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Objective: To evaluate the efficacy of medial open wedge high tibial osteotomy (MOWHTO) combined with anterior cruciate ligament (ACL) reconstruction in the treatment of varus knee osteoarthritis (OA) with ACL injury. Methods: A follow-up study. The study retrospectively analyzed the patients underwent MOWHTO combined with ACL reconstruction for treatment of varus knee OA with ACL injury in Tianjin Hospital between April 2018 and September 2022. The preoperative and postoperative posterior slope angle (PSA), hip-knee-ankle angle (HKA), visual analog scale (VAS) pain scores, Lysholm score, International Knee Documentation Committee (IKDC) score, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, and Tegner score were compared. The follow-up indicators were recorded at 6 weeks, 3 months and 1 year after operation, and the complications were recorded. Results: The study included 32 patients (23 males, 9 females) with a mean age of (50.7±8.4) years. The mean follow-up time was (21.2±4.8) months. PSA increased from 9.2°±1.8° preoperatively to 11.1°±2.4° postoperatively, and HKA increased from 168.7°±2.2° to 181.5°±2.2° (both P<0.01). The indicators such as VAS score (6.8±1.1 vs 1.8±0.4), Lysholm score (52.6±7.1 vs 82.0±6.4), IKDC score (64.7±6.2 vs 80.3±10.0), WOMAC score (51.8±6.3 vs 81.8±6.5), and Tegner score (1.9±0.6 vs 5.0±1.0) were all improved after the operation (all P<0.01). Complications occurred in 5 patients (15.6%), including hematomas, sensory abnormalities, intermuscular vein thrombosis and correction angle loss. Conclusion: MOWHTO combined with ACL reconstruction is a safe and effective approach for the treatment of varus knee OA with ACL injury.
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Lesões do Ligamento Cruzado Anterior , Reconstrução do Ligamento Cruzado Anterior , Osteoartrite do Joelho , Osteotomia , Tíbia , Humanos , Masculino , Feminino , Osteotomia/métodos , Pessoa de Meia-Idade , Estudos Retrospectivos , Reconstrução do Ligamento Cruzado Anterior/métodos , Osteoartrite do Joelho/cirurgia , Tíbia/cirurgia , Lesões do Ligamento Cruzado Anterior/cirurgia , Lesões do Ligamento Cruzado Anterior/complicações , Resultado do Tratamento , Articulação do Joelho/cirurgiaRESUMO
Objective: To understand the impact of diet on glycemic control in community-managed patients with type 2 diabetes mellitus (T2DM) and provide evidence for implementing prevention strategies and measures for diabetes patients. Methods: Eight communities were randomly selected from Changshu and Wuhan in 2015, and T2DM patients managed in the community were selected to conduct questionnaire surveys, physical measurements, and blood glucose testing. Factor analysis was used to obtain dietary patterns. A binary logistic regression model was used to analyze the factors affecting glycemic control. Results: Finally, 1 818 T2DM patients were included, and the control rate of FPG was 57.59% (95%CI: 55.30%-59.86%), and the control rate of 2 h postprandial blood glucose (2 h PBG) was 24.90% (95%CI: 22.93%- 26.91%). Five dietary patterns were obtained by factor analysis: animal food pattern, fruit-aquatic products-potato patterns, vegetable-grain pattern, egg-milk-bean pattern, and oil-salt patterns. No-conditional multivariate logistic regression analysis showed that after adjusting for confounding factors, the reduced probability of FPG control was related to animal food pattern (OR=0.71, 95%CI: 0.52-0.98) and fruit-aquatic products-potato patterns (OR=0.71, 95%CI: 0.51-0.97). The decrease in the 2 h PBG control probability was related to fruit-aquatic products-potato patterns (OR=0.60, 95%CI: 0.40-0.90). The increased probability of FPG and 2 h postprandial glucose control were both related to vegetable-grain pattern (OR=1.41, 95%CI: 1.03-1.94; OR=1.68, 95%CI: 1.13-2.51) and egg-milk-bean pattern (OR=1.75, 95%CI: 1.25-2.46; OR=1.56, 95%CI: 1.00-2.42). Compared with the Q4 group of egg-milk-bean pattern, the FPG control rate of the combination of "fruit-aquatic products-potato pattern (Q4 group), vegetable-grain pattern (Q2 group), egg-milk-bean pattern (Q3 group)" was higher (OR=6.79, 95%CI: 1.15-40.23, P=0.035). Compared with the Q4 group of vegetable-grain pattern, the combination of "fruit-aquatic products-potato pattern (Q4 group), vegetable-grain pattern (Q3 group), egg-milk-bean pattern (Q2 group), oil-salt pattern (Q2 group)" had higher control rate of 2 h PBG (OR=12.78, 95%CI: 1.26-130.05, P=0.031). Conclusions: A proper combination of dietary patterns and dietary patterns are more conducive to the control of FPG and 2 h PBG in T2DM patients managed in the communities of Wuhan and Changshu. Patient nutrition education should be strengthened, and the food-matching ability of patients should be improved.
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Diabetes Mellitus Tipo 2 , Animais , Humanos , Glicemia , Padrões Dietéticos , Controle Glicêmico , Dieta , Verduras , Grão ComestívelRESUMO
Heart failure is a serious and end-stage status of various heart diseases, characterized by comparatively high rate of readmission and mortality, and has become an important public health issue. The risk of readmission and mortality following discharge of an index hospitalization are key indicators to evaluate the quality of medical care among patients with acute heart failure. Therefore, it is important to carry out risk prediction research for patients with acute heart failure, quantify the disease risk, perform risk stratification, optimize clinical decision-making, elevate patients' quality of life and prognosis, and comprehensively improve the medical quality of acute heart failure. During the past 20 years, foreign researchers have developed dozens of models to predict the risk of acute heart failure readmission and mortality, and Chinese researchers have also developed up to 10 models applicable to the Chinese population. However, there is no recommended risk prediction model for acute heart failure in current clinical guidelines across China. In this report, we aim to introduce the major models for predicting the risk of acute heart failure readmission and mortality from home and abroad, focus on putting forward limitations of established models, and initiating potential directions for future studies from the following aspects: integrate multi-source data, mine emerging biomarkers, establish polygenic risk scores, optimize machine learning methods, promote flexible adjustment, and broaden approaches that applicable for various scenarios. Accordingly, this study will help facilitate domestic research in predicting the risk of readmission and mortality among patients hospitalized for acute heart failure.
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Insuficiência Cardíaca , Readmissão do Paciente , Humanos , Qualidade de Vida , Hospitalização , Fatores de RiscoRESUMO
We consider the problem of multiple hypothesis testing when there is a logical nested structure to the hypotheses. When one hypothesis is nested inside another, the outer hypothesis must be false if the inner hypothesis is false. We model the nested structure as a directed acyclic graph, including chain and tree graphs as special cases. Each node in the graph is a hypothesis and rejecting a node requires also rejecting all of its ancestors. We propose a general framework for adjusting node-level test statistics using the known logical constraints. Within this framework, we study a smoothing procedure that combines each node with all of its descendants to form a more powerful statistic. We prove a broad class of smoothing strategies can be used with existing selection procedures to control the familywise error rate, false discovery exceedance rate, or false discovery rate, so long as the original test statistics are independent under the null. When the null statistics are not independent but are derived from positively-correlated normal observations, we prove control for all three error rates when the smoothing method is arithmetic averaging of the observations. Simulations and an application to a real biology dataset demonstrate that smoothing leads to substantial power gains.
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Objective To establish a method for determining volatile components from Actinidia valvata Dunn .Methods A static headspace‐gas chromatography‐mass spectrometry (HS‐GC‐MS) method was used to analyze volatile components , and the separated peaks were identified by mass spectal library searching combined with retention index comparison .Results 42 volatile components were separated from Actinidia valvata Dunn and 25 of them were identified ,mainly including alcohols ,es‐ters ,aldehydes ,hydrocarbons and so on .Conclusion Combined with retention index calculation ,this method improved accuracy of qualitation of HS‐GC‐MS and provided scientific proof for the exploitation and utilization of Actinidia valvata Dunn .
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Purpose: To explore the association between the 3,144 m/ z protein peak and the clinicopathological features and prognosis in breast cancer. Methods: Using SELDITOF MS, we analyzed serum protein peak at 3,144 m/z in 283 patients with node-positive breast cancer, its relationship with clinicopathological features and their prognosis evaluating value of survival. Results 3,144 m/z positive rate was higher in elderly patients (42.8 % in C50-year-old vs. 31.2 % in (, P = 0.04). However, no correlation was observed between 3,144 m/z and other clinicopathological features (body mass index, menstrual status, family history, TNM, molecular subtypes, vascular invasion, neural invasion, p53 and CA15-3). However, the positive rate of 3,144 m/z was higher than that of CA15-3 (35.5 vs. 11.4 %, McNemar v2 test, p
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Humanos , Neoplasias da Mama/patologia , Mucina-1/análise , Biomarcadores Tumorais/análise , Proteínas Sanguíneas/análise , Prognóstico , Fatores de RiscoRESUMO
Objective To identify the chemical components in Artemisiae argyi folium by rapid resolution liquid chromatog-raphy-time of flight mass spectrometry (RRLC-TOFMS).Methods The separation was performed on an Agilent Eclipse C18 column (2.1 mm ×100 mm,1.8 μm ).The mobile phase consisted of acetonitrile (A) and 0.1% formic acid (B) were in gradient elu-tion.The flowing rate was 0.35 ml/min, the injection volume was 1μl and the temperature of column was 40℃.Time of flight mass spectrometer ( TOFMS) with electro spray ion source ( ESI) was applied to qualitative analysis under the positive ion mode, and mass scan range was m/z 100-1 500 .Results 31 chemical compounds in Artemisiae argyi folium were identified unequivocally .Conclu-sion A rapid and efficient RRLC-TOFMS approach for identifying the chemical constituents of Artemisiae argyi folium had been suc-cessfully established,which paved a way for quality control and further in vivo studies of Artemisiae argyi folium.
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AIM: To investigate the relationship between morphologic changes in neuron or neuroglial cells and expression of tumor necrosis factor ? (TNF-?) and c-Myc in cortex after focal cerebral ischemia/reperfusion in MCAO rats. METHODS: The focal cerebral ischemia/reperfusion model was established by intraluminal thread occlusion of the middle cerebral artery (MCAO). The middle cerebral arteries of rats were occluded for 2 hours and reperfused for 1, 3 and 7 days. Using the techniques of immunohistochemical staining and optical microscopy, the morphologic changes in neuron or neuroglial cells were observed in the cortex of frontal or parietal lobe; the cell types which dynamicaly expressed TNF-?, c-Myc in the different period were also observed. RESULTS: The degeneration or necrosis of neuron or neuroglial cells were observed at the center of infarction, it was very serious at 3 d after reperfussion. Astrocyte and microglial cell proliferation were observed at the broder of infarction. TNF-? and c-Myc positive cells, most of which were astrocytes and microglial cells, increased significantly at 3 d after reperfusion. CONCLUSION: TNF-? and c-Myc may play an important role in the regulation of neuron or neuroglial cells after focal cerebral ischemia with reperfusion. [