1.Analysis of risk factors for death within 1 year after hip fracture surgery in the elderly
Xuefeng HU ; Zhiqin YU ; Shijun NI ; Guangfei LI ; Honghui SONG ; Jia JIN ; Liuhui CHANG ; Yancheng DAI ; Youjia XU ; Peng ZHANG
Chinese Journal of Trauma 2023;39(3):245-251
Objective:To explore the risk factors for death within 1 year after hip fracture surgery in the elderly.Methods:A case control study was made on the clinical data of 551 elderly patients with hip fracture treated in Second Affiliated Hospital of Soochow University from January 2019 to December 2020, including 182 males and 369 females; aged 65-100 years [80(73,86)years]. Joint replacement, cannulated screw fixation or proximal femoral nail fixation were performed. The patients were divided into survival group ( n=494) and death group ( n=57) based on the death within 1 year after surgery recorded at postoperative telephone follow-up. The gender, age, hypertension, diabetes, cardiovascular diseases, chronic respiratory diseases, neurological diseases, chronic renal failure, anemia on admission, fracture types, American anesthesiologist Association (ASA) classification, operative methods, preoperative waiting time, duration of operation and perioperative blood transfusion were recorded in two groups. Univariate Cox regression was used to analyze the correlation between the above indexes and death within 1 year after surgery. All indexes with P<0.2 in the univariate analysis were included in multivariate Cox regression analysis to clarify the independent risk factors for death within 1 year after surgery. Results:Univariate Cox regression analysis showed that death within 1 year after surgery correlated with gender, age chronic respiratory diseases, chronic renal failure and anemia on admission (all P<0.01), but not with hypertension, diabetes, cardiovascular diseases, neurological diseases, fracture types, ASA classification, operative methods, preoperative waiting time, duration of operation or perioperative blood transfusion (all P>0.05). Multivariate Cox regression analysis showed that male ( HR=2.08, 95% CI 1.20, 3.61, P<0.01), age ≥ 80 years ( HR=2.22, 95% CI 1.15, 4.28, P<0.05), chronic respiratory diseases ( HR=2.54, 95% CI 1.19, 5.40, P<0.05), chronic renal failure ( HR=4.57, 95% CI 1.27, 16.44, P<0.05), anemia on admission ( HR=2.82, 95% CI 1.38, 5.76, P<0.01) were significantly associated with death within 1 year after surgery. Conclusion:Male age≥ 80 years, chronic respiratory disease, chronic renal failure and anemia on admission are independent risk factors for death within 1 year after hip fracture surgery in the elderly.
2.Early clinical efficacy of the orthopaedische chirurgie munchen approach to hemiarthroplasty in the treatment of femoral neck fractures in the elderly
Hongquan HENG ; Yuan YANG ; Xuefeng HU ; Mu SHEN ; Guangfei LI ; Peng ZHANG ; Youjia XU ; Jian LI
Chinese Journal of Orthopaedics 2023;43(4):230-237
Objective:To investigate the early clinical outcomes of a minimally invasive anterolateral approach (Orthopadische chirurgie munchen, OCM) versus a conventional (posterolateral approach, PLA) hemiarthroplasty in the treatment of senior femoral neck fractures.Methods:A retrospective analysis was performed on 90 elderly patients with femoral neck fractures who received anterolateral and posterolateral approaches for hemiarthroplasty in the Second Affiliated Hospital of Soochow University from December 2019 to June 2021 and were followed up. In the OCM group, there were 45 cases, including 18 males and 27 females, aged 83.33±5.29 years (range, 76-96 years); In the PLA group, there were 45 cases, including 13 males and 32 females, aged 81.87±5.00 years (range, 75-94 years). Postoperative, surgical indices, perioperative bleeding, and soft tissue injury were assessed; pain was assessed using the visual analogue scale (VAS), and hip function was evaluated using the Harris score and the University of California at Los Angeles (UCLA) score.Results:The incision length, postoperative hospital stay, hemoglobin reduction, and occult blood loss were lower in the OCM group than in the PLA group ( P<0.05), but there was no significant difference in intraoperative bleeding and postoperative transfusion rate ( P>0.05). Serum creatine kinase and C-reactive protein levels (232.98±83.70 IU/L and 81.67±48.85 mg/L) were lower in the OCM group than in the PLA group (296.93±124.58 IU/L and 104.79±36.75 mg/L) 1 day after surgery, and the differences were statistically significant ( t=2.86, P=0.005; t=2.54, P=0.013). Postoperative pain was significantly improved in all patients, and VAS scores were lower in the OCM group than in the PLA group at 12 h, 24 h, and 48 h postoperatively ( P<0.05). The time to get out of bed after surgery was 20.73±4.99 h in the OCM group compared with 41.69±13.58 h in the PLA group, with a statistically significant difference ( t=9.71, P<0.001). Harris scores (63.31±6.21 and 75.76±4.91) and UCLA scores (1.84±0.42 and 3.69±0.76) were higher in the OCM group on the day of discharge and at 1 month postoperatively than in the PLA group (52.69±10.01 and 71.33±3.66); (1.62±0.54 and 3.16±0.80) points, all with statistically significant differences ( P<0.05). However, the differences in Harris score and UCLA score between the two groups at 6 months postoperatively were not statistically significant ( P>0.05). There were two cases of intermuscular vein thrombosis in the OCM group, with a complication rate of 4% (2/45), and one case of dislocation in the PLA group, with a complication rate of 2% (1/45), there was no significant difference between the two groups ( P=1.000). Conclusion:The minimally invasive anterolateral approach is a more ideal procedure for elderly patients with femoral neck fractures undergoing hemiarthroplasty. It has the advantages of a short incision, small soft tissue damage, low occult blood loss, early removal from bed, a short postoperative hospital stay, an improvement in pain, and a good early recovery of hip function.
3. Iron accumulation induces osteoporosis by disrupting Wnt signaling pathway
Guangfei LI ; Hui ZHANG ; Aifei WANG ; Zihou CAO ; Yan GAO ; Youjia XU
Chinese Journal of Endocrinology and Metabolism 2019;35(12):1061-1064
The specimens of femur from wild-type mice(WT) of 6 months and Hepcidin-knockout(KO) mice of 6 months(iron accumulation model) were obtained for Micro-CT examination. Western blot and co-immunoprecipitation were used to detect the changes of related parameters in Wnt signaling pathway. Compared with wild-type mice, the bone mass in Hepcidin-KO mice was significantly decreased, the binding of β-catenin to FOXO3a increased, and binding of β-catenin to TCF4/TCF7L2 decreased in bone tissue, without significant changes in the expression of β-catenin, TCF4/TCF7L2, and FOXO3a. These results suggest that iron accumulation may affect bone formation through interfering with canonical Wnt/β-catenin signaling pathway, finally leading to osteoporosis.
4.Study on the best concentration of miRNA-22 agomir in the treatment of temporal lobe epilepsy by single injection of lateral ventricle
Qiubo LI ; Xingrao WU ; Qingxia KONG ; Fenghai NIU ; Guangfei SUN ; Cuiping ZHU ; Xu CHU
Journal of Chinese Physician 2019;21(2):197-200,206
Objective To investigate the optimal initial concentration of microRNA22 agomir in epilepsy model induced by lithium chloride-pilocarpine after single injection of lateral ventricle.Methods 36 rats with acute temporal lobe epilepsy were randomly divided into 6 groups:the control group and the other five groups were the experimental group.All epilepsy rats were selected for right lateral ventricle injection.The control group was given negative control reagent,while the experimental group were given 0.1 mmol/L,2.5 mmol/L,5 mmol/L,10 mmol/L,20 mmol/L different concentrations of miRNA22agomir reagent.6 rats in each group were randomly selected for acute phase experiment after 3 days of administration.The expression of P2X7 in hippocampus of epilepsy rats was determined by Western blot and quantitative real-time polymerase chain reaction (qRT-PCR).Results Compared with control group,the protein and mRNA expression of P2X7 reduced in all of the model group.The protein and mRNA expression level of P2X7 protein in hippocampus of rats injected with 2.5 mmol/L,5 mmol/L and 10 mmol/L in each experimental group were significantly lower than that in the other two groups (P < 0.05).Moreover,the protein and mRNA expression level of P2X7 were the lowest at 2.5 mmol/L injection and 10 mmol/L,and there was no significant difference between the two groups (P > 0.05).Conclusions The optimal onset concentration for unilateral lateral ventricle injection miRNA22 agomir treatment of temporal lobe epilepsy is 2.5 mmol/L.
5.Discussion on Pollution-free Production Technology of Carthamus tinctorius
Lili SU ; Guangfei WEI ; Mengzhi LI ; Xiangxiao MENG ; Yaru XU ; Huanhuan WANG ; Gang LI ; Linlin DONG
World Science and Technology-Modernization of Traditional Chinese Medicine 2018;20(6):1032-1039
The problems of non-standard use of pesticides, and excessive pesticide residues and excessive heavy metal, etc. are common in the productive process of safflower (Carthamus tinctorius) and they are the factors restricting the sustainable development of safflower industry. Pollution-free production is an effective measure to ensure high quality of safflower. This paper summarized the environment of production area, selection of improved varieties for the production in the local places and its characteristics, the standardized comprehensive agronomic management and pollution-free rational fertilization technology. Additionally, the pollution-free control of safflower pests and diseases should follow the principle of priority to prevention and comprehensive prevention. Agricultural, biological and physical control should be preferred to use, and be combined with safe and low toxicity of chemical control. The standardization and industrialization of safflower production were realized by the construction of a comprehensive control technology system of pests and diseases of pollution-free safflower, which promoted the healthy development of the safflower plantation industry and achieved pollution-free standards.
6.Study Progress of Components of Notoginsenoside and the Affecting Factors
Guangfei WEI ; Feng YANG ; Yaru XU ; Huanhuan WANG ; Lili SU ; Can YUAN ; Linlin DONG
World Science and Technology-Modernization of Traditional Chinese Medicine 2018;20(10):1876-1881
Panax notoginseng is a traditional Chinese medicinal herb in China. Due to its widespread pharmacology and significant clinical effect, the demand of Panax notoginseng is increasing surprisingly. Saponins are effective components in Radix Notoginseng. It has the effect of stopping bleeding and dispelling blood stasis. The content of saponins is affected by the factors such as location, variety and origin. This paper mainly introduced the notoginsenoside in different parts, the factors (origin and varieties) affecting the contents of notoginsenoside. A standard and pollution-free cultivation system of Panax notoginseng was established to help to cultivate the high-yield, high-quality and pollution-free P.notoginseng, which can provide the basis for choosing reasonable administration parts and provide the references for the development and utilization of Panax notoginseng.
7.Integrated metabolomic and transcriptomic analyses revealed the distribution of saponins in .
Guangfei WEI ; Linlin DONG ; Juan YANG ; Lianjuan ZHANG ; Jiang XU ; Feng YANG ; Ruiyang CHENG ; Ran XU ; Shilin CHEN
Acta Pharmaceutica Sinica B 2018;8(3):458-465
is famous for its important therapeutic effects. Saponins are bioactive compounds found in different parts and developmental stages of plants. Thus, it is urgently to study saponins distribution in different parts and growth ages of plants. In this study, potential biomarkers were found, and their chemical characteristic differences were revealed through metabolomic analysis. High-performance liquid chromatography data indicated the higher content of saponins (, Rg1, Re, Rd, and Rb1) in the underground parts than that in the aerial parts. 20()-Protopanaxadiol saponins were mainly distributed in the aerial parts. Additionally, the total saponin content in the 3-year-old plant (188.0 mg/g) was 1.4-fold higher than that in 2-year-old plant (130.5 mg/g). The transcriptomic analysis indicated the tissue-specific transcription expression of genes, namely, , , , , and , which encoded critical synthases in saponin biosyntheses. These genes showed similar expression patterns among the parts of plants. The expression levels of these genes in the flowers and leaves were 5.2fold higher than that in the roots and fibrils. These results suggested that saponins might be actively synthesized in the aerial parts and transformed to the underground parts. This study provides insights into the chemical and genetic characteristics of to facilitate the synthesis of its secondary metabolites and a scientific basis for appropriate collection and rational use of this plant.
8.Rhizospheric microbial communities are driven by at different growth stages and biocontrol bacteria alleviates replanting mortality.
Linlin DONG ; Jiang XU ; Lianjuan ZHANG ; Ruiyang CHENG ; Guangfei WEI ; He SU ; Juan YANG ; Jun QIAN ; Ran XU ; Shilin CHEN
Acta Pharmaceutica Sinica B 2018;8(2):272-282
The cultivation of plants is hindered by replanting problems, which may be caused by plant-driven changes in the soil microbial community. Inoculation with microbial antagonists may efficiently alleviate replanting issues. Through high-throughput sequencing, this study revealed that bacterial diversity decreased, whereas fungal diversity increased, in the rhizosphere soils of adult ginseng plants at the root growth stage under different ages. Few microbial community, such as , Cytophagaceae, , , Sphingomonadaceae, and Zygomycota, were observed; the relative abundance of microorganisms, namely, , Enterobacteriaceae, , Cantharellales, , , and Chytridiomycota, increased in the soils of adult ginseng plants compared with those in the soils of 2-year-old seedlings. 50-1, a microbial antagonist against the pathogenic , was isolated through a dual culture technique. These bacteria acted with a biocontrol efficacy of 67.8%. The ginseng death rate and abundance decreased by 63.3% and 46.1%, respectively, after inoculation with 50-1. Data revealed that microecological degradation could result from ginseng-driven changes in rhizospheric microbial communities; these changes are associated with the different ages and developmental stages of ginseng plants. Biocontrol using microbial antagonists alleviated the replanting problem.
9.Research Progress of Chemical Composition And Pharmacological Actions of Panax notoginseng
Juan YANG ; Yizheng YUAN ; Guangfei WEI ; Lianjuan ZHANG ; Jiang XU ; Linlin DONG
World Science and Technology-Modernization of Traditional Chinese Medicine 2017;19(10):1641-1647
Panax notoginseng (Burk.) F.H.Chen contains saponins,polysaccharides,flavonoids,alkyne,alcohol and other physiological active substances.Among notoginseng,saponins and decichine are the main effective components.Their pharmacological actions mainly include hemostasis,activating blood,blood tonic,anti-thrombus,protecting myocardium and various pharmacological actions.Notoginseng has been widely used in the treatment of clinical diseases.This paper was aimed to review the application status of notoginseng based on previous studies from both at home and abroad.It summarized main active ingredients of notoginseng saponins and polysaccharides;compared extraction process of notoginseng saponins and polysaccharides,respectively;outlined active ingredients of notoginseng in antiinflammatory,anti-tumor,immune strengthening,activating blood to remove stasis and other aspects of pharmacological effects.Additionally,we provided multiple researches,such as strengthening research of notoginseng polysaccharides,optimizing extraction process of notoginseng active substances,and improving compatibility system of notoginseng saponins and other medicinal components,in order to promote a comprehensive exploitation of notoginseng.
10.An improved method for percutaneous pedicle screw implantation and the effect of the improvement on radiation exposure
Xu ZHOU ; Shisheng HE ; Hailong ZHANG ; Guangfei GU ; Lei ZHANG ; Qingsong FU
Chinese Journal of Orthopaedics 2014;34(3):265-272
Objective To introduce a new minimally invasive lumbar positioning system and its positioning method as well as conduct a prospective control study on the differences in positioning time,positioning frequency and radiation exposure dose between the new positioning method and the traditional positioning method.Methods 121 patients with lumbar disc herniation combined with lumbar instability and patients with thoracolumbar vertebral fracture admitted in our hospital from May 2010 to February 2013 were randomized into two groups.68 patients in Group A had undergone the traditional positioning method before and during operation.Among the 68 patients,41 were with single-segment lesion and 27 were with two-segment lesion.53 patients in Group B had undergone the new minimally invasive lumbar positioning system before and during operation.Among the 53 patients,34 were with single-segment lesion and 19 were with two-segment lesion.There were no significant differences in gender,age,course of disease and other general information between the two groups.The positioning time,positioning frequency and radiation dose of the two groups before and during operation were compared and statistically analyzed.Results The positioning time of Group A and Group B were 8.26±3.44 min and 3.51±1.82 min respectively; the positioning frequencies were 3.57 and 1.22; the accuracy were 60.8% and 96.2%.For the patients with single-segment lesion,the positioning time before implanting two percutaneous pedicle screws during operation were 15.12±4.69 min and 5.51±1.32 min respectively and the positioning frequency were 6.47 and 2.45.For the patients with two-segment lesion,the positioning time before implanting three percutaneous pedicle screws during operation were 24.91±7.43 min and 8.84±2.32 min respectively and the positioning frequency were 11.72 and 3.69.Moreover,the radiation dose detected at neck,chest and wrist of the surgical staff in Group A were 3.09±0.24 Gy,4.23±0.71 Gy and 5.17±0.62 Gy and that detected in Group B were 1.38±0.47 Gy,2.69±0.33 Gy and 3.21±1.05 Gy.There were significant differences in positioning time,positioning frequency and radiation dose between Group A and Group B.Conclusion The minimally invasive spine positioning system and positioning method can simplify the operative procedures and largely reduce radiation exposure,which is characterized by high positioning accuracy,short positioning time,low fluoroscopy frequency and X-ray radiation dose.

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