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Objective To determine the acetylation level of nucleophosmin(NPM)in female breast cancer and to discuss its function through mutation of modified lysine sites.To construct positive and negative NPM mutants on its acetylated lysine sites and to express them in breast cancer cells.Methods Acetylation level and acetylated lysine sites of NPM in three breast cancer tissues and para-carcinoma tissues were detected by acetylome technology;NPM mutants were constructed by site-directed mutagenesis PCR,specific PCR products were digested by DpnI and transformed into Escherichia coli(E.coli)to obtain specific plasmids for mutants;The accuracy of mutants were verified by double restriction enzyme digestion and sequencing;The mutants were expressed in BT-549 cells by transient transfection and verified by RT-PCR method.Protein expression and acetylation level of NPM were validated by Western blotting;Function of NPM acetylation was analyzed by proteomic detection and bioinformatic analysis.Results The 27th and 32nd lysine of NPM were highly acetylated in breast cancer tissues,which were 2.76 and 2.22 times higher than those in adjacent normal tissues,respectively;The NPM mutants showed the same molecular weight as that of wild type NPM and contained expected mutation sites;Corresponding NPM mRNA levels of BT-549 cells transfected with NPM mutants were significantly increased.With the increase of wild type NPM expression level,NPM acetylation level increased,while decreased after 27th lysine underwent negative mutation.NPM acetylation can significantly change the expression levels of 101 proteins in BT-549 cells,which are enriched in regulation of cellular macromolecule biosynthesis,DNA-template transcription,RNA biosynthesis and RNA metabolism process.Conclusion NPM is highly acetylated in breast cancer and can play a key role in cellular macromolecule biosynthesis,DNA-templated transcription,RNA biosynthesis and RNA metabolism process.
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Most chemical medicines have polymorphs. The difference of medicine polymorphs in physicochemical properties directly affects the stability, efficacy, and safety of solid medicine products. Polymorphs is incomparably important to pharmaceutical chemistry, manufacturing, and control. Meantime polymorphs is a key factor for the quality of high-end drug and formulations. Polymorph prediction technology can effectively guide screening of trial experiments, and reduce the risk of missing stable crystal form in the traditional experiment. Polymorph prediction technology was firstly based on theoretical calculations such as quantum mechanics and computational chemistry, and then was developed by the key technology of machine learning using the artificial intelligence. Nowadays, the popular trend is to combine the advantages of theoretical calculation and machine learning to jointly predict crystal structure. Recently, predicting medicine polymorphs has still been a challenging problem. It is expected to learn from and integrate existing technologies to predict medicine polymorphs more accurately and efficiently.
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Objective Cervical disc herniation(CDH)is one of the common orthopaedic diseases.With the in-depth study of it and the development of cervical implants,the establishment of cervical fusion animal models has become an indispensable part.Notably however,studies of the establishment and evaluation of cervical fusion animal models in China are currently lacking.This study aimed to provide a suitable animal model and evaluation scheme for implants for cervical spine-related research.Methods Small-tailed Han sheep were chosen for anterior cervical discectomy fusion(ACDF)after modified surgery,and a polyetheretherketone(PEEK)interbody fusion cage(Cage)(control group),3D-printed Ti6Al4V Cage(group 1),and new method Ti6Al4V Cage(group 2)were implanted in different cervical segments(C2/3~C4/5)in each sheep,respectively.Hematology and histopathological analyses were carried out after surgery to evaluate recovery of sheep and the biosafety of the materials.Bone in-growth and bone fusion were assessed by X-ray,computed tomography(CT),Micro-CT and quantitative analysis,hard tissue section staining,and biomechanical tests.Results The modified ACDF ovine model was established successfully.There were no significant differences in important hematology indexes(P>0.05)and histopathological analysis showed no pathological changes,such as inflammatory cell infiltration.The implants had good biosafety.Furthermore,X-ray and CT examinations showed that the position of internal fixation and the interbody fusion were good.Micro-CT and quantitative analysis at 3 and 6 months after operation showed that compared with PEEK Cage group,the bone volume/total volume and trabecular number were significantly increased(P<0.01)while the trabecular spacing was significantly decreased in the new method Ti6Al4V and 3D-printed Ti6Al4V groups compared with the PEEK Cage group(P<0.01).Moreover,the new method new method Ti6Al4V Cage group had more bone growth(P<0.01).Hard tissue section staining demonstrated that the pores of the new method Ti6Al4V Cage and 3D-printed Ti6Al4V Cage had obvious bone growth and relatively dense pores in the new method Ti6Al4V and 3D-printed Ti6Al4V groups,and the combination was slightly better than that of PEEK Cage.Biomechanical evaluation indicated that the new method Ti6Al4V Cage and 3D-printed Ti6Al4V Cage reduced the range of cervical flexion-extension,lateral bending,and axial rotation(P<0.05)compared with the PEEK cage,as well as enhancing the stability of the cervical vertebra,and the new method Ti6Al4 V Cage was more advantageous(P<0.05).Conclusions After the establishment of the modified ACDF ovine model,reasonable and effective assessment method were used to demonstrate the suitability and effectiveness of the model and the good biosecurity of all three Cage materials.Compared with the PEEK Cage,the new method Ti6Al4V Cage and 3D-printed Ti6Al4V Cages showed better performances in terms of bone growth and bone fusion,which could enhance the stability of the cervical vertebrae.The new method Ti6Al4V Cage was particularly advantageous.
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OBJECTIVE@#To explore the influential factors associated with functional status of those patients who undertook a full-endoscopic lumbar discectomy operation.@*METHODS@#A prospective study was conducted. A total of 96 patients who undertook a full-endoscopic lumbar discectomy operation and met inclusive criteria were enrolled in the study. The postoperative follow-up was held 1 month, 3 months and 6 months after operation. The self-developed record file was used to collect the patient's information and medical history. Visual analogue scale (VAS) score, Oswestry disability index (ODI) score, Gene-ralised anxiety disorder-7 (GAD-7) scale score and patient health questionnaire-9 (PHQ-9) scale score were applied to measure pain intensity, functional status, anxiety status and depression status. Repeated measurement analysis of variance was used to explore the ODI score 1 month, 3 months and 6 months after operation. Multiple linear regression was recruited to illuminate the influential factors associated with functional status after the operation. Logistic regression was employed to explore the independent risk factors related to return to work 6 months after operation.@*RESULTS@#The postoperative functional status of the patients improved gradually. The functional status of the patients 1 month, 3 months and 6 months after operation were highly positively correlated with the current average pain intensity. The factors influencing the postoperative functional status of the patients were different according to the recovery stage. One month and 3 months after operation, the factors influencing the postoperative functional status were the current average pain intensity; 6 months after operation, the factors influencing the postoperative functional status included the current average pain intensity, preoperative average pain intensity, gender and educational level. The risk factors influencing return to work 6 months after operation included women, young age, preoperative depression status and high average pain intensity 3 months after operation.@*CONCLUSION@#It is feasible to treat chronic low back pain with full-endoscopic lumbar discectomy operation. In the process of postoperative functional status recovery, medical staffs should not only take analgesic mea-sures to reduce the pain intensity experienced by the patients, but also pay attention to the impact of psychosocial factors on the recovery. Women, young age, preoperative depression status, and high average pain intensity 3 months after operation may delay return to work after the operation.
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Humans , Female , Infant , Intervertebral Disc Displacement/etiology , Prospective Studies , Functional Status , Treatment Outcome , Diskectomy/adverse effects , Endoscopy , Pain , Lumbar Vertebrae/surgery , Retrospective StudiesABSTRACT
In recent years, with the development and maturity of endoscopic technique, endoscopic spinal surgery represented by water media and optical rigid endoscope has been widely used in the treatment of many disorders in the cervical, thoracic and lumbar spine. Endoscopic spinal surgery shows similar clinical effects as traditional open surgery or other minimally invasive procedures, and is favored by spinal surgeons due to its advantages of less trauma and rapid recovery after surgery. However, the large-scale application of endoscopic technique brings problems such as non-standard nomenclature and unreasonable indications. Therefore, this article will summarize the surgical nomenclature and indications of endoscopic spinal surgery, in order to provide a reference for spinal surgeons to understand and apply endoscopic technology reasonably.
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Objective:To investigate the effect of application of problem-based learning (PBL) combined with evidence-based medicine (EBM) in clinical practice teaching of an orthopedic department.Methods:A total of 48 interns who entered Department of Orthopedics, The Second Hospital of Anhui Medical University, Hefei, China from June 2017 to June 2018 were randomly divided into experimental group (the PBL combined with EBM concept teaching group, n = 24) and control group (the traditional teaching group, n = 24). In the experimental group, teachers selected typical cases, designed questions with certain flexibility and complexity, and organized the students to consult the literature, discuss in groups, and report and summarize around the practical problems. In the control group, traditional indoctrination teaching was adopted according to the clinical experience of the teachers. The teaching effect was assessed by a questionnaire survey, a theoretical examination, and a clinical skill examination. The results were analyzed by t-test and Chi-square test using SPSS 16.0 software. Results:The questionnaire survey showed that compared with the control group, the experimental group gave a significantly better evaluation of the teaching methods they received in terms of improving their theoretical knowledge comprehension ability, comprehensive analysis ability, team collaboration awareness, document retrieval and language expression ability, stimulating their learning motivation, and enhancing their scientific thinking and innovation ability ( P < 0.05). Furthermore, compared with the control group, the experimental group had significantly higher mean scores for both the theoretical test (92.42±2.55 vs. 86.17±3.36, P < 0.05) and the clinical skill test (85.79±3.15 vs. 78.88±3.41, P < 0.05). Conclusion:The application of PBL teaching in orthopedic practice, with the concept of EBM throughout the teaching process, has obtained a good effect. It can improve the clinical teaching quality in orthopedics, improve the comprehensive quality of clinical medical students, inspire their active learning enthusiasm, and cultivate their creative thinking, problem construction, comprehensive analysis, literature retrieval, and communication ability.
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ObjectiveTo analyze the application of International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) in China. MethodsResearches using ISNCSCI in the spinal cord injury were retrieved from CNKI, from January 1st, 2020 to December 31st, 2022. The authors and the keywords of the included literatures were analyzed using VOSviewer and CiteSpace to generate a collaboration network graph of authors and a theme distribution map of keywords. The objects, purposes, causes of spinal cord injury, distribution of researchers' departments, ISNCSCI version used, corresponding publication time and other information of the included studies were manual searched and analyzed. ResultsA total of 285 literatures were finally included, involving 1 279 authors, out of whom 111 published 97.19% of the total number of articles. The main keywords included spinal cord injury, spinal fractures, neurological function, thoracolumbar fractures and spinal tuberculosis, which classified in seven clusters, and the topics of spinal cord injury, efficacy, spinal fractures, quality of life and prognosis were the hotspots in the field. With manual searching, the main topic was spinal cord injury; the main object was traumatic spinal cord injury; the main purpose was to evaluate the surgical efficacy; the research institutions were mostly the comprehensive hospitals or specialized hospitals focusing on orthopedics (spinal surgery); the clinical departments that used ISNCSCI the most were orthopedics (including spinal surgery) and rehabilitation medicine, and nursing teams were paying more attention to ISNCSCI; the most commonly used versions of ISNCSCI were 2011 (7th edition) and 2000 (6th edition), however, for a large number of articles, the versions were not clear or earlier than 2000. ConclusionThe application of ISNCSCI in China should be improved in the standardization.
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AIM: To observe the efficacy of moderate and high myopia patients with vault greater than 1 000μm after implantation of phakic posterior chamber implantable contact lens(ICL).METHODS: A total of 42 patients(73 eyes)who received ICL implantation in the hospital and had postoperative vault greater than 1 000 μm between January 2014 and January 2017 were selected and retrospectively studied. Changes in visual acuity, intraocular pressure, corneal endothelial cell density, anterior chamber-related parameters(chamber angle, central anterior chamber depth, anterior chamber volume)and vault were compared among patients before surgery, at 1, 3, 6mo and 1a after surgery and at the last follow-up.RESULTS: The uncorrected visual acuity(UCVA)at 1, 3, 6mo and 1a after surgery and at the last follow-up was better than that before surgery(all P&#x003C;0.05), and the chamber angle, central anterior chamber depth and anterior chamber volume were smaller or lower than those before surgery(all P&#x003C;0.05), but there were no statistical differences in UCVA, chamber angle, central anterior chamber depth and anterior chamber volume at each time point after surgery(all P&#x003E;0.05). The intraocular pressure at 1mo after surgery was lower than that before surgery(P&#x003C;0.05), but the intraocular pressure at 3, 6mo and 1a after surgery and at the last follow-up was not statistically different from that before surgery(all P&#x003E;0.05). There was no statistical significance in the corneal endothelial cell density at 1, 3, 6mo and 1a after surgery and at the last follow-up compared with that before surgery(all P&#x003E;0.05). The vault at 1, 3, 6mo and 1a after surgery and at the last follow-up showed a decreasing trend, and the difference was statistically significant at each time point after surgery(all P&#x003C;0.05).CONCLUSION: The short-term and long-term efficacy are better in moderate and high myopia patients with vault greater than 1 000 μm after ICL implantation, and there are no significant effects on the intraocular pressure and corneal endothelial cell. The postoperative anterior chamber structure is relatively stable and the vault tends to decrease over time. In most cases, close observation is sufficient and intraocular lens replacement is generally not required.
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Objective:To explore the clinical efficacy of arthroscopic repair of ulnar tear of triangular fibrocartilage complex (TFCC) by loop stitch using a suture anchor.Methods:A retrospective case series study was used to analyze the clinical data of 46 patients with TFCC ulnar tear admitted to Ningbo Sixth Hospital from February 2019 to October 2020, including 28 males and 18 females; aged 18-64 years [(35.9±10.3)years]. All the patients had unilateral tears, including 18 on the left side and 28 on the right side, and all of them had Palmer type IB injuries. During the operation, one anchor was placed in the proximal end of the ulnar styloid process, and the ulnar side tear of the TFCC was repaired using arthroscopic anchor loop suture method. The visual analogue score (VAS), modified Mayo wrist score, disability of the arm, shoulder and hand (DASH) score, hand grip strength, wrist flexion and extension, and forearm rotation range of motion were compared before operation, at 3 months after operation, and at the last follow-up. The healing of surgical incisions and postoperative complications were observed.Results:All the patients were followed up for 13-35 months [24.0(17.5, 28.0)months]. The VAS, modified Mayo wrist score, DASH score and hand grip strength were improved from preoperative (4.2±0.9)points, (72.9±8.1)points, (27.9±4.7)points and (17.4±3.6)kg to (2.6±1.7)points, (82.1±6.1)points, (15.3±4.2)points and (20.3±3.5)kg at postoperative 3 months, and to (0.7±0.3)points, (91.8±4.2)points, (12.3±3.8)minutes and (23.6±4.1)kg at the last follow-up ( P<0.05 or 0.01), which were further improved at the last follow-up when compared to those at postoperative 3 months (all P<0.05). Based on the modified Mayo wrist score, the results were excellent in 28 patients, good in 14, and fair in 4 at the last follow-up, with an excellent and good rate of 91.3% (42/46). No significant differences were found in the wrist flexion-extension or forearm rotation range of motion before operation, at 3 months after operation, or at the last follow-up (all P>0.05). All surgical incisions achieved phase I healing. The postoperative complications included hypoesthesia and numbness of the skin on the ulnar side of the hand dorsum and the dorsal proximal section of the little finger in 3 patients and tenderness at the anchor in 2. No anchor loosening or prolapse occurred at the last follow-up. Conclusion:Arthroscopic repair of TFCC ulnar tear by loop stitch using a suture anchor can effectively relieve ulnar-sided wrist pain, improve the function of the wrist joint and upper limbs, and increase the grip strength of the hand, with fewer postoperative complications, making it an effective treatment method for TFCC ulnar tear.
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Objective:To investigate the IL-38 level in patients with primary biliary cholangitis (PBC), and to assess the modulatory function of IL-38 on the phenotype shift from regulatory T cells (Tregs) to Th17 cells in PBC.Methods:Forty-six PBC patients and 24 controls were included. Serum IL-38, IL-35 and IL-17 levels were measured by enzyme-linked immunosorbent assay. CD4 +CD25 +CD127 dim/-Tregs and CD4 +IL-17A +Th17 cell proportions in peripheral blood mononuclear cells (PBMC) were assessed by flow cytometry. Forkhead box P3 (FoxP3) and retinoid acid receptor related orphan receptor γt (RORγt) mRNA expressions were semi-quantified by real-time PCR. Purified Tregs were stimulated with recombinant IL-38, and were cocultured with autologous PBMC. Tregs function was assessed by measuring cellular proliferation and cytokines expression in the supernatants. Tregs were also polarized for Th17 culture, and recombinant IL-38 was added for stimulation. The influence of IL-38 on trans-differentiation of Tregs into Th17 phenotype was investigated by measuring CCR4/CCR6 expression, IL-17 secretion and RORγt mRNA expression. Student′s t test or Mann-Whitney U test were used for comparison between groups. Results:Serum IL-38 level was significantly lower in PBC group compared with control group [68.02(48.51, 96.74) pg/ml vs 89.6(58.0, 265.5)pg/ml, Z=3.25, P=0.037]. Proportion of Tregs [(6.9±1.3)% vs (11.3±3.5)%, t=7.64, P<0.001], FoxP3 mRNA expression [(1.0±0.3) vs (1.9± 0.7), t=7.74, P<0.001] and serum IL-35 level [25.87(16.08, 37.26)pg/ml vs 30.99(24.81, 52.29)pg/ml, Z=2.02, P=0.047] were notably lower in PBC group, while Th17 cell proportion [(5.5±1.4)% vs (3.8±1.0)%, t=5.43, P<0.001)], RORγt mRNA expression [(1.4±0.6) vs (1.0±0.4), t=2.72, P=0.008] and serum IL-17 level [202.0(121.6, 311.6)pg/ml vs 104.5(79.8, 155.5)pg/ml, Z=4.43, P<0.001] were remarkably higher in PBC group. Purified Tregs were co-cultured with autologous PBMC. Cellular proliferation was increased in PBC group compared with control group [(6.5±1.40)×10 5vs (5.3±1.1)×10 5, t=2.49, P=0.020]. IL-35 and IL-10 secretions in the supernatants were lower in PBC group ( P<0.05), but interferon- γ was higher in PBC group ( P=0.011). Tregs were also polarized for Th17 culture. CCR4 and CCR6 mean fluorescence intensity (MFI), RORγt mRNA and IL-17 secretion were higher in PBC group compared with control group ( P<0.05). IL-38 stimulation enhanced the inhibitory activity of Tregs from both PBC group and control group, which presented as reduced cellular proliferation as well as enhanced IL-35 and IL-10 secretion ( P<0.05). IL-38 stimulation only suppressed transdifferentiation of Tregs into Th17 phenotype in PBC group, which presented as down-regulation of CCR4 MFI, CCR6 MFI and IL-17 secretion ( P<0.05). However, IL-38 did not affect Tregs trans-differentiation into Th17 phenotype in control group. Conclusion:IL-38 played an immune-protective role and suppressed inflammatory response in the disease progression of PBC. IL-38 inhibited transdifferentiation of Tregs into Th17 phenotype in PBC patients.
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OBJECTIVES@#To develop the birth weight curve of singleton neonates with a gestational age of 24-42 weeks, and to investigate the regional differences of the birth weight curve.@*METHODS@#A total of 11 maternal and child health hospitals with more than 7 000 neonates delivered annually were selected in 11 cities of China (Haikou, Guangzhou, Shenzhen, Liuzhou, Guilin, Quanzhou, Chongqing, Chengdu, Changsha, Ningbo, and Lianyungang), and all live singleton neonates delivered in the 11 hospitals from January 1, 2017 to December 31, 2020 were enrolled for the development of birth weight curves.@*RESULTS@#A total of 93 720 singleton neonates with a gestational age of 24-42 weeks from the 11 cities were included in the study. The reference values of the 3rd-97th percentiles of birth weight of singleton neonates for the total of the 11 cities and for each of the 11 cities were established, and the birth weight percentile curves were drawn. The birth weight curve level of singleton neonates in Shenzhen and Quanzhou was almost the same as the average level of the 11 cities; the birth weight curve level of singleton neonates in Haikou, Guangzhou, Guilin, and Liuzhou was slightly lower than the average level of the 11 cities; the birth weight curve level of singleton neonates in Chongqing, Chengdu, and Changsha was slightly higher than the average level of the 11 cities; the birth weight curve level of singleton neonates in Ningbo and Lianyungang was higher than the average level of the 11 cities. The average birth weight curve level of singleton neonates in the 11 cities were very close to that of China Neonatal Cooperation Network in 2011-2014.@*CONCLUSIONS@#The reference values of the 3rd-97th percentiles of birth weight of singleton neonates for the total of the 11 cities and for each of the 11 cities are developed, which can be used as a reference for evaluating the intrauterine growth of singleton neonates in the region. The level of intrauterine growth of neonates in some cities is different from the national level.
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Child , Humans , Infant , Infant, Newborn , Birth Weight , China , Cities , Gestational Age , Reference ValuesABSTRACT
Objective:To understand the iodine nutritional status and the prevalence of goiter and thyroid nodules among children in Suqian City, and to provide a basis for prevention and treatment of iodine deficiency disorders.Methods:From May 2019 to July 2020, the counties (districts) in Suqian City were divided into 5 areas according to east, west, south, north, and middle, each area selected 1 township (street) every year, and 40 non-boarding students aged 8 - 10 years were selected (balanced age and gender) from 1 primary school from each township (street). Children's urine samples and household salt samples were collected to detect urinary iodine and salt iodine contents, and some children were subjected to thyroid examination and height and weight measurements.Results:A total of 1 999 urine samples were collected from children aged 8 to 10 years, and the median urinary iodine was 221.0 μg/L. There was a statistically significant difference among different counties (districts, H = 147.89, P < 0.05). A total of 1 999 edible salt samples were collected from children's homes, and the salt iodine content was (24.01 ± 4.55) mg/kg. Among them, iodized salts was 1 979, the coverage rate of iodized salt was 99.00%; the qualified iodized salts was 1 910, and the iodized salt qualified rate was 96.51%, and the consumption rate of qualified iodized salt was 95.55%. A total of 1 000 cases of children's thyroid were examined, and 22 cases of goiter, 51 cases of solid thyroid nodules, and 54 cases of thyroid cyst were detected, and the detection rates were 2.20%, 5.10%, and 5.40%, respectively. There were significant differences in the detection rates of solid nodules and cysts beteen different counties (districts, χ 2 = 16.41, 37.66 , P < 0.05), but there was no significant difference in the detection rates of goiter (χ 2 = 8.65 , P > 0.05). According to Spearman correlation analysis, children's thyroid volume was positively correlated with height and weight ( r = 0.403, 0.315, P < 0.05). Conclusions:The iodine nutrition of children in Suqian City is at an excessively suitable level of iodine, and the salt iodine monitoring indicators meet the national iodine deficiency disorders elimination standards (the coverage rate of iodized salt ≥ 95%, and the consumption rate of qualified iodized salt > 90%). The children's thyroid volume is affected by factors such as height and weight.
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Objective:To investigate anticoagulant effects of mechanical methods in obese patients undergoing laparoscopic sleeve gastrectomy (LSG).Methods:In this prospective study, 54 obese patients receiving LSG were enrolled . All patients were given post-op mechanical methods for thrombogenic interventions. BMI and the operation-related factors were recorded. Venous blood specimens were taken from each patient before surgery, at the end of pneumoperitoneum (i.e., 0 h after surgery), at 24 hours after surgery for prothrombin time (PT) and activated partial thromboplastin time (APTT), fibrinogen (FIB) and D-dimer (D-D).Results:All 54 obese patients successfully underwent LSG. No severe complications were observed. Before operation, the mean BMI was (43.49±8.29) kg/m 2. DVT-2600 device was applied in all patients for 3 consecutive days after surgery. The PT values increased at 0 h, 24 h after surgery [(12.4±1.2) s, (12.4±0.8) s vs. (11.2±0.8) s, P=0, 0]. The APTT values at 0 h, 24 h after surgery decreased [(29.7±3.6) s, (29.0±3.1) s vs.(31.2±3.3) s, P=0.020, 0.001]. However, the D-D values increased at 0 h,24 h after operation [(213±143) ng/ml ,(445±237) ng/ml vs. (85±108) ng/ml, P=0, 0]. All patients were followed up for 1 month, and no thrombosis -related complications were observed. Conclusion:Mechanical methods for obese patients after LSG can help decrease the risk of deep venous thrombosis.
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Objective: To examine the modalities of treatment and clinical outcomes of emphysematous pyelonephritis (EPN), in order to improve the survival rate of EPN patients. Methods: Totally 14 patients diagnosed as EPN between October 2011 and November 2020 at Department of Urology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine were included in this article. Data collection including patient demographics, clinical manifestations, management and clinical outcomes were conducted by retrospective charts review, after receiving the institutional review board's approval. There were 11 females and 3 males with a median age of 59 years (range: 52 to 73 years). The lesions were located on the left side in 10 patients and right side in 4 patients. All the 14 patients suffered from fever, and present with severe sepsis or septic shock. The median time from symptom onset to admission to hospital was 3 days(range: 2 to 5 days). All cases had diabetes mellitus. Escherichia coli was the most common organism been cultured (11 cases), while Klebsiella pneumonia was the second (3 cases). CT scan showed bubbly or located gas in the renal parenchyma in 5 cases and presence of steaky or mottled gas in the renal parenchyma in 9 cases. All patients had been admitted to ICU for anti-septic shock therapy. Three patients had undergone percutaneous catheter drainage along with broad-spectrum antibiotics therapy while 3 patients had immediate nephrectomy, the other 8 cases had a combination of an initial percutaneous catheter drainage and second stage nephrectomy. Results: In this case series, 3 patients were died from EPN while the other 11 were survived. The median ICU stay time was 6 days (range: 3 to 11 days). Of the 3 patients died from EPN, 2 had undergone percutaneous catheter drainage along and 1 had received immediate nephrectomy. Among the 11 patients who were survived, only 1 had received percutaneous catheter drainage while the other 10 received nephrectomy (8 patients had staged nephrectomy). Follow-up was performed 6 months after discharge. Of the 11 surviving patients, 2 were lost to follow-up, and the remaining 9 patients had an creatine level of (118.4±29.4) μmol/L (range: 89 to 176 μmol/L). Conclusions: For patients coupled with diabetes who were initially diagnosed as acute pyelonephritis, the possibility of EPN should be considered when the disease progressed rapidly especially septic shock occurred. On the basis of empirical broad-spectrum antibiotics therapy and standardized anti-septic shock treatment, a combination of an initial percutaneous catheter drainage and second stage nephrectomy could be efficacious.
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Aged , Female , Humans , Male , Middle Aged , Emphysema/therapy , Escherichia coli Infections , Pyelonephritis/therapy , Retrospective Studies , Treatment OutcomeABSTRACT
Objective: To examine the effectiveness and safety of application of the ureteral access sheath in the treatment of middle or lower ureteral calculi in patients with large-volume benign prostatic hyperplasia above grade Ⅲ, which is expected to avoid the simultaneous or staged treatment of benign prostatic hyperplasia via eliminate the difficult angle and resistance of ureteroscopy caused by severe prostatic hyperplasia. Methods: From April 2018 to December 2020, the clinical data of 27 patients with massive benign prostatic hyperplasia above grade Ⅲ and middle and lower ureteral calculi treated with indwelling ureteral access sheath plus ureteroscopy holmium laser lithotripsy at Department of Urology, Zhejiang Quhua Hospital were retrospectively analyzed and followed up. All the patients were male, aged (69.7±12.8) years (range: 55 to 87 years). Prostate volume measured by transrectal ultrasound was (94.8±16.2) cm3 (range: 85 to 186 cm3). The ureteral access sheath was indwelled in advance, and then the semirigid ureteroscopy was introduced through the working channel of the sheath. Holmium laser lithotripsy was performed, and intraoperative and postoperative complications were recorded. Urinary abdominal plain X-ray or CT urography were performed at 1-and 2-month postopaerative to evaluate the residual stones and clinical efficacy. Results: The ureteral access sheath was placed and holmium laser lithotripsy under a semirigid ureteroscopy was performed successfully in all the 27 patients. In 2 patients, a second session of auxiliary procedure was required due to the large load of preoperative stones and residual stones after surgery, among whom 1 patient received extracorporeal shock wave lithotripsy and 1 patient underwent extracorporeal shock wave lithotripsy plus ureteroscopic lithotripsy. The stone free rate at 1-and 2-month postoperative were 92.6% (25/27) and 100% (27/27), respectively. There were no severe complications such as ureteral avulsion and perforation, perirenal hematoma, septic shock, severe hematuria, urinary retention, iatrogenic ureteral stricture occurred during and after the surgery. The ureteral calculus was wrapped by polyps heavily in 1 patient, he was diagnosed as ureteral stenosis 1 month postoperative, receiving laparoscopic resection of ureteral stricture plus anastomosis 3 months postoperative. Conclusions: In the operations of middle and lower ureteral calculi in patients with large-volume prostatic hyperplasia above grade Ⅲ, the ureteral access sheath can be placed first to effectively eliminate the difficult angle and resistance of ureteroscopy caused by severe prostatic hyperplasia, and then semirigid ureteroscopic lithotripsy can be safely performed. It could avoid the treatment of benign prostatic hyperplasia at the same time or by stages.
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Aged , Aged, 80 and over , Humans , Male , Middle Aged , Lithotripsy , Lithotripsy, Laser , Prostatic Hyperplasia/complications , Retrospective Studies , Treatment Outcome , Ureteral Calculi/surgery , UreteroscopyABSTRACT
Hepatitis B virus infection and hepatitis C virus infection often progress to end-stage liver diseases such as liver cirrhosis, liver failure, and hepatocellular carcinoma, which endanger the life of patients. Recent studies have shown that gut microbiota are closely associated with chronic viral liver diseases. This article reviews the association of gut microbiota with chronic hepatitis B (CHB), chronic hepatitis C (CHC), and their related liver diseases and the research advances in therapies targeting gut microbiota against CHB and its related liver diseases, in order to provide more ideas for the clinical treatment of CHB, CHC, and their related liver diseases.
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Adulteration in meat products is a widespread issue that could lead to serious threats to public health and religious violations. Technology that offers rapid, sensitive, accurate and reliable detection of meat species is the key to an effectual monitoring and control against meat adulteration. In recent years, high-throughput sequencing-based DNA metabarcoding technology has developed rapidly. With the characteristics of being high-throughput, highly precise and high-speed, this technology can simultaneously identify multiple species in complex samples, thus offering pronounced advantages in the surveillance of adulteration in meat and meat products. Starting with an introduction of the major developments in the high-throughput sequencing technology in the past two decades, this review provides an overview of the technical characteristics and research methods of DNA metabarcoding, summarizes the application of DNA metabarcoding technology in meat adulteration detection over the last few years, discusses the challenges of using DNA metabarcoding technology in the detection of meat adulteration, and provides future prospects on the development of this technology.
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DNA , Food Contamination/analysis , High-Throughput Nucleotide Sequencing/methods , Meat/analysis , Meat Products , TechnologyABSTRACT
Objective:To study the clinical efficacy and prognostic quality of neurointervention combined with alteplase in the treatment of acute ischemic stroke.Methods:Ninety-two patients with acute ischemic stroke admitted to the First People's Hospital of Bijie City from February 2019 to December 2020 were selected and divided into the control group and the observation group using the random number method, with 46 cases in each group. Patients in both groups received conventional treatment with intravenous thrombolytic therapy with alteplase, and on this basis, patients in the observation group received neurointerventional treatment. The overall efficiency, national institutes of health stroke scale (NIHSS) score, modified Thrombolysis in cerebral infarction classification (mTICI) score, modified rankin scale (mRS) score, complication rate, and prognostic indexes of patients in both groups were compared after the treatment.Results:The total treatment efficiency of patients in the observation group was 93.48%, which was significantly higher than that of 76.09% in the control group ( P<0.05). The NIHSS scores of both groups were significantly lower than those of the same period before treatment at 1 and 7 days and 1 and 3 months after the treatment (all P<0.05), and the NIHSS scores of the observation group were significantly lower than those of the control group at the same period ( P<0.01). The proportions of mTICI grades < grade 2 and mRS scores in the observation group were significantly lower than those in the control group after treatment(all P<0.05). The overall complication rate of patients in the observation group was significantly lower than that of the control group( P<0.05), and the re-infarction rate of patients in the observation group was significantly lower than that of the control group ( P<0.05). Conclusions:For acute ischemic stroke, neurointervention combined with alteplase is effective, can reduce the risk of complications, and improve the quality of the patient's prognosis, and therefore deserves to be promoted in clinical practice.
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Objective:To learn about the iodine nutritional status of pregnant women in Suqian City, Jiangsu Province, and to provide evidence for scientific supplementation of iodine of pregnant women.Methods:From May 2016 to July 2020, five sampling districts were divided in each county (district) of Suqian City according to the oriation of east, west, south, north and center each year. One township (street) was selected from each district, and 20 pregnant women who lived in the local area for more than half a year were selected from each township (street). The 30 g of household salt samples of pregnant women and 5 ml of urine samples at random once were collected to test the salt iodine and urinary iodine content.Results:A total of 2 483 household salt samples of pregnant women were tested, and the median salt iodine was 23.9 mg/kg; among them, 2 454 were iodized salt, and the coverage rate of iodized salt was 98.8%; the qualified iodized salt was 2 383, the qualified rate of iodized salt was 97.1%, and the consumption rate of qualified iodized salt was 96.0%. There were statistically significant differences in coverage rate of iodized salt, qualified rate of iodized salt and consumption rate of qualified iodized salt between different years (χ 2 = 10.55, 13.23, 11.37, P < 0.05). A total of 2 483 urine samples of pregnant women were tested, and the median urinary iodine was 167.6 μg/L, which was at the appropriate iodine level. However, the median urinary iodine of pregnant women in 2020 was 146.7 μg/L, lower than the WHO/UNICEF/ICCIDD recommendation standard (150 μg/L). The differences of median urinary iodine of pregnant women in different years, pregnancy periods and regions were statistically significant ( H = 26.08, 8.17, 19.87, P < 0.05). Conclusions:The coverage rate of iodized salt, qualified rate of iodized salt and consumption rate of qualified iodized salt in Suqian City , meet the national standard for eliminating iodine deficiency disorders. Iodine nutrition of pregnant women in Suqian City is at an appropriate iodine level, but some pregnant women may have iodine deficiency.
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Objective:To investigate the effects of hyperuricemia on the prognosis of IgA nephropathy (IgAN) using propensity score matching (PSM) method.Methods:IgAN patients proven by biopsy were included. PSM was used to match patients. Kaplan-Meier method was used for survival analysis, and Cox regression analysis was used to analyze the effects of hyperuricemia on IgAN prognosis. Primary outcome events were defined as death, or end-stage renal disease (dialysis, transplantation), or a decrease in estimated glomerular filtration rate (eGFR) greater than 40%. Renal outcome was defined as end-stage renal disease (dialysis, transplantation), or a decrease in eGFR greater than 40%.Results:A total of 1 454 IgAN patients were included in this study, including 850 females and 604 males. Uric acid level was (368.26±92.87) μmol/L in the males, and (277.23±92.71) μmol/L in the females. The median follow-up time was 85.00(56.10, 106.33) months. During the follow-up period, a total of 134 patients reached the primary outcome events, including 5 deaths, 24 dialysis patients, 5 kidney transplant patients, and 100 patients with eGFR decreased by more than 40%. After 1∶1 matching, 131 males and 159 females in the hyperuricemia group were successfully matched with 131 males and 159 females in the normal uric acid group, and there was no significant statistical difference in each parameter in baseline between the hyperuricemia group and normal uric acid group after matching. Kaplan-Meier survival analysis showed that either before or after matching, the incidence of primary outcome events in male or female patients with hyperuricemia was higher than those with normal uric acid, but there was no statistically significant difference in incidence of primary outcome events between female hyperuricemia group and female normal uric acid group after matching (Log-rank test, χ2=3.586, P=0.058). Cox proportional hazard regression model showed that, in the pre-match fully adjusted model, the hazard ratio ( HR) of entering primary outcome events was 2.29-fold (95% CI 1.27-4.11, P=0.006) for men with hyperuricemia and 1.85-fold (95% CI 1.01-3.37, P=0.045) for women with hyperuricemia compared with those with normal uric acid. In the post-match fully adjusted model, the HR of entering primary outcome events was 2.41-fold (95% CI 1.18-4.93, P=0.016) for men with hyperuricemia and 1.83-fold (95% CI 0.91-3.67, P=0.091) for women with hyperuricemia compared with those with normal uric acid. In the pre-match fully adjusted model, the HR of entering renal outcome events was 2.68-fold (95% CI 1.47-4.88, P=0.001) for men with hyperuricemia and 1.81-fold (95% CI 0.99-3.33, P=0.056) for women with hyperuricemia compared with those with normal uric acid. In the post-match fully adjusted model, the HR of entering renal outcome events was 2.89-fold (95% CI 1.36-6.15, P=0.006) for men with hyperuricemia and 1.81-fold (95% CI 0.88-3.72, P=0.106) for women with hyperuricemia compared with those with normal uric acid. Conclusion:Hyperuricemia may be associated with IgAN progression, and it has a more significant effect on male IgAN patients.