Development and Validation of a Predictive Model for Intraoperative Hypothermia in Elderly Patients Undergoing Craniocerebral Tumor Resection: A Retrospective Cohort Study.

OBJECTIVE: Timely identification of elderly patients who are at risk of developing intraoperative hypothermia (IH) is imperative to enable appropriate interventions. This study aimed to develop a nomogram for predicting the risk of IH in elderly patients undergoing resection of craniocerebral tumor, and to validate its effectiveness. METHODS: Elderly patients who underwent craniocerebral tumor resection at a large tertiary hospital in eastern China between January 2019 and December 2022 were included (n = 988). The study population was divided into a training set and a validation set by time period. Risk factors identified through the Least Absolute Shrinkage and Selection Operator method and logistic regression analysis were used to establish the nomogram. The model was validated internally by Bootstrap method and externally by validation set through receiver operating characteristic curve analysis, Hosmer-Lemeshow test, and decision curve analysis. RESULTS: A total of 273 (27.6%) patients developed IH. Duration of anesthesia (P < 0.001), blood loss (P < 0.001), preoperative temperature (P < 0.001), tumor location (P < 0.001), age (P < 0.05), and mean arterial pressure (P < 0.05) were identified as independent risk factors for IH. A nomogram integrating these 6 factors was constructed. The area under the curve was 0.773 (95% confidence interval: 0.735-0.811) (70.5% specificity and 75.0% sensitivity), indicating good predictive performance. The decision curve analysis demonstrated the clinical benefit of using the nomogram. CONCLUSIONS: Our model showed good performance in identifying elderly patients who are at high risk of developing IH during craniocerebral tumor resection. The nomogram can help inform timely preventive interventions.

Clinical Impact of Active Inflatable Insulation in Older with Undergoing Knee Arthroplasty.

Objective: This study aimed to explore the safety and effectiveness of active inflatable insulation in older patients who underwent knee arthroplasty. Methods: A total of 210 patients who came to our hospital for knee arthroplasty between November 2020 and December 2021 were selected for the study. They were randomly divided into a control group and two experimental groups, i.e., the intraoperative active warming (IOAW) group and the perioperative active warming (POAW) group, with 70 patients in each group. IOAW measures are taken to reduce heat loss during surgery and help maintain core temperature. POAW measures were taken to reduce the heat loss during surgery and help maintain the core temperature. The core body temperature, incidence of hypothermia, chills, bleeding volume (P = .043), extubation and awakening time, blood routine, and coagulation function of the patients in the three groups were compared. Results: The core body temperature in the POAW group was higher than that in the IOAW and control groups. The awakening and extubation times in the POAW group were shorter than those in the IOAW and control groups. The incidences of hypothermia, chills and intraoperative bleeding in the POAW group were lower than those in the IOAW and control groups. Conclusion: Perioperative active inflatable insulation for older patients undergoing knee arthroplasty can effectively protect the core body temperature, reduce the incidence of perioperative hypothermia, and reduce related complications. This measure is beneficial for the postoperative recovery of patients and provides a reference for active inflatable insulation measures for clinical knee arthroplasty.

TSHZ3 functions as a tumor suppressor by DNA methylation in colorectal cancer.

OBJECTIVE: Teashirt zinc finger homeobox 3 (TSHZ3) is currently reported to be aberrantly expressed in several tumors, but the detailed functions and epigenetic mechanisms of TSHZ3 in colorectal cancer (CRC) remain unclear. MATERIALS AND METHODS: In this study, the TSHZ3 expression in 118 CRC and normal adjacent tissues (NATs) was evaluated, and the methylation status of the TSZH3 promoter region in CRC tissues and cell lines was also analyzed. RESULTS: The results of PCR analysis showed that TSHZ3 was significantly down-regulated in CRC tissues, and patients with low TSHZ3 levels had a poorer 5-year overall survival (OS) rate. Analyzing the promoter sequence (-1000∼0) by MethPrimer, TSHZ3 promoter was found to harbor abundant of CpG islands. The methylation specific PCR (MSP) analysis presented a relatively hypermethylated status of THSZ3 promoter in CRC samples. The data of MSP and bisulfite sequencing PCR (BSP) also confirmed that CpG sites of TSHZ3 promoter were methylated in CRC cells, and the DNA methyltransferase (DNMT) inhibitor 5-aza-2'-deoxycytidine (5-Aza) could effectively restored the TSHZ3 expression in vitro. Functionally, the proliferation, apoptosis and metastasis of CRC cells were regulated by TSZH3 over-expression, and the suppressing effects of TSHZ3 in CRC were also confirmed in a xenograft mouse model. CONLUSIONS: Our results indicated that promoter methylation was one of the mechanisms contributing to the down-regulation of TSHZ3 in CRC, and TSZH3 might served as a potential tumor suppressor gene in the development and progression of CRC.