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Objective:To investigate the prognostic value of thymosin β4 (TMSB4X) expression and preoperative systemic immune-inflammatory index/serum albumin (SII/ALB) level in patients with early operable non-small cell lung cancer (NSCLC).Methods:A total of 128 patients with early NSCLC admitted to Zibo Central Hospital from January 2016 to January 2021 were selected. TMSB4X and SII/ALB were detected before surgery, and they were divided into TMSB4X positive group (52 cases) and TMSB4X negative group (76 cases) according to TMSB4X expression. According to the median SII/ALB value, the patients were divided into high SII/ALB group (64 cases) and low SII/ALB group (64 cases). The relationship between TMSB4X, SII/ALB and clinical characteristics in patients with early operable NSCLC was analyzed. The survival curve was drawn by Kaplan-Meier method and the difference of progression free survival (PFS) between TMSB4X positive group and negative group, high SII/ALB group and low SII/ALB group was tested by log-rank. The influencing factors of PFS was analyzed by Cox univariate and multivariate regression.Results:There were difference in lesion site, carcinoembryonic antigen (CEA) and lymphocyte count (LY) between TMSB4X positive group and TMSB4X negative group (all P<0.05). There were significant difference in age, American Joint Committee on Cancer (AJCC) stage, ALB, cytokeratin 19 fragment (CYFRA21-1), CEA, LY, platelet count (PLT) between the high SII/ALB group and the low SII/ALB group (all P<0.05). The median PFS of TMSB4X positive group (17.11 months) was lower than that of TMSB4X negative group (26.64 months) (log rank P<0.001); The median PFS (15.82 months) in the high SII/ALB group was lower than that in the low SII/ALB group (28.24 months) (log rank P<0.0001); Cox univariate analysis showed that lesion location, AJCC stage, ALB, CYFRA21-1, CEA, LY, PLT, TMSB4X, and SII/ALB were all factors influencing PFS in early operable NSCLC patients (all P<0.05); Multivariate analysis showed that AJCC stage, LY, TMSB4X, SII/ALB were independent factors influencing PFS in early operable NSCLC patients (all P<0.05). Conclusions:The expression of TMSB4X and the preoperative level of SII/ALB can be used as prognostic indicators for patients with early operable NSCLC.
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Objective:To investigate the value of 256-slice CT coronary angiography(CTA)in evaluating graft patency after coronary artery bypass grafting(CABG)in elderly patients.Methods:A total of 30 elderly patients under follow-up after CABG surgery in our hospital from May 2016 to May 2018 were randomly selected.During the same period, coronary angiography(CAG)and 256-slice CTA were performed to evaluate the patency of grafts.The diagnostic efficacy of CTA in evaluating the patency of bypass grafts was assessed by using CAG results as the gold standard.Results:In all, 82 grafts were observed on CAG, of which 31 were arterial grafts and 51 were saphenous vein grafts(SVG). Arterial grafts involved 27 original left internal mammary arteries(LIMA)→left anterior descending branch(LAD)grafts, 1 original right internal mammary artery(RIMA)→LAD graft, 1 aorta(AO)→LIMA→LAD graft, and 2 AO→radial arteries(RA)→right coronary artery(RCA)grafts.Venous grafts involved 9 AO→SVG→LAD grafts, 20 AO→SVG→left circumflex artery(LCX)grafts, and 22 AO→SVG→RCA grafts.CAG results showed that 28 arterial grafts were unobstructed with a patency rate of 90.3%, while 3 arterial grafts(9.7%)were occluded.Meanwhile, 34 venous grafts were unobstructed with a patency rate of 66.7%, 11 venous grafts(21.6%)had stenosis and 6 grafts(11.8%)were occluded.A total of 87 grafts were observed by using CTA.Based on the results from CAG, the overall sensitivity, specificity and Kappa value of CTA for the assessment of grafts were 95.1%, 97.6% and 0.93, respectively.The sensitivity, specificity and Kappa value of CTA were 96.8%, 95.0% and 0.90 for assessing unobstructed grafts, 81.8%, 97.2% and 0.79 for assessing stenosed grafts, and 100%, 98.6%, and 0.94 for assessing occluded grafts, respectively.Conclusions:256-slice CT coronary angiography can be used to accurately evaluate graft status and possesses advantages such as non-invasiveness, simplicity and low risk.Therefore, it should be recommended as the first choice in the evaluation of graft patency after CABG in elderly patients.
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Objective To evaluate biomechanical properties of self-designed polyaxial self-locking anatomical plate so as to offer scientific evidence for clinical application.Methods According to anatomic characteristics of distal tibiae of domestic people,a polyaxial self-locking anatomical plate for distal tibia was designed.Six paired ( left,right) fresh cadaver tibial specimens were used to make fracture fixation models and were divided into groups A and B,six specimens per group.Common anatomical locking plates were assembled in group A and polyaxial self-locking anatomical plates were assembled in group B.The biomechanical tests were performed by using 858 Mini Bionix testing machine.Non-destructive tests were performed in both groups,including axial loading,4-point bending and torsional loading and the stiffness of the two fixation instruments was compared.SPSS 13.0 software was used for statistical analysis.Results Polyaxial self-locking anatomical plate was fit for the morphology of distal tibiae.The self-designed pelyaxial plate could increase angular regulation amplitude for the locking screw up to 30°.Compression stiffness was (557.53 ± 20.72) N/mm in group A and (562.80 ± 28.26 ) N/mm in group B.Four-point bending stiffness was ( 268.02 ± 36.77) N/mm in group A and ( 265.76 ± 27.21 ) N/mm in group B.Torsional stiffness was (0.28 ±0.01) Nm/deg in group A and (0.29 ±0.02) Nm/deg in group B.The three tests in two groups showed no statistical significance ( P ＞ 0.05 ).Conclusions The self-designed polyaxial self-locking anatomical plate of distal tibia is fit for the tibial morphology of domestic people.Its biomechanical properties are equivalent to those of common anatomical locking plate,which can meet the needs for clinical application.
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BACKGROUND: Orthopedic academics are committed to the modification of calcium phosphate cement (CPC) by adding different additives, including the promotion of curing agents, plasticizers, anti-water blood solvent, porogen, enhancer, or biological activity substance or drug compound to the CPC in order to enhance its physical and chemical and biological properties which is a research hotspot in the field. OBJECTIVE: To investigate the physical and chemical characteristics of a biodegradable injectable CPC. DESIGN, TIME AND SETTING: Duplicated testing study was performed at the National Key Laboratory, College of Materials, South China University of Technology from December 2008 to May 2009. MATERIALS: Calcium phosphate with partial crystallization and strontium phosphate and calcium hydrogen phosphate dehydrate with partial crystallization were added with modified starch and type I collagen to prepare a new type of self-injectable CPC. METHODS: CPC phase was analyzed using X'Pert Pro X-ray diffractometer; CPC morphology was observed using HITA2 -CHIH-800 transmission/scanning electron microscope; setting-up time was tested using Vicat apparatus according to A S TM C190203 standard; compressive strength was measured using Instron 5567 omnipotent electron apparatus; syringeability was detected using syringe apparatus with 1.6 mm of inside diameter; collapsibility was tested using soaking-shaking quantitative materials. MAIN OUTCOME MEASURES: Phase component and microstructure of CPC products, setting-up time, syringeability, compressive strength, and collapsibility. RESULTS: The material coul be injected with an excellent performance, and the modified starch significantly improved the resistance of bone cement collapsibility. As the bone cement liquid-solid ratio increased, the compressive strength of cement decreased. When the bone cement liquid-solid ratio was 0.3, the compressive strength for cement was (48.0±2.3) MPa when the bone cement liquid-solid ratio was 0.6, the compressive strength of bone cement reduced to (21,0±2.5) MPa. Hydration productof cement-like bone hydroxyapatite crystallization also could be seen from the X-ray diffraction, due to the hydration of-cement was not complete, a baseline level of volatile explained fully hydrated conditions, suggesting that the bone cement could farther improve the compression strength. CONCLUSION: Developed an injectable strontium-contained collagen CPC is coincidence with the biomechanical strength of the human body and meets the requirements of the operation conditions.
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Objective To evaluate the effectiveness of locking compression plate (LCP) in treatment of comminuted fractures of distal end of radius. Methods A retrospective analysis of the clinical data was done for the 24 patients with comminuted fracture of distal end of radius who had been treated by locking compression plate fixation from August 2002 to August 2003. Results The follow up duration averaged 7.8 months. The satisfactory rate of functional outcome with LCP fixation was 91.6 percent. Conclusion Although LCP can provide the outstanding stability theoretically, it has not resulted in more exciting outcomes in treatment of comminuted fractures of distal end of radius than traditional methods.
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OBJECTIVE Deep sternal wound infection (DSWI) is one of the most serious complications after the open heart cardiac surgery. To explore the risk factors and appropriate treatment methods,we performed this study retrospectively. METHODS Between Jan 2001 and Jan 2006,1123 patients underwent various cardiac surgical procedures via a median sternotomy in the Cardiovascular Center of Beijing Tongren Hospital. These patients were divided into two groups by whether suffered from DSWI. Univariate analyses were performed for possible risk factors,and Logistic regression was used in multivariate analysis. RESULTS Eight among 1123 (0.71%) patients suffered from DSWI. No one died from wound infection. Results from both single variate analysis and multivariate analysis showed that only age significantly associated with DSWI. No other independent risk factors significantly associated with DSWI. Blood culture in acute DSWI group tended to be positive,while in chronic group it tended to be negative. All patients with DSWI were effectively cured. CONCLUSIONS Age is an independent risk factor for DSWI. Early debridement with closed chest catheter irrigation and antibiotics using are strongly recommended as an easy and effective way to treat DWSI. Large-scale multicenter studies are still needed to determine reliable risk factors for DSWI.
