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Aim: To investigate whether it is safe for patients with Omicron variant infection to undergo surgery during perioperative period. Methods: A total of 3,661 surgical patients were enrolled: 3,081 who were not infected with the Omicron variant and 580 who were infected with the Omicron variant. We conducted propensity score matching (PSM) with a ratio of 1:4 and a caliper value of 0.1 to match the infected and uninfected groups based on 13 variables. After PSM, we further divided the Infected group (560 cases) by the number of days between the preoperative Omicron variant infection and surgery: 0-7, 8-14, 15-30, and >30 days. Multivariate logistic regression analysis was subsequently conducted on the categorical variables and continuous variables with a P value below 0.05, thereby comparing the infected group (0-7, 8-14, 15-30, >30 days) and the uninfected group for perioperative complications. Results: Multivariate logistic regression analysis revealed that, compared to the uninfected group, among the four subgroups of the infected patients (0-7, 8-14, 15-30, >30 days), only renal insufficiency in the 8-14 days subgroup (OR: 0.09, 95%CI 0.01-0.74, P = 0.025) and anemia in the > 30 days subgroup (OR 0.6, 95%CI 0.4-0.9, P < 0.017) showed significant difference. However, there was no statistically significant difference in the incidence rate of blood transfusion, postoperative intensive care unit transfer, lung infection/pneumonia, pleural effusion, atelectasis, respiratory failure, sepsis, postoperative deep vein thrombosis, hypoalbuminemia, urinary tract infections, and medical expenses. Conclusion: Omicron infection does not significantly increase the risk of perioperative major complications. The Omicron infection may not be a sufficient risk factor to postpone elective surgery.
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Procedimentos Cirúrgicos Eletivos , Hipoalbuminemia , Humanos , Estudos de Casos e Controles , Pontuação de Propensão , Procedimentos Cirúrgicos Eletivos/efeitos adversos , Unidades de Terapia IntensivaRESUMO
Purpose: We aimed to investigate the impact of Omicron variant infection on the perioperative organ function in patients undergoing elective surgery. Methods: A total of 5029 patients who underwent elective surgery between October 2022 and January 2023 at our hospital were enrolled. Among them, the patients who underwent elective surgery between October 2022 and November 2022 composed Group 1 (not infected with the Omicron variant) the control group; those who underwent elective surgery between December 2022 and January 2023 composed Group 2 (one month after Omicron variant infection) the experimental group. We further divided the patients into two subgroups for analysis: the tumor subgroup and the nontumor subgroup. Data on organ system function indicators, including coagulation parameters, liver function, complete blood count (CBC), and kidney function, were collected before and after surgery. Differences between the two groups were subsequently analyzed via binary logistic regression analysis. Results: Compared with those in the uninfected patient group, the following changes were observed in patients with Omicron variant infection who underwent elective surgery one month after infection: prothrombin activity (PTa), prothrombin time (PT), fibrinogen, albumin/globulin, alanine aminotransferase (ALT), mean corpuscular hemoglobin concentration (MCHC), platelet (PLT), and anemia were increased AST/ALT, indirect bilirubin (IBILI), eosinophils, and uric acid were decreased before surgery; and lung infection/pneumonia and fibrinogen were increased, while AST/ALT, globulin, total bilirubin (TBIL), white blood cell count (WBC), and uric acid were decreased after surgery. There was no significant difference in the mortality rate or length of hospital stay (LOS) between the two groups. Subgroup analysis revealed elevated monocyte, PLT, and fibrinogen classification, levels and decreased globulin, prealbumin (PBA), eosinophil, and uric acid levels in the tumor subgroup of patients who underwent elective surgery one month after Omicron infection compared with those in the uninfected patients. Compared with the nontumor subgroup, fibrinogen levels, lung infection/pneumonia, TBIL, and PLT count were increased in the uninfected patients, while the globulin and eosinophil levels were decreased. Conclusion: Compared with uninfected patients, patients who underwent elective surgery one month after Omicron variant infection exhibited minimal changes in perioperative coagulation parameters, liver function, CBC counts, and kidney function. Additionally, no significant differences in postoperative mortality or LOS were observed between the two groups.
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Globulinas , Neoplasias , Pneumonia , Humanos , Estudos Retrospectivos , Estudos de Casos e Controles , Ácido Úrico , Fígado/cirurgia , Fígado/patologia , Rim/cirurgia , Fibrinogênio , Bilirrubina , Neoplasias/patologiaRESUMO
BACKGROUND: To investigate the relationship between preoperative low serum albumin and perioperative blood transfusion in patients undergoing total joint arthroplasty (TJA). METHODS: We enrolled 2,772 TJA patients from our hospital between January 1, 2017, and January 1, 2022. Clinical data were extracted from electronic medical records, including patient ID, sex, BMI (Body Mass Index), age, and diagnoses. Receiver operating characteristic curves were constructed to establish thresholds for serum albumin levels categorization. Propensity score matching (PSM) was developed with preoperative serum albumin as the dependent variable and perioperative blood transfusion-related factors as covariates, including BMI grade, age grade, sex, diagnosis, hypertension, diabetes, coronary heart disease, chronic obstructive pulmonary disease, chronic bronchitis, cerebral infarction, major surgeries within the last 12 months, renal failure, cancer, depression, corticosteroid use, smoking, drinking, and blood type. The low serum albumin group was matched with the normal albumin group at a 1:2 ratio, employing a caliper value of 0.2. Binary logistic regression was employed to analyze the outcomes. RESULTS: An under the curve of 0.601 was discovered, indicating a cutoff value of 37.3 g/L. Following PSM, 892 cases were successfully paired in the low serum (< 37.3 g/L) albumin group, and 1,401 cases were matched in the normal serum albumin (≥ 37.3 g/L) group. Binary logistic regression in TJA patients showed that the albumin OR was 0.911 with 95%CI 0.888-0.935, P < 0.001. Relative to the preoperative normal serum albumin group, TJA patients in the low serum albumin group experienced a 1.83-fold increase in perioperative blood transfusion rates (95% CI 1.50-2.23, P < 0.001). Compared to the normal serum albumin group, perioperative blood transfusion rates for TJA patients with serum albumin levels of 30-37.3 g/L, 25-30 g/L, and ≤ 25 g/L increased by 1.63 (95% CI 1.37-1.99, P < 0.001), 5.4 (95% CI 3.08-9.50, P < 0.001), and 6.43 times (95% CI 1.80-22.96, P = 0.004), respectively. CONCLUSION: In TJA patients, preoperative low serum albumin levels have been found to be associated with an increased risk of perioperative blood transfusion. Furthermore, it has been observed that the lower the preoperative serum albumin level is, the higher the risk of perioperative blood transfusion. TRIAL REGISTRATION: 28/12/2021, Chinese Clinical Trial Registry, ChiCRT2100054844.
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Transfusão de Sangue , Pontuação de Propensão , Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Transfusão de Sangue/estatística & dados numéricos , Transfusão de Sangue/tendências , Estudos Retrospectivos , Período Pré-Operatório , Albumina Sérica Humana/análise , Artroplastia de Quadril/efeitos adversos , Fatores de Risco , Albumina Sérica/análise , Albumina Sérica/metabolismo , Artroplastia do Joelho/efeitos adversos , Perda Sanguínea Cirúrgica/prevenção & controleRESUMO
BACKGROUND: To analyze the risk factors for preoperative deep vein thrombosis (DVT) in knee osteoarthritis (OA) patients undergoing total knee arthroplasty (TKA). METHODS: In this retrospective study, a total of 584 knee OA patients undergoing TKA were enrolled. General information, medical records and preoperative laboratory examination results of the patients were collected. According to the results of Doppler ultrasonography for the lower extremities, the patients were divided into DVT group and non-DVT group. Univariate and multivariate logistic regression were used to identify independent risk factors for preoperative DVT in knee OA patients undergoing TKA. RESULTS: The incidence of DVT before TKA was 6.85% (40 cases). The increase of ESR (Erythrocyte Sedimentation Rate), platelet crit, IL-6 (Interleukin-6), and PCT (Procalcitonin) were associated with the development of DVT before TKA. Factors as coronary heart disease (CHD), diabetes mellitus (DM), Chronic Kidney Disease (CKD), NLR (ratio of neutrophils to lymphocytes), lower limb venous blood stasis, the time from onset to admission, RBC, PLT were identified by multivariate logistic regression to be the independent risk factors for preoperative DVT in knee OA patients undergoing TKA. CONCLUSIONS: DM, CKD, CHD, increased in ESR, IL-6 and PCT, blood stasis of the lower extremities, increased in PLT, platelet crit and the time from onset to admission, decreased in RBC, were high risk factors for preoperative DVT in knee OA patients undergoing TKA.
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Artroplastia do Joelho , Osteoartrite do Joelho , Trombose Venosa , Humanos , Artroplastia do Joelho/efeitos adversos , Artroplastia do Joelho/métodos , Osteoartrite do Joelho/complicações , Osteoartrite do Joelho/cirurgia , Trombose Venosa/diagnóstico por imagem , Trombose Venosa/epidemiologia , Trombose Venosa/etiologia , Estudos Retrospectivos , Interleucina-6 , Fatores de Risco , Complicações Pós-Operatórias/etiologiaRESUMO
Investigation of the ethanol extract of the whole plant of Ainsliaea yunnanensis led to the isolation of four new dimeric sesquiterpene lactones, ainsliadimer F-I (1-4), together with seven known dimeric sesquiterpene lactones (5-11) and ten sesquiterpenes (12-21). Their structures were elucidated by spectroscopic methods. The relative stereochemistry of ainsliadimer F was further confirmed by single crystal X-ray diffraction analysis. Compounds 1-21 were tested for the inhibition of nuclear factor kappa B (NF-κB) in the 293-NF-κB-luciferase reporter cell line induced by lipopolysaccharide (LPS), and Compounds 5, 18, 20 and 21 were further tested for the production of TNF-α, IL-1ß, IL-6 and IL-10 in RAW 264.7 macrophages induced by LPS. Compounds 5, 18, 20 and 21 exhibited significant activity in anti-inflammatory activity assays.
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Anti-Inflamatórios/química , Asteraceae/química , Citocinas/metabolismo , Lactonas/química , Sesquiterpenos/química , Animais , Anti-Inflamatórios/farmacologia , Cristalografia por Raios X , Regulação da Expressão Gênica/efeitos dos fármacos , Lactonas/farmacologia , Lipopolissacarídeos/efeitos adversos , Camundongos , NF-kappa B/antagonistas & inibidores , Células RAW 264.7 , Sesquiterpenos/farmacologiaRESUMO
A new polyacetylene glucoside (3E,5E,11E)-tridecatriene-7,9-diyne-1,2,13-triol-2-O-ß-D-glucopyranoside (1), a new phenylpropanoid glucoside 2'-butoxyethylconiferin (2), and a new flavonoid glycoside 8,3',4'-trihydroxyflavone-7-O-(6''-O-p-coumaroyl)-ß-D-glucopyranoside (3), have been isolated from Bidens frondosa together with fifty-three known compounds 4-56. The structures of these compounds were established by spectroscopic methods. mainly ESIMS, 1D- and 2D-NMR spectroscopic data. and comparison with literature data. Compounds 1-34, 36, 39, 43, 47, 51, and 52 were tested for inhibition of nuclear factor kappa B (NF-κB) in 293-NF-κB-luciferase report cell line induced by lipopolysaccharide (LPS), and compounds 1, 2, 3, 9, 15, 21, 24 and 51 were tested for the production of TNF-α, IL-1ß, IL-6, IL-10 in RAW 264.7 macrophages induced by LPS. In conclusion, the isolated compounds 1, 2, 3, 9, 15, 21, 24 and 51 exhibited significant activity in anti-inflammatory activity assays.
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Anti-Inflamatórios/isolamento & purificação , Bidens/química , Flavonoides/isolamento & purificação , Glucosídeos/isolamento & purificação , Fenilpropionatos/isolamento & purificação , Poli-Inos/isolamento & purificação , Animais , Anti-Inflamatórios/química , Anti-Inflamatórios/farmacologia , Linhagem Celular , Flavonoides/química , Flavonoides/farmacologia , Regulação da Expressão Gênica , Genes Reporter , Glucosídeos/química , Glucosídeos/farmacologia , Células HEK293 , Humanos , Interleucina-10/antagonistas & inibidores , Interleucina-10/genética , Interleucina-10/metabolismo , Interleucina-1beta/antagonistas & inibidores , Interleucina-1beta/genética , Interleucina-1beta/metabolismo , Interleucina-6/antagonistas & inibidores , Interleucina-6/genética , Interleucina-6/metabolismo , Lipopolissacarídeos/antagonistas & inibidores , Lipopolissacarídeos/farmacologia , Luciferases/genética , Luciferases/metabolismo , Macrófagos/citologia , Macrófagos/efeitos dos fármacos , Macrófagos/metabolismo , Camundongos , NF-kappa B/antagonistas & inibidores , NF-kappa B/genética , NF-kappa B/metabolismo , Fenilpropionatos/química , Fenilpropionatos/farmacologia , Extratos Vegetais/química , Poli-Inos/química , Poli-Inos/farmacologia , Transdução de Sinais , Fator de Necrose Tumoral alfa/antagonistas & inibidores , Fator de Necrose Tumoral alfa/genética , Fator de Necrose Tumoral alfa/metabolismoRESUMO
BACKGROUND: Preoperative anemia is a common complication in knee osteoarthritis (KOA) patients. However, the association between anemia and preoperative deep vein thrombosis (DVT) in osteoarthritis patients remains unknown. The aim of this study was to investigate such association. METHODS: In this retrospective study, we included 1005 KOA patients undergoing total knee arthroplasty (TKA) in our hospital. According to preoperative hemoglobin levels, the patients were divided into anemia group and non-anemia group. According to the results of Doppler ultrasonography for the lower extremities, the patients were divided into DVT group and non-DVT group. A logistic model was established through propensity score matching (PSM), with anemia before TKA as the dependent variable, DVT-related variable as the covariate, and 0.03 as the Caliper value. The anemia group and non-anemia group were matched at a 1:1 ratio and 310 successfully matched. After matching, logistic regression analysis was used to evaluate the correlation between preoperative anemia and DVT in KOA patients. RESULTS: In this study, 342 cases (33.6%) had preoperative anemia and 73 cases (7.2%) had DVT before TKA. After matching, 46 DVT cases (7.42%) were found. By using binary logistic regression after PSM, we found that the risk for preoperative DVT formation in TKA patients with preoperative anemia increased by 1.97 times [95% (CI 1.05-3.69)], P = 0.035. CONCLUSION: Preoperative anemia is considered as an independent risk factor for the formation of preoperative DVT in KOA patients. TRIAL REGISTRATION: ChiCRT2100054844.
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Osteoartrite do Joelho , Trombose Venosa , Humanos , Osteoartrite do Joelho/complicações , Osteoartrite do Joelho/diagnóstico por imagem , Osteoartrite do Joelho/cirurgia , Estudos Transversais , Estudos Retrospectivos , Trombose Venosa/diagnóstico por imagem , Trombose Venosa/etiologia , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Fatores de RiscoRESUMO
To investigate the association between platelet (PLT) indices and preoperative deep vein thrombosis (DVT) in elderly patients undergoing total joint arthroplasty (TJA). A total of 1391 patients were enrolled. We created receiver operator characteristic (ROC) curve using the ratio of PLT indices to DVT before TJA, divided the enrolled patients into groups based on the cut-off value, and then analyzed risk factors for DVT before TJA in the multivariate binary logistic regression analysis. Preoperative DVT occurred in 103 cases. Based on the ROC curve, we determined that the cut-off values for PLT, mean platelet volume (MPV), platelet distribution width (PDW), platelet large cell ratio (P-LCR), and plateletcrit (PCT) were 202 × 109/L, 11.4â fL, 13.2â fL, 34.6%, and 0.228%. And the areas under the curve were 0.606, 0.605, 0.617, 0.616, and 0.598. Multivariate binary regression analysis revealed that the risk of preoperative DVT in TJA patients with PLT≥202 × 109/L, MPV≤11.4â fL, PDW≤13.2â fL, P-LCR≤34.6%, and PCT≥0.228% increased by 2.32 (P < .001, 95% confidence interval [CI] [1.50-3.60]), 1.86 (P < .001, 95% CI [1.22-2.83]), 2.17 (P < .001, 95% CI [1.43-3.31]), 2.27 (P < .001, 95% CI [1.50-3.45]), and 1.76 times (P = .013, 95% CI [1.13-2.76]), respectively. Age, P < .001, odds ratio (OR) = 1.08, 95% CI [1.04-1.11]; corticosteroid use, P = .011, OR = 3.66, 95% CI [1.34-9.96]. We found that increased PLT count and PCT, decreased MPV, PDW, and P-LCR, old age, and corticosteroid use were independent risk factors for preoperative DVT in elderly TJA patients.
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Plaquetas , Trombose Venosa , Humanos , Idoso , Estudos Retrospectivos , Contagem de Plaquetas , Volume Plaquetário Médio , Artroplastia , Trombose Venosa/etiologia , CorticosteroidesRESUMO
To investigate the association between albumin and preoperative deep vein thrombosis (DVT) in patients undergoing total joint arthroplasty (TJA). This study enrolled 2133 patients. We created the receiver operator characteristic curve to determine the cut-off values for preoperative albumin (bromocresol green method) and DVT in TJA patients. We divided the patients into groups based on the albumin cut-off value and then assessed the risk factors in a multivariate logistic regression analysis. DVT occurred in 110 cases. The cut-off value for albumin was 37.2â g/L and the area under the curve was 0.611. Multivariate logistic regression analysis revealed that the risk for DVT before TJA in patients with albumin <37.2â g/L was increased by 1.99 times (P = .001, 95% confidence interval [CI] [1.34-2.97]); albumin of 30 to 37.2â g/L group and the albumin < 30â g/L group increased by 1.9 times (P = .002, 95% CI [1.28-2.88]) and 3.25 times (P = .015, 95% CI [1.26-8.4]), respectively. The patients in the albumin of 30 to 37.2â g/L and the albumin < 30â g/L group had 1.6 times (P < .001, 95% CI [1.3-1.99] and 6.1 times (P < .001, 95% CI [3.46-10.75]), respectively, higher risk of perioperative transfusion. Patients older than 69.5 years had a 3.8-fold increased risk of preoperative DVT (P = .005, 95% CI [2.47-5.78]). Corticosteroid use had a 3 times higher risk of preoperative DVT (P = .013, 95% CI [1.26-7.2]). We found that albumin < 37.2â g/L, patients older than 69.5 years, and corticosteroid use were independent risk factors for preoperative DVT in TJA patients. Additionally, the lower the preoperative albumin level, the greater the odds of preoperative DVT formation, and the higher the risk of perioperative transfusion.
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Artroplastia do Joelho , Trombose Venosa , Humanos , Estudos Retrospectivos , Trombose Venosa/etiologia , Artroplastia do Joelho/efeitos adversos , Fatores de Risco , Corticosteroides , Albumina SéricaRESUMO
PURPOSE: To investigate the association of red blood cell (RBC), hemoglobin (Hb), red cell distribution width-coefficient of variation (RDW-CV), and red cell distribution width-standard deviation (RDW-SD) with preoperative deep vein thrombosis (DVT) in patients undergoing total joint arthroplasty (TJA). METHODS: A total of 2059 TJA patients were enrolled. We used the ratios of RBC, Hb, RDW-CV, and RDW-SD to DVT before TJA to create the receiver operator characteristic (ROC) curve, thereby calculating the cut-off values and the area under the curve (AUC). The patients were categorized into groups based on cut-off value, and risk factors for DVT before TJA were subsequently analyzed. We included the variates that were statistically significant in the univariate analysis in the multivariate binary logistic regression analysis. RESULTS: Preoperative DVT occurred in 107 cases (5.20%). Based on the ROC curve, we found that the AUC for RBC, Hb, RDW-CV, and RDW-SD were 0.658, 0.646, 0.568, and 0.586, respectively. Multivariate binary regression analysis revealed that the risk of preoperative DVT in TJA patients with RBC≤3.92*109 /L, Hb≤118g/L, RDW-CV≥13.2%, and RDW-SD≥44.6fL increased 3.02 (P < 0.001, 95% confidence interval (CI) [2.0-4.54]), 2.15 (P < 0.001, 95% CI [1.42-3.24]), 1.54 (P = 0.038, 95% CI [1.03-2.3]), and 1.98 times (P = 0.001, 95% CI [1.32-2.98]), respectively. The risk of preoperative DVT in patients with corticosteroid use increased approximately 2.6 times (P = 0.002, 95% CI [1.22-5.81]). CONCLUSION: We found that decreased RBC and Hb, increased RDW-CV and RDW-SD, and corticosteroid use were independent risk factors for preoperative DVT in patients undergoing TJA.
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Artroplastia do Joelho , Trombose Venosa , Humanos , Índices de Eritrócitos , Estudos Retrospectivos , Trombose Venosa/etiologia , Artroplastia do Joelho/efeitos adversos , Eritrócitos , CorticosteroidesRESUMO
BACKGROUND: Most case reports on laryngeal granuloma formation have described patients after tracheotomy and single-lumen endotracheal intubation. Few studies have investigated vocal cord granuloma formation after double-lumen endotracheal (DLT) intubation. CASE SUMMARY: We report granulation tissue formation on the bilateral vocal cords after DLT intubation in a 45-year-old, 153-cm-tall female patient. Previous imaging reports showed no formation of vocal cord granuloma before DLT intubation. Therefore, we inferred that DLT intubation may have been the main reason for the postoperative granulation tissue formation on her bilateral vocal cords, based on the patient's history of DLT intubation, persistent hoarseness after thoracic surgery, and fibrolaryngoscopic and pathological reports during 12 mo follow-up. CONCLUSION: Thirty-two Fr DLT tubes should be utilized for thoracic surgery on female patients who are shorter than 153 cm in height.
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BACKGROUND: To explore the correlation of the severity of preoperative anemia with deep vein thrombosis (DVT) in patients undergoing total joint arthroplasty (TJA). METHODS: A total of 2461 TJA patients were classified into anemia and non-anemia groups or DVT and non-DVT groups. A logistic regression model was established using propensity score matching (PSM) analysis with preoperative anemia of TJA patients as a dependent variable and DVT-related variables as covariates. The caliper value was set as 0.01, and the anemia and non-anemia groups were matched based on the ratio of 1:1 (835 pairs). Finally, data of all patients were analyzed by binary logistic regression. RESULTS: Preoperative anemia was observed in 872 cases (35.43%) and DVT in 170 cases (6.91%). Binary logistic regression after PSM revealed that the DVT risk of patients with preoperative, moderate and severe anemia increased by 1.82 [P = 0.00, 95% confidence interval (95% CI) (1.32-2.48)], 2.77 [P = 0.00, 95% CI (1.72-4.45)], and 8.26 [P = 0.00, 95% CI (3.22-21.16)] times, respectively. The risks of blood transfusion in the perioperative period in patients with anemia, mild anemia, moderate anemia, and severe anemia increased by 3.52 times [P = 0.00, 95% CI (2.78-4.47)], 2.13 [P = 0.00, 95% CI (1.63-2.79)], 7.22 [P = 0.00, 95% CI (5.30-9.83)], and 61.37 [P = 0.00, 95% CI (14.21-265.04)] times, respectively. CONCLUSION: Preoperative anemia is an independent risk factor for preoperative DVT and blood transfusion in the perioperative period for TJA patients. The more severe the preoperative anemia, the greater the risk of preoperative DVT and perioperative blood transfusion in TJA patients. Therefore, patients with preoperative anemia, especially with moderate and severe anemia, should be screened for DVT formation before undergoing TJA. Trial registration ChiCRT2100054844.
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Anemia , Artroplastia de Quadril , Artroplastia do Joelho , Trombose Venosa , Humanos , Artroplastia do Joelho/efeitos adversos , Artroplastia de Quadril/efeitos adversos , Estudos Retrospectivos , Trombose Venosa/etiologia , Anemia/complicações , Fatores de RiscoRESUMO
BACKGROUND: To investigate the association between the level of glycosylated hemoglobin (HbA1c) and preoperative deep vein thrombosis (DVT) and that between diabetes mellitus (DM) and preoperative DVT in patient undergoing total joint arthroplasty (TJA). METHODS: A total of 1386 patients were enrolled. We created the receiver operating characteristic (ROC) curve of HbA1c, and based on the cutoff value, patients were divided into two groups. Risk factors were subsequently examined. Chi-square test or Fisher's exact test was adopted for enumeration data. The results were expressed in percentages (%), and DVT-related variates were analyzed. We included the variates that were statistically significant in the univariate analysis in the multivariate binary logistic regression analysis and calculated the adjusted odds ratio (OR) and 95% confidence interval (95% CI). RESULTS: Preoperative DVT was 100 cases (7.22%) and DM in 301 cases (21.7%). We determined the cutoff value of HbA1c of 6.15% using the ROC curve as the area under the curve (AUC) was 0.548. Univariate logistic regression revealed that the risk of preoperative DVT in TJA patients with HbA1c ≥ 6.15%, HbA1c between 7 and 7.9%, HbA1c ≥ 8%, DM, female, and major surgery in the last 12 months increased by 1.84 (P = 0.005; 95% CI [1.20-2.80]), 2.22 (P = 0.028, 95% CI [1.09-4.52]), 2.47 (P = 0.013, 95% CI [1.21-5.04]), 2.03 (P = 0.004, 95% CI [1.25-3.30]); 1.85 (P = 0.010, 95% CI [1.16-2.95]); and 2.86 times (P = 0.006, 95% CI [1.35-6.05]), respectively. And multivariate logistic regression revealed that the risk of preoperative DVT in TJA patients with HbA1c ≥ 6.15%, HbA1c between 7 and 7.9%, HbA1c ≥ 8%, DM patients, female patients, and major surgery in the last 12 months increased by 1.77 (P = 0.009, 95% CI [1.16-2.72]); 2.10 (P = 0.043, 95% CI [1.02-4.30]); 2.50 (P = 0.013, 95% CI [1.22-5.14]); 2.01 (P = 0.005, 95% CI [1.23-3.28]); 1.80 (P = 0.014, 95% CI [1.13-2.89]); and 3.04 times (P = 0.004, 95% CI [1.42-6.49]), respectively. CONCLUSION: We conclude that HbA1c ≥ 6.15%, DM, female and major surgery in the last 12 months are the independent risk factors for preoperative DVT in patients undergoing TJA. And patients with a higher HbA1c level are at an increased risk of preoperative DVT. TRIAL REGISTRATION: ChiCRT2100054844.
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Artroplastia de Quadril , Diabetes Mellitus , Trombose Venosa , Artroplastia de Quadril/efeitos adversos , Feminino , Hemoglobinas Glicadas , Humanos , Estudos Retrospectivos , Fatores de Risco , Trombose Venosa/epidemiologia , Trombose Venosa/etiologiaRESUMO
Erucic acid (C22:1, ω-9, EA) is a very-long-chain monounsaturated fatty acid (FA) that is an important oleochemical product with a wide range of uses in metallurgy, machinery, rubber, the chemical industry, and other fields because of its hydrophobicity and water resistance. EA is not easily digested and absorbed in the human body, and high-EA rapeseed (HEAR) oil often contains glucosinolates. Both glucosinolates and EA are detrimental to health and can lead to disease, which has resulted in strict guidelines by regulatory bodies on maximum EA contents in oils. Increasingly, researchers have attempted to enhance the EA content in Brassicaceae oilseeds to serve industrial applications while conversely reducing the EA content to ensure food safety. For the production of both LEAR and HEAR, biotechnology is likely to play a fundamental role. Elucidating the metabolic pathways of EA can help inform the improvement of Brassicaceae oilseeds through transgenic technology. In this paper, we introduce the industrial applications of HEAR oil and health benefits of low-EA rapeseed (LEAR) oil first, following which we review the biosynthetic pathways of EA, introduce the EA resources from plants, and focus on research related to the genetic engineering of EA in Brassicaceae oilseeds. In addition, the effects of the environment on EA production are addressed, and the safe cultivation of HEAR and LEAR is discussed. This paper supports further research into improving FAs in Brassicaceae oilseeds through transgenic technologies and molecular breeding techniques, thereby advancing the commercialization of transgenic products for better application in various fields.
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Nervonic acid (NA) is a very-long-chain monounsaturated fatty acid that plays crucial roles in brain development and has attracted widespread research interest. The markets encouraged the development of a refined, NA-enriched plant oil as feedstocks for the needed further studies of NA biological functions to the end commercial application. Plant seed oils offer a renewable and environmentally friendly source of NA, but their industrial production is presently hindered by various factors. This review focuses on the NA biosynthesis and assembly, NA resources from plants, and the genetic engineering of NA biosynthesis in oil crops, discusses the factors that affect NA production in genetically engineered oil crops, and provides prospects for the application of NA and prospective trends in the engineering of NA. This review emphasizes the progress made toward various NA-related topics and explores the limitations and trends, thereby providing integrated and comprehensive insight into the nature of NA production mechanisms during genetic engineering. Furthermore, this report supports further work involving the manipulation of NA production through transgenic technologies and molecular breeding for the enhancement of crop nutritional quality or creation of plant biochemical factories to produce NA for use in nutraceutical, pharmaceutical, and chemical industries.
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BACKGROUND: Generation of marker-free transgenic plants is very important to the regulatory permission and commercial release of transgenic crops. Co-transformation methods that enable the removal of selectable marker genes have been extensively used because they are simple and clean. Few comparisons are currently available between different strain/plasmid co-transformation systems, and also data are related to variation in co-transformation frequencies caused by other details of the vector design. RESULTS: In this study, we constructed three vector systems for the co-transformation of allotetraploid Brassica napus (B. napus) mediated by Agrobacterium tumefaciens and compared these co-transformation methods. We tested a mixed-strain system, in which a single T-DNA is harbored in two plasmids, as well as two "double T-DNA" vector systems, in which two independent T-DNAs are harbored in one plasmid in a tandem orientation or in an inverted orientation. As confirmed by the use of PCR analysis, test strips, and Southern blot, the average co-transformation frequencies from these systems ranged from 24 to 81% in T0 plants, with the highest frequency of 81% for 1:1 treatment of the mixed-strain system. These vector systems are valuable for generating marker-free transgenic B. napus plants, and marker-free plants were successfully obtained in the T1 generation from 50 to 77% of T0 transgenic lines using these systems, with the highest frequency of 77% for "double T-DNA" vector systems of pBID RT Enhanced. We further found that marker-free B. napus plants were more frequently encountered in the progeny of transgenic lines which has only one or two marker gene copies in the T0 generation. Two types of herbicide resistant transgenic B. napus plants, Bar + with phosphinothricin resistance and Bar + EPSPS + GOX + with phosphinothricin and glyphosate resistance, were obtained. CONCLUSION: We were successful in removing selectable marker genes in transgenic B. napus plants using all three co-transformation systems developed in this study. It was proved that if a appropriate mole ratio was designed for the specific length ratio of the twin T-DNAs for the mixed-strain method, high unlinked co-insertion frequency and overall success frequency could be achieved. Our study provides useful information for the construction of efficient co-transformation system for marker-free transgenic crop production and developed transgenic B. napus with various types of herbicide resistance.
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High-dose cyclophosphamide (HD-CTX) treatment often leads to severe nephrotoxicity and neurotoxicity, which are mainly caused by one of its metabolites, chloroacetaldehyde (CAA). However, there are no effective antidotes to prevent these side effects. The objective of this study was to evaluate the effect of Wuzhi Capsule (WZC) on the pharmacokinetics of CTX and its metabolites in rats, and the attenuation of CAA induced kidney and brain injuries, which was produced at equimolar with 2-dechloroethylcyclophosphamide. Rats were treated with single- or multiple-dose of WZC when giving HD-CTX, and the plasma concentration of CTX and its metabolites were quantitated by UHPLC-MS/MS Single-dose, not multiple-dose of WZC co-administration (300 mg/kg) significantly reduced Cmax and AUC0â24 h of DC-CTX by 33.10% and 35.51%, respectively. Biochemical assay suggested oxidative stress was involved in kidney and brain injuries by HD-CTX, which were attenuated by single-dose WZC (300 mg/kg) pre-treatment, with increased glutathione, glutathione peroxidase and superoxide dismutase contents/or activities in both tissues and plasma (P < 0.05). Meanwhile, WZC pre-treatment could also significantly decrease the plasma levels of creatinine, blood urea nitrogen and malondialdehyde (P < 0.05). Additionally, WZC treatment improved the morphology and pathology condition of the kidneys and brains in rats. In conclusion, single-dose WZC co-administration decreased CAA production and exerted protective effect on CTX-induced oxidative stress in kidney and brain, whereas repetitive WZC co-administration with CTX was probably not recommended.
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Acetaldeído/análogos & derivados , Ciclofosfamida/toxicidade , Medicamentos de Ervas Chinesas/uso terapêutico , Síndromes Neurotóxicas/prevenção & controle , Insuficiência Renal/prevenção & controle , Acetaldeído/farmacocinética , Acetaldeído/toxicidade , Animais , Encéfalo/efeitos dos fármacos , Encéfalo/patologia , Ciclofosfamida/administração & dosagem , Ciclofosfamida/farmacocinética , Modelos Animais de Doenças , Relação Dose-Resposta a Droga , Humanos , Rim/efeitos dos fármacos , Rim/patologia , Masculino , Síndromes Neurotóxicas/etiologia , Síndromes Neurotóxicas/patologia , Estresse Oxidativo/efeitos dos fármacos , Ratos , Insuficiência Renal/induzido quimicamente , Insuficiência Renal/patologiaRESUMO
Few literatures have evaluated the exact role of metabolomics in the identification process of potential biomarkers for acute kidney injury among the patients receiving renal transplantation. On top of this, the success of metabolomics in biomarker translation seems to lie in the robust quantitative method. As such, a single-center retrospective observational study was conducted enrolling 42 patients underwent renal transplantation with/without acute kidney injury, as well as 24 healthy volunteers, in Shanghai Changzheng Hospital. Plasma amino acid metabolic patterns for the participants were investigated by targeted UHPLC-MS/MS metabolic profiling. The most significant changes of the explored metabolites were related to the disturbance of tryptophan metabolism and arginine metabolism. Abnormal circulating tryptophan and symmetric dimethylarginine were identified to be potential biomarkers of acute kidney injury, combination of which showed a higher area under receiver-operator curve value (AUC = 0.901), improved sensitivity (0.889) and specificity (0.831) compared with creatinine only. Overall, these results revealed that targeted metabolomics analysis would be a potent and promising strategy for identification and pre-validation of biomarkers of acute kidney injury in renal transplantation patients.
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Injúria Renal Aguda/induzido quimicamente , Injúria Renal Aguda/diagnóstico , Arginina/análogos & derivados , Imunossupressores/efeitos adversos , Transplante de Rim , Tacrolimo/efeitos adversos , Triptofano/sangue , Adulto , Antidepressivos de Segunda Geração , Arginina/sangue , China , Feminino , Humanos , Imunossupressores/administração & dosagem , Masculino , Metabolômica , Pessoa de Meia-Idade , Plasma/química , Estudos Retrospectivos , Sensibilidade e Especificidade , Tacrolimo/administração & dosagem , Transplantados , Adulto JovemRESUMO
AIM: Quantification of amino acids in human plasma has become an important and essential analysis parameter in life science. In this paper, we developed a targeted UHPLC-MS/MS method for 18 amino acids in the renal transplant patients. METHODS & RESULTS: Plasma in small volume (150 µl) was pretreated by a one-step protein precipitant extraction for analysis. Detection was executed by MS/MS in the MRM mode. Assays were validated according to current bioanalytical guidelines, with good linearity (R > 0.99), intraday and interday precision (CV < 11.6%, RE ≤ ± 14.8%), extraction recovery (between 77.4 and 117.6%), matrix effect (73.3-118.0%) and stability (RE≤ ±14.7%). CONCLUSION: The method was successfully applicable for amino acid analysis in the renal transplant patient.
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Aminoácidos/sangue , Cromatografia Líquida de Alta Pressão/métodos , Espectrometria de Massas em Tandem/métodos , Adulto , Feminino , Humanos , Transplante de Rim , Limite de Detecção , Masculino , Pessoa de Meia-Idade , Adulto JovemRESUMO
Oilseed rape (Brassica napus) is one of the most important oilseed crops globally. To meet increasing demand for oil-based products, the ability to enhance desirable oil content in the seed is required. This study assessed the capability of five genes in the triacylglyceride (TAG) synthesis pathway to enhance oil content. The genes BnGPDH, BnGPAT, BnDGAT, ScGPDH and ScLPAAT were overexpressed separately in a tobacco (Nicotiana benthamiana) model system, and simultaneously by pyramiding in B. napus, under the control of a seed specific Napin promoter. ScLPAAT transgenic plants showed a significant increase of 6.84% to 8.55% in oil content in tobacco seeds, while a ~4% increase was noted for BnGPDH and BnGPAT transgenic seeds. Seed-specific overexpression of all four genes in B. napus resulted in as high a 12.57% to 14.46% increased in seed oil content when compared to WT, equaling close to the sum of the single-gene overexpression increases in tobacco. Taken together, our study demonstrates that BnGPDH, BnGPAT and ScLPAAT may effectively increase seed oil content, and that simultaneous overexpression of these in transgenic B. napus may further enhance the desirable oil content relative to single-gene overexpressors.