Role of liver sinusoidal endothelial cell in metabolic dysfunction-associated fatty liver disease.

Liver sinusoidal endothelial cells (LSECs) are highly specialized endothelial cells that represent the interface between blood cells on one side and hepatocytes on the other side. LSECs not only form a barrier within the hepatic sinus, but also play important physiological functions such as regulating hepatic vascular pressure, anti-inflammatory and anti-fibrotic. Pathologically, pathogenic factors can induce LSECs capillarization, that is, loss of fenestra and dysfunction, which are conducive to early steatosis, lay the foundation for the progression of metabolic dysfunction-associated fatty liver disease (MAFLD), and accelerate metabolic dysfunction-associated steatohepatitis (MASH) and liver fibrosis. The unique localization, phenotype, and function of LSECs make them potential candidates for reducing liver injury, inflammation, and preventing or reversing fibrosis in the future.

COVID­19 vaccine: recent advancements and future prospects.

Nowadays, although severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) epidemic has been handled with long-term management globally, the virus strains keep continuous evolution in an uncertain direction. The newly emerged JN.1 dominated the globally circulating variants in a short time and resulted in increasing hospitalizations. Up to 2024, variant vaccines with the composition of XBB sub-lineage were available due to the coordinated efforts of developers and regulatory agencies. The development of updated vaccines is still needed and the regular availability of coronavirus disease 2019 (COVID-19) vaccines should be timely guaranteed. The current landscape of COVID-19 vaccines and the strategies for accelerating vaccine development and approval are reviewed. Proposals to enhance variants monitoring and the establishment of the strain recommendation mechanism are made. This review provides suggestions about platform technology designation and application, real-world data leveraging and modification to regulatory pathways both for the post-pandemic era of SARS-CoV-2 and for the future unknown pathogen pandemic.

From growth and fixed creative mindsets to creative thinking: an investigation of the mediating role of creativity motivation.

Studies documenting and seeking to understand the mindset effect have yielded mixed and inconclusive findings. The present study sought to address the research question pertaining to the mindset effect on creative thinking and its underlying mechanism from the perspectives of social cognitive theory and mindset theory, which postulate a motivational mechanism underlying the mindset-creativity link. Specifically, this study aimed to examine the mediating role of creativity motivation in the effects of growth and fixed creative mindsets on creative thinking. A convenience sample of 948 college students from three universities in Hong Kong participated in the study. Creative mindset, creativity motivation, and creative thinking were assessed using the Chinese version of the Creative Mindset Scale, the Creativity Motivation Scale, and the Test for Creative Thinking-Drawing Production (TCT-DP), respectively. Lending support to the perspectives of social cognitive and mindset theories, the results of mediation analyses conducted using Preacher and Hayes's bootstrapping approach indicated that creativity motivation had partial mediating effects on the positive and negative roles of growth and fixed mindsets, respectively, in creative thinking. Enriching the research on the motivation mechanism underlying the impacts of creative mindsets on creative thinking, the results further illustrated that creativity motivation has a stronger mediating effect on the impact of growth creative mindset on creative thinking than on that of fixed creative mindset. The possible theoretical and educational implications of the findings of this research are discussed.

NT-proBNP ratio is a potential predictor for COVID-19 outcomes in adult Chinese patients: a retrospective study.

Despite the progressive decline in the virulence of the novel coronavirus, there has been no corresponding reduction in its associated hospital mortality. Our aim was to redefine an accurate predictor of mortality risk in COVID-19 patients, enabling effective management and resource allocation. We conducted a retrospective analysis of 2917 adult Chinese patients diagnosed with COVID-19 who were admitted to our hospital during two waves of epidemics, involving the Beta and Omicron variants. Upon admission, NT-proBNP levels were measured, and we collected demographic, clinical, and laboratory data. We introduced a new concept called the NT-proBNP ratio, which measures the NT-proBNP level relative to age-specific maximum normal values. The primary outcome was all-cause in-hospital mortality. Our analysis revealed a higher in-hospital mortality rate in 2022, as shown by the Kaplan-Meier Survival Curve. To assess the predictive value of the NT-proBNP ratio, we employed the time-dependent receiver operating characteristic (ROC) curve. Notably, the NT-proBNP ratio emerged as the strongest predictor of mortality in adult Chinese hospitalized COVID-19 patients (area under the curve, AUC = 0.826; adjusted hazard ratio [HR], 3.959; 95% confidence interval [CI] 3.001-5.221; P < 0.001). This finding consistently held true for both the 2020 and 2022 subgroups. The NT-proBNP ratio demonstrates potential predictive capability compared to several established risk factors, including NT-proBNP, hsCRP, and neutrophil-to-lymphocyte ratio, when it comes to forecasting in-hospital mortality among adult Chinese patients with COVID-19.Trial registration Clinical Trial Registration: www.clinicaltrials.gov NCT05615792.

The effect of guardrail color on driver behavior based on driving style along mountain curves.

OBJECTIVE: Mountain highways are linearly complex, with extensive curves and high accident injury rates, how to improve driving safety is the key to traffic safety management on mountain highways, and it also meets the need for harmonious and sustainable development of the society. Therefore, this study investigates the effects of different guardrail color configurations on the driving behavior of different styles of drivers when driving on mountainous curves from the perspective of improving road aids - guardrails. METHODS: A virtual reality experiment was designed using a driving simulator and VR technology, and 64 subjects were recruited to participate and complete the experiment. RESULTS: Drivers with non-adaptive driving styles (Reckless, Angry, Anxious) traveled at significantly higher speeds than subjects with adaptive driving styles (Cautious) on mountainous roads; drivers with Cautious styles had better lane-keeping ability when passing through different radii of curves as compared to non-adaptive drivers; and the red and yellow guardrails were more effective in decreasing the speeds at which drivers passed and in increasing the stability of lane-keeping. CONCLUSIONS: The results of the study show that the effectiveness of red and yellow guardrails is better, which provides a reference for the traffic management department to propose a standardized color setting of guardrails in mountainous areas, which is conducive to the development of more precise traffic management measures to reduce the occurrence of traffic accidents.

Effects of age and playing position on field-based physical fitness measures in adolescent female soccer players.

BACKGROUND: While numerous studies have explored age and playing position effects on fitness levels in male adolescent soccer players, research on female players in this context is lacking. The purpose of this study was to examine the effects of age and playing position on field-based physical fitness measures in adolescent female soccer players, with consideration for maturity. METHODS: This cross-sectional study involved 284 females aged 12.0-15.9 years. Participants performed the 20-m multi-stage fitness test (20MSFT) to assess estimated maximum oxygen uptake (VO2max), 10-m and 20-m sprints, 505 Test to evaluate change of direction speed (CODS), the medicine ball chest throw (MBCT) and countermovement vertical jump (CMVJ) to assess muscle power. For data analysis, participants were separated into age groups (12, 13, 14, and 15 years), and playing position (forward, midfielder, defender, and goalkeeper). Age at peak height velocity was considered a covariate to account for maturity status. RESULTS: Players aged 14 years demonstrated faster CODS compared to 15 years old (P=0.014), while superior MBCT performance was noted at both ages compared to younger ages (P<0.001). Goalkeepers exhibited lower VO2max than midfielders and defenders (P<0.05). Defenders and goalkeepers exhibited greater hip circumference and body mass compared to midfielders (P≤0.01), along with a larger waist circumference for defenders compared to midfielders (P=0.003). Age and position interactions were absent. When analyses were run without controlling for maturity, all results were the same except for CODS where no age effect was found. CONCLUSIONS: This study suggests that upper body power, and flexibility may be impacted by age and playing position in adolescent female soccer players, regardless of maturity status. The CODS appears to be influenced by age only when controlling for maturity.

An investigation into the influence of context effects on crowd exit selection under gender difference in indoor evacuation.

Introduction: Exit selection is crucial in indoor emergency evacuation. Domestic and foreign scholars have found that exit choice behavior is influenced by three factors: environmental factors, social interactions, and individual internal factors. Previous studies have shown that in addition to a single environmental factor affecting exit decisions, the influence of other available exit options in the context can ultimately lead to a reversal of exit decisions -The context effect. However, the impact of context effects on exit decisions in emergency situations has not been thoroughly explored. Therefore, this article identifies three basic independent variables: context effects, crowd flows, and gender differences, to study the exit decisions of different gender groups facing different crowd flows, as well as how context effects affect existing exit decisions. Methods: In this paper, we used virtual reality technology to construct an indoor fire scene and designed a total of 15 virtual experiments with different crowd distribution or context effects. 131 participants were divided into two groups, male and female, and their exit decisions were observed under different crowd flows and contextual effects. Results: The research results show that: 1) Both men and women have an innate preference to avoid crowded exits, and the proportion of following crowd evacuation significantly decreases when there are crowded crowds in the scene; 2) The exit decisions of female participants are more influenced by the crowd, while men tend to be more influenced by context effects when evacuating independently; 3) The context effects on exit decisions in emergency situations is statistically significant, and this performance is more significant in the male population. Further analysis reveals that similarity effects have a more significant impact on exit decisions than attraction effects. Discussions: These findings provide deeper insights into the exit choice behavior of the population and may contribute to the design of safe exits in indoor buildings. In addition, this article emphasizes the importance of context effects and provides a foundation for future research.

Effects of different treatments for type 2 diabetes mellitus on mortality of coronavirus disease from 2019 to 2021 in China: a multi-institutional retrospective study.

The coronavirus disease (COVID-19) pandemic has continued for 5 years. Sporadic cases continue to occur in different locations. Type 2 diabetes mellitus (T2DM) is associated with a high risk of a poor prognosis in patients with COVID-19. Successful control of blood glucose levels can effectively decrease the risks of severe infections and mortality. However, the effects of different treatments were reported differently and even adversely. This retrospective study included 4,922 patients who have been diagnosed as COVID-19 and T2DM from 138 Hubei hospitals. The clinical characteristics and outcomes were compared and calculated their risk for death using multivariate Cox regression and Kaplan-Meier curves. After adjustment of age, sex, comorbidities, and in-hospital medications, metformin and alpha-glucosidase inhibitor (AGI) use performed lower all-cause mortality (adjusted hazard ratio [HR], 0.41; 95% confidence interval [CI]: 0.24-0.71; p = 0.001 for metformin; 0.53, 0.35-0.80, p = 0.002 for AGIs), while insulin use was associated with increased all-cause mortality (adjusted HR, 2.07, 95% CI, 1.61-2.67, p < 0.001). After propensity score-matched (PSM) analysis, adjusted HRs for insulin, metformin, and AGIs associated with all-cause mortality were 1.32 (95% CI, 1.03-1.81; p = 0.012), 0.48 (95% CI, 0.23-0.83, p = 0.014), and 0.59 (95% CI, 0.35-0.98, p = 0.05). Therefore, metformin and AGIs might be more suitable for patients with COVID-19 and T2DM while insulin might be used with caution.

Identification and experimental validation of programmed cell death- and mitochondria-associated biomarkers in osteoporosis and immune microenvironment.

Background: Prior research has demonstrated that programmed cell death (PCD) and mitochondria assume pivotal roles in controlling cellular metabolism and maintaining bone cell equilibrium. Nonetheless, the comprehensive elucidation of their mode of operation in osteoporosis (OP) warrants further investigation. Therefore, this study aimed at analyzing the role of genes associated with PCD (PCD-RGs) and mitochondria (mortality factor-related genes; MRGs) in OP. Methods: Differentially expressed genes (DEGs) were identified by subjecting the GSE56815 dataset obtained from the Gene Expression Omnibus database to differential expression analysis and comparing OP patients with healthy individuals. The genes of interest were ascertained through the intersection of DEGs, MRGs, and PCD-RGs; these genes were filtered using machine learning methodologies to discover potential biomarkers. The prospective biomarkers displaying uniform patterns and statistically meaningful variances were identified by evaluating their levels in the GSE56815 dataset and conducting quantitative real-time polymerase chain reaction-based assessments. Moreover, the functional mechanisms of these biomarkers were further delineated by constructing a nomogram, which conducted gene set enrichment analysis, explored immune infiltration, generated regulatory networks, predicted drug responses, and performed molecular docking analyses. Results: Eighteen candidate genes were documented contingent upon the intersection between 2,354 DEGs, 1,136 MRGs, and 1,548 PCD-RGs. The biomarkers DAP3, BIK, and ACAA2 were upregulated in OP and were linked to oxidative phosphorylation. Furthermore, the predictive ability of the nomogram designed based on the OP biomarkers exhibited a certain degree of accuracy. Correlation analysis revealed a strong positive correlation between CD56dim natural killer cells and ACAA2 and a significant negative correlation between central memory CD4+ T cells and DAP3. DAP3, BIK, and ACAA2 were regulated by multiple factors; specifically, SETDB1 and ZNF281 modulated ACAA2 and DAP3, whereas TP63 and TFAP2C governed DAP3 and BIK. Additionally, a stable binding force was observed between the drugs (estradiol, valproic acid, and CGP52608) and the biomarkers. Conclusion: This investigation evidenced that the biomarkers DAP3, BIK, and ACAA2 are associated with PCD and mitochondria in OP, potentially facilitate the diagnosis of OP in clinical settings.

Biological Functions of CD24 in Malignant Tumor and its Application as a Novel Anti-tumor Target / 中国生物化学与分子生物学报

CD24 is a highly glycosylated protein that is linked to the plasma membrane via a glycosylphosphatidylinositol anchor. As a universally expressed protein on immune cells, CD24 is also overexpressed in nearly 70% of human cancers including hepatocellular carcinoma, lung cancer and bladder cancer et al. Studies revealed that CD24 is involved in regulating cell proliferation, migration and invasion in cancer cells by interacting with P-selectin, activating Wnt and MAPK signaling pathway or other signaling molecules. Therefore, CD24-targeted siRNA or antibody has a great potential to exert anti-tumor effects by blocking the interaction. There are currently several agents or regiments targeting CD24 for the treatment of patients with various kinds of cancers that are undergoing assessment in the preclinical study at present. Recent studies revealed that CD24 was able to interact with the inhibitory receptor sialic-acid-binding Ig-like lectin 10 (Siglec-10), which located on the surface of macrophages, to compose a novel immune checkpoint. The binding of CD24 to Siglec-10 elicits an inhibitory signaling cascade, limits macrophage phagocytosis, evades immune surveillance, and promotes tumor growth, which suggested that CD24 may be a potential target in anti-tumor immunotherapy. In this review, we introduced the structure and function of CD24 and its role in cancer progression and anti-tumor immunity. Moreover, the progression in developing novel anti-cancer drugs or treatment strategies with the target of CD24 was summarized, which aims to provide a new insight in CD24-targeting therapy.

Research progress of microglia regulating phagocytosis of apoptotic neurons after intracerebral hemorrhage / 中华神经科杂志

Intracerebral hemorrhage is the bleeding caused by spontaneous non-traumatic rupture of blood vessels in brain parenchyma. It has high disability rate and mortality. A series of injuries after intracerebral hemorrhage will lead to neuronal apoptosis. If apoptotic neurons are not cleared in time, intracellular toxic substances will be released, thereby further aggravating the inflammatory reaction. Therefore, the timely clearance of apoptotic cells is of great significance to the brain homeostasis after intracerebral hemorrhage. At the same time, a large number of phagocytic "eat me" signal phosphatidylserine (PS) will appear on the surface of apoptotic neurons. Microglia, as resident macrophages in the brain, have a variety of PS receptors on their surface, which promote the phagocytosis of apoptotic neurons by microglia and reduce the occurrence of local inflammatory responses.

A study on repair method of type Ⅱc injury in lateral meniscus popliteal tendon area of porcine knee / 中国修复重建外科杂志

OBJECTIVE@#To investigate the repair method of type Ⅱc injury in the lateral meniscus popliteal tendon area based on the porcine knee joint.@*METHODS@#Eighteen commercially available fresh porcine knee joints were randomly divided into 3 groups ( n=6). After preparing a type Ⅱc injury in the lateral meniscus popliteal tendon area, and the anterior (group A), posterior (group B), or anterior and posterior (group C) of the popliteal hiatus (PH) was sutured by vertical mattress. The tension meter was used to apply gradient tensions of 2, 4, 6, 8, and 10 N along the tibial plateau horizontally, respectively, to pull the midpoint of the lateral meniscus popliteal tendon area. The displacement values before modeling, after modeling, and after suture were recorded. The reduction value of lateral meniscus displacement and reduction rate after suture were calculated and compared between groups.@*RESULTS@#There was no significant difference between groups ( P>0.05) in the displacement values before modeling, after modeling, and after suture under different tensions. There was no significant difference between groups A and C ( P>0.05) in the reduction value of lateral meniscus displacement and reduction rate after suture under different tensions. The reduction value of lateral meniscus displacement and reduction rate after suture in group B were lower than those in groups A and C. The reduction value of lateral meniscus displacement under tension of 2 N and the reduction rates under tensions of 2, 4, and 6 N between groups A and B showed significant differences ( P<0.05). The reduction value of lateral meniscus displacement and the reduction rate under tensions of 2, 4, and 6 N between groups B and C showed significant differences ( P<0.05).@*CONCLUSION@#Suturing the anterior area of PH is the key to repairing type Ⅱc injury of lateral meniscus popliteal tendon area.

Comparing Arsenic-Containing Qinghuang Powder and Low-Intensity Chemotherapy in Elderly Patients with Acute Myeloid Leukemia / 中国结合医学杂志

OBJECTIVE@#To compare the clinical effect of arsenic-containing Qinghuang Powder (QHP) and low-intensity chemotherapy (LIC) in treatment of elderly acute myeloid leukemia (eAML) patients.@*METHODS@#Clinical data of 80 eAML patients treated at Xiyuan Hospital of China Academy of Chinese Medical Sciences from January 2015 to December 2020 were retrospectively analyzed. The treatment scheme was designed by real world study according to patients' preference, and patients were divided into a QHP group (35 cases) and a LIC group (45 cases). The median overall survival (mOS), 1-, 2-, and 3-year OS rates, and incidence of adverse events were compared between the two groups.@*RESULTS@#The mOS of 80 patients was 11 months, and the 1-, 2-, and 3-year OS rates were 45.51%, 17.96%, and 11.05%, respectively. The QHP and LIC groups demonstrated no significant difference in mOS (12 months vs. 10 months), 1- (48.57% vs. 39.65%), 2- (11.43% vs. 20.04%), and 3-year OS rates (5.71% vs. 13.27%, all P>0.05). Moreover, the related factors of mOS demonstrated no significant difference in patients with age>75 years (11 months vs. 8 months), secondary AML (11 months vs. 8 months), poor genetic prognosis (9 months vs. 7 months), Eastern Cooperative Oncology Group performance status score ⩾ 3 (10 months vs. 7 months) and hematopoietic stem cell transplant comorbidity index ⩾ 4 (11 months vs. 7 months) between the QHP and LIC groups (all P>0.05). However, the incidence of myelosuppression was significantly lower in the QHP group than that in the LIC group (28.57% vs. 73.33%, P<0.01).@*CONCLUSIONS@#QHP and LIC had similar survival rates in eAML patients, but QHP had a lower myelosuppression incidence. Hence, QHP can be an alternative for eAML patients who do not tolerate LIC.

Association between posterior tibial slope and tibial torsion angle and recurrent patellar dislocation based on the full-length CT of the lower limbs / 解剖学报

Objective To measure and compare the lateral posterior tibial slope (LPTS) , medial posterior tibial slope ( MPTS) and tibial torsion angle ( TTA) between the patients of recuiTent patellar dislocation and the heathy people, and to analyze the correlation between LPTS, MPTS and TTA and the risk factors of recuiTent patellar dislocation. Methods A total of 33 patients (44 knees) with recuiTent patellar dislocation in our hospital from July 2019 to June 2021 were selected and listed as the stud)' group. Twenty-three subjects (46 knees) who were suspected iliac vascular and lower limb vascular diseases during the same period were selected and listed as the control group. All the enrolled researchers had fulllength CT scans date of the lower limbs. Three-dimensional models were reconstructed using Mimics 21. 0 software and then imported into 3-matic software. The LPTS, MPTS and TTA were measured and compared between the two groups. Results In the study group, the LPTS, MPTS and TTA were (7. 69} 1. 42) ° , ( 10. 06} 1. 71) ° , ( 36. 42}8. 13 ) ° , respectively while the control group, the LPTS, MPTS and TTA were ( 8. 42 } 1. 65 ) ° , ( 10. 44 } 0. 86 ) ° , ( 25. 77} 3. 90 ) ° , respectively. There were no signiiicant differences in the LPTS, MPTS and TTA between different genders and sides both in the stud)' group and the control group ( P > 0. 0 5 ) . Compared with the control group, the LPTS in the stud)' group was smaller, and the difference was statistically significant (P0. 05). Compared with the control group, the TTA in the stud)' group was higher, and the difference was statistically significant (P< 0. 0 5 ) . Compared with the control group, the LPTS and MPTS in the study group were significant asymmetry, and the difference was statistically significant ( P < 0 . 0 5 ). Conclusion The lateral posterior tibial slope of patients with recurrent patellar dislocation is significantly smaller than that in the healthy people, while there is no significant difference in the medial posterior tibial slope; The tibial torsion angle of patients with recurrent patellar dislocation is significantly larger than in the healthy people; The lateral posterior tibial slope and tibial torsion angle have certain correlation with recurrent patellar dislocation, which can conduct the diagnosis of recurrent patellar dislocation.

Progress of human epidermal growth factor receptor 2 expression in breast cancer and its detection methods / 肿瘤研究与临床

Positively expressed human epidermal growth factor receptor 2 (HER2) occurs in 20%-30% of breast cancer patients, and the prognosis of them is generally poor. Fortunately, the application of HER2-targeted drugs has bright hopes for these patients. The comprehensive detection strategy of immunohistochemistry (IHC) for detecting HER2 protein overexpression combined with fluorescence in situ hybridization (FISH) for detecting HER2 gene amplification is widely used in HER2 breast cancer. However, this strategy applied in some patients with specially expressed HER2 in clinic is still controversial. RNAscope technique can make in situ analysis of HER2 mRNA expression and can be used as a complementary method. This paper summarizes the detection methods of HER2 on protein, DNA and RNA levels in order to provide references for accurate HER2 detection methods in breast cancer.

Hematoma regression: a therapeutic target for intracerebral hemorrhage / 国际脑血管病杂志

The disability and mortality rate of patients with intracerebral hemorrhage are very high. At present, there is no effective treatment to improve the outcome of patients with intracerebral hemorrhage. Mechanical compression of hematoma and release of toxic products are the main causes of primary and secondary brain injury in patients with intracerebral hemorrhage, while safe and effective acceleration of hematoma regression is the key strategy to improve the neurological deficit in patients with intracerebral hemorrhage. Microglia/macrophages are the main phagocytic system that mediates hematoma clearance and are mainly polarized into M1 and M2 phenotypes. Cell surface receptors and possible signal transduction pathways play an important role in regulating the endogenous hematoma regression mediated by microglia/macrophages, and may become a new target for clinical treatment of intracerebral hemorrhage and improvement of the outcomes of patients in the future.

Repair of soft tissue defect of forefoot with free posterior tibial artery perforator flap: Report of 13 cases / 中华显微外科杂志

Objective:To investigate the clinical effect of free posterior tibial artery perforator flap in repair of forefoot soft tissue defect.Methods:From January 2017 to January 2021, a retrospective study was conducted on 13 patients with forefoot soft tissue defect, metatarsal head exposed, and forefoot transverse arch integrity, including 9 males and 4 females. The age was (40.0±13.0) years old. Cause of injury: 8 cases of traffic accident injury, 5 cases of heavy object smashing injury. Seven cases had forefoot skin defect and toe damage, and 6 cases had forefoot skin avulsion injury, open toe fracture with tendon, blood vessel and nerve injury. The wound area was 4.5 cm×3.0 cm-8.0 cm×6.0 cm. VSD treatment was performed in the first stage, and free posterior tibial artery perforator flap was used for the second stage. The flap area was 5.5 cm×4.0 cm-9.0 cm×7.0 cm. Outpatient reviews scheduled at 1, 2, 3, and 6 months after surgery, through outpatient clinic, telephone or WeChat. The flaps were evaluated according to appearance, texture, sensory recovery, and the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hind foot function scoring system.Results:All 13 flaps survived. The follow-up lasted for 6 to 24 months. The feet were in good shape, walking with weight beries, and the flaps had satisfactory appearance without wear and tear. Five cases were S 3, 6 were S 2, and 2 were S 1. According to AOFAS ankle-hindfoot function score, 4 had excellent scores, 7 were in good, and 2 in fair. Conclusion:The free posterior tibial artery perforator flap has relatively constant perforators, and the pedicle of the middle and upper perforators is longer, and the flap can build part of the sensation. Posterior artery perforator flap is a good flat for repairing the soft tissue defects of the metatarsal head of the forefoot.

Impact of visceral obesity on the short-term outcomes after radical operation for mid-low rectal cancers / 中国肿瘤临床

Objective: To investigate the effect of visceral obesity on the short-term outcomes after radical operation for mid-low rectal cancers. Methods: We conducted a prospective study on patients who underwent selective rectal cancer resection at The Second Affili-ated Hospital of Wenzhou Medical University between April 2017 and October 2018. The cutoff visceral fat area (VFA) for visceral obe-sity was≥134.6 cm2 for men and≥91.1 cm2 for women. Results: A total of 127 patients were included in the study, of whom 64 were diagnosed as having visceral obesity and 63 as having non-visceral obesity. The patients with visceral obesity had a higher body mass index (BMI) (P<0.001) than those without visceral obesity. The proportions of female patients and those who had a laparoscopy-assist-ed surgery were higher in the visceral obesity group than in the non-visceral obesity group. We found no significant differences in age, albumin level, hemoglobin count, American Society of Anesthesiologists (ASA) stage, Nutritional Risk Screening (NRS) 2002 score, Charlson comorbidity index, tumor location, TNM stage, lymphatic invasion, and laparoscopy-assisted surgery between the two groups. The postoperative complication rate was significantly higher in the visceral obesity group than in the non-visceral obesity group (35.9% vs . 19% , P=0.033). A multivariate Logistic regression analysis revealed that visceral obesity [odds ratio (OR)=2.732, P=0.019] and NRS 2002 scores of≥3 (OR=2.574, P=0.042) were independent risk factors for postoperative complications. Conclusions:Visceral obesity was an independent risk factor for complications after surgery for mid-low rectal cancers.

The clinical efficacy of ticagrelor in the treatment of patients with acute coronary syndrome / 中国基层医药

Objective To investigate the clinical efficacy and safety of ticagrelor in the treatment of patients with acute coronary syndrome (ACS).Methods From January 2016 to June 2017,112 patients with ACS in the Central Hospital of Maanshan were selected as study objects,and according to the digital table they were randomized divided into two groups:ticagrelor group (n =57) and clopidogrel group (n =55).The clopidogrel group received clopidogrel treatment,and the clopidogrel group was treated with clopidogrel.The time of short-term curative effect was 3 months after taking medcine.The differences of platelet inhibition rate,efficacy of platelet inhibition,main adverse cardiovascular events and hemorrhage complication in medication after 1 d and 3 months after PCI of patients in two groups were observed.Results The platelet inhibition rate and efficacy of platelet inhibition in medication after 1 d and 3 months after PCI in the ticagrelor group were (83.2 ± 15.4)％ and (78.4 ± 19.6)％,respectively,which were significantly higher than those in the clopidogrel group[(69.5 ± 19.9)％ and (41.3 ± 14.6)％] (t =2.555,4.468,all P ＜ 0.05).The cases with better platelet inhibition in medication after 1 d and 3 months after PCI in ticagrelor group were 42cases and 45cases,which were significantly higher than those in the clopidogrel group (30cases and 7cases) (x2 =4.466,47.805,P =0.035 and 0.000).Compared with the clopidogrel group (n =9),the major adverse cardiovascular events in the ticagrelor group(n =2) was significantly decreased(x2 =5.222,P ＜ 0.05).The total rate of hemorrhage complication was no statistically significant difference between these two groups(x2 =0.874,P ＞ 0.05).Conclusion Compared with clopidogrel,the application of ticagrelor in the treatment of ACS is more efficient and safe.

Radiological study on the cup abduction angle during total hip arthroplasty / 中国骨伤

OBJECTIVE@#To analyze the relationship among the parameters by measuring the relevant parameters of the anteroposterior X-ray of both hips in patients after total hip arthroplasty, to discuss the reliable anatomical markers and reference standards of acetabulum placement in total hip arthroplasty, and finally to accurately control the abduction angle of acetabulum.@*METHODS@#From January 2016 to June 2017, 282 patients (235 hips) underwent total hip arthroplasty and 128 patients(157 hips) met the inclusion criteria. There were 91 males and 37 females, 82 cases of the left hip and 75 cases of the right hip; ranging in age from 22 to 78 years old, with a mean of 55.1 years old. The abduction angle(β), ilium thickness (a), acetabular cup insertion depth (b), ischial thickness (c), acetabular cup insertion depth(d), acetabular abrasion and contusion depth(e) were measured on the postoperative AP X-ray of both hips, and the data were compared.@*RESULTS@#There was a positive correlation between β and b (=0.424, =0.000), a negative correlation between β and d (=-0.407, =0.000), a positive correlation between β and b/a (=0.419, =0.000), a negative correlation between β and d/c (=-0.472, =0.000). There was a linear relationship between β and b/a (5.753, =0.000) and a linear relationship between β and d/c (-6.671, =0.000).@*CONCLUSIONS@#The outreach angle is mainly controlled by the distance between the outer edge of the cup and the outer edge of the cup in the inferior portion(d) during the operation. The distance b from the outer edge of the cup can be used as a reference.