Plasma Deoxycholic Acid Levels are Associated with Hemodynamic and Clinical Outcomes in Acute Pulmonary Embolism Patients.

This study aimed to evaluate the correlation of plasma deoxycholic acid (DCA) levels with clinical and hemodynamic parameters in acute pulmonary embolism (APE) patients. Total 149 APE adult patients were prospectively recruited. Plasma DCA levels were measured using rapid resolution liquid chromatography-quadrupole time-of-flight mass spectrometry. Baseline clinical and hemodynamic parameters were evaluated according to plasma DCA levels. The plasma DCA levels were significantly lower in APE patients than in those without APE (P < 0.001). APE patients with adverse events had lower plasma DCA levels (P < 0.001). Low DCA group patients presented more adverse cardiac function, higher NT-proBNP levels (P = 0.010), and higher WHO functional class levels (P = 0.023). Low DCA group also presented with an adverse hemodynamic status, with higher pulmonary vascular resistance levels (P = 0.027) and lower cardiac index levels (P = 0.024). Both cardiac function and hemodynamic parameters correlated well with plasma DCA levels. Kaplan-Meier survival analysis demonstrated that APE patients with lower plasma DCA levels had a significantly higher event rate (P = 0.009). In the univariate and multivariate Cox regression analyses, the plasma DCA level was an independent predictor of clinical worsening events after adjusting for age, sex, WHO functional class, NT-proBNP level, pulmonary vascular resistance, and cardiac index (HR 0.370, 95% CI 0.161, 0.852; P = 0.019). Low plasma DCA levels predicted adverse cardiac function and hemodynamic collapse. A low DCA level was correlated with a higher clinical worsening event rate and could be an independent predictor of clinical outcomes in multivariate analysis.

[Analysis of hemostatic effect of intra-articular injection of tranexamic acid after minimally invasive unicompartmental knee arthroplasty].

OBJECTIVE: To investigate the effect of intra-articular injection of tranexamic acid on blood loss and blood transfusion rate after minimally invasive unicompartmental knee arthroplasty. METHODS: From January 2015 to September 2017, 90 patients underwent minimally invasive unicompartmental knee arthroplasty were divided into tranexamic acid group and control group, 45 cases in each group. In the tranexamic acid group, there were 22 males and 23 females, aged 62 to 69 (66.1±2.4) years;in the control group, 20 males and 25 females, aged 63 to 71(68.5±5.2) years. The amount of bleeding in the drainage ball at 48 hours after operation was recorded, and the blood transfusion rate and hematocrit level duringthe perioperative period were recorded. The factors influencing perioperative blood loss included gender, age and body mass index (BMI). RESULTS: All patients were followed up for 12.5 to 28.3 (22.8±7.9) months. During the follow-up, the wounds of the two groups healed well, and no deep vein thrombosis and pulmonary embolism occurred. There was no significant difference in postoperative blood loss between the tranexamic acid group and the control group. The postoperative bleeding volume in the tranexamic acid group was (110.0±52.1) ml, and that in the control group was (123.0±64.5) ml (P=0.39). There was no blood transfusion in the two groups. CONCLUSION: Intra articular injection of tranexamic acid can not significantly reduce the postoperative blood loss in patients with minimally invasive unicompartment.

[Monitoring leaf nitrogen concentration and nitrogen accumulation of double cropping rice based on crop growth monitoring and diagnosis apparatus]. / 基于作物生长监测诊断仪的双季稻叶片氮含量和氮积累量监测.

To verify the accuracy and adaptability of crop growth monitoring and diagnosis apparatus (CGMD) in monitoring nitrogen nutrition index of double cropping rice, we established a monitoring model of leaf nitrogen concentration (LNC) and leaf nitrogen accumulation (LNA) for double cropping rice based on CGMD. Eight early and late rice cultivars were selected and four nitrogen application rates were set up. The differential vegetation index (DVI), normalized difference vegetation index (NDVI) and ratio vegetation index (RVI) were collected using CGMD. Meanwhile, ASD FH2 high spectrometer was used to collect canopy spectral reflectance and calculated DVI, NDVI, and RVI. To verify the accuracy of CGMD, we compared the canopy vegetation indices change characteristics collected by CGMD and ASD FH2. The CGMD-based monitoring models of LNC and LNA were established, which was tested with independent field data. The results showed that LNC, LNA, DVI, NDVI and RVI of early and late rice increased with increasing nitrogen application rate, and increased first and then decreased with the advance of growth progress. The determination coefficient (R2) of fitting for DVI, NDVI and RVI from CGMD and ASD FH2 were 0.9350, 0.9436 and 0.9433, respectively. This result indicated that the measurement accuracy of CGMD was high, and that the CGMD could be used to replace ASD FH2 to measure canopy vegetation indices of early and late rice. Compared with the three canopy vegetation indices based on CGMD, the correlation between NDVICGMD and LNC and that between RVICGMD and LNA was the highest. The exponential model based on NDVICGMD could be used to accurate estimate LNC with the R2 in the range of 0.8581-0.9318, and the root mean square error (RMSE), relation root mean square error (RRMSE) and correlation coefficient (r) of model validation in the range of 0.1%-0.2%, 4.0%-8.5%, and 0.9041-0.9854, respectively. The power function model based on RVICGMD could be used to estimate LNA with the R2 in the range of 0.8684-0.9577, and the RMSE, RRMSE and r of model validation in the range of 0.37-0.89 g·m-2, 6.7%-20.4% and 0.9191-0.9851, respectively. Compared with the chemical testing method, using the CGMD could conveniently and accurately measure LNC and LNA of early and late rice, which had a potential to be widely applied for high yield and high efficiency cultivation and precise management of nitrogen fertilizer in double cropping rice production.

[Model construction and application for nitrogen nutrition monitoring and diagnosis in double-cropping rice of Jiangxi Province, China]. / æ±Ÿè¥¿åŒå­£ç¨»æ°®ç´ ç›‘æµ‹è¯Šæ–­æ¨¡åž‹çš„å»ºç«‹ä¸Žåº”ç”¨.

The spectrometer-based nitrogen (N) nutrition monitoring and diagnosis models for double-cropping rice in Jiangxi is important for recommending precise N topdressing rate, achieving high yield, improving grain quality and increasing economic efficiency. Field experiments were conducted in Jiangxi in 2016 and 2017, involving different early rice and late rice cultivars and N application rates. Plant N accumulation (PNA) and canopy spectral vegetation indices (VIs) were measured at tillering and jointing stages with two spectrometers, i.e., GreenSeeker (an active multispectral sensor containing 780 and 660 nm wavelengths) and crop growth monitoring and diagnosis apparatus (CGMD, a passive multispectral sensor containing 810 and 720 nm wavelengths). The VI-based models of PNA were established from a experimental dataset and then validated using an independent dataset. The N topdressing rates for tillering and jointing stages were calculated using the newly developed N spectral diagnosis model and higher yield cultivation experience of double-cropping rice. The results showed that the VIs from two spectrometers were strongly positively correlated with PNA at both growth stages, with the model performance for tillering or jointing stages was better than that for the early growth stages. The exponential equation of normalized difference vegetation index (NDVI(780,660)) from GreenSeeker could be used to estimate PNA with a determination coefficient (R2) in the range of 0.92-0.94, the root mean square error (RMSE), relative root mean square error (RRMSE) and correlation coefficient (r) of model validation in the range of 3.09-5.96 kg·hm-2, 5.8%-18.5% and 0.92-0.98, respectively. The linear equation of difference vegetation index (DVI(810,720)) from CGMD could be used to estimate PNA with a R2 in the range of 0.90-0.93, the RMSE, RRMSE and r of model validation in the range of 3.71-6.33 kg·hm-2, 11.7%-14.3% and 0.93-0.96, respectively. The recommended N topdressing rate with CGMD was higher than that with GreenSeeker. Compared with conventional farmer's plan, the precision N application plan reduced N fertilizer application rate by 5.5 kg·hm-2, while N agronomic efficiency and net income was improved by 0.8% and 128 yuan·hm-2, respectively. Application of the spectral monitoring and diagnosis method to guiding fertilization could reduce cost and increase grain yield and net income, and thus had great potential for guiding double-cropping rice production.

[Spatial and Temporal Variability of CO2 Emissions from the Xin'anjiang Reservoir].

Xin'anjiang Reservoir is the largest reservoir in eastern China, with a surface area of 580 km2 and a mean depth of 30 m. It is in an oligotrophic or mesotrophic state at present. This study measured carbon dioxide (CO2) emissions from the upstream river, the reservoir's main body, and the river downstream of the Xin'anjiang Reservoir to investigate the spatial and seasonal variability of CO2 emissions from the water surface using static floating chambers and gas chromatography. Results showed that the downstream river had, significantly, the highest CO2 emission flux[(1535.00±1447.46) mg·(m2·h)-1], followed by the upstream river[(120.39±135.41) mg·(m2·h)-1]. The reservoir's main body had the lowest flux[(36.65-61.94) mg·(m2·h)-1]. The high CO2 emission flux in the downstream river was probably influenced by turbulence during the discharge periods, which would allow the dissolved CO2 in the hypolimnion before the dam to be released to the atmosphere in the watercourse of the downstream river. However, the CO2 emission flux decreased with distance to the dam, likely because of the drop in strength of the turbulence. Moreover, there was an obvious alternation between CO2 source and CO2 sink in the main body of the reservoir, with CO2 sources in autumn and winter and CO2 sinks in spring and summer. The maximum and minimum CO2 emission values occurred in winter and spring, respectively. Such variability in the CO2 emissions was probably influenced by the bloom of alga in spring and summer, because dissolved CO2 in the water was absorbed by the respiration of alga. However, hydrologic conditions were unstable in the upstream river due to a fast water flow, so alga was difficult to bloom there, and a CO2 source was observed throughout the year, except during April and August. The measurement of the flux from the upstream river, main body, and downstream river required a long period for the investigation of greenhouse gas emissions to avoid underestimating the total CO2 emission from a hydroelectric reservoir system.

[Antero-medial incision of knee joint for the treatment of intercondylar fracture of femur].

OBJECTIVE: To explore the clinical effect of antero-medial incision of knee joint in treating intercondylar fracture of femur. METHODS: From September 2012 to March 2015, 24 patients with intercondylar fracture of femur were selected, including 17 males and 7 females, aged from 20 to 65 years old with an average of(38.3±9.5) years old. Among them, 12 cases were caused by traffic accident, 8 cases were caused by falling injury and 4 cases were caused by falling down. All patients were closed fractures. The time from injury to hospital was from 30 min to 8 h with an average of(2.2±0.3) h. According to AO classification, 4 cases were type B1, 3 type B2, 2 type B3, 5 type C1, 6 type C2 and 4 type C3. All patients were treated with antero-medial incision of knee joint. Operative time, blood loss and postoperative complications were observed and recovery of keen function was evaluated by Kolmert scoring. RESULTS: All patients were followed-up from 6 to 12 months with average of (9.0±1.7) months. Operative time ranged from 50 to 90 min with an average of (70.0±8.2) min; blood loss ranged from 90 to 400 ml with an average of (180±36) ml; negative pressure flow was from 30 to 90 ml, with an average of (50.0±7.1) ml. All fracture were healed at stage I without loosening of internal fixator, fracture nonunion, and deep vein thrombosis. According to Kolmert scoring, 16 patients got excellent result, 5 patients good and 3 fair. CONCLUSIONS: Antero-medial incision of knee joint in treating intercondylar fracture of femur, which has advantages of good fracture reduction, less injury of soft tissue and simple operation, could obtain good clinical results.

[Expansive pedicle screws fixation combined with Wright artificial bone implantation for treatment of thoracolumbar burst fracture of the elderly patients].

OBJECTIVE: To observe the effects of expansive pedicle screws fixation combined Wright artificial bone implantation in treating thoracolumbar burst fracture of the elderly. METHODS: From March 2007 to July 2009, 12 patients with thoracolumbar burst fractures were treated with surgery in the study. There were 7 males and 5 females, with an average age of 62.3 years (from 56 to 71 years). Nerve functions of all patients were ASIA classified grade E. According to TLICS score system, 6 points were in 5 cases and 7 points were in 7 cases. Expansive pedicle screw system was used and Wright artificial bone was injected into the injuried vertebrae. The anterior border height of vertebral body and Cobb angle were observed at the preoperation, postoperation and final follow-up. RESULTS: All patients were followed up from 10 to 15 months with an average of 12 months. Wounds healed well, pain in the chest-back abated, no the expansive pedicle screws loosened or broke down. The anterior border height of vertebral body increased from (32.3 +/- 9.1)% preoperatively to (95.3 +/- 3.2)% postoperatively; and the Cobb angle decreased from (31.6 +/- 6.8) degrees preoperatively to (4.5 +/- 3.2) degrees postoperatively. There was significant difference between two groups (P<0.01). After 3 months, the anterior border height of vertebral body was (94.7 +/- 3.3)% and the Cobb angle was (4.6 +/- 3.4) degrees; at the final follow-up, the anterior border height of vertebral body was (93.2 +/- 3.6)% and the Cobb angle was (5.3 +/- 3.7) degrees. There was no significant difference between the two data (P>0.05). CONCLUSION: The combination of expansive pedicle screws fixation and Wright artificial bone injection is a good treatment for thoracolumbar burst fracture, with advantages such as easy operation and good effect, which mainly applied to patients with no obvious nerve injuries.

[Clinical observation of anterior cruciate ligament reconstruction with tibial-remnant preserving technique using hamstring autograft].

OBJECTIVE: To observe the outcome of ACL reconstruction with tibial-remnant preserving technique using hamstring autograft. METHODS: From January 2007 to June 2009,18 patients, including 11 male and 7 female with an average age of 28.2 years (from 18 to 42 years), received ACL reconstruction in Kunshan traditional Chinese medicine hospital, Jiangsu province. All cases were confirmed that the remnant of torn ACL were more than 1/3 by arthroscopic observation. The gracillis and semitendinosus tendons harvested from the patient were folded and weaved as a graft, which was pulled into the femoral and tibia tunnel through the sheath formed by the remnant preserved carefully, then fixed by Rigidfix at femoral side and Intrafix at tibial side respectively. The Lysholm scores were recorded at the last follow-up to evaluate the postoperative knee function. The knee stability, range of motion (ROM), and proprioception were evaluated by physical examination. RESULTS: The average duration of follow-up of all 18 patients was 17.3 months (ranged from 15 to 24 months), no synovitis, graft tear, and ROM limitation were found. The average postoperative Lysholm score was (91.56 +/- 4.60) improved from preoperative (49.43 +/- 2.85) (P < 0.05). There were no differences between bilateral knees on the knee flexion (P > 0.05). CONCLUSION: To preserve the tibial remnant of torn ACL during ACL reconstruction had good outcomes, and contributed to recovery of knee proprioceptive function.