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ObjectiveBased on the nuclear factor erythroid 2 related factor 2 （Nrf2）/heme oxygenase-1 （HO-1） signaling pathway， this paper explores the effect of Sinisan （SNS） on liver oxidative stress injury in cholestatic hepatitis rats and its mechanism. MethodThirty 6-week-old male SD rats were randomly divided into a control group， model group， low and high dose groups of SNS （2.5 and 5 g·kg-1） and ursodeoxycholic acid group （UDCA， 63 mg·kg-1）， with six rats in each group. Rats were administrated for seven consecutive days. On the 5th day， the control group was given olive oil of 10 mL·kg-1， and the other groups were given alpha-naphthalene isothiocyanate （ANIT） of 80 mg·kg-1. The serum biochemical indicator levels of cholestasis and the content of antioxidant factors in rat liver were detected by enzyme-linked immunosorbent assay （ELISA）. Hematoxylin-eosin （HE） staining was used to observe the pathological changes in liver tissue. The relative mRNA and protein expressions of Nrf2， HO-1， and quinone oxidoreductase 1 （NQO1） in liver tissue were detected by real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） and Western blot. ResultCompared with the control group， the model group showed a significant increase in the serum biochemical indicator levels of cholestasis and the content of antioxidant factors in liver tissue （P<0.01）. There were obvious pathological changes in the model group such as the disordered arrangement of hepatocytes， obvious congestion and necrosis in the portal area， infiltration of inflammatory cells， and destruction of the interlobular bile duct. The relative mRNA and protein expressions of Nrf2， HO-1， and NQO1 in liver tissue were significantly down-regulated in the model group （P<0.05， P<0.01）. Compared with the model group， the groups of SNS showed a significant decrease in the serum biochemical indicator levels of cholestasis and the content of antioxidant factors in liver tissue （P<0.01）， and the pathological liver injury was obviously improved. The necrotic area was reduced， and the infiltration of inflammatory cells was decreased. In addition， there was a small amount of extravasated blood in the interlobular vein. The relative mRNA and protein expressions of Nrf2， HO-1， and NQO1 in liver tissue were significantly up-regulated （P<0.05， P<0.01）. ConclusionSNS can significantly improve liver injury in cholestatic hepatitis rats， and its mechanism may be related to the inhibition of oxidative stress response mediated by the Nrf2/HO-1 signaling pathway.
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Objective To compare the diagnostic value of smear acid-fast staining,TB-DNA,X-pert MTB/RIF and culture of Mycobacterium tuberculosis.Methods Four methods were used to detect the perifocal pus of the patients with bone destruction in orthopaedics department within one year,and the results were analyzed statistically,the indexes included sensitivity,specificity,positive predictive value and negative predictive value.Results The sensitivity,specificity,positive predictive value,negative predictive value,and Youden index were 31.75%,100.00%,100.00%,53.74%and 0.32 respectively.TB-DNA had a sensitivity of 88.89%,a specificity of 98.00%,a positive predictive value of 98.25%,a negative predictive value of 87.50%,and a Youden Index of 0.87.Xpert MTB/Rif had a sensitivity of 95.23%,a specificity of 68.00%,and a positive predictive value of 78.95%,the negative predictive value was 91.90%,the Youden index was 0.63.The sensitivity,the specificity,the positive predictive value,the negative predictive value and the Youden index were 41.27%,100.00%,100.00%,57.47%and 0.41 respectively,(χ2 = 77.354,P<0.005).Conclusion Among the four methods,TB-DNA has a good Sensitivity and specificity,Xpert mtbrif has a good sensitivity,TB-DNA and Xpert mtbrif ha a good authenticity,and both positive and negative predictive values are high,it has good value in the diagnosis of bone tuberculosis.
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Objective:To compare the parameters for infra-acetabular screw placement between men and women using a digital Chinese anatomical model of the pelvis and acetabulum.Methods:The normal pelvic CT data were collected from the 163 adult patients who had been admitted to the Traditional Chinese Medicine Hospital of Xinjiang Uygur Autonomous Region from January 2018 to December 2021. There were 61 males and 102 females with an age of 53.0 (45.0, 60.0) years. Mimics 21.0 software was used to reconstruct the three dimensional pelvis which was then imported into Autodesk maya 2022 software before the model was flattened. Polygonal modeling tools were used to create a cylinder to simulate an infra-acetabular screw for length and angle measurements of the screw. The diameters of the infra-acetabular screws were measured by axial fluoroscopy in Mimics 21.0 software. The maximum diameters and maximum lengths of the infra-acetabular bone channel were compared between males and females, and the angles between the axis of the infra-acetabular screw and the anterior pelvic plane and the median sagittal plane were also compared between genders.Results:The maximum diameters of the left and right infra-acetabular corridors were 5.24 (4.26, 6.38) mm and 5.04 (4.50, 6.57) mm in males, and 3.99 (3.81, 4.51) mm and 3.89 (3.65, 4.90) mm in females; the maximum lengths of the left and right infra-acetabular corridors were (98.43±4.42) mm and (98.01±5.08) mm in males and 87.73 (84.22, 90.98) mm and 87.51 (84.59, 90.15) mm in females. The left and right angles between the infra-acetabular screw axis and the median sagittal plane were -0.98°±4.79° and -1.08°±4.91° in men, and 6.20° (3.34°, 11.16°) and 6.44° (3.77°, 11.85°) in women. The differences in the above data between men and women were statistically significant ( P<0.05). There was no statistically significant difference between men and women in the angle between the infra-acetabular screw axis and the anterior pelvic plane ( P>0.05). Conclusions:The length and diameter of the infra-acetabular corridor in males are greater than those in females, the angle between the infra-acetabular corridor and the sagittal plane in males is smaller than that in females, and the infra-acetabular corridor in males is more parallel to the sagittal plane. Therefore, the fluoroscopy angle should be adjusted for males to reduce the difficulty in screw placement when an infra-acetabular screw is placed during surgery.
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Objective To explore the co-infection rate,immune function and drug resistance status among tuberculosis patients co-infected with HBV,HCV and HIV in Yunnan.Methods A total of 2271 TB patients in Yunnan province admitted to the Third People's Hospital of Kunming from April 2020 to March 2023 were collected for HBV,HCV,HIV serological tests,lymphocyte tests and drug resistance gene detection,and analysis of TB infection of HBV,HCV,HIV infection,immune function and resistance.Results Among the 2271 TB patients,499 cases were infected with TB and HBV,the infection rate was 21.97%.196 cases were infected with HCV,the infection rate was 8.63%.166 cases were infected with HIV,the infection rate was 7.31%.There were 1410 patients with simple tuberculosis,accounting for 62.09%.The infection rates of tuberculosis combined with HBV,HCV and HIV were statistically significant in different age groups(P<0.01).The absolute number expression of CD3+,CD4+ and CD8+T cells was higher in TB patients with HBV and HCV,and the differences between the two were statistically significant(P<0.05).The absolute number expression of CD3+ and CD4+T cells was lower in TB patients with HIV,and the absolute number expression of CD8+T cells was increased,and the difference between the two was statistically significant(P<0.01).The absolute number of CD3+,CD4+ and CD8+T cells was higher in female patients with tuberculosis and HIV,and the differences were statistically significant(P<0.05).In all age groups,the absolute number of CD3+ and CD8+T cells in tuberculosis patients with HIV was the lowest in 46-65 years old group,and the differences were statistically significant(P<0.05).Among the 2271 TB patients,391 were resistant to any first-line drug(single drug resistance),and the overall drug resistance rate was 17.22%.Among them,52 cases were combined with HBV drug resistance,the resistance rate was 10.42%.There were 10 cases with HCV drug resistance,the drug resistance rate was 5.10%.40 cases were combined with HIV drug resistance,the drug resistance rate was 24.10%.Drug resistance in 289 patients with simple tuberculosis was 20.50%.Among them,33 cases were single drug resistant rifampicin,accounting for 19.88%.Conclusion Tuberculosis has the highest rate of co-infection with HBV,and the immune function of TB patients co-infected with HIV is the worst.The drug resistance rate of TB patients co-infected with HIV is also the highest,with resistance to rifampicin being the most common.TB is a chronic wasting disease,with poorer immune function compared to the general population,making it more susceptible to HBV infection.TB patients who are also infected with HIV tend to have worsened immune function and increased drug resistance.
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ObjectiveTo study the mechanism of matrine in the treatment of inflammatory bowel disease （IBD） based on the zebrafish model and network pharmacology. MethodThe IBD model of zebrafish was established using 2，4，6-trinitro-benzenesulfonicacid （TNBS）， and the intestinal phagocytic function， goblet cell secretion， and neutrophil aggregation were evaluated using neutral red staining， alcian blue staining， and neutrophil number changes. Changes in tumor necrosis factor （TNF）-α and cholecystokinin （CCK） content in zebrafish were determined by using relevant reagent kits. Network pharmacology and molecular docking techniques were used to predict the potential mechanism of matrine in the treatment of IBD. Gene expression of relevant targets was verified through Real-time polymerase chain reaction （Real-time PCR）. ResultCompared with the model group， the matrine administration group can increase the neutral red staining area in a dose-dependent manner and improve intestinal phagocytic function（P<0.05，P<0.01）. It can reduce the staining area of alcian blue and affect the secretion of intestinal goblet cells（P<0.01）. It can reduce the number of neutrophil granulocytes， relieve its aggregation， significantly reduce TNF-α content（P<0.01）， and increase the CCK content. Network pharmacology analysis identifies 28 potential targets for matrine in the treatment of IBD. The top five targets by protein-protein interaction （PPI） network analysis are CHRNA7， DRD1， CHRNA4， SLC6A3， and GRM5. The Kyoto encyclopedia of genes and genomes （KEGG） results show that the treatment of IBD with matrine may be related to neuroactive ligand-receptor interaction， cholinergic synapse， and neutrophil extracellular trap formation. Real-time PCR results show that matrine can affect the expression level of related target genes. Conclusionmatrine has a certain therapeutic effect on IBD and can affect the inflammatory response of IBD. Its therapeutic effect may be related to neuroactive ligand-receptor interaction and other pathways.
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Objective:To analyze the clinical characteristics and treatment methods of the patients who suffered from ice and snow sports injuries in Xinjiang in winter so that useful information can be provided for medical service for ice and snow sports.Methods:A retrospective study was conducted to analyze the clinical data of 147 patients who had sought medical attention for ice and snow sports injuries at Department of Orthopaedics, Xinjiang Uygur Autonomous Region Hospital of Traditional Chinese Medicine from November 2018 to March 2022. The basic information, injury site, injury type, injury cause, length of hospitalization, and treatment methods of the patients were classified and statistically analyzed. The χ2 test was used to compare the injury site and type in patients of different ages, and the nonparametric Kruskal-Wallis test to compare the length of hospitalization in patients of different ages. Results:Of the 147 patients, 73 were males and 74 females with an age of (27.8±15.6) years. The top 3 injury sites were the lower limb (36.91%, 55/149), the upper limb (31.54%, 47/149), and the head and face (14.77%, 22/149). The top 3 injury types were fractures (61.90%, 91/147), skin and soft tissue lesions (14.97%, 22/147), and ligament lesions (10.20%, 15/147). The main causes for injury were fall (58.50%, 86/147), sprain (20.41%, 30/147), and bruise (19.73%, 29/147). Of the 91 patients with fractures, 55 (60.44%, 55/91) underwent surgical treatment, and 32 (35.16%, 32/91) closed reduction and plaster/brace external fixation. Eight of the 22 patients with soft tissue lesions (36.36%, 8/22) and 7 of the 15 patients with ligament lesions (46.67%, 7/15) underwent surgical treatment. The length of hospitalization for the 147 patients was 6.0 (4.0, 9.0) d. The differences in injury site and injury type were statistically significant between different age groups of patients, and the length of hospitalization was significantly different between different age groups of fracture patients ( P<0.05). Conclusions:Young people are the population who suffered from the most injuries due to ice and snow sports in winter in Xinjiang. Injury sites, injury types, and lengths of hospitalization varied with different age groups. Fractures were the most common type of injury. The participants of ice and snow sports should be fully aware that ice and snow sports are highly risky and thus avoid high-risk movements. Doctors should consider the patient's age, injury site, and injury type comprehensively when they formulate specific diagnostic and treatment schemes.
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Objective To explore the improvements of high-fat intake on lung injury induced by Paragonimus proliferus infection in rats, and to preliminarily explore the mechanisms underlying the role of cytochrome P450 4A1 (CYP 4A1) in the improve ments. Methods SD rats were randomly assigned into three groups, including the normal control group (n = 10), the infection and normal diet group (n = 12) and the infection and high-fat diet group (n = 12). Rats in the normal control group were fed with normal diet and without any other treatments, and animals in the infection and normal diet group were subcutaneously injected with 8 excysted metacercariae of P. proliferus via the abdominal wall, followed by feeding with normal diet, while rats in the infection and high-fat diet group were subcutaneously injected with 8 excysted metacercariae of P. proliferus via the abdominal wall, followed by feeding with high-fat diet. All rats were sacrificed 28 weeks post-infection, and serum samples and lung specimens were collected. Following hematoxylin-eosin (HE) staining of rat lung specimens, the rat lung injury was observed under an optical microscope, and alveolitis was evaluated using semi-quantitative scoring. Serum interleukin-1β (IL-1β) and tumor necrosis factor alpha (TNF-α) levels were measured using enzyme-linked immunosorbent assay (ELISA), and the cytochrome P450 4A1 (CYP 4A1) expression was quantified in rat lung specimens at transcriptional and translational levels using quantitative real-time PCR (qPCR) and Western blotting assays. Results Alveolar wall thickening, edema and inflammatory cell infiltration were alleviated 28 weeks post-infection with P. proliferus in rats in the infection and high-fat diet group relative to the infection and normal diet group, and no alveolar consolidation was seen in the infection and high-fat diet group. The semi-quantitative score of alveolitis was significantly higher in the infection and normal diet group [(2.200 ± 0.289) points] than in the normal control group [(0.300 ± 0.083) points] and the infection and high-fat diet group [(1.300 ± 0.475) points] (both P values < 0.05), and higher serum IL-1β [(151.586 ± 20.492)] pg/mL and TNF-α levels [(180.207 ± 23.379) pg/mL] were detected in the infection and normal diet group than in the normal control group [IL-1β: (103.226 ± 3.366) pg/mL; TNF-α: (144.807 ± 1.348) pg/mL] and the infection and high-fat diet group [IL-1β: (110.131 ± 12.946) pg/mL; TNF-α: (131.764 ± 27.831) pg/mL] (all P values < 0.05). In addition, lower CYP 4A1 mRNA (3.00 ± 0.81) and protein expression (0.40 ± 0.02) was quantified in lung specimens in the infection and normal diet group than in the normal control group [(5.03 ± 2.05) and (0.84 ± 0.14)] and the infection and high-fat diet group [(11.19 ± 3.51) and (0.68 ± 0.18)] (all P values < 0.05). Conclusion High-fat intake may alleviate lung injuries caused by P. proliferus infection in rats through up-regulating CYP 4A1 expression in lung tissues at both translational and transcriptional levels.
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Objective To determine the serum IgM and IgG antibody levels post-COVID-19 vaccination， and provide scientific evidence for COVID-19 antibody response after vaccination. Methods A total of 980 healthy persons were included in Kunming Third People’s Hospital from July through August， 2021， which had been vaccinated with COVID-19 vaccines and then tested for anti-SARS-CoV-2 IgM and IgG antibodies. Results After the COVID-19 vaccination， 469 persons （positive rate， 47.86%） were positive for anti-IgG antibody. Of them， 75 were males with （positive rate， 39.06%）， and the average IgG level was 0.618 （0.180， 2.526） AU·mL-1［M（Q1，Q3）］； 394 were females （50.00%）， and the IgG level was 0.999 （0.305， 3.334） AU·mL-1. In addition， 53 persons （5.41%） were anti-IgM antibody positive. Of them， 14 were males （positive rate， 7.29%）， and the average IgM level was 0.057 （0.026， 0.195） AU·mL-1； 39 were females （4.95%）， and the IgM level was 0.047 （0.027， 0.110） AU·mL-1. The positive rate of anti-IgG antibody was highest in those aged ≤30 years， which was 51.02% in male （n=25） and 55.88% in female （n=133）. The anti-IgG response differed significantly by gender （χ2=7.401， D=0.135 1， P<0.05）， whereas the anti-IgM response was not significantly different （χ2=1.656， P>0.05）. Among the age groups， anti-IgG antibody level was higher in those aged ≤30 and 51-70 years， with 158 （55.05%） and 122 （52.36%） persons， respectively； the average antibody level was 1.209 （0.426， 4.386） AU·mL-1 and 1.074 （0.191， 7.670） AU·mL-1， respectively. The differences in the positive rates of IgG and IgM antibodies and the levels of IgG antibodies among different age groups were statistically significant （P<0.05）. Using Kruskal-Wallis test and Spearman correlation analysis， it showed a high correlation between the IgG and IgM antibodies （r=0.836 4， H=64.82， 20.09， P<0.05）. Conclusion The Anti-SARS-CoV-2 IgG antibody remains high six months post-COVID-19 vaccination， while anti-IgM antibody is low. The IgM and IgG response are higher in the young and elderly. The response differs by gender and age， demonstrating a correlation.
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Objective:To explore the method and effect in repairing the defect of fingertip with lateral V-Y advancement flap with one side palmar proper digital artery.Methods:From October 2014 to May 2019, Department of the Hand and Foot Surgery, the Third People's Hospital of Jining(Yanzhou District People's Hospital of Jining City) treated 34 digits of 27 cases with a defect area of 0.5 cm×0.5 cm-1.5 cm×2.0 cm. A lateral V-Y advancement flap with one side palmar proper artery was used to repair the fingertip defect, and the flap size was 1.7 cm×1.0 cm-4.5 cm×1.5 cm. Twenty cases entered long-time follow-up after operation, with 7 cases lost in follow-up, 16 cases were reviewed at outpatient and 4 by WeChat.Results:All the flaps of 34 digits of 27 cases survived. The color of the flaps were close to or completely normal to the surrounding tissue, the texture was soft and the appearance was good. The TPD of the flap was 2.0-6.0 mm. The follow-up time ranged from 22 to 77 months, with an average of 31.45 months. The flexion and extension function of the digits were good with total range of motion(ROM) of the thumb was > 90 °; total active motion (TAM) of the fingers was 260 °-200 °. The fingers of 1 case had hook nail or hook finger deformity. According to the Evaluation Trial Standard of Upper Limb Partial Function of Hand Surgery of Chinese Medical Association, 18 cases were excellent and 2 cases were good.Conclusion:The lateral V-Y advancement flap with one side palmar proper digital artery is easy to operate. The blood supply of the flap is reliable, with good sensation. The flexion and extension of the digits are good, and the appearance and texture of the flap are good.
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Pelvic and acetabular fractures are one of the serious traumatic diseases, leading to a high rate of disability and fatality. Their operative principles are anatomical repositioning and rigid fixation to achieve early functional exercise and avoid complications. The updating modern technology has made precision and minimally invasion a trend in orthopedic surgery. An increasingly number of new technologies has been applied in clinical surgery, such as three-dimensional printing, three-dimensional navigation, and orthopedic robotics, each with its own characteristics. Of them, three-dimensional printing technology is more advantageous in terms of reducing surgical cost and risk, enhancing surgical efficiency, achieving surgical precision and reducing radiation exposure, as evidenced by a large number of clinical case reports and randomized controlled trials. This paper summarizes the current situation and assesses the prospects of three-dimensional printing technology in the diagnosis and treatment of pelvic and acetabular fractures in order to provide reference for orthopedic colleagues.
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Amid the pandemic of COVID-19, the collaborative innovation network of enterprises is conducive to the sharing of innovation resources, knowledge transfer, and technology diffusion, which is closely related to the improvement of corporate technological innovation performance. Based on the patent application data of listed enterprises in Jiangsu, Zhejiang, and Shanghai in China, this study constructs a cooperation matrix, describes the characteristics of collaborative innovation network from two dimensions of network structure and network relationship, introduces the breadth of the knowledge base as a moderating variable, and analyzes the nexus between characteristics of a collaborative innovation network and technological innovation performance. Based on the panel data of 193 listed companies in Jiangsu, Zhejiang, and Shanghai, this study uses a multiple linear regression model for empirical analysis. The results show a U-shaped relationship between clustering coefficient and technological innovation performance. The breadth of knowledge base strengthens the positive relationship between the structural hole and technological innovation performance. In contrast, the breadth of knowledge base weakens the positive relationship between network relationships strength and technological innovation performance. The study findings will enhance enterprises' participation in a suitable collaborative innovation according to their knowledge-based characteristics and improve the technological innovation performance.
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By incorporating the conservation of resource theory, this study examines how high-performance work practices (HPWPs) affect the employee's in-role performance (EIRP) and employee's task performance (ETP) during the coronavirus disease 2019 (COVID-19) pandemic. Furthermore, this study investigates how organization-based self-esteem (OBSE) and positive psychological capital (PPC) affect the relationship between HPWPs and outcomes of employees such as EIRP and ETP. A quantitative technique based on the survey method was used to gather the primary data of the investigation. Two hundred and eleven bank employees working in different banks of Punjab and Pakistan participated in the survey process. The PROCESS-macro was used to test the relationship among the study constructs. Our results supported all the study hypotheses, however positive psychological capital did not moderate the indirect effect of high performance work practices on employee's task performance via organization based self-esteem. This study is the earliest of its kind that focuses on HPWPs and outcomes of employees amid the COVID-19 pandemic in a developing country like Pakistan. The findings of this study provide practical implications in the post and continuing pandemic situation for organizations to human resource management to redesign workforce strategies to increase their contribution and responses to realize organizational priorities. Although researchers have explored the topic in different sectors, scant studies have investigated the potential impact, barriers, and enabling mechanisms that function as a catalyst in HPWPs during the pandemic situation.
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Drawing insight from affective events theory, this study presents a new dimension of perceived organizational politics and job attitudes. The motivation for this study was based on the fact that perceived organizational politics affect job attitudes and that personal resources (political skill and work ethic) moderate the direct relationship between perceived organizational politics and job attitudes in the context of the higher-education sector. In this regard, the data was collected through purposive sampling from 310 faculty members from higher-education institutions in Pakistan. To test the relationships among the variables, we employed structural equation modeling via the AMOS software version 24.0. The results indicated that perceived organizational politics were significantly negatively related to job satisfaction. Moreover, perceived organizational politics were non-significantly related to job involvement. Political skill and work ethic weakened the relationship between perceived organizational politics and job satisfaction. We anticipated that these personal resources could mitigate the negative effect of perceived organizational politics and job attitudes. This study also suggests organizations to train their employees to develop essential personal skills.
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Objective:To investigate the risk factors for early complications after laparoscopy-assisted gastrectomy in patients with gastric cancer.Methods:The retrospective case-control study was conducted. The clinicopathological data of 196 patients who underwent laparos-copy-assisted radical gastrectomy at Peking Union Medical College Hospital from March 2016 to March 2019 were collected. There were 144 males and 52 females, aged (61±10)years. Observation indicators: (1) early complications after laparoscopy-assisted radical gastrectomy and treatment; (2) analysis of risk factors for early complications after laparoscopy-assisted radical gastrectomy.Measurement data with normal distribution were represented as Mean± SD, and measurement data with skewed distribution were represented as M( P25,P75). Count data were represented as absolute numbers. Univariate analysis was conducted using the t test, Mann-Whitney U test or chi-square test. Multivariate analysis was conducted using the Logistic regressional model. Results:(1) Early complications after laparoscopy-assisted radical gastrectomy and treatment: 51 of 196 patients had early postoperative complications, including 7 cases of grade Ⅰ according to Clavien-Dindo classi-fication system, 32 cases of grade Ⅱ, 9 cases of grade Ⅲa, 3 cases of grade Ⅲb. There was no grade Ⅳ or Ⅴ complication. There were 25 cases with abdominal complications, 7 cases with thoracic complications, 3 cases with internal/catheter related complications and 16 cases with other unclassified complications. All patients with complications were improved after symptomatic and supportive treatments. (2) Analysis of risk factors for early complications after laparoscopy-assisted radical gastrectomy: results of univariate analysis showed that the lymphocyte count, neutrophil-to-lymphocyte ratio, radiotherapy, operation time, volume of intraoperative blood loss, T stage, lymph node metastasis were related factors for early complications after laparoscopy-assisted radical gastrectomy in patients with gastric cancer ( Z=?2.048, χ2=6.385, 4.168, 8.068, 6.336, 12.497, 7.522, P<0.05). Results of multivariate analysis showed that the neutrophil/lymphocyte ratio ≥1.96, operation time ≥222 minutes, and lymph node metastasis were independent risk factors for early complica-tions after laparoscopy-assisted radical gastrectomy in patients with gastric cancer ( odds ratio=2.279, 2.245, 2.226, 95% confidence interval as 1.149-4.519, 1.116-4.517, 1.125-4.402, P<0.05). Conclusions:The abdominal complications are the most common early complications after laparoscopy-assisted radical gastrectomy. The neutrophil-to-lymphocyte ratio ≥1.96, operation time ≥222 minutes, and lymph node metastasis are independent risk factors for early complications after laparoscopy-assisted radical gastrectomy in patients with gastric cancer.
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Objective:To describe and compare the perioperative changes of body weight, skeletal muscle and fat mass in patients with benign and malignant gastrointestinal tumors.Methods:All adult patients admitted to the surgery department of a referral hospital in Beijing with voluntary consent were included in the study. For all participants, preoperative medical history were collected and body composition measurements were performed 1-2 days prior to the surgery and 3-6 days after the surgery. Pathological results and tumor diagnosis were recorded.Results:A total of 80 participants completed the study. There was no significant difference in weight and body composition between patients with benign and malignant tumors before operation, but patients experiencing a weight loss of more than 5% in the past 6 months were dramatically more in malignant tumor group compared with benign tumor group (9.1% vs. 42.0%, P=0.024). With the parenteral and enteral nutrition support, there was no significant difference in the changes of weight, muscle, or fat mass between benign and malignant tumor patients in different stages (all P>.05). Patients with malignant tumors were divided into severe weight loss group and observational group with the percentage weight loss cut-off of 5%. Analysis showed that patients in the severe weight loss group had significantly decreased weight [(-4.3±1.6)kg vs. (-1.9±1.1)kg, P<0.01], BMI[(-1.3±0.9)kg/m 2vs. (-0.7±0.4)kg/m 2, P<0.01], muscle[(-1.2±2.0)kg vs. (-0.4±1.2)kg, P=0.046] and fat mass [(-2.6±2.0)kg vs. (-1.1±0.9)kg, P=0.018] compared with observational group, while visceral [(-0.5±0.6)kg vs. (-0.2±0.7)kg, P=0.107] and subcutaneous fat [(-2.2±1.9)kg vs. (-1.4±1.8)kg, P=0.235] of two groups had no significant difference. Univariate analysis revealed age as the only influencing factor for perioperative weight loss ( P=0.036). Fat loss was predominant in the overall weight loss compared with muscle loss ( P=0.026) among patients with gastrointestinal malignant tumors. Conclusion:With parenteral and enteral nutrition support, there is no significant difference in perioperative changes of weight, muscle or fat mass among patients with benign and malignant tumors. Muscle and fat loss both have contributed to the overall weight loss, which is noteworthy.
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Objective:To investigate the clinical efficacy of infra-acetabular screwing in the treatment of acetabular fractures.Methods:A retrospective analysis was conducted of the 22 patients with acetabular fracture who had been admitted to Department of Trauma and Orthopedics, The Affiliated Hospital of Traditional Chinese Medicine, Xinjiang Medical University from January 2016 to January 2019. They were 16 males and 6 females, aged from 19 to 65 years (mean, 45.2 years). According to Letournel-Judet classification, there were 2 anterior column fractures, 12 anterior plus posterior hemi-transverse fractures, 3 T-shaped fractures and 5 both-column fractures. All patients were treated with infra-acetabular screwing through the ilioinguinal approach. Recorded were the patients＇ operation time, intraoperative blood loss, reduction quality, fracture union time, hip function and complications.Results:Operation time for this cohort ranged from 115 to 285 min (mean, 160 min), and intraoperative blood loss from 360 to 1,600 mL (mean, 650 mL). By the Matta scoring, fracture reduction was assessed as excellent in 14 cases, as good in 5 cases and as poor in 3 cases, giving an excellent and good rate of 86.4% (19/22). Of this cohort, 21 were followed up from 12 to 45 months (mean, 28.5 months) and one was lost to the follow-up. The fracture healing time for 21 patients ranged from 1.6 to 3.0 months, averaging 2.2 months. No patient had fracture displacement. The Merle d’Aubigné & Postel hip scores at the last follow-up ranged from 8 to18 points (average, 16 points), giving 12 excellent, 6 good, 2 fair, and one poor cases and an excellent and good rate of 85.7% (18/21). Follow-ups observed injury to the lateral femoral cutaneous nerve in one case, deep venous thrombosis of lower limb in 2 cases, superficial wound infection in one case and traumatic arthritis in one case, yielding a total rate of compilations of 23.8% (5/21).Conclusion:Application of infra-acetabular screwing after anatomical reduction of an acetabular fracture can effectively enhance the strength of internal fixation with no risk of fracture re-displacement, conducive to early functional exercise of the patient and leading to good clinical efficacy.
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Generally, it is difficult to work efficiently in a toxic environment. Surprisingly, leaders are found to be liable for such toxic atmosphere because they possess certain traits that employees perceive as victimization. This research assesses the relationship between the dark triad (narcissism, Machiavellianism, and psychopathy) and perceived victimization with a focus on the mediating effect of abusive supervision and the moderating effect of mindfulness. For this purpose, we surveyed 274 employees in the healthcare sector of Pakistan by using random sampling technique in three waves. To analyze the data, the structural equation model with partial least squares and PROCESS were used. The findings suggest that abusive supervision plays a mediating role in the association between the dark triad and perceived victimization. The results did not support the mediating role of abusive supervision in the association between narcissism and perceived victimization, however, the mediated moderation model was supported. Further, the findings suggest that mindfulness weakens the effect of abusive supervision on perceived victimization. Finally, the theoretical and practical implications of the results are also discussed.
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With the outbreak of COVID-19, non-stop working medical staff need to wear protective equipment for a long time, which could easily cause device-related pressure injuries to nose, cheek, forehead or the back of auricle, and might even cause facial skin swelling and ulceration. The above problems reduce work efficiency and increase the infection risk for healthcare people. This article introduces the concept of device-related pressure injuries and summarizes the progress of the treatment for device-related pressure injuries at home and abroad in recent years, aiming at providing guidance for frontline medical staff to prevent device-related pressure injuries.
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Objective To designe, synthesize a series of chlorin p6 ether photosensitizers and preliminarily investigate their photodynamic antitumor activity based on previous research results that alkoxyl ether derivatives of 3-vinyl on chlorin f exhibited stronger photosensitive antitumor activity than parent compound. Methods Purpurin-18 (4) was obtained by oxidative degradation with air and alkali on pheophorbide a (5) which was prepared through acid hydrolysis of chlorophyll a from crude chlorophyll extracts in Chinese traditional herb named Silkworm excrement. Then, chlorin p6 trimethylester (2) were formed via basic hydrolysis of internal anhydride ring for lead compound 3 and following immediately methylation with CH2N2. The intermediate 2 reacted with 33% HBr, following nucleophilic substitution with various alkoxyl alcohol to get six title compounds (1). All title compounds were subjected to photodynamic antitumor activity screening for melanoma B16-F10 cell in vitro. Results All title compounds showed much higher phototoxicity against melanoma B16-F10 cells than talaporfin and verteporfin. Their structures were confirmed by 1H-NMR, 13C-NMR, ESI-MS and ESI-HRMS spectra. Conclusion Chlorin p6 ether compounds were promising candidate photosensitizers for PDT applications due to theirs high dark toxicity/phototoxicity ratio and excellent phototoxicity, which were worthy of further research and development.