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Objective To analyze the prognostic value of thrombin generation assay(TGA)and coagulation factor testing in postoperative deep venous thrombosis(DVT)of lower extremities in elderly patients with traumatic fracture.Methods A retrospective case-control study was conducted to collect traumatic patients older than 60 years old who underwent surgery in our department from March 2019 to March 2022.The number of patients was 104.According to the ultrasonic examination of DVT 5 days after operation,the patients were divided into DVT group and non-DVT group.The differences of general demographic data,previous chronic diseases,time from trauma to operation,related indexes of TGA and TF coagulation factors(F)between the two groups were analyzed.The indexes with statistical significance were analyzed by receiver operating curve(ROC);the indexes with statistically significant differences were analyzed by Logistic regression and the prediction probability was calculated by ROC curve analysis.Results The incidence of postoperative DVT was 21.12%.Compared with the non-DVT group,the time from trauma to operation was longer in the DVT group,and the peak value under 5 pmol/L TF activation was lower(258.13±40.88 vs 209.58±30.09).F V,F Ⅷ and Fib were higher(141.25(125.38,158.18)vs 176.12(150.65,186.34),145.49(133.36,147.48)vs 165.96(153.07,180.65),3.25± 0.55 vs 3.92±0.72,respectively).The differences were statistically significant(all P<0.01).ROC curve analysis showed that the time from trauma to operation,the peak value of 5 pmol/L TF activation,F V,FⅧ and Fib combined had more predictive value for postoperative DVT,the AUC was 0.91(P<0.01),the sensitivity was 0.82 and the specificity 0.92.Conclusion The time from trauma to operation,the peak value of TGA under the condition of 5 pmol/L TF activation,F V,F Ⅷ and Fib have excellent prognostic value for the postoperative DVT of lower extremities in elderly patients with traumatic fracture,and the combined detection is more significative.
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Objective To explore whether PI3K inhibitor combined with oncolytic virus can play an effective oncolytic effect on osteosarcoma. Methods The cytotoxicity to tumor cells was detected by MTT method, and the mechanism of enhancing the anti-tumor activity was explored by observation of the swelling of endoplasmic reticulum using electron microscope and the expression of apoptosis-related proteins using Western blotting. The tumor clearance ability of the combination of the PI3k inhibitor ZSTK474 and vesicular stomatitis virus A51 (VSVA51) was verified by anti-tumor experiment in vivo. The apoptosis of tumor cells was verified by immunohistochemistry. Results PI3K inhibitor could be used as sensitizers of oncolytic VSVA51, and confirmed that the)' promoted the strong apoptosis of osteosarcoma cells by aggravating the stress of endoplasmic reticulum in tumor cells (P < 0 . 01). In vivo experiments also showed that PI3K inhibitors combined with VSVA51 could significantly promote the oncolytic effect of osteosarcoma (P<0.001), and this combination therapy enhanced the infiltration of immune cells in the tumor (P<0.001). Conclusion PI3K inhibitors combined with oncolytic virus is a potential therapy for osteosarcoma.
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BACKGROUND: It is an urgent problem to effectively make bone marrow mesenchymal stem cells exert proper effects under hypoxic preconditioning. OBJECTIVE: To investigate the effects of diazoxide, a Mito-KATPchannel activator, on the proliferation and apoptosis of mouse BMSCs in hypoxic environment. METHODS: Mouse BMSCs were divided into four groups: blank control group, 0.16, 0.8, 4 μmol/L diazoxide groups. Cells intervened by diazoxide were cultured in a 10% O2incubator. MTT assay was performed to detect cell proliferation at 1, 2, 4, 6, 8 days after intervention, and Hoechst 33258 staining was performed to observe cell apoptosis at 14 days after intervention. RESULTS AND CONCLUSION: High homogeneity and purity but low proliferation of BMSCs was found. There was no significant difference in the activity of BMSCs among 0.16, 0.8, 4 μmol/L diazoxide groups (P > 0.05). In the blank control group, concentrated nuclei were dark blue in color and aggregated, and several round apoptotic bodies were found. In the diazoxide groups, apoptotic bodies were occasionally found, and no significant difference was found among different diazoxide groups. These findings indicate that a certain concentration of diazoxide can reduce cell apoptosis but has no effects on the proliferation of mouse BMSCs under hypoxic environment (10% O2).
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Objective To compare the clinical effect of vacuum sealing drainage and traditional methods on open tibial fractures of Gustilo grade-Ⅲ.Methods Seventy-eight patients with open tibial fractures of Gustilo grade-Ⅲ were divided into two groups,43 patients in observation group were treated by vacuum sealing drainage,while 35 patients in control group were treated by traditional methods.The operative quality,postoperative recovery condition,clinical effect and rate of adverse reaction were analyzed between two groups.Results As for the hospital stays,healing time of wound and fracture,the observation group were significant shorter than control group (P<0.05).The excellent and good rate of observation group was 83.72%,which was significantly higher than that of control group 65.71% (P <0.01).The adverse reaction rate of observation group was 6.98%,which was significantly lower than that of control group 17.14% (P<0.05) Conclusions Vacuum sealing drainage used for treatment of open tibial fractures of Gustilo grade-Ⅲ can shorten wound and fracture healing time,reduce the incidence of adverse reaction and improve the clinical effect.It is worth of popularization and application.
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OBJECTIVE@#To explore the effect and indications of radiofrequency ablation for the treatment of obstructive sleep apnea-hypopnea syndrome.@*METHOD@#Multilevel temperature-controlled radiofrequency therapy of soft palate, uvula, inferior turbinate, and tonsils were applied to 74 adults with obstructive sleep apnea-hypopnea syndrome (OSAHS). There were 16 mild, 23 moderate, and 35 severe cases respectively in this study. Evaluation of mucosal injury and effect of radiofrequency therapy on pain, speech and swallowing were performed early after operation. The volume of targets and length of soft palate and uvula were measured three months after operation. Polysomnography, Epworth Sleepiness Scale and Snoring Scale Score questionnaires were reevaluated six months after operation and compared with the results of pre-operation. Treatment outcome measurements were mainly based on polysomnography.@*RESULT@#By our definition, 5 of 74 patients (6.76%) have been cured and 42 of 74 (56.76%) had improved totally. Mean Apnea-Hypopnea Index (AHI) decreased significantly and mean lowest oxygen saturation value increased significantly postoperatively (P < 0.01). The total effective rate of the patients, whose obstructive sites were all treated by radiofrequency, was remarkably higher than that of the ones, whose obstructive sites were only partly treated by radiofrequency (P < 0.01). The total effective rate of the former was 72.92%. Patients showed a significant decrease in mean score on ESS and SSS postoperatively (P < 0.01). No significant complications were observed in most patients. There were little influence on pain, speech and swallowing. The volume or length of targets decreased obviously three months after operation.@*CONCLUSION@#Radiofrequency can reduce the volume of tissue. The short-term outcomes of radiofrequency were satisfying if obstructive sites had been all treated. This study demonstrates that the characters of radiofrequency are as follows: minimally invasive, safe, efficient, repeatable and multilevel applicable. Temperature-controlled radiofrequency therapy is a safe and effective procedure for hypertrophic infraturbinal when used separately, or as a part of a the combined approach for complex syndromes.
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Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Ablação por Cateter , Métodos , Contraindicações , Apneia Obstrutiva do Sono , Cirurgia Geral , Resultado do TratamentoRESUMO
Based on hydroxyapatite (HAP), a kind of antimicrobial ceramic, i.e. hydroxyapatite loading Ag+ ions (HAP-Ag), is prepared in a wet chemical process with the addition of AgNO3. The X-ray diffraction analysis shows that the HAP-Ag is mainly composed of nitrate-apatite, which is formed by the substitution of Ca2+ with Ag+. The antimicrobial effects of the HAP-Ag and its resistibility against the acrobic Escherichia coli and Staphylococcus aureus are tested respectively through the spread plate method. The results show that HAP-Ag is capable of inhibiting the growths of E.coli and S.aureus.