BACKGROUNDContinuous negative pressure drainage (CNPD) is widely used after lower lumbar internal fixation; however, it may cause tremendous blood loss and lead to postoperative hemorrhagic anemia. The present study explored the efficacy and safety of improved intermittent-clamped drainage (ICD) for lower lumbar internal fixation.

METHODSThis was a prospective study that included 156 patients with decompression of the spinal canal and internal fixation for the first time from January 2012 to December 2014. The patients were randomly divided into ICD group and CNPD group, and each group had 78 cases. A drainage tube was placed under the deep fascia in all patients within 10 min after the commencement of wound closure. The postoperative drainage amount at different time points, the hemoglobin level, and postoperative complications were recorded and compared between the two groups. Shapiro-Wilk test, independent samples t-test, and Mann-Whitney U-test were used in this study.

RESULTSThe drainage amount was significantly reduced in the ICD group, as compared with the CNPD group (Z = 10.74, P < 0.01). The mean total drainage amount (in ml) of the single-segment and two-segment procedures was significantly greater in the CNPD group than the ICD group (Z = 10.63 and 10.75, respectively; P < 0.01). For the adverse events, there was no significant difference in postoperative temperature, wound problem, and complications between the two groups.

CONCLUSIONSThe present study showed a statistically significant reduction in postoperative drainage amount between ICD and CNPD groups, and ICD is an effective, convenient, and safe method for routine use in lower lumbar surgery. It is essential to focus on the effect of clamping drainage with long-segment surgical procedure and complex lumbar disease in the further investigation, as well as the effect of clamping on long-term functional outcomes.

Blood Loss, Surgical ; prevention & control ; Drainage ; methods ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Intervertebral Disc Degeneration ; surgery ; Lumbar Vertebrae ; surgery ; Male ; Middle Aged ; Prospective Studies ; Spinal Fusion ; methods ; Treatment Outcome

To explore the method of establishing a cell model of traditional Chinese medicine (TCM) syndromes, HepG2 cells were induced by human serum of liver-depression and spleen-deficiency syndrome(LDSDS) to establish a cell model of LDSDS in this research. The concentration of cells, the content of human serum in culture medium and the growth characteristics of model-cell (cell growth curve, the survival rate and apparent morphology were investigated by MTT assay and microscopy. Evaluation of syndrome cell model: metabolomics was used to analyze the human serum of normal individuals and patients with LDSDS, and cell models induced by these serums, respectively. We obtained the difference metabolites from serums and cell models of LDSDS, respectively; then compared the biomarkers from two metabolomics and their metabolic pathways, to verify that the reliability and applicability of the model. Metabolomics data were collected by UPLC-Q-TOF-MS, and then all data were analyzed by multivariate statistical (PCA，OPLS-DA). The results showed that, model cells have the characteristics of normal growth, slow proliferation and stable morphological structure inducted by 10% serum of LDSD in 24-72 h. There were the same 19 difference metabolites which from the human serum of normal individuals and patients with LDSDS, and cell models induced by these serums; including 9 metabolic pathways that play an important role in maintaining normal physiological activities of the human body, such as lipids, amino acids, nucleotides, and energy metabolism etc. It was shown that the established syndrome cell model can reflect the biological basis of LDSDS to some extent. This research provides a reference method for the establishment of TCM syndrome cell model.

ObjectiveTriple-negative breast cancer (TNBC) is the breast cancer subtype with the worst prognosis, and lacks effective therapeutic targets. Colony stimulating factors (CSFs) are cytokines that can regulate the production of blood cells and stimulate the growth and development of immune cells, playing an important role in the malignant progression of TNBC. This article aims to construct a novel prognostic model based on the expression of colony stimulating factors-related genes (CRGs), and analyze the sensitivity of TNBC patients to immunotherapy and drug therapy. MethodsWe downloaded CRGs from public databases and screened for differentially expressed CRGs between normal and TNBC tissues in the TCGA-BRCA database. Through LASSO Cox regression analysis, we constructed a prognostic model and stratified TNBC patients into high-risk and low-risk groups based on the colony stimulating factors-related genes risk score (CRRS). We further analyzed the correlation between CRRS and patient prognosis, clinical features, tumor microenvironment (TME) in both high-risk and low-risk groups, and evaluated the relationship between CRRS and sensitivity to immunotherapy and drug therapy. ResultsWe identified 842 differentially expressed CRGs in breast cancer tissues of TNBC patients and selected 13 CRGs for constructing the prognostic model. Kaplan-Meier survival curves, time-dependent receiver operating characteristic curves, and other analyses confirmed that TNBC patients with high CRRS had shorter overall survival, and the predictive ability of CRRS prognostic model was further validated using the GEO dataset. Nomogram combining clinical features confirmed that CRRS was an independent factor for the prognosis of TNBC patients. Moreover, patients in the high-risk group had lower levels of immune infiltration in the TME and were sensitive to chemotherapeutic drugs such as 5-fluorouracil, ipatasertib, and paclitaxel. ConclusionWe have developed a CRRS-based prognostic model composed of 13 differentially expressed CRGs, which may serve as a useful tool for predicting the prognosis of TNBC patients and guiding clinical treatment. Moreover, the key genes within this model may represent potential molecular targets for future therapies of TNBC.