive moving average model to assess changes in the total number of spontaneous ADR reports before the intervention (2013-2015), the first intervention (2016-2018), and the second intervention (2019-2021). RESULTS: After the combined PDCA and Teach-back method intervention, the median number of reported ADRs per year increased from 50 (range 37-55) in the pre-intervention period to 88 (range 83-162) in the first intervention period and to 374 in the second (range 312-566). Breakpoint regression analysis of the spontaneous reporting rate of ADRs showed that the instantaneous increase after the first intervention was not statistically significant (P = 0.526). However, the reporting rate of ADRs increased at a month-by-month growth rate during the second intervention compared to the first intervention. Its spontaneous reporting rate improved 1.034 times (P = 0.002). After the second intervention, the spontaneous reporting rate of ADRs transiently increased 6.111-fold (P < 0.001), and the month-to-month growth rate increased 1.024-fold (P < 0.001) again. CONCLUSION: The management model that combines the PDCA and the Teach-back method significantly improves the reporting rate of adverse drug reactions.

Prognosis of patients with familial hypertrophic cardiomyopathy: A single-center cohort study with ten-year follow-up by propensity score matching analysis.

Objectives: Hypertrophic cardiomyopathy (HCM) is the most common hereditary cardiomyopathy. However, few studies have investigated the prognosis of familial HCM (FHCM) through clinical data. The purpose of this study was to compare the clinical outcomes of FHCM and non-FHCM through propensity score matching analysis. Methods and results: The cohort study included 1243 patients with HCM between 1996 and 2013 in Fuwai Hospital, Chinese Academy of Medical Sciences, among whom 125 patients had FHCM. During a mean follow-up of 7.6 ± 3.8 years (interquartile range: (IQR) 5.0-10.0 years), 217 (16.57%) of the 1243 patients had died, including 3 patients who underwent cardiac transplantation. Using 30 demographic and clinical variables, a 4:1 propensity score matched cohort for FHCM was established. The stepwise variable selection procedure for the Cox proportional hazards model was performed to identify the factors associated with mortality and competing risk regression analysis was performed to analyze the competitive risk of cardiovascular and non-cardiovascular mortality. The results showed that FHCM patients had a higher risk of cardiovascular mortality/cardiac transplantation (log-rank χ2 = 6.8, P = 0.0084) and an increased tendency of sudden cardiac death (SCD) (log-rank χ2 = 3.2, P = 0.074) compared with non-FHCM patients, but there was no difference in all-cause mortality (log-rank χ2 = 2.7, P = 0.1) between the two groups. Moreover, the Cox model showed that FHCM was an independent prognostic predictor for cardiovascular mortality/cardiac transplantation in HCM patients. Conclusion: FHCM patients had a higher risk of cardiovascular mortality/cardiac transplantation and a higher tendency of SCD than non-FHCM patients, but there was no difference in all-cause mortality. Moreover, FHCM was an independent prognostic predictor for cardiovascular mortality/cardiac transplantation in HCM patients.

Potential Factors of Primary Hospital Healthcare Professionals in Hindering the Abolition of Routine Skin Test for Cephalosporin: A Cross-Sectional Study.

Background: In 2021, National Health Commission of the People's Republic of Chinese issued a document that no longer recommended the routine skin test for cephalosporin (RSTC). However, there is still resistance to the cancellation of RSTC in a primary hospital. The study aimed to explore the potential factors for hindering the abolition of the RSTC in a county-level hospital based on the PRECEDE model. Methods: The cross-sectional study was conducted on healthcare workers in the Pidu District People's Hospital, Chengdu, by online questionnaire from September 10 to September 25 in the 2021.The PRECEDE model was used to divide the potential factors of healthcare professionals in hindering the abolition of the RSTC into predisposing factors, enabling factors and reinforcing factors. Data were analyzed by ANOVA, Chi-square test, multiple linear and multiple logistic regression analysis. Results: We collected 605 respondents' valid questionnaires. 254 healthcare professionals were against cancellation of the RSTC, accounting for 41.98%. Multiple linear regression analysis showed that working for 6~10 years (ß = 1.953, P = 0.024), medium (ß = 1.995, P = 0.030) or senior (ß = 4.003, P = 0.007) professional qualification, pharmacists (ß = 3.830, P = 0.013) and working in surgical department (ß= 4.462, P < 0.001) were significantly associated with higher score of predisposing factors, enabling factors, and reinforcing factors on abolition of RSTC. Furthermore, multiple logistic regression analysis showed that pharmacists (OR=3.113, 95% CI: 1.341-7.223, P=0.030), medium professional qualification (OR=1.272, 95% CI: 0.702-2.302, P=0.008), scores of predisposing factors (OR=1.335, 95% CI: 1.033-1.726, P=0.009), and scores of enabling factors (OR=1.208, 95% CI: 1.109-1.315, P<0.001) were independently associated with the positive anticipated behavior on the abolition of RSTC. While nurses (OR=0.516, 95% CI: 0.284-0.938, P<0.001) were independently associated with anticipated negative behavior. Conclusion: Pharmacists, medium professional qualification, and healthcare professionals with higher scores of predisposing and enabling factors were more likely to have a positive anticipated behavior on the abolition of RSTC, while nurses did not.

Prognosis for patients with apical hypertrophic cardiomyopathy: A multicenter cohort study based on propensity score matching.

BACKGROUND: Apical hypertrophic cardiomyopathy (AHCM) is a subtype of HCM, and few studies on the prognosis in AHCM are available. AIMS: This study aimed to explore the clinical prognosis for AHCM and non-AHCM patients through clinical data based on propensity score matching (PSM) in a large cohort of Chinese HCM patients. METHODS: The cohort study included 2268 HCM patients, 226 AHCM and 2042 non-AHCM patients from 13 tertiary hospitals, who were treated between 1996 and 2021. Fifteen demographic and clinical variables of 226 AHCM patients and 2042 non-AHCM patients were matched using 1:2 PSM. A Cox proportional hazard regression model was constructed to assess the effect of AHCM on mortality. RESULTS: During a median follow-up of 5.1 (2.4-8.4) years, 353 (15.6%) of the 2268 HCM patients died, of whom 205 died due to cardiovascular mortality/cardiac transplantation and 94 experienced sudden cardiac death (SCD). In the matched cohort, the ACHM patients had lower rates of all-cause mortality (P = 0.003), cardiovascular mortality/cardiac transplantation (P = 0.03), and SCD (P = 0.02) than the non-AHCM patients. Furthermore, the Cox proportional hazard regression model showed that AHCM was an independent prognostic predictor of all-cause HCM mortality (P = 0.004) and a univariable prognostic predictor of cardiovascular mortality/cardiac transplantation (P = 0.03) and for SCD (P = 0.03). However, AHCM was not significant in multivariable Cox regression models in relation to cardiovascular mortality/cardiac transplantation and SCD. CONCLUSION: AHCM had a favorable prognosis both before and after matching, with lower all-cause mortality, cardiovascular mortality/cardiac transplantation, and SCD than non-AHCM.

Diagnostic Accuracy of Deep Learning and Radiomics in Lung Cancer Staging: A Systematic Review and Meta-Analysis.

Background: Artificial intelligence has far surpassed previous related technologies in image recognition and is increasingly used in medical image analysis. We aimed to explore the diagnostic accuracy of the models based on deep learning or radiomics for lung cancer staging. Methods: Studies were systematically reviewed using literature searches from PubMed, EMBASE, Web of Science, and Wanfang Database, according to PRISMA guidelines. Studies about the diagnostic accuracy of radiomics and deep learning, including the identifications of lung cancer, tumor types, malignant lung nodules and lymph node metastase, were included. After identifying the articles, the methodological quality was assessed using the QUADAS-2 checklist. We extracted the characteristic of each study; the sensitivity, specificity, and AUROC for lung cancer diagnosis were summarized for subgroup analysis. Results: The systematic review identified 19 eligible studies, of which 14 used radiomics models and 5 used deep learning models. The pooled AUROC of 7 studies to determine whether patients had lung cancer was 0.83 (95% CI 0.78-0.88). The pooled AUROC of 9 studies to determine whether patients had NSCLC was 0.78 (95% CI 0.73-0.83). The pooled AUROC of the 6 studies that determined patients had malignant lung nodules was 0.79 (95% CI 0.77-0.82). The pooled AUROC of the other 6 studies that determined whether patients had lymph node metastases was 0.74 (95% CI 0.66-0.82). Conclusion: The models based on deep learning or radiomics have the potential to improve diagnostic accuracy for lung cancer staging. Systematic Review Registration: https://inplasy.com/inplasy-2022-3-0167/, identifier: INPLASY202230167.

Correlation Between Non-insulin-Based Insulin Resistance Indices and Increased Arterial Stiffness Measured by the Cardio-Ankle Vascular Index in Non-hypertensive Chinese Subjects: A Cross-Sectional Study.

Data are limited on the relationship between the cardio-ankle vascular index (CAVI) and non-insulin-based insulin resistance (IR) indices, including the triglyceride to high-density lipoprotein cholesterol ratio (TG/HDL-C), fasting triglyceride and glucose index (TyG), and metabolic score for IR (METS-IR). In this study, we explored the relationship between TG/HDL-C, TyG, METS-IR, and the risk of increased arterial stiffness (CAVI ≥ 8.0) and compared their ability to detect arterial stiffness in the non-hypertensive Chinese population. A total of 3,265 non-hypertensive subjects were included. Spearman's and partial correlation analyses were used to assess the relationship between non-insulin-based IR indices and CAVI. The correlation between these indices and the risk of a CAVI ≥ 8.0 was explored by multiple logistic regression analysis. The area under the receiver-operating characteristic curve was used to compare the ability of TG/HDL-C, TyG, and METS-IR to detect a CAVI ≥ 8.0. After adjustment for confounding factors, linear regression analysis showed that the CAVI changed by 0.092 [95% confidence interval (CI) 0.035-0.149] per standard deviation increase in TyG. While, this linear relationship was not found when analyzing TG/HDL-C and METS-IR. Multiple logistic regression analysis showed that the proportion of patients with CAVI ≥ 8.0 in the fourth quartile of TG/HDL-C [Q4 vs. Q1: odds ratio (OR) 2.434, 95% CI 1.489-3.975], TyG (Q4 vs. Q1: OR 2.346, 95% CI 1.413-3.896), and METS-IR (Q4 vs. Q1: OR 2.699, 95% CI 1.235-5.897) was significantly higher than that in the lowest quartile. The area under the curve that could discriminate CAVI ≥ 8.0 was 0.598 (95% CI 0.567-0.629) for TG/HDL-C, 0.636 (95% CI 0.606-0.667) for TyG, and 0.581 (95% CI 0.550-0.613) for METS-IR. In this study, we demonstrated a significant association between increased arterial stiffness and non-insulin-based IR indices. Among them, TyG showed better discriminatory ability than TG/HDL-C or METS-IR.

Shedding of SARS-CoV-2 for 85 Days in COVID-19 Patients With Type 2 Diabetes Mellitus and Lung Metastasis: A Case Report.

Background: COVID-19 (coronavirus disease 2019) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) seriously endangers people's lives. The variation in SARS-CoV-2 makes the research and development of vaccines and specific drugs particularly important. However, the prevention and diagnosis of COVID-19 cannot be underestimated in the control of the epidemic. Case Presentation: We introduced a 65-year-old female patient who was diagnosed with COVID-19. The SARS-CoV-2 nucleic acid test result of this patient was positive again during treatment. It took 85 days from the first symptom to the final cure. According to the known reports, she is currently the patient with the longest virus shedding in Sichuan Province, China. Due to the patient's special condition, she was treated in four hospitals before and after, and she was diagnosed with type 2 diabetes mellitus (T2DM) and right lung metastatic adenocarcinoma. We fully introduced the patient's epidemiological history, diagnosis, testing, and treatment process. The patient was finally discharged from the hospital under the treatment of antiviral, hypoglycaemic, anti-anxiety, and a combination of Chinese and Western medicine. Conclusions: The epidemic is still rampant, and we should not relax our efforts in the prevention and control of viruses. For the elderly, especially those who are suffering from complications or vulnerable to diseases, it is recommended to extend the observation time. Additionally, medical workers should pay attention to the mental state of patients.

Correlation between non-insulin-based insulin resistance indexes and the risk of prehypertension: A cross-sectional study.

The authors aimed to characterize the relationships between non-insulin-based insulin resistance (IR) indexes and the risk of prehypertension, and to compare their abilities to identify prehypertension. The authors recruited 3274 adults who did not have hypertension and were not taking hypoglycemic or lipid-lowering medications. The triglyceride-to-high-density lipoprotein-cholesterol ratio (TG/HDL-C), fasting triglyceride and glucose index (TyG), and metabolic score for IR (METS-IR) were calculated. Bivariate Spearman's correlation analysis and multiple logistic analysis were used. The area under the receiver operating characteristic (ROC) curve was used to compare the ability of the three indexes to identify prehypertension. Systolic and diastolic blood pressure (BP) positively correlated with TG/HDL-C (r = .272, P < .001), TyG (r = .286, P < .001), and METS-IR (r = .340, P < .001) in the entire cohort. Multiple logistic analysis showed that the proportion of prehypertension in the third and fourth quartiles of the TG/HDL-C (Q3 vs. Q1: odds ratio (OR) = 1.527, 95% confidence interval (CI): 1.243-1.988; Q4 vs. Q1: OR = 1.580, 95% CI: 1.231-2.028), TyG (Q3 vs. Q1: OR = 1.519, 95% CI: 1.201-1.923; Q4 vs. Q1: OR = 1.658, 95% CI: 1.312-2.614), and METS-IR (Q3 vs. Q1: OR = 1.542, 95% CI: 1.138-2.090; Q4 vs. Q1:OR = 2.216, 95% CI: 1.474-3.331) were significantly higher than in the lowest quartiles. The areas under the curves and 95% CIs for the identification of prehypertension were .647 (.628-.667) for TG/HDL-C, .650 (.631-.669) for TyG, and .683 (.664-.702) for METS-IR, respectively. Thus, non-insulin-based IR indexes (TG/HDL-C, TyG, and METS-IR) are significantly associated with the risk of prehypertension. Furthermore, METS-IR is better able to identify prehypertension than TG/HDL-C and TyG. These non-insulin-based IR indexes might assist with the prevention of hypertension in primary care and areas with limited medical resources.

Effect of holistic rehabilitation nursing on postoperative neurological function recovery and limb function improvement in patients with intraintracerebral hemorrhage.

OBJECTIVE: The aim of this study was to explore the effect of holistic rehabilitation nursing on postoperative neurological functional recovery and limb function improvement in patients with intraintracerebral hemorrhage (ICH). METHODS: One hundred and twelve patients with ICH treated in our hospital were divided into the observation group (n=56) for holistic rehabilitation nursing and the control group (n=56) for routine nursing by a random number table. The neurological function [the National Institutes of Health Stroke Scale (NIHSS)], limb function (Fugl Meyer Assessment, FMA), psychological state (Hamilton Anxiety/Depression Scale, HAMA/HAMD), activities of daily living (ADL score) and nursing satisfaction were compared between the two groups. RESULTS: After two weeks of intervention, NIHSS, HAMA, HAMD and ADL scores all decreased in the two groups, and were even lower in the observation group (all P<0.05); the scores of FMA and Simple Test for Evaluating hand Function (STEF) increased, and the scores were higher in the observation group as compared to the control group (both P<0.05). The nursing satisfaction of patients in the observation group was higher than that in the control group (P<0.05). CONCLUSION: Holistic rehabilitation nursing intervention is more conducive to the recovery of postoperative neurological function and limb function improvement in patients with ICH, and meanwhile, it can alleviate the adverse psychological mood of patients and significantly improve their activities of daily living after operation.

An infant with a mild SARS-CoV-2 infection detected only by anal swabs: a case report

ABSTRACT Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in Wuhan, China and has spread rapidly worldwide. We present a mild SARS-CoV-2 infection in a baby with non-productive cough and normal chest computed tomography, in whom only anal swabs tested positive by real-time PCR testing for SARS-CoV-2. She was given atomization inhalation therapy with recombinant human interferon alfa-1b for 10 days. Her anal swabs remained positive for eight days, whereas her throat swabs were persistently negative by real-time PCR testing. Mild and asymptomatic cases, especially in children, might present with PCR negative pharyngeal/nasal swabs and PCR positive anal swabs. Those patients are potential sources of infection via fecal-oral transmission for COVID-19.

An infant with a mild SARS-CoV-2 infection detected only by anal swabs: a case report.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in Wuhan, China and has spread rapidly worldwide. We present a mild SARS-CoV-2 infection in a baby with non-productive cough and normal chest computed tomography, in whom only anal swabs tested positive by real-time PCR testing for SARS-CoV-2. She was given atomization inhalation therapy with recombinant human interferon alfa-1b for 10 days. Her anal swabs remained positive for eight days, whereas her throat swabs were persistently negative by real-time PCR testing. Mild and asymptomatic cases, especially in children, might present with PCR negative pharyngeal/nasal swabs and PCR positive anal swabs. Those patients are potential sources of infection via fecal-oral transmission for COVID-19.

Comparative Study of Percutaneous Sacroiliac Screw with or without TiRobot Assistance for Treating Pelvic Posterior Ring Fractures.

OBJECTIVES: To analyze the curative effect of TiRobot surgical robotic navigation and location system-assisted percutaneous sacroiliac screw fixation and percutaneous sacroiliac screw by traditional fluoroscopy, and to summarize the safety and benefits of TiRobot. METHODS: A total of 91 patients with pelvic posterior ring fractures from December 2015 to February 2018 were included in this study. According to the surgical methods selected by the patients, the patients were divided into a TiRobot surgical robotic navigation and location system group (TiRobot group) and a percutaneous sacroiliac screw fixation group (traditional group). Statistical indicators included the number of sacroiliac screws, the time of planning the sacroiliac screw path, fluoroscopy frequency, fluoroscopy time, operation time, length of incision, blood loss, anesthesia time, the healing process of skin incisions, and fracture healing time. Fracture reduction was evaluated according to the maximum displacement degree at the inlet and outlet view X-ray or CT. Matta standard was used to evaluate fracture reduction. At the last follow-up, the Majeed function system was used to evaluate the function. RESULTS: All patients were followed up for 8 to 32 months. A total of 66 sacroiliac screws were implanted in the TiRobot group. A total of 43 sacroiliac screws were implanted in the traditional group. There were statistically significant differences in terms of fluoroscopy frequency, fluoroscopy time, operation time, incision length, anesthesia time, and blood loss between the two groups; the TiRobot group was superior to the traditional group. The healing time of the TiRobot group and the traditional group was 4.61 ± 0.68 months (range, 3.5-6.3 months) and 4.56 ± 0.78 months (range, 3.4-6.2 months), respectively, and there was no statistical difference. Postoperatively, by Matta standard, the overall excellent and good rate of fracture reduction was 89.28% and 88.57%, respectively. At the last follow-up, by Majeed function score, the overall excellent and good rate was 91.07% and 91.43%. There was no statistical difference between the two groups. CONCLUSION: Sacroiliac screw implantation assisted by TiRobot to treat the posterior pelvic ring fractures has the characteristics of less trauma, shorter operation time, and less blood loss. TiRobot has the characteristics of high safety and accuracy and has great clinical application value.

Intramedullary Nail Fixation Assisted by Orthopaedic Robot Navigation for Intertrochanteric Fractures in Elderly Patients.

OBJECTIVE: To compare the clinical efficacy of intramedullary nail fixation for intertrochanteric fractures assisted by orthopaedic robot navigation and the traditional intramedullary nail fixation in elderly patients, and to investigate the application advantages of intramedullary nail fixation for femoral intertrochanteric fractures assisted by orthopaedic robot navigation in the elderly. METHODS: Among the 51 patients with intertrochanteric fractures who were selected from April 2015 to September 2017 in the Affiliated Hospital of Chengdu University, 25 patients underwent the intramedullary nail fixation assisted by orthopaedic robot navigation (orthopaedic robot navigation surgery group) and 26 patients underwent the traditional intramedullary nail fixation (traditional surgery group). The operation time, the number of intraoperative fluoroscopy images taken, the frequency of guide pins inserted into the femoral marrow cavity, the amount of intraoperative bleeding, and the one-time success rate of the guide pin inserted into the femoral marrow cavity were recorded. Fracture healing and internal fixation were observed. The Harris score was used to evaluate hip joint function 1 year after surgery. RESULTS: All patients were followed up for 12-24 months. The operation time was 65.44 ± 8.01 min in the orthopaedic robot navigation surgery group and 77.50 ± 16.64 min in the traditional surgery group. The number of intraoperative fluoroscopy images taken was 10.28 ± 0.61 in the orthopaedic robot navigation surgery group and 13.23 ± 1.75 in the traditional surgery group. The frequency of guide pins inserted into the femoral marrow cavity was 1.00 ± 0.00 times in the orthopaedic robot navigation surgery group and 2.46 ± 1.10 times in the traditional surgery group. The one-time success rate of intramedullary pin puncture was 100% (25/25) in the orthopaedic surgical robot navigation surgery group and 19.23% (5/26) in the traditional surgery group. The amount of surgical bleeding was 90.80 ± 14.98 mL in the orthopaedic robot navigation surgery group and 118.46 ± 32.21 mL in the traditional surgery group. Compared with the traditional surgery group, the operation time of the orthopaedic surgical robot navigation surgery group was shorter (P < 0.05), the number of intraoperative fluoroscopy images taken was fewer (P < 0.05), the frequency of guide pins inserted into the femoral marrow cavity was lower (P < 0.05), the one-time success rate of intramedullary pin puncture was higher (P < 0.05), and the amount of surgical bleeding was less (P < 0.05). One year after surgery, fracture healing occurred in both groups without failure of internal fixation or fracture displacement. The Harris score of hip function in the orthopaedic robot navigation surgery group was 86.68 ± 6.23 and that in the traditional surgery group was 82.69 ± 6.85. It was higher than that in the traditional surgery group (P < 0.05). The fine rate of hip joint function in the orthopaedic robot navigation surgery group was 84.00% (21/25) and that in the traditional surgery group was 73.07% (19/26). There was no significant difference between the two groups (P > 0.05). CONCLUSION: Intramedullary nail fixation for intertrochanteric fractures assisted by orthopaedic robot navigation in elderly patients is an ideal method, offering a short operation time, minimal surgical trauma, less radiation, and good recovery of hip function.

Comprehensive analysis of serum metabolites in gestational diabetes mellitus by UPLC/Q-TOF-MS.

Gestational diabetes mellitus (GDM) refers to the first sign or onset of diabetes mellitus during pregnancy rather than progestation. In recent decades, more and more research has focused on the etiology and pathogenesis of GDM in order to further understand GDM progress and recovery. Using an advanced metabolomics platform based on ultra-performance liquid chromatography quadrupole time-of-flight mass spectrometry (UPLC/Q-TOF-MS), we explored the changes in serum metabolites between women with GDM and healthy controls during and after pregnancy. Some significant differences were discovered using multivariate analysis including partial least-squares discriminant analysis (PLS-DA) and orthogonal PLS-DA (OPLS-DA). The dysregulated metabolites were further compared and verified in several databases to understand how these compounds might function as potential biomarkers. Analyses of the metabolic pathways associated with these potential biomarkers were subsequently explored. A total of 35 metabolites were identified, contributing to GDM progress to some extent. The identified biomarkers were involved in some important metabolic pathways including glycine, serine, and threonine metabolism; steroid hormone biosynthesis; tyrosine metabolism; glycerophospholipid metabolism; and fatty acid metabolism. The above mentioned metabolic pathways mainly participate in three major metabolic cycles in humans, including lipid metabolism, carbohydrate metabolism, and amino acid metabolism. In this pilot study, the valuable comprehensive analysis gave us further insight into the etiology and pathophysiology of GDM, which might benefit the feasibility of a rapid, accurate diagnosis and reasonable treatment as soon as possible but also prevent GDM and its related short- and long-term complications.

Diabetic muscle infarction in a patient admitted to the cardiac ward.

Diabetic muscle infarction (DMI) is a rare complication of long-standing diabetes mellitus. This is the first case of DMI reported by cardiologists. A 49-year-old patient with a history of diabetes and hypertension for only two years was admitted to the cardiac ward due to pain in the left thigh with pitting edema in both lower extremities. Magnetic resonance imaging finally confirmed the presence of DMI in the left thigh, which was improved by treatment with anticoagulants, analgesics and rest. However, the typical clinical symptoms of DMI were unrecognizable at the start of treatment, which may be attributed to a lack of awareness of this rare condition among non-endocrinologist physicians.

Multi-center, multi-topic heart sound databases and their applications.

This paper describes a large resource of multi-center and multi-topic heart sound databases, which were based on the measured data from more than 9,000 heart sound samples (saved in WAV file format). According to different research topics, these samples were respectively stored in different folders (corresponding to different research topics and distributed over various cooperative research centers), most of which as subfolds were stored in a pooled folder in the principal center. According to different research topics, the measured data from these samples were used to create different databases. Relevant data for a specific topic can be pooled in a large database for further analysis. This resource is shared by members of related centers for their own specific topic. The applications of this resource include evaluation of cardiac safety of pregnant women, evaluation of cardiac reserve for children, athletes, addicts, astronauts, and general populations, as well as studies on a bedside method for evaluating cardiac energy, reversal of S1-S2 ratio, etc.