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Objective: To compare the accuracy of intraocular lens (IOL) power calculations using total keratometry (TK) versus standard keratometry (K) in post-corneal refractive surgery cataract patients. Methods: This retrospective case series study included 30 patients (36 eyes) with a history of laser corneal refractive surgery who underwent cataract extraction and IOL implantation at Qingdao Eye Hospital, Affiliated to Shandong First Medical University, from September 2022 to December 2023. The cohort comprised 16 males and 14 females, with an average age of (53.6±8.1) years. IOL power was calculated using the K-based Haigis-L and Barrett True-K formulas, as well as the TK-based Haigis and Barrett Universal â ¡ formulas. Postoperative objective refraction was performed to obtain the actual refractive status of the operated eyes. The refractive prediction error (RPE) was defined as the difference between the actual spherical equivalent and the predicted refraction. The absolute value of the RPE was taken as the refractive absolute error (RAE). Differences in errors calculated by the four formulas were compared. Results: TK showed good consistency with K, with TK being on average 0.50 D lower than K. Analysis of variance revealed statistically significant differences in RPE among the four formulas (P<0.001). The RPE for the TK-based Haigis formula was (0.17±0.09) D, and for the Barrett Universal â ¡ formula, it was (0.21±0.11) D, both significantly better than the K-based Haigis-L formula (-0.61±0.12) D and Barrett True-K formula (-0.57±0.11) D (all P<0.001). The percentage of eyes with postoperative RPE<±1.00 D was higher for the TK-based Haigis (92%, 33 eyes) and Barrett Universal â ¡ (86%, 31 eyes) formulas compared to the TK-based Barrett True-K (75%, 27 eyes) and Haigis-L formulas (67%, 24 eyes), with statistically significant differences (P<0.05). Conclusions: Compared with K, TK improves the accuracy of IOL power calculation in post-corneal refractive surgery patients. Both the TK-based Barrett Universal â ¡ and Haigis formulas demonstrate high accuracy.
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Extracción de Catarata , Catarata , Córnea , Implantación de Lentes Intraoculares , Lentes Intraoculares , Refracción Ocular , Humanos , Masculino , Femenino , Estudios Retrospectivos , Persona de Mediana Edad , Córnea/cirugía , Implantación de Lentes Intraoculares/métodos , Procedimientos Quirúrgicos Refractivos/métodosRESUMEN
BACKGROUND: High tumor mutational burden (TMB) is one of the widely researched predictive biomarkers of immune checkpoint inhibitors and has been shown to be closely related with response to immunotherapy in multiple cancer types. However, for patients who have failed conventional therapy and are about to undergo immunotherapy, there is no consensus recommendation on the timing of tumor sampling for TMB analysis, and the effects of different therapies on TMB have not been clarified. This retrospective observational study aimed to investigate the heterogeneity of TMB and genomic mutation under the treatment pressure. PATIENTS AND METHODS: We retrospectively collected the available genomic and therapeutic information from 8051 samples across 15 tumor types (>50 samples/tumor) found in 30 published studies and investigated the distribution and heterogeneity of TMB under treatment across diverse cohorts. RESULTS: This integrated analysis has shown anticancer treatments increased TMB. Significant effects of treatment on TMB were more frequently observed in tumor types with lower treatment-naïve TMB, including breast, prostate, and pediatric cancers. For different cancer therapies, chemotherapy was prone to be correlated with an increased TMB in most cancer types. Meanwhile, the fraction of the TMB-high category of breast, prostate, and bladder cancers and glioma increased significantly after chemotherapy. Several actionable genes including ERS1 and NF1 in breast cancer, as well as some prognostic markers including TERT in bladder cancer and IDH1 in glioma, were significantly changed in post-chemotherapy tumors compared to treatment-naïve tumors. CONCLUSION: Our study reveals the heterogeneity of TMB under treatment across diverse cancer types and provides evidences that chemotherapy was associated with increases in TMB as well as the fraction of TMB-high category, suggesting that resampling tumor tissues for calculating post-chemotherapy TMB could be a better option for predicting the response to immunotherapy, especially for tumors with initially low TMB.
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Biomarcadores de Tumor , Mutación , Neoplasias , Femenino , Humanos , Biomarcadores de Tumor/genética , Genómica/métodos , Inmunoterapia/métodos , Neoplasias/genética , Neoplasias/tratamiento farmacológico , Estudios RetrospectivosRESUMEN
Objective: To evaluate the in vitro optical performance of three types of non-diffractive extended depth-of-focus (EDoF) intraocular lenses (IOLs). Methods: Experimental study. Three Vivity IOLs, three Eyhance IOLs, and three ES60 IOLs were included. The professional optical bench OptiSpheric® IOL PRO 2 and an ISO-2 corneal model were applied. The through-focus modulation transfer function (MTF) and predicted visual acuity (logarithm of the minimum angle of resolution) of different spatial frequencies and different focuses under apertures of 3.0 mm and 4.5 mm were recorded. The aspheric monofocal (Tecnis ZCB00), diffractive EDoF (Tecnis Symfony), and trifocus (STF1) IOLs, as well as the lowest visual requirement criteria of EDoF IOLs of American Academy of Ophthalmology served as assessment controls. Results: For the 3.0-mm aperture, the peak value of the MTF was highest with ZCB00, followed by Eyhance, ES60, Vivity, Symfony, and STF1. All experimental non-diffractive EDoF IOLs had two MTF peaks, and the distance between both peaks was longest with Vivity (1.76 D), followed by ES60 (1.43 D) and Eyhance (1.36 D). Among the control IOLs, Symfony had two MTF peaks, and the peak MTF of the intermediate focus was highest. STF1 had three MTF peaks, and the peak MTF of the near focus was highest. For the 4.5-mm aperture, the ranking of the MTF peak of the six types of IOLs was the same as that for the 3.0-mm aperture. Vivity had an increased MTF peak of the distance focus, but a decreased intermediate focus MTF peak, while the MTF peaks of the distance, intermediate, and near focuses in the other IOLs decreased, compared to those for the 3.0-mm aperture. The predicted visual acuity of the distance focus of the three types of non-diffractive EDoF IOLs was all better than 0.0. The predicted visual acuity of the intermediate focus of the Vivity IOL and the ES60 IOL was 0.11 and 0.05 better than that of the Eyhance IOL, respectively. Based on the predicted visual acuity of 0.2, Vivity and ES60 had a depth of focus of at least 0.50 D exceeding ZCB00, while Eyhance had a depth of focus of 0.40 D exceeding ZCB00. Conclusions: In the experiments in vitro, the three types of non-diffractive EDoF IOLs exhibited varying degrees of intermediate to near focus optical performance while maintaining distance focus optical performance. The Eyhance IOL showed better distance focus optical performance than ES60 and Vivity IOL. The Vivity IOL and the ES60 IOL showed better depth of focus extensions than the Eyhance IOL and met the lowest visual requirement criteria of EDoF IOLs of American Academy of Ophthalmology.(This article was published ahead of print on the Online-First Publishing Platform for Excellent Scientific Researches of Chinese Medical Association Publishing House on April 29, 2024).
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Lentes Intraoculares , Humanos , Diseño de Prótesis , Percepción de Profundidad , Agudeza Visual , Refracción Ocular , Óptica y FotónicaRESUMEN
Objective: To evaluate the accuracy of five intraocular lens (IOL) power calculation formulas for calculating IOL power in patients with previous myopia-corrected corneal refractive surgery. Methods: In this case series study, a total of 30 eyes of 30 patients who had excimer laser corneal refractive surgery for myopia and subsequent cataract surgery in Qingdao Eye Hospital from April 2020 to October 2022 were included. The Pentacam anterior segment analysis system and IOLMaster were used to measure ocular parameters, including axial length, anterior chamber depth, keratometry, lens thickness, and mean true net power (mTNP). Five formulas were used for IOL power calculation: Shammas formula, Olsen formula, SRK/T (mTNP) formula, Haigis-L formula, and Barrett True-K formula. After cataract extraction, we obtained the actual postoperative refraction by measuring the objective refraction. The prediction error was determined as the difference between the actual postoperative refraction and the predicted refraction, and the absolute value of the prediction error was the absolute error. The differences in the calculation errors of the 5 formulas were compared. Results: Regarding the prediction errors, the results of the SRK/T (mTNP) and Olsen formulas were better than those of Shammas and Haigis-L, and the differences were statistically significant (all P<0.05). The proportion of eyes with an absolute error of 0.50 D for Barrett True-K was highest (70%, 21/30), followed by the SRK/T (mTNP) formula (67%, 20/30). The proportions of eyes with an absolute error within 1.00 D for Barrett True-K, SRK/T (mTNP), and Olsen were all over 80%, with 24 eyes, 24 eyes, and 25 eyes, respectively. Conclusions: The Barrett True-K formula showed high accuracy in predicting the refraction after cataract extraction in patients with a history of corneal refractive surgery for myopia. The calculation result of the Haigis-L formula was highly unstable.
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Lentes Intraoculares , Miopía , Facoemulsificación , Procedimientos Quirúrgicos Refractivos , Humanos , Implantación de Lentes Intraoculares , Refracción Ocular , Miopía/cirugía , Estudios Retrospectivos , Biometría , Facoemulsificación/métodosRESUMEN
Objective: To explore the efficacy of myocardial protection with single-dose histidine-tryptophan-ketoglutarate (HTK) cardioplegia during aortic root operation, and the correlation between short-term clinical outcomes and duration of myocardial ischemia. Methods: The data of clinical cases undergoing myocardial protection with single-dose HTK cardioplegia during aortic root operation from January 2018 to December 2022 were retrospectively reviewed. Patients were divided into conventional HTK cardioplegia group (<3 h) and prolonged HTK cardioplegia group (≥3 h) according to duration of intraoperative myocardial ischemia. A 1â¶1 propensity score matching was performed and the correlations between duration of myocardial ischemia and postoperative short-term outcomes (30-day mortality, readmission, mechanical circulation support and renal insufficiency) were analyzed. Results: A total of 282 patients were included in the final analysis, with 210 cases in the conventional HTK cardioplegia group and 72 cases inthe prolonged HTK cardioplegia group before matching. After matching, there were 64 cases (53 males and 11 females) in the conventional HTK cardioplegia group, with a mean age of (49.4±14.2) years. The prolonged HTK cardioplegia group had 64 cases (55 males and 9 females), with a mean age of (50.5±12.3) years. Higher sensitivity troponin [12 h: 10.1 (4.6, 18.7) µg/Lvs 4.1(2.2, 8.6) µg/L, P=0.002; 24 h: 7.7 (4.5, 19.0) µg/L vs 4.8 (2.2, 11.9) µg/L, P=0.025] and creatine kinase isoenzyme[12 h: 46.3 (28.1, 62.4) µg/L vs 20.7(14.1, 32.9) µg/L, P<0.001; 24 h: 26.3(13.4, 49.2) µg/L vs 14.5 (10.1, 33.5)µg/L, P=0.011] after surgery was detected in prolonged HTK cardioplegia group. Comparisons of other primary and secondary endpoint events showed no significant differences between the two groups (all P>0.05). Multivariate binary logistic regression showed that duration of myocardial ischemia had no significant effect on postoperative 30-day mortality (OR=1.255, 95%CI: 0.500-3.148, P=0.629), 30-day readmission (OR=0.378, 95%CI: 0.069-2.065, P=0.261) and mechanical circulation support (OR=0.991, 95%CI: 0.331-2.970, P=0.998). Conclusion: During aortic root surgery, single-dose HTK cardioplegia may provide satisfactory myocardial protection, and there was no significant correlation between duration of myocardial ischemia and short-term clinical outcomes.
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Enfermedad de la Arteria Coronaria , Isquemia Miocárdica , Masculino , Femenino , Humanos , Adulto , Persona de Mediana Edad , Histidina , Triptófano , Estudios Retrospectivos , Aorta Torácica , Soluciones Cardiopléjicas/uso terapéutico , Glucosa , Paro Cardíaco Inducido , ManitolRESUMEN
Solar flares are one of the severest solar activities that have important effects on near-Earth space. Previous studies have shown that flight arrival delays increase as a result of solar flares, but the intrinsic mechanism behind this relationship is still unknown. In this study, we conducted a comprehensive analysis of flight departure delays during 57 solar X-ray events by using a huge amount of flight data (~ 5 × 106 records) gathered over a 5-year period. It is found that the average flight departure delay time during solar X-ray events increased by 20.68% (7.67 min) compared to quiet periods. Our analysis also revealed apparent time and latitude dependencies, with flight delays being more serious on the dayside than on the nightside and longer (shorter) delays tending to occur in lower (higher) latitude airports during solar X-ray events. Furthermore, our results suggest that the intensity of solar flares (soft X-ray flux) and the Solar Zenith Angle directly modulate flight departure delay time and delay rate. These results indicate that communication interferences caused by solar flares directly affect flight departure delays. This work expands our conventional understanding of the impacts of solar flares on human society and provides new insights for preventing or coping with flight delays.
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Although the sun is really far away from us, some solar activities could still influence the performance and reliability of space-borne and ground-based technological systems on Earth. Those time-varying conditions in space caused by the sun are also called solar storm or space weather. It is known that aviation activities can be affected during solar storms, but the exact effects of space weather on aviation are still unclear. Especially how the flight delays, the top topic concerned by most people, will be affected by space weather has never been thoroughly researched. By analyzing huge amount of flight data (~ 4 × 106 records), for the first time, we quantitatively investigate the flight delays during space weather events. It is found that compared to the quiet periods, the average arrival delay time and 30-min delay rate during space weather events are significantly increased by 81.34% and 21.45% respectively. The evident negative correlation between the yearly flight regularity rate and the yearly mean total sunspot number during 22 years also confirms such correlation. Further studies show that the flight delay time and delay rate will monotonically increase with the geomagnetic field fluctuations and ionospheric disturbances. These results indicate that the interferences in communication and navigation during space weather events may be the most probable reason accounting for the increased flight delays. The above analyses expand the traditional field of space weather research and could also provide us with brand new views for improving the flight delay predications.
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Objective: To evaluate the clinical safety and efficacy of toric intraocular lens (IOL) implantation for more than 5 years. Methods: This study was a prospective cohort study in which subjects were continuously observed over a two-year period (May 2014 to May 2016) in nine hospitals. The study randomly assigned subjects to two groups using a central dynamic randomization system: the study group, which received Proming® IQ toric IOL implants, and the control group, which received AcrySof® IQ toric IOL implants. The subjects completed a one-year follow-up, during which various measures were taken and evaluated, including visual acuity, IOL rotation, postoperative complications, intraocular pressure, and subjective evaluation (preoperatively and at 1 day, 6 months, 1 year, and 5 years post-surgery). The main statistical analysis methods include the Mann-Whitney U test, independent sample t-test, Wilcoxon signed rank test, paired sample t-test, chi-square test, and Fisher's exact test. Results: A total of 45 eyes (26 in the study group and 19 in the control group) completed the five-year continuous observation period. The mean age of the subjects was (72.07±10.67) years and the mean interval from surgery to the last visit was (5.39±0.47) years. After five years, there were no significant differences in uncorrected distance visual acuity (0.20±0.26 vs. 0.16±0.13, t=0.17,P=0.752), best corrected distance visual acuity[0.00(0.00, 0.20) vs. 0.05±0.10, U=188.00, P=0.880], uncorrected near visual acuity[0.50 (0.20, 0.60) vs. 0.42±0.20, t=0.35, P=0.857], and best corrected near visual acuity (0.13±0.16 vs. 0.17±0.23, U=161.00, P=0.884) between the two groups. However, all measures improved significantly from baseline levels in both groups (all P<0.05). Five years after surgery, no matter objective refraction [(-0.67±0.85) D vs. (-0.73±1.08)D] or subjective refraction[-0.50 (-1.00, 0.00)D vs. (0.69±0.87)D], the degree of cylindrical degree is significantly lower than preoperative corneal astigmatism [(1.27±0.49) D vs. (1.34±0.82) D, all P<0.001]. In addition, there were no significant differences in intraocular pressure, subjective evaluation of visual adverse symptoms, distance vision spectacle independence, or overall satisfaction evaluation between the two groups (all P>0.05). The IOL rotation was 3.0°(1.0°, 6.0°) in the study group and 4.0°(2.0°, 6.0°)in the control group (U=185.50,P=0.574), indicating no significant difference between the groups in terms of rotational stability. Five years after surgery, there were 7 cases of posterior capsular opacification in the study group and 4 cases in the control group. There were no cases of IOL glistening in the study group, but 5 cases (26.32%) were observed in the control group. Conclusions: The long-term effects of Proming® toric IOL implantation in correcting cataracts with regular corneal astigmatism are clear after five years, with few complications and stable results.
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Catarata , Implantación de Lentes Intraoculares , Anciano , Anciano de 80 o más Años , Humanos , Persona de Mediana Edad , Astigmatismo/cirugía , Opacificación Capsular/cirugía , Enfermedades de la Córnea/cirugía , Implantación de Lentes Intraoculares/efectos adversos , Implantación de Lentes Intraoculares/métodos , Lentes Intraoculares , Estudios Prospectivos , Refracción OcularRESUMEN
BACKGROUND: High-risk pediatric acute myeloid leukemia confers a poor prognosis, and alternative strategies are needed to improve outcomes. We hypothesized that intensifying induction on the AAML1031 clinical trial would improve outcomes compared to the predecessor trial AAML0531. METHODS: Patients on AAML0531 received cytarabine (1600 mg/m2 )/daunorubicin (150 mg/m2 )/etoposide (ADE) for induction II and patients on AAML1031 received mitoxantrone (48 mg/m2 )/cytarabine (8000 mg/m2 ) (MA). Stem cell transplant (SCT) conditioning included busulfan/cyclophosphamide on AAML0531, whereas AAML1031 used busulfan/fludarabine and liberalized donor eligibility. Patients were included in this analysis if they met high-risk criteria common to the two trials by cytogenics or poor disease response after induction I ADE. RESULTS: MA provided no benefit over ADE at: induction II response (complete response [CR]: 64% vs. 62%, p = .87; measurable residual disease [MRD]+: 57% vs. 46%, p = .34); or intensification I response (CR: 79% vs. 94%, p = .27; MRD+: 27% vs. 20%, p = 1.0). When considered with altered SCT approach, MA did not improve 5-year disease-free survival (24% ± 9% vs. 18% ± 15%, p = .63) or 5-year overall survival (35% ± 10% vs. 38% ± 18%, p = .66). MA was associated with slower neutrophil recovery (median 34 vs. 27 days, p = .007) and platelet recovery (median 29 vs. 24.5 days, p = .04) and longer hospital stay (32 vs. 28 days, p = .01) during induction II. CONCLUSION: Intensification of induction II did not improve treatment response or survival, but did increase toxicity and resource utilization. Alternative strategies are urgently needed to improve outcomes for pediatric patients with high-risk acute myeloid leukemia (trials registered at clinicaltrials.gov NCT01371981, NCT00372593).
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Quimioterapia de Inducción , Leucemia Mieloide Aguda , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Busulfano/uso terapéutico , Niño , Ensayos Clínicos como Asunto , Citarabina/uso terapéutico , Supervivencia sin Enfermedad , Humanos , Leucemia Mieloide Aguda/tratamiento farmacológico , Leucemia Mieloide Aguda/etiología , Neoplasia Residual/tratamiento farmacológico , Resultado del TratamientoRESUMEN
Objective: To analyze the cause of late postoperative opacification of hydrophilic acrylic intraocular lenses (IOLs) and the effect of IOL replacement surgery. Methods: This retrospective case series study comprised 15 eyes of 15 patients who were diagnosed as late postoperative opacification of hydrophilic acrylic IOLs from January 2019 to June 2020 at Qingdao Eye Hospital of Shandong First Medical University. The clinical data of patients were reviewed, and two IOLs were examined by scanning electron microscopy and energy dispersive X-ray spectroscopy. The intraoperative and postoperative complications of IOL replacement surgery were evaluated, and best corrected visual acuity was compared before and after surgery. Preoperative and postoperative data were compared using the paired t test. Results: The interval between the first IOL implantation and the detection of IOL opacification in 15 patients was (27.3±5.9) months. All the 15 patients had unilateral IOL opacification, and 9 patients had hypertension. Glycosylated hemoglobin A1c was significantly higher than the normal value in 4 of the 10 patients who underwent cataract surgery at our hospital. Confocal microscopy disclosed coralliform deposits on the superficial IOL optic. Scanning electron microscopy and energy dispersive X-ray spectroscopy showed the presence of calcium and phosphorus crystals in the opacification region of IOLs. Visual acuity in all 13 eyes receiving IOL exchange was significantly improved from 1.03±0.64 (logarithm of the minimum angle of resolution) to 0.39±0.21 (P<0.05). Posterior capsule rupture (4 eyes), new IOL implanted in the ciliary sulcus (3 eyes) and zonule breaking (1 eye) occurred during IOL replacement. Conclusions: IOL opacification is related with the IOL material and calcium ion concentration on the IOL surface. IOL replacement surgery can improve visual acuity safely and effectively. (Chin J Ophthalmol, 2021, 57: 512-518).
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Extracción de Catarata , Lentes Intraoculares , Facoemulsificación , Humanos , Implantación de Lentes Intraoculares , Complicaciones Posoperatorias/etiología , Estudios Retrospectivos , Agudeza VisualRESUMEN
Objective: To investigate the influencing factors and their predictive value of skin graft survival after Meek grafting in severe burn patients. Methods: A retrospective case-control study was conducted in 115 severe burn patients (95 males, 20 females, aged 1-74 years) who met the inclusion criteria and received Meek grafting in the First Affiliated Hospital of Army Medical University (the Third Military Medical University) from January 2013 to December 2019. The patients were divided into good skin graft survival group with skin graft survival rate≥70% (68 cases) and poor skin graft survival group with skin graft survival rate<70% (47 cases). The statistics of patients in the two groups were recorded during their first Meek grafting after admission including the gender, age, body mass index, full-thickness burn area, burn index, complication of inhalation injury, time from injury to operation, preoperative cystatin C level, preoperative albumin level, preoperative neutrophil, preoperative hemoglobin level, preoperative platelet count, and platelet count on the first, third, and fifth day after operation. The above indicators were statistically analyzed between the two groups with independent sample t test, Mann-Whitney U test, and chi-square test. A 1â¶1 propensity score matching (PSM) of the gender, age, body mass index, full-thickness burn area, burn index, complication of inhalation injury, time from injury to operation of patients in the two groups were performed to eliminate the differences in baseline data, and then the above indicators of the remaining patients in the two groups were recorded and analyzed again. The indicators with statistically significant differences between the two groups after 1â¶1 PSM were selected for multivariate logistic regression analysis to screen the independent risk factors affecting the skin graft survival after Meek grafting in severe burn patients. The receiver operating characteristic (ROC) curve of independent risk factors for predicting poor skin graft survival after Meek grafting in severe burn patients after 1â¶1 PSM was drawn, and the area under the curve, the cut-off value, and the sensitivity and specificity under the cut-off value were calculated. The patients after 1â¶1 PSM were divided into independent risk factor>the cut-off value group and independent risk factor≤the cut-off value group with the incidence of poor skin graft survival after Meek grafting compared using the chi-square test, and the relative risk of poor skin graft survival after Meek grafting was calculated. Results: Before 1â¶1 PSM, there were no statistically significant differences in gender, age, body mass index, complication of inhalation injury, time from injury to operation, preoperative cystatin C level, preoperative albumin level, preoperative neutrophil, preoperative hemoglobin level of patients between the two groups (P>0.05); the full-thickness burn area and burn index of patients in poor skin graft survival group were significantly higher than those in good skin graft survival group (Z=-2.672, -2.882, P<0.01); the preoperative platelet count and the platelet count on the first, third, and fifth day after operation of patients in poor skin graft survival group were significantly lower than those in good skin graft survival group (Z=-3.411, -3.050, -2.748, -2.686, P<0.01). After 1â¶1 PSM, 46 cases were remained in each group. There were no statistically significant differences in gender, age, body mass index, full-thickness burn area, burn index, complication of inhalation injury, time from injury to operation, preoperative cystatin C level, preoperative albumin level, preoperative neutrophil, preoperative hemoglobin level of remaining patients between the two groups (P>0.05); the preoperative platelet count and the platelet count on the first, third, and fifth day after operation of patients in poor skin graft survival group were significantly lower than those in good skin graft survival group (Z=-3.428, -2.940, t=-2.427, -2.316, P<0.05 or P<0.01). Multivariate logistic regression analysis showed that the preoperative platelet count was the only independent risk factor affecting the skin graft survival after Meek grafting in severe burn patients (odds ratio=0.994, 95% confidence interval=0.989-0.998, P<0.01). The area under the ROC curve of preoperative platelet count predicting poor skin graft survival after Meek grafting in 92 patients was 0.707 (95% confidence interval=0.603-0.798, P<0.01), and the cut-off value of preoperative platelet count was 98×109/L, with sensitivity of 54.3% and specificity of 78.3% under the cut-off value. The incidence of poor skin survival after Meek grafting of patients in preoperative platelet count≤98×109/L group was 71.4% (25/35), which was obviously higher than 36.8% (21/57) in preoperative platelet count>98×109/L group (χ2=10.376, P<0.01). Compared with that in preoperative platelet count>98×109/L group, patients in preoperative platelet count≤98×109/L group had a relative risk of poor skin graft survival after Meek grafting of 2.211 (95% confidence interval=1.263-3.870). Conclusions: Preoperative platelet count is an independent risk factor affecting the skin graft survival after Meek grafting in severe burn patients and has a good predictive value. Meek grafting should be performed with caution when the preoperative platelet count of patients is≤98×109/L.
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Quemaduras , Supervivencia de Injerto , Adolescente , Adulto , Anciano , Quemaduras/cirugía , Estudios de Casos y Controles , Niño , Preescolar , Femenino , Humanos , Lactante , Masculino , Persona de Mediana Edad , Pronóstico , Curva ROC , Estudios Retrospectivos , Trasplante de Piel , Adulto JovenRESUMEN
OBJECTIVE: This study aimed to explore the clinical value of simulated puncture in percutaneous nephrolithotomy in the treatment of complex kidney stones. PATIENTS AND METHODS: A total of 120 patients with complex kidney stones who were treated with percutaneous nephrolithotomy in our hospital between March 2017 and March 2020 were enrolled in this study and randomly divided into two groups: the research group and the control group (n = 60 in each). Each subject underwent a dual-source computed tomography (CT) scan of the pelvis and both kidneys before the operation. The research team imported the CT data into Mimics19 software to create a three-dimensional (3D) reconstruction of the skin, bones, kidneys, collecting system, and stones. Based on the 3D reconstruction model, the target renal calyx to be punctured was determined, the best puncture channel was designed, and puncture was simulated. Data regarding the simulated puncture were imported into 3-Matics11 software; the angle and depth of the puncture were measured, and then these data were used to guide percutaneous nephrolithotomy. 3D reconstruction and simulated puncture were not undertaken for the patients in the control group before the operation. The effects of treatment in the two groups were compared. RESULTS: First-stage percutaneous nephrolithotomy was successfully completed in both groups of patients. The outcome was better in the research group than in the control group in terms of operation time, number of punctures required for successful establishment of a percutaneous renal channel, number of percutaneous kidney puncture channels, and intraoperative blood loss, and the differences were statistically significant (p < 0.05 for all). The stone clearance rate was higher in the research group than in the control group, but the difference was not statistically significant (p = 0.471). The incidence of penetrating kidney injury was lower in the research group than in the control group, but the difference was not statistically significant (p = 0.154). CONCLUSIONS: For patients due to undergo percutaneous nephrolithotomy for the treatment of complex kidney stones, preoperative simulated puncture helps to improve the puncture accuracy and to reduce the number of punctures required for successful establishment of a percutaneous renal channel, the number of puncture channels, the operation time, and the blood loss, and therefore it is worth promoting.
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Cálculos Renales/cirugía , Nefrolitotomía Percutánea , Punciones , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Programas Informáticos , Resultado del Tratamiento , Adulto JovenRESUMEN
Objective: To explore the effects of B-cell lymphoma-2/adenovirus E1B 19 000 interacting protein 3 (BNIP3) on the migration and motility of human dermal microvascular endothelial cells (HDMECs) under hypoxia and the mechanism. Methods: The experimental research method was applied. (1) HDMECs were divided into normoxia group received routine culture and hypoxia 6, 12, 24 h groups treated under hypoxia with oxygen volume fraction of 2% for corresponding time according to the random number table (the same grouping method below). Western blotting was used to detect the protein expressions of BNIP3 and microtubule-associated protein 1 light chain 3â ¡ (LC3â ¡) in HDMECs. (2) HDMECs were divided into normoxia+ unloaded group, normoxia+ BNIP3 knockdown group, hypoxia+ unloaded group, and hypoxia+ BNIP3 knockdown group which were transfected with unloaded virus or BNIP3 knockdown virus and were subjected to normoxic or hypoxic treatment. The BNIP3 protein expression was detected by Western blotting and immunofluorescence staining. The scratch area at 24 h post scratching was detected by scratch test, and the healing rate of scratch was calculated. The curve distance of cell movement was measured with the living cell workstation, and the speed of movement was calculated within 3 hours. (3) HDMECs were grouped and treated as experiment (2). Western blotting and immunofluorescence staining were performed to detect the protein expression of LC3â ¡. The number of sample was 3 in the above-mentioned experiments. Data were statistically analyzed with one-way analysis of variance and least significant difference test. Results: (1) Compared with those of normoxia group, the protein expressions of BNIP3 and LC3â ¡ of cells in hypoxia 6, 12, 24 h groups were significantly increased (P<0.01). (2) After 6 hours of culture, compared with that of hypoxia+ unloaded group, the BNIP3 protein expressions of cells in normoxia+ unloaded group and hypoxia+ BNIP3 knockdown group were significantly decreased (P<0.05 or P<0.01). The red fluorescence denoting BNIP3 protein expression of cells in normoxia+ unloaded group and normoxia+ BNIP3 knockdown group was weak, the red fluorescence of cells in hypoxia+ unloaded group was strong, and the red fluorescence of cells in hypoxia+ BNIP3 knockdown group was significantly decreased compared with that in hypoxia+ unloaded group. After scratching for 24 hours, the scratch of cells in hypoxia+ unloaded group basically healed, while the remaining scratch area in the other three groups were large. The healing rates of scratch of cells in normoxia+ unloaded group, normoxia+ BNIP3 knockdown group, hypoxia+ unloaded group, and hypoxia+ BNIP3 knockdown group were (61±4)%, (58±4)%, (88±4)%, and (57±4)%, respectively. The healing rate of scratch of cells in hypoxia+ unloaded group was significantly higher than that in normoxia+ unloaded group (P<0.01) and hypoxia+ BNIP3 knockdown group (P<0.05). Within 3 hours of observation, the range of cell movement in hypoxia+ unloaded group was significantly larger than that in normoxia+ unloaded group, the range of cell movement in hypoxia+ BNIP3 knockdown group was significantly smaller than that in hypoxia+ unloaded group, and the curve movement velocity of cells in hypoxia+ unloaded group was significantly higher than that in normoxia+ unloaded group and hypoxia+ BNIP3 knockdown group (P<0.01). (3) After 6 hours of culture, compared with hypoxia+ unloaded group, the LC3â ¡ protein expressions of cells in hypoxia+ unloaded group and hypoxia+ BNIP3 knockdown group were decreased significantly (P<0.05 or P<0.01). After 6 hours of culture, the red fluorescence denoting LC3 protein expressions of cells was weak in normoxia+ unloaded group and normoxia+ BNIP3 knockdown group, the red fluorescence of cells was significantly enhanced in hypoxia+ unloaded group, and the red fluorescence of cells was significantly inhibited in hypoxia+ BNIP3 knockdown group. Conclusions: BNIP3 can promote the migration and motility of HDMECs under hypoxia, and autophagy may be involved in the regulation migration of HDMECs by BNIP3.
Asunto(s)
Adenoviridae , Células Endoteliales , Movimiento Celular , Humanos , Hipoxia , Proteínas Proto-Oncogénicas c-bcl-2RESUMEN
The core problem of wound treatment is how to speed up healing. In recent years, the impact of wound microenvironment on healing has received increasing attention. Among the many factors affecting the wound microenvironment, wound bioelectric field and oxygen are crucial. At present, some new technologies based on microenvironmental factors including wound bioelectric field and oxygen to promote wound healing have been used in clinical practice. With further research development on the roles of wound bioelectric field and oxygen in wound healing and their mechanisms, a series of new technologies and products that regulate or create the most suitable wound microenvironment for healing including the bioelectric field of wound and oxygen will be produced, therefore providing effective means for precise wound treatment.