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OBJECTIVE@#To evaluate the implications of the prognostic nutrition index (PNI) in non-metastatic renal cell carcinoma (RCC) patients treated with surgery and to compare it with other hematological biomarkers, including neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and systemic immune inflammation index (SII).@*METHODS@#A cohort of 328 non-metastatic RCC patients who received surgical treatment between 2010 and 2012 at Peking University First Hospital was analyzed retrospectively. Receiver operating characteristic (ROC) curve analysis was used to determine the optimal cutoff values of the hematological biomarkers. The Youden index was maximum for PNI was value of 47.3. So we divided the patients into two groups (PNI≤ 47. 3 and >47. 3) for further analysis. Categorical variables [age, gender, body mass index (BMI), surgery type, histological subtype, necrosis, pathological T stage and tumor grade] were compared using the Chi-square test and Student' s t test. The association of the biomarkers with overall survival (OS) and disease-free survival (DFS) was analyzed using Kaplan-Meier methods with log-rank test, followed by multivariate Cox proportional hazards model.@*RESULTS@#According to the maximum Youden index of ROC curve, the best cut-off value of PNI is 47. 3. Low level of PNI was significantly associated with older age, lower BMI and higher tumor pathological T stage (P < 0.05). Kaplan-Meier univariate analysis showed that lower PNI was significantly correlated with poor OS and DFS (P < 0.05). In addition, older age, lower BMI, tumor necrosis, higher tumor pathological T stage and Fuhrman grade were significantly correlated with poor OS (P < 0.05). Cox multivariate analysis showed that among the four hematological indexes, only PNI was an independent factor significantly associated with OS, whether as a continuous variable (HR=0.9, 95%CI=0.828-0.978, P=0.013) or a classified variable (HR=2.397, 95%CI=1.061-5.418, P=0.036).@*CONCLUSION@#Low PNI was a significant predictor for advanced pathological T stage, decreased OS, or DFS in non-metastatic RCC patients treated with surgery. In addition, PNI was superior to the other hematological biomar-kers as a useful tool for predicting prognosis of RCC in our study. It should be externally validated in future research before the PNI can be used widely as a predictor of RCC patients undergoing nephrectomy.
Subject(s)
Humans , Prognosis , Nutrition Assessment , Carcinoma, Renal Cell/surgery , Retrospective Studies , Biomarkers , Kidney Neoplasms/pathologyABSTRACT
In this study, an established ultra-high performance liquid chromatography coupled with quadrupole-time-of-flight mass spectrometry(UPLC-Q-TOF-MS) method was combined with multivariate statistical analysis to investigate the commonality and difference of main chemical components in the medicinal parts of Paeonia lactiflora from different cultivars; in addition, a high performance liquid chromatography(HPLC) method was established to simultaneously determine the content of eight active components in Paeoniae Radix Alba. Non-targeted analysis was carried out by UPLC-Q-TOF-MS on a Waters ACQUITY UPLC BEH C_(18)(2.1 mm×100 mm, 1.7 μm) column with a gradient elution of 0.1% aqueous formic acid(A)-acetonitrile(B) as the mobile phase at a flow rate of 0.2 mL·min~(-1). The column temperature was 30 ℃, and an electrospray ionization source was used to acquire mass spectrometry data in positive and negative ion modes. According to the accurate molecular weight and fragment ion information provided by multi-stage mass spectrometry and by comparison with reference substances and literature reports, thirty-six identical components were identified in Paeoniae Radix Alba from different cultivars with positive and negative ion modes. In the negative ion mode, two groups of samples were well separated; specifically, seventeen components with significant differences in content were screened and identified, and one component unique in "Bobaishao" was obtained. Quantitative analysis was conducted by high-performance liquid chromatography(HPLC) on an Agilent HC-C_(18)(4.6 mm×250 mm, 5 μm) column with a gradient elution of 0.1% aqueous phosphoric acid(A)-acetonitrile(B) as the mobile phase at a flow rate of 1.0 mL·min~(-1). The column temperature was 30 ℃ and the detection wavelength was at 230 nm. An HPLC method was developed for the simultaneous determination of eight active components(gallic acid, oxypaeoniflorin, catechin, albiflorin, paeoniflorin, galloylpaeoniflorin, 1,2,3,4,6-O-pentagalloylglucose, benzoyl-paeoniflorin) in Paeoniae Radix Albaa from different cultivars. Satisfactory linearity was achieved within the investigated linear ranges and with fine coefficients(r>0.999 0), and the methodological investigation showed that the method had good precision, repeatability and stability. The mean recoveries were 90.61% to 101.7% with RSD of 0.12% to 3.6%(n=6). UPLC-Q-OF-MS provided a rapid and efficient qualitative analytical method for the identification of the chemical components in Paeoniae Radix Alba, and the developed HPLC method was simple, rapid and accurate, which could provide a scientific basis for the evaluation of the germplasm resources and herbal quality of Paeoniae Radix Alba from different cultivars.
Subject(s)
Chromatography, High Pressure Liquid , Paeonia , AcetonitrilesABSTRACT
ABSTRACT Introduction There was a delay in China for the implementation of athletic physical training, often opting for technical and repetitive movements in their teaching method, resulting in an unsatisfactory didactic model. Objective Innovate physical training technology for teaching athletics in colleges and universities. Methods 80 students in two college and university athletics sports classes were submitted to two weekly athletics classes lasting 60 minutes. This paper measured and collected data before and after the battery of exercises, comparing the results pertinent to the group's physical fitness. All training lasted eight weeks. After this period, the relevant indices were measured again, ranked, and compared. Results The research shows that physical training can improve students' athletic performance in different grades, and the effect of athletic gain in students with lower initial performance is more significant. At the same time, strengthening physical training can effectively improve the basal performance of athletics and reduce the occurrence of sports injuries, ensuring the safety of the sports experienced. Conclusion Physical training can promote positive performance in athletics, deserving further research to popularize the implementation of athletic training in athletics for colleges and universities. Level of evidence II; Therapeutic studies - investigation of treatment results.
RESUMO Introdução Houve um atraso na China para a implementação do treino físico atlético, muitas vezes optando por movimentos técnicos e repetitivos em seu método de ensino, resultando num modelo didático insatisfatório. Objetivo Inovar a tecnologia de treinamento físico do ensino de atletismo em faculdades e universidades. Métodos 80 alunos em duas aulas de esportes de atletismo de Faculdades e universidades foram submetidos à duas aulas semanais de atletismo com duração de 60 minutos, este artigo mediu e coletou os dados antes e após a bateria de exercícios, comparando os resultados pertinentes à aptidão física do grupo. Todo o treinamento durou oito semanas. Após este período, os índices relevantes foram medidos novamente, classificados e comparados. Resultados A pesquisa mostra que o treinamento físico pode melhorar o desempenho atlético dos alunos em diferentes séries, e o efeito de ganho esportivo em alunos com menor desempenho inicial é mais significativo. Ao mesmo tempo, o fortalecimento do treinamento físico pode melhorar efetivamente o desempenho basal do atletismo e reduzir a ocorrência de lesões esportivas, garantindo a segurança dos esportes experenciados. Conclusão O treinamento físico pode promover rendimento positivo nos esportes de atletismo, merecendo mais pesquisas afim de popularizar a implementação do treinamento esportivo em atletismo para as Faculdades e universidades. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.
RESUMEN Introducción En China se ha producido un retraso en la implantación del entrenamiento físico atlético, optando a menudo por movimientos técnicos y repetitivos en su método de enseñanza, lo que ha dado lugar a un modelo didáctico insatisfactorio. Objetivo Innovar la tecnología de entrenamiento físico de la enseñanza del atletismo en colegios y universidades. Métodos 80 estudiantes de dos clases de deportes de atletismo de la universidad fueron sometidos a dos clases semanales de atletismo de 60 minutos de duración, este trabajo midió y recogió los datos antes y después de la batería de ejercicios, comparando los resultados pertinentes a la aptitud física del grupo. La formación completa duró ocho semanas. Tras este periodo, se volvieron a medir los índices pertinentes, se clasificaron y se compararon. Resultados La investigación muestra que el entrenamiento físico puede mejorar el rendimiento deportivo de los estudiantes en diferentes grados, y el efecto de la ganancia deportiva en los estudiantes con menor rendimiento inicial es más significativo. Al mismo tiempo, el fortalecimiento del entrenamiento físico puede mejorar eficazmente el rendimiento basal del atletismo y reducir la aparición de lesiones deportivas, garantizando la seguridad de los deportistas experimentados. Conclusión El entrenamiento físico puede promover un rendimiento positivo en los deportes de atletismo, mereciendo una mayor investigación con el fin de popularizar la implementación del entrenamiento en el atletismo para los colegios y universidades. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.
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The hyperacute stage of myocardial infarction refers to a period of time within 30 minutes after the occurrence of myocardial infarction, when the symptoms are not obvious and the diagnosis is difficult, and the related pathophysiological mechanism has received less attention. In this study, proteomics was used to investigate the pathological changes in the early hyperacute phase of myocardial infarction, aiming to provide experimental evidence for pathological mechanism of myocardial infarction hyperacute stage. Meanwhile, the intervention effect and related mechanism of salvianolate injection were discussed based on heat shock protein B6 (HSPB6), aiming to benefit the clinical rational use of salvianolate injection. The protein expression changes before and after myocardial infarction model establishment were detected by label-free proteomics via mass spectrometry and analyzed by bioinformatics method. Then the binding effect of salvianolate injection on the commonly differential protein HSPB6 was evaluated by molecular docking technology, which was finally verified by animal experiments. All animal experimental protocols were approved by the Ethics Committee of Xiyuan Hosptial (2022XLC041). The results of this study showed that a total of 2 166 proteins were quantified by lable-free proteomics, of which 194 shared differential proteins were involved in myocardial injury and body regulation in the hyperacute phase of myocardial infarction, mainly involving molecular functions such as protein homodimerization activity, oxygen binding and transport, and serine endopeptidase inhibitor activity. Among them, HSPB6 protein is involved in the regulation of myocardial function. Molecular docking results indicated that magnesium salvianolate acetate, which is the main component of salvianolate injection, had the lowest binding energy with HSPB6 protein: -14.53 kcal·mol-1. Animal experiments showed that compared with the Sham group, the model group had significantly lower ejection fraction (EF) and fractional shortening (FS) (P < 0.001), cardiac blood perfusion decreased significantly (P < 0.001). There were obvious pathological changes such as myocardial fiber disorder, cardiomyocyte edema and interstitial small blood vessel congestion; the injury of cardiac function of rats in the administration group was attenuated, and the FS of rats in the low-dose group was significantly improved (P < 0.05), the pathological injury of myocardial tissue was markedly mitigated, and the expression of HSPB6 protein was up-regulated to varying degrees (P < 0.01, P < 0.001). In conclusion, salvianolate injection could be able to improve the cardiac function and pathological morphology of rats in the early hyperacute stage of myocardial infarction, and its mechanism may be related to the promotion of expression of HSPB6.
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Based on the technology of platelet proteomics, the key regulatory proteins and pathogenesis of coronary heart disease with phlegm and blood stasis syndrome were explored and analyzed. Based on the previous laboratory research, the model of coronary heart disease in mini-swine with phlegm-stasis cementation syndrome was duplicated. The model was judged by the changes in blood lipid and myocardial tissue characteristics. Furthermore, the platelet proteins were studied by quantitative proteomics, and the differentially expressed proteins were screened. The critical regulatory proteins and biological pathways of coronary heart disease with phlegm-stasis cementation syndrome were analyzed by bioinformatics. After ten weeks of modeling, the levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), very low density lipoprotein (VLDL-C), triglyceride (TG), creatine kinase (CK) and creatine kinase-MB (CK-MB) in the model group were significantly increased, reflecting the pathological changes such as increased blood lipid, abnormal coagulation function and myocardial ischemia in the model group. In addition, compared with the sham group, there were 26 up-regulated proteins and 8 down-regulated proteins in the platelets of the model group. Combined with bioinformatics analysis, it was found that differential proteins mainly involved in glycolysis/gluconeogenesis, pyruvate metabolism, lipid and atherosclerosis, Ras protein signal transduction. Among them, lactate dehydrogenase B (LDHB), alcohol dehydrogenase 5 (ADH5), neuroblastoma ratsarcoma viral oncogene homolog (NRAS) and Kirsten ratsarcoma viral oncogene homolog (KRAS) play a central role when interacting with other proteins and simultaneously participate in multiple action pathways. The results showed that LDHB, ADH5, NRAS, and KRAS may be the marker proteins in CHD with phlegm-stasis cementation syndrome by regulating glycolysis/gluconeogenesis, pyruvate metabolism, lipid and atherosclerosis, Ras protein signal transduction and other biological processes.
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Objective To investigate the application value of tenofovir alafenamide fumarate (TAF) in elderly patients with chronic hepatitis B (CHB) and its influence on bones and kidneys. Methods A total of 36 CHB patients, aged ≥60 years, who received TAF antiviral therapy in Qingdao Municipal Hospital, The Affiliated Hospital of Qingdao University, Qingdao Sixth People's Hospital, Chengyang People's Hospital, and Jimo People's Hospital from June 2021 to October 2022 were enrolled in this study, and all patients received TAF (25 mg/d) antiviral therapy. Related data were collected at baseline and weeks 24 and 48 of treatment, including virological indicators, biochemical parameters, urinary protein electrophoresis indices, transient elastography (FibroScan), and bone mineral density. Virological indicators included high-sensitivity HBV DNA quantification; biochemical parameters included total bilirubin, direct bilirubin (DBil), indirect bilirubin (IBil), alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, gamma-glutamyl transpeptidase, total bile acid (TBA), glucose, blood urea nitrogen, creatinine, estimated glomerular filtration rate, and cystatin C (Cys C); urinary protein electrophoresis indices included urinary β2 microglobulin (β2-MG), urinary retinol (URBP), and urinary α1 microspherin (α1-MG). The paired t -test was used for comparison of normally distributed continuous data before and after treatment, and the Wilcoxon signed-rank test was used for comparison of non-normally distributed continuous data before and after treatment; the chi-square test or the Fisher's exact test was used for comparison of categorical data. Results A total of 36 CHB patients completed 24 weeks of follow-up. The complete virological response rate after 24 weeks of treatment was higher than that at baseline [83.3% (30/36) vs 77.8% (28/36), χ 2 =0.36, P =0.55], and there were significant reductions in DBil ( t =-2.42, P =0.02) and Cys C ( t =-4.34, P 0.05). Conclusion TAF has a good antiviral effect in CHB patients aged ≥60 years and can help more CHB patients achieve complete virological response, without causing damage to the kidney, and it can also improve bone mineral density and liver fibrosis degree.
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【Objective】 To explore the expression of checkpoint kinase 2 (CHEK2) in clear cell renal cell carcinoma (ccRCC), its association with the clinicopathological features and prognosis, and to predict its relevant molecular signaling pathways and biological functions. 【Methods】 The gene expression data, phenotype data, and corresponding survival information of ccRCC patients were downloaded from TCGA database. The optimal cutoff value of CHEK2 was determined with the "survminer" package. The patients were divided into low and high expression groups, and the association between CHEK2 expression and clinicopathological features was analyzed. The correlation between CHEK2 expression and ccRCC prognosis was evaluated with univariate and multivariate Cox proportional hazard models. The changes of cell signaling pathways involved in different CHEK2 expression levels were explored with gene set variation analysis (GSVA). The correlation between CHEK2 and immune cell infiltration as well as immune checkpoint molecular expression was analyzed. 【Results】 CHEK2 expression was significantly higher in ccRCC tissues than in normal tissues (P<0.01). Higher level of CHEK2 was significantly associated with higher T stage of ccRCC (P<0.01). Kaplan-Meier analysis showed overall survival (OS) of patients with high CHEK2 expression were notably decreased (P<0.001). Univariate and multivariate analyses revealed CHEK2 expression as an independent risk factor of survival (HR=1.950, 95%CI: 1.490-2.570, P<0.001; HR=1.588, 95%CI: 1.185-2.127, P=0.002). GSVA showed that CHEK2 was involved in the following pathways: proximal tubule bicarbonate reclamation, propanoate metabolism, limonene and pinene degradation, fatty acid metabolism, primary immunodeficiency, systemic lupus erythematosus, p53 signaling pathway, homologous recombination, DNA replication and mismatch repair. Correlation analysis suggested that CHEK2 was associated with increased infiltration of multiple immune cells in ccRCC and upregulation of various immune checkpoint molecules. 【Conclusion】 The high level of CHEK2 in ccRCC is an independent predicting factor for poor prognosis. It is probably involved in regulating related events of tumor immune infiltration and may become a new target for ccRCC therapy.
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@#Objective To investigate the safety and feasibility of day surgery for patients with palmar hyperhidrosis based on the principles of enhanced recovery after surgery (ERAS). Methods We retrospectively reviewed the medical records of consecutive patients who underwent endoscopic thoracic sympathicotomy (ETS) in the First Affiliated Hospital of Xi'an Jiaotong University from March 2020 to December 2021. Patients were divided into a day surgery group and a conventional group according to their perioperative management methods. The patients in the day surgery group underwent an optimized perioperative procedure under the guidance of ERAS, and were ventilated with a laryngeal or face mask during the operation. The patients in the conventional group completed the preoperative examination, operation and postoperative observation according to the conventional procedures, and were intubated with a single-lumen endotracheal tube. The demographic characteristics, operation time, hospital stay, postoperative complications, and hospitalization cost were compared between the two groups. Results Finally 172 patients were collected, including 90 males and 82 females, with an average age of 25.97±7.43 years. There were 86 patients in each group. All patients ceased suffering from palmar sweating after surgery. No patient experienced massive bleeding or conversion to thoracotomy. There was no statistical difference in operation time between the two groups (P=0.534). Patients in the day surgery group were discharged within 24 hours. The average hospital stay in the conventional group was 2.09±0.41 days. Incidence of postoperative respiratory complications, and the hospitalization cost of the day surgery group were significantly lower than those of the conventional group (P<0.001). The satisfaction rate in both groups was greater than 95%. Conclusion Day surgery for patients with palmar hyperhidrosis based on the principles of ERAS is safe and feasible, which can reduce postoperative complications, shorten the length of hospital stay and save the cost of hospitalization.
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Objective:To understand the status of medical science and technology achievement transformation policies in application, this study conducted a descriptive statistical analysis of the collected relevant policy texts according to type, time, and publication sector. On this basis, the X-Y two-dimensional analysis framework of policy texts is constructed using the dual dimensions of Howlett and Ramesh′s policy tool classification and policy development to classify policies into 3 categories: mandatory tools, voluntary tools, and hybrid tools, and to quantify the policy texts on the transformation of medical science and technology achievements, analyze the policy support received in the transformation of medical science and technology achievements and the policy obstacles in the transformation of achievements in China. Finally, this study was aiming to propose targeted countermeasure suggestions.Methods:The texts of medical achievement transformation policies were collected through the official websites of the State Council and the Ministry of Science and Technology, and combined with relevant literature. Research methods such as literature research method and quantitative and qualitative analysis method were applied to conduct the study. The policy samples were coded and organized, and two-dimensional analysis was conducted through the constructed X-Y two-dimensional analysis framework. The texts were quantitatively analyzed through a combination of quantitative and qualitative methods.Results:The results of the analysis of the coded data revealed that the current mandatory tools of China′s medical science and technology achievement transformation policy account for a relatively high proportion, and the use of voluntary tools still needed to be further improved. The use of various policy tools was uneven. The internal structure of various policy tools was also uneven, and there was still room for improvement.Conclusions:Through qualitative and quantitative analysis of the results of the application of medical science and technology achievement transformation policy in China, this paper puts forward 3 countermeasure suggestions: firstly, in the stage of policy strengthening and implementation, the implementation path and scheme of policy tools need to be refined so that the policy can realize implementation. Secondly, the balanced development of various policy tools, the coordination of policy formulation and implementation, the balanced role of mandatory tools, hybrid tools and voluntary tools, and the establishment of a smooth policy system for the transformation of medical science and technology results on this basis to improve the effectiveness of the policy. Thirdly, improve the internal orientation and evaluation mechanism of medical institutions to motivate medical institutions and medical personnel to carry out scientific and technological innovation and transformation work.
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This paper summaries the Risk of Bias in Non-randomized Studies-of Environmental Exposure (ROBINS-E), a tool for evaluating risk of bias about non-randomized studies of exposures (NRSE), and introduces the application of ROBINS-E in a published NRSE. According to the characteristics of NRSE, evaluation fields and signaling questions were designed in ROBINS-E to provide essential information about risk of bias for NRSE included in systematic reviews and GRADE. ROBINS-E is the tool in assessment of risk of bias in observational studies and quasi-randomized studies. Although the tool has been used in practice to some extent, but it still needs further improvement. Attention should be paid to its update and progress.
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Humans , Bias , Environmental Exposure , Systematic Reviews as TopicABSTRACT
Objective:To investigate the application of system relaxation training on the posttraumatic stress disorder for the families of burned children, so as to provide a basis for the application of valid nursing in children families.Methods:A total of 80 cases of burned children in Children′s Hospital of Nanjing Medical University and corresponding 80 households were recruited and divided into the observation group and the control group with 40 cases each group. The patients and households from January 2019 to May 2019 in the control group received routine care, while the patients and households from February 2020 to June 2020 in the observation group received system relaxation training based on the routine care for four days. The posttraumatic stress disorder and uncertainty in illness of children families before and after intervention were evaluated by Posttraumatic stress Checklist-Civilian version(PLC-C) and Mishel Uncertainty in Illness Scale-Family Member form(MUIS-FM) and compared between the two groups.Results:There was no significant difference in the scores of PLC-C and MUIS-FM before intervention in the households between the two groups( P>0.05). After intervention, the scores of re-experiencing symptoms, avoidance/numbing, increased arousal symptoms and total PTSD scores in the households were (8.40 ± 1.79), (14.35 ± 2.85), (8.25 ± 1.28), (31.10 ± 3.52) points in the observation group and (11.28 ± 2.37), (16.75 ± 2.09), (9.10 ± 1.93), (37.13 ± 4.40) points in the control group, the differences were statistically significant ( t values were -6.76 - -2.32, all P<0.05). After intervention, the scores of ambiguity, deficit information and total MUIS-FM scores of the households were (37.08 ± 6.58), (20.15 ± 4.38), (84.38 ± 6.90) points in the observation group and (41.13 ± 6.54), (22.05 ± 3.32), (90.13 ± 7.85) points in the control group, the differences were statistically significant ( t =-2.76, -2.19, -3.48, all P<0.05). Conclusions:System relaxation training can alleviate posttraumatic stress disorder and reduce uncertainty in illness of the families of burned children.
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Omicron is a newly discovered variant virus of coronavirus disease 2019 and has spread rapidly around the world. Omicron has been defined as a variant of concern by the World Health Organization. Its epidemiology, pathogenic characteristics, clinical diagnosis, treatment, and prevention are still being observed and summarized, and in particular, there are few reports on the diagnosis and treatment of children with Omicron infection. This article introduces the influence of Omicron infection in children and its prevention, diagnosis, and treatment.
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Child , Humans , COVID-19/prevention & control , SARS-CoV-2ABSTRACT
Background/Aims@#Non-alcoholic fatty liver disease (NAFLD) is closely associated with metabolic dysfunction. Among the multiple factors, genetic variation acts as important modifiers. Klotho, an enzyme encoded by the klotho (KL) gene in human, has been implicated in the pathogenesis of metabolic dysfunctions. However, the impact of variants in KL on NAFLD risk remains poorly understood. The aim of this study was to investigate the impact of KL rs495392 C>A polymorphism on the histological severity of NAFLD. @*Methods@#We evaluated the impact of the KL rs495392 polymorphism on liver histology in 531 Chinese with NAFLD and replicated that in the population-based Rotterdam Study cohort. The interactions between the rs495392, vitamin D, and patatin-like phospholipase domain containing 3 (PNPLA3) rs738409 polymorphism were also analyzed. @*Results@#Carriage of the rs495392 A allele had a protective effect on steatosis severity (odds ratio [OR], 0.61; 95% confidence interval [CI], 0.42–0.89; P=0.010) in Chinese patients. After adjustment for potential confounders, the A allele remained significant with a protective effect (OR, 0.66; 95% CI, 0.45–0.98; P=0.040). The effect on hepatic steatosis was confirmed in the Rotterdam Study cohort. Additional analysis showed the association between serum vitamin D levels and NAFLD specifically in rs495392 A allele carriers, but not in non-carriers. Moreover, we found that the rs495392 A allele attenuated the detrimental impact of PNPLA3 rs738409 G allele on the risk of severe hepatic steatosis. @*Conclusions@#The KL rs495392 polymorphism has a protective effect against hepatic steatosis in patients with NAFLD.
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Objective:The study retrospectively identified the correlative factors of low back pain after single-level oblique lateral interbody fusion (OLIF).Methods:Records of 93 patients (55 males and 38 females) who underwent OLIF (oblique lateral interbody fusion) surgery for lumbar degenerative diseases from May 2016 to September 2019 were analyzed retrospectively and patients' age was 55.73±9.48 years (range 32-78 years). There were 18 patients underwent L 3, 4 segment (19.35%), 73 patients underwent L 4, 5 segment (78.50%), and 2 patients underwent L 5S 1 segment (2.15%). There were 43 patients underwent OLIF stand alone and 50 patients underwent OLIF combined with lateral or posterior internal fixation. The follow-up time was 22.86±5.90 months (range 12-32 months). According to whether the visual analog scale (VAS)≥3 at the last follow-up visit, the patients were divided into low back pain group and no low back pain group. The demographic characteristics (age, gender, body mass index and comorbidities), basic surgical data (surgical segments, surgical methods, surgical time, intraoperative bleeding, endplate injury or not during operation), imaging data (lumbar lordosis, segmental lordosis, intervertebral height and cage subside) and lumbar function were recorded. The potential related factors were analyzed by univariate analysis, and the factors with P<0.05 were selected in the multivariate logistic regression model. Then the risk factors of low back pain after OLIF were determined by multivariate logistic regression analysis. Results:Nineteen patients with VAS score equal or greater than 3 were included in low back pain group, and the remaining 74 patients were included in no low back pain group. There was no significant difference in baseline data such as age, gender, BMI, follow-up time and comorbidities between two groups. There was no significant difference in VAS score between the two groups before operation ( t=0.818, P=0.414), but there was significant difference in VAS score at last follow-up visit ( t=6.958, P<0.001). The incidence rate of osteoporosis in low back pain group (63.16%) was significantly higher than that in no low back pain group (25.68%) ( t=9.558, P=0.002). There was no significant difference in vertebral height between the two groups ( t=1.008, P=0.316), however, the vertebral height was higher in no low back pain group ( t=2.537, P=0.316) at the last follow-up. The incidence of cage subsidencewas 8.11% in no low back pain group and 36.84% in low back pain group and there was significant difference between the two groups ( t=10.381, P=0.001). Multivariate logistic regression analysis showed that osteoporosis ( P=0.009), intraoperative bone endplate injury ( P=0.031), decreased intervertebral space height ( P=0.029) and cage subsidence ( P=0.016) were associated with low back pain after single-level OLIF. Conclusion:Low back pain is one of the common complications after OLIF. Osteoporosis, intraoperative bony endplate injury, decreased intervertebral space height and cage subsidence were closely related to postoperative low back pain. In order to reduce the incidence of postoperative low back pain and improve the clinical outcomes, attention should be paid to the protection of the bony endplate, rational use of internal fixation and active anti-osteoporosis treatment after operation.
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Objective:To investigate the clinical efficacy of infra-acetabular screwing in the treatment of acetabular fractures.Methods:A retrospective analysis was conducted of the 22 patients with acetabular fracture who had been admitted to Department of Trauma and Orthopedics, The Affiliated Hospital of Traditional Chinese Medicine, Xinjiang Medical University from January 2016 to January 2019. They were 16 males and 6 females, aged from 19 to 65 years (mean, 45.2 years). According to Letournel-Judet classification, there were 2 anterior column fractures, 12 anterior plus posterior hemi-transverse fractures, 3 T-shaped fractures and 5 both-column fractures. All patients were treated with infra-acetabular screwing through the ilioinguinal approach. Recorded were the patients＇ operation time, intraoperative blood loss, reduction quality, fracture union time, hip function and complications.Results:Operation time for this cohort ranged from 115 to 285 min (mean, 160 min), and intraoperative blood loss from 360 to 1,600 mL (mean, 650 mL). By the Matta scoring, fracture reduction was assessed as excellent in 14 cases, as good in 5 cases and as poor in 3 cases, giving an excellent and good rate of 86.4% (19/22). Of this cohort, 21 were followed up from 12 to 45 months (mean, 28.5 months) and one was lost to the follow-up. The fracture healing time for 21 patients ranged from 1.6 to 3.0 months, averaging 2.2 months. No patient had fracture displacement. The Merle d’Aubigné & Postel hip scores at the last follow-up ranged from 8 to18 points (average, 16 points), giving 12 excellent, 6 good, 2 fair, and one poor cases and an excellent and good rate of 85.7% (18/21). Follow-ups observed injury to the lateral femoral cutaneous nerve in one case, deep venous thrombosis of lower limb in 2 cases, superficial wound infection in one case and traumatic arthritis in one case, yielding a total rate of compilations of 23.8% (5/21).Conclusion:Application of infra-acetabular screwing after anatomical reduction of an acetabular fracture can effectively enhance the strength of internal fixation with no risk of fracture re-displacement, conducive to early functional exercise of the patient and leading to good clinical efficacy.
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Objective:To investigate the effect of O-arm navigation assisted posterior pedicle screw reduction and internal fixation of atlantoaxial fractures.Methods:A retrospective case-control study was conducted to analyze 37 patients with atlantoaxial fractures admitted to Third Hospital of Hebei Medical University from January 2016 to June 2018, including 22 males and 15 females, aged from 29 to 68 years [(50.9±9.8)years]. The posterior pedicle screw reduction and internal fixation was performed under O-arm navigation system (navigation group, n=24), and using free-hand technique (free-hand group, n=13). The operation time and blood loss were compared between the two groups. The Japanese Orthopaedic Association (JOA) score and neck disability index (NDI) were used to evaluate the clinical efficacy before operation, 7 days operation and at the last follow-up. The complications were detected. A total of 86 screws were placed in navigation group (Neo grade 0: 83 screws, grade 1: 2 screws, grade 2: 1 screw ), and 44 screws were inserted in free-hand group (Neo grade 0: 36 screws, grade 1: 5 screws, grade 2: 2 screws, grade 3: 1 screw)( P<0.05). Classification of screw positions proposed by Neo et al was used to evaluate the position relationship between the screw and the bone cortex and the incidence of screw penetration. Results:All patients were followed up 24-38 months [(27.7±4.0)months]. The operation time in navigation group was (189.8±35.4)minutes, significantly shorter than (221.5±48.6)minutes in free-hand group ( P<0.05). The bleeding volume in navigation group was 300.0 (250.0, 537.5)ml , significantly less than 500.0 (425.0, 625.0)ml in free-hand group ( P<0.05). Both groups showed significantly enhanced JOA and decreased NDI after operation and at last follow-up, compared with those before operation ( P<0.05). However, there was no significant difference in JOA and NDI between the two groups ( P>0.05). No severe complications such as neurovascular injury occurred during operation. The incidence of cortical penetration was 3% (3/86) in navigation group and 18% (8/44) in free-hand group ( P<0.05). Conclusions:In the process of posterior atlantoaxial pedicle screw placement, the application of O-arm navigation can significantly reduce the operation time and amount of bleeding, and enhance the accuracy of pedicle screw implantation.
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Background/Aims@#Nonalcoholic steatohepatitis (NASH) is a progressive form of nonalcoholic fatty liver disease (NAFLD) characterized by hepatic steatosis, inflammation, hepatocellular injury, and fibrosis. We aimed to investigate the usefulness of a key biomarker, lipocalin-2 (LCN2), for the detection of NASH progression. @*Methods@#A mouse NASH model was established using a high-fat diet and a high-sugar drinking water. Gene expression profile of the NASH model was analyzed using RNA sequencing. Moreover, 360 NAFLD patients (steatosis, 83; NASH, 277), 40 healthy individuals, and 87 patients with alcoholic fatty liver disease were recruited. @*Results@#Inflammatory infiltration, focal necrosis in the leaflets, steatosis, and fibrosis were documented in the mouse liver. In total, 504 genes were differentially expressed in the livers of NASH mice, and showed significant functional enrichment in the inflammation-related category. Upregulated liver LCN2 was found to be significantly interactive with various interleukins and toll-like receptors. Serum LCN2 levels were significantly increased in NAFLD patients. Serum LCN2 levels were correlated with steatosis, intralobular inflammation, semiquantitative fibrosis score, and nonalcoholic fatty liver disease activity score. The area under the curve of serum LCN2 was 0.987 with a specificity of 100% and a sensitivity of 93.5% for NASH diagnosis, and 0.977 with almost the same specificity and sensitivity for steatosis. @*Conclusions@#LCN2 might be involved in the transition from NAFL to NASH by mediating inflammation. Serum LCN2 levels might be a novel biomarker for the diagnosis of NASH.
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Objective:To explore the evaluation dimensions and indicators of research hospital, provide empirical evidence for the construction of research hospital.Methods:Non-probability sampling was adopted, physicians from 9 hospitals in Shanghai that have a National Clinical Medical Research Center or Shanghai Clinical Medical Research Center were invited as survey participants. The physician participants were divided into senior and junior groups. For senior group, a questionnaire including 5 dimensions and 21 indicators was provided. The survey participants were consulted to determine whether the indicators can be used to measure this dimension, and also invited to propose additional dimensions and indicators for improvement.For junior group, two open questions were proposed to explore their needs of support in both clinical service and research.Results:Based on suggestions from the research participants, the research team, and other expert consultant, this article tried to propose 5 dimensions and 21 indicators for evaluating research hospitals. Among them, 11 were indicators compiled by the research team based on the literature review and agreed by more than 2/3 of senior physicians surveyed, while others were proposed based on the survey results. The research team planned to use the entropy method to determine the weights of different indicators, thus, the participants were not required to make judgments on the weights of dimensions and indicators.Conclusions:The evaluation of research hospitals has not yet formed a systematic consensus. Through the exploration and establishment of evaluation dimensions and indicators, identify hospitals that are closer to the development goals of research hospitals can provide a basis for future next-step practices.
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Paeoniae Radix Alba is the dried root of Paeonia lactiflora, which was first recorded in the Shennong's Classic of Materia Medica and listed as the top grade. It is a common blood-tonifying herb, and its chemical components are mainly monoterpenes and their glycosides, triterpenes, flavonoids and so on. Modern research has demonstrated that Paeoniae Radix Alba has the activities of anti-inflammation, pain easing, liver protection, and anti-oxidation, and thus it is widely used in clinical practice and has broad development prospects. In this paper, the research progress on the chemical composition, pharmacological effects, and quality control of Paeoniae Radix Alba were summarized. On this basis, the Q-markers of Paeoniae Radix Alba were predicted from the aspects of mass transfer and traceability, chemical composition specificity, and availability and measurability of chemical components, which will provide a scientific basis for the quality evaluation of Paeoniae Radix Alba.
Subject(s)
Drugs, Chinese Herbal , Medicine, Chinese Traditional , Monoterpenes , Paeonia , Plant ExtractsABSTRACT
BACKGROUNDS@#Previous surveys have found that children with iron deficiency (ID) were likely to suffer from early childhood caries (ECC). We aimed to assess the scientific evidence about whether ID is intrinsically related to ECC.@*METHODS@#The medical subject headings (MeSH) terms and free words were searched on PubMed, Web of Science, Cochrane, China National Knowledge Infrastructure, Wanfang, and the Database for Chinese Technical Periodicals from March 2020 to September 2020. Two researchers independently screened the articles. Data extraction and cross-checking were performed for the studies that met the inclusion criteria. Meta-analysis was performed using the Cochrane Collaboration's Review Manager 5.3 software.@*RESULTS@#After excluding duplication and irrelevant literature, 12 case-control studies were included in the study. The meta-analysis demonstrated that children with ECC were more likely to have ID (odds ratio [OR] = 2.63, 95% confidence interval [CI]: [1.85, 3.73], P < 0.001). There was no statistically significant association found between the level of serum ferritin and ECC (weighted mean difference (WMD) = -5.80, 95% CI: [-11.97, 0.37], P = 0.07). Children with ECC were more likely to have iron-deficiency anemia (OR = 2.74, 95% CI: [2.41,3.11], P < 0.001). The hemoglobin (HGB) levels in the ECC group were significantly lower compared with that in the ECC-free group (WMD = -9.96, 95% CI: [-15.45, -4.46], P = 0.0004). The mean corpuscular volume (MCV) levels in the ECC group were significantly lower compared with that in the ECC-free group (WMD = -3.72, 95% CI: [-6.65, -0.79], P = 0.01).@*CONCLUSIONS@#ID was more prevalent in children with ECC, and the markers of iron status in the ECC group, such as serum ferritin, HGB, and MCV, were relatively lower than the ECC-free group.