Objective To explore influencing factors of postoperation fast-track recovery in patients with thoracoscopic lobectomy and provide support for the concept of fast track surgery in clinically application. Methods A total of 129 patients who underwent thoracoscopic lobectomy were selected and questionnaire were adopted for survey between January 2015 and September 2015. Univariate analysis and multivariable logistic regression analysis were used to screen influencing factors of postoperation fast-track recovery. Results Univariate analysis showed that the influnecing factors of postoperation fast-track recovery in patients with thoracoscopic lobectomy were closely related to the age, combined basic disease or not,smoking index,preoperative smoking cessation time,preoperative pulmonary function training or not,systematic health education or not,postoperative wound pain,early postoperative ambulation or not,postoperative chest exercises in time or not (t=2.880,χ2=0.219-33.224, P<0.01 or 0.05). Multivariable logistic regression analysis showed that systematic health education or not, postoperative wound pain,preoperative pulmonary function training or not,postoperative chest exercises in time or not,combined basic disease or not,smoking index,and quit smoking more than two weeks or not were the independent risk factors. Conclusions For the patients with thoracoscopic lobectomy, preoperative condition and postoperative condition in the early should be assessed in time. Controlling the pain effectively,giving reasonable guidance of preoperative pulmonary function exercise,strengthening the respiratory tract management,systematic health education,improving the ward environment,high quality of social support and other diversified services could accelerate the recovery of the postoperative patients.

Objective We aimed to systematically review the effect of Comfeel transparent dressing for preventing PICC-associated phlebitis.Methods We electronically searched in China National Knowledge Infrastructure (CNKI),Chinese Science Technology Periodical Databases (VIP),Wanfang Database,China Biology Medicine Disc (CBM),PubMed and Embase for studies about effect of Comfeel transparent dressing for preventing PICC-associated phlebitis from inception to June 2014.Literature was screened and evaluated by inclusion and exclusion criterion.The RevMan 5.1 software was used for Meta-analysis.Results This study included 7 RCTs involving 524 patients.Meta analysis showed that compared with the 3M occlusive dressing,Comfeel transparent dressing could significantly decrease the incidence of PICC-associated phlebitis,OR=0.17,95％CI (0.08,0.34),Z=4.95,P＜0.01.Conclusions Comfeel plus transparent dressing can prevent the incidence of PICC-associated phlebitis.

Objective To discuss the effect of the occurrence of congestive heart failure on the outcome of pregnant women with pulmonary hypertension. Methods Fifty-four pregnant patients complicated with pulmonary hypertension were admitted from January 2000 through December 2010. Among them, 34 had comorbidity of congestive heart failure. The timing and mode of pregnancy termination, and perinatal outcomes were studied, and comparison was made between those with and without heart failure. Results ① Of all 54 pregnant women with pulmonary hypertension, 34 had congestive heart failure. The incidences of congestive heart failure in patients with mild, moderate and severe degree of pulmonary hypertension were 27.78% (5/18), 73.33% (11/15) and 85.71% (18/21), respectively (P<0.05).②The rate of maternal complications was 47.06% (16/34) and maternal mortality was 17.65% (6/34) in the patients with combined pulmonary hypertension and heart failure. The rate of iatrogenic fetal loss was 29.41% ( 10/34) , preterm labor 52.94% (18/34), neonatal asphyxia 35.29% (12/34) and neonatal mortality 23.53% (8/34) in case of patients with pulmonary hypertension complicated with congestive heart failure. ③The rate of Cesarean section was 91. 18% (31/34) in the patients with combined pulmonary hypertension and heart failure. ④ The rates of iatrogenic induction, premature delivery, maternal complications and mortality, neonatal asphyxia and fetal or neonatal fatality were significantly higher in women with combined pulmonary hypertension and heart failure than those with simple pulmonary hypertension ( P < 0. 05). Conclusions The risk of heart failure increases with the severity of pulmonary hypertension. The occurrence of heart failure is the most important factor affecting the outcome of patients in pregnancy already complicated with pulmonary hypertension , and Cesarean section is the safer mode of termination of pregnancy in this cohort of women.

Objective To investigate the effect of continuing nursing care on the patient′s survival quality ,medication compli-ance and exercise tolerance after mechanical heart valve replacement surgery in the patients with rheumatic heart disease .Methods The eligible patients were randomly divided into the experiment group and control group by adopting the random grouping method , 50 cases in each group .The control group received the routine nursing care .In addition to this ,the experiment group was given the continuing nursing care intervention .The intervention time lasted for 6 months .Results The various fields in the survival quality before discharge from hospital had no statistically significant difference between the two groups (P>0 .05) .Except for the enviro-ment score and family friction score after discharge ,the rest fields had statistically significant difference between the two groups (P<0 .05) .There was no statistically significant difference in 6 min walk distance before discharge between the two groups (P>0 .05) ,while which at 6 months after discharge had statistically significant difference between the two groups (P<0 .05) .The medi-cation compliance at 3 ,6 months after discharge had statistically significant differences between the two groups (P<0 .05) .Conclu-sion The continuous nursing care can improve the patient′s survival quality ,medication compliance and exercise tolerance ,and re-duces the occurrence of anticoagulation related complications .

Objectives:To explore the risk factors related to the prolonged postoperative length of hospital stay(LOS)in patients after spinal tuberculosis lesion removal and fusion with internal fixation,and to construct a nomogram prediction model,so as to provide a theoretical basis for the enhanced recovery management of spinal tuberculosis patients.Methods:The clinical data of 142 patients with spinal tuberculosis who underwent lesion removal and fusion with internal fixation in the Department of Orthopedics of the Affiliated Hospital of Zunyi Medical University between December 2018 and June 2023 were retrospectively analyzed.The patients were randomly divided into modeling group(n=96)and validation group(n=46)in a 2∶1 ratio.Setting the postoperative LOS＞21d as the outcome variable for prolonged LOS,and taking age,gender,alcohol history,smoking history,hypertension,coronary heart disease,diabetes,anemia,postoperative hypoproteinemia,spinal cord injury,tuberculosis in other parts,bone destruction,blood transfusion,removal time of drainage,postoperative complications,operative time,blood loss,preoperative American Society of Anesthesiologists(ASA)score,postoperative ASA score,surgical incision length,pus formation,chemotherapy before surgery,and chemotherapy regimens as independent variables to develop univariate logistic regression model.The risk factors screened after univariate analysis were included for multivariate logistic regression model to determine the independent risk factors for LOS＞21d after lesion removal and fusion with internal fixation in patients with spinal tuberculosis and to construct a predictive model for risk factors.The area under the curve(AUC)of receiver operating characteristics(ROC)curve was used to assess the the differentiation of the model;Calibration curve was used to assess the calibration situation of the model;Decision curve analysis(DCA)was used to assess the clinical value and influence of the model on actual decision-making process.Data of validation group was applied to draw ROC curve and calibration curve for external verification.Results:Univariate and multivariate analyses revealed that age(OR=1.040,95%CI:1.011-1.069),tuberculosis at other sites(OR=2.867,95%CI:1.157-7.106),and preoperative ASA score(OR=1.543,95%CI:1.015-2.347)were the independent risk factors for prolonged postoperative hospitalization in patients with spinal tuberculosis after lesion removal and fusion with internal fixation.The AUC of ROC curves of modeling group and validation group were 0.767(95%CI:0.671-0.863)and 0.720(95%CI:0.569-0.871),respectively,suggesting the predictive model had good predictive efficiency.The results of the calibration curve analysis demonstrated that the actual curve roughly resembled the ideal curve,and DCA curve revealed that the nomogram had superior clinical benefits.Conclusions:The spinal tuberculosis patients who are at older age,combined with other sites of tuberculosis,and with high preoperative ASA score are prone to prolonged LOS after lesion removal and fusion with internal fixation,and the risk prediction nomogram model developed accordingly has great predictive efficiency.

BACKGROUND:Interleukin-8 is an important cytokine that has been found to play an important role in bone regeneration through multiple pathways. OBJECTIVE:To comprehensively review the action mechanism of interleukin-8 effects on bone regeneration to provide ideas for the following studies on interleukin-8. METHODS:By searching the China National Knowledge Infrastructure database for articles published from January 1999 to February 2023 and PubMed database for articles published from January 1985 to February 2023 reporting the role of interleukin-8 in bone-associated cells and vascularisation.Chinese and English search terms were"interleukin-8,bone repair,bone metabolism,mesenchymal stem cells,osteoblasts,osteoclasts,vascularization".The initial review yielded 508 articles in English and Chinese,and a total of 51 articles were included for review and analysis according to the inclusion and exclusion criteria. RESULTS AND CONCLUSION:According to the existing research,interleukin-8 can promote bone cell regeneration and assist bone healing through multiple pathways,which is mainly divided into three aspects:(1)Promote the proliferation and differentiation of bone cells such as mesenchymal stem cells and osteoblasts,and promote the development of cells in the direction of promoting bone healing;(2)interleukin-8 can promote angiogenesis and provide sufficient nutrition and oxygen for bone tissue,thus further improving the quality and stability of bone healing.(3)The appearance of interleukin-8 facilitates the expression of hypoxia-inducible factor-1α,vascular endothelial growth factor,and matrix metalloproteinase,which can create a microenvironment conducive to bone regeneration,thus promoting the regeneration and repair of bone tissue.In summary,interleukin-8 plays an important role in bone healing by promoting osteoblast proliferation and differentiation,facilitating angiogenesis and improving the mechanical properties of bone regeneration,as well as influencing bone metabolism through osteoclasts,mesenchymal stem cells,and other action sites.

Objective:To investigate the relationship between gene polymorphism of osteoprotegerin (OPG) and coal-burning endemic fluorosis in Guizhou Province.Methods:In 2018 and 2019, a case-control study was conducted in Bijie City, a typical coal-burning endemic fluorosis area in Guizhou Province, and 260 cases of coal-burning endemic fluorosis patients were selected as case group. According to the "Diagnostic Criteria for Endemic Skeletal Fluorosis" (WS 192-2008), the case group was divided into severe group (130 cases) and mild group (130 cases). At the same time, 130 cases without dental fluorosis and skeletal fluorosis symptoms were chosen as control group in Changshun County, a non-coal-burning endemic fluorosis area in Guizhou Province. Whole blood genomic DNA was extracted, and real-time fluorescence quantitative PCR with TaqMan-MGB probe was utilized to type the OPG gene rs2460985, rs2073618, rs6469804 and rs6993813 four single nucleotide polymorphism (SNP) loci of all samples, and genetic model analysis was performed to compare the frequency distribution of its alleles, genotypes and constructed haplotypes in control, mild and severe groups. Results:By Hardy-Weinberg equilibrium test, the genotype frequencies of the four SNP loci all reached genetic balance in control, mild and severe groups ( P > 0.05). There was a statistically significant difference in the genotype frequency of OPG gene rs6469804 locus among the three groups (χ 2 = 10.615, P < 0.05), and the difference in the genotype frequency of this locus between the control group and the severe group was statistically significant (χ 2 = 6.784, P < 0.05). The results of genetic model analysis showed that in comparison between the control group and the severe group, the optimal genetic model of rs6469804 locus was the overdominant genetic model, the frequency distribution of genotypes AA + GG and AG in the control group and the severe group was statistically significant [odds ratio ( OR) = 1.94, 95% confidence interval ( CI): 1.16 - 3.23, P < 0.05], genotype AG was a risk factor for coal-burning endemic fluorosis. In comparison between the control group and the mild group, the optimal genetic model of rs2073618 locus was the recessive genetic model, the frequency distribution of genotypes GG + GC and CC in the control group and the mild group was statistically significant ( OR = 3.17, 95% CI: 1.08 - 9.30, P < 0.05), genotype CC was a risk factor for coal-burning endemic fluorosis. In comparison between the control group and the mild group, haplotypes C-C-G-T and T-G-A-C were risk factors for coal-burning endemic fluorosis (adjusted OR = 2.41, 1.98, 95% CI: 1.29 - 4.50, 1.22 - 3.23, P < 0.05); in comparison between the control group and the severe group, haplotype T-G-A-C was a risk factor for coal-burning endemic fluorosis (adjusted OR = 1.87, 95% CI: 1.14 - 3.07, P < 0.05). Conclusion:OPG gene rs6469804 locus genotype AG and rs2073618 locus genotype CC may be risk factors for coal-burning endemic fluorosis.

Objective:To investigate the association between relative mitochondrial DNA copy number (mtDNA-CN) and coal-burning-borne endemic fluorosis (abbreviated as coal-burning-borne fluorosis).Methods:From June 2018 to March 2019, using cross-sectional study, 482 patients with coal-burning-borne fluorosis were selected as the case group in Bijie City, a typical coal-burning-borne fluorosis area of Guizhou Province; meanwhile, 212 healthy individuals from Changshun County, a non-coal-burning-borne fluorosis area in Guizhou Province, were selected as the control group. Questionnaire survey and physical examination were used to collect general condition such as basic information and living habits of the two groups, peripheral venous blood samples were collected, and real-time fluorescence quantitative PCR was used to detect the relative mtDNA-CN in peripheral blood. The correlation between relative mtDNA-CN and coal-burning-borne fluorosis was analyzed by binary and unordered multi-class logistic regression.Results:There were significant differences in the body mass index (BMI), and the distribution of gender rario, marital status and education level between the control group and the case group ( t = 7.91, χ 2 = 5.11, 13.33, 34.32, P < 0.05). The relative mtDNA-CN in the control group was higher than that in the case group [median (quartile): 202 (138, 292) vs 131 (96, 217), Z = - 7.80, P < 0.001]. The results of binary logistic regression analysis [odds ratio (95% confidence interval)] showed that educational level [primary school: 0.572 (0.377 - 0.868), junior high school and above: 0.292 (0.174 - 0.493)], relative mtDNA-CN [131 - < 217: 0.265 (0.144 - 0.488), ≥217: 0.183 (0.100 - 0.335)] and BMI [1.222 (1.142 - 1.307)] were the influencing factors for the risk of coal-burning-borne fluorosis( P < 0.05). In subgroups with different BMI and educational levels, the relative mtDNA-CN was significantly negatively correlated with the risk of coal-burning-borne fluorosis( Ptrend < 0.05), and there was no interaction between mtDNA-CN and BMI and educational levels ( Pinteraction > 0.05). The results of unordered multi-class logistic regression analysis showed that the relative mtDNA-CN were significantly negatively correlated with the risk of dental fluorosis and skeletal fluorosis ( Ptrend < 0.05). Conclusion:The higher the relative mtDNA-CN, the lower the risk of coal-burning-borne fluorosis, suggesting that mtDNA-CN may be a potential biomarker of coal-burning fluorosis.

Objective:To explore the relationship between children's intelligence and urinary fluoride in Suojia Township of Miao, Yi and Hui Nationalities (referred to as Suojia Township), a coal-burning-borne endemic fluorosis area in Guizhou Province.Methods:In April 2019, 173 children aged 10 to 13 years old were selected from three schools in Suojia Township. According to whether they had dental fluorosis, the children were divided into case group ( n = 104) and control group ( n = 69). Middle segment urine samples of the children were collected and urinary fluoride level was determined by the method of ion-selective electrode. Combined Raven's Test-the Rural in China (CRT-RC2) was used for children's intelligence quotient (IQ) test. Linear regression analysis was used to observe the association between urinary fluoride and IQ, and the results were expressed by regression coefficient ( β) and 95% confidence interval ( CI). Results:Urinary fluoride level of case group was higher than that of control group [(2.14 ± 1.78) vs (1.53 ± 0.98) mg/L], and IQ was lower than that of control group [(92.33 ± 11.68) vs (100.38 ± 11.87) points], and the differences were statistically significant ( t = 2.58, 4.41, P < 0.05). The linear regression equation of urinary fluoride ( X) and IQ ( Y) of case group was Y = 96.99 - 2.86 X. For every 1 mg/L increase in urinary fluoride level, IQ decreased by 2.86 points ( β = - 2.86, 95% CI: - 5.48 - - 0.24). Conclusion:Long-term exposure to fluoride pollution from coal burning may damage children's intelligence, and children's IQ decreases with increase of fluoride level in urine.