BACKGROUND: Lower extremity deep venous thrombosis is commonly seen after hip arthroplasty. The time of thrombosis after arthroplasty in senile patients with osteoporotic femoral neck fractures is little reported.OBJECTIVE: To investigate the time of perioperative lower extremity deep venous thrombosis in senile patients with osteoporotic femoral neck fractures undergoing hip arthroplasty. METHODS: The data of 178 patients with femoral neck fractures undergoing hip arthroplasty were analyzed, and were then allocated to anticoagulant and non-anticoagulant groups according to the preoperative use of low-molecular-weight heparins or not. Doppler ultrasonography of both lower extremity arteries was conducted at 1, 3, 5 and 5-7 days after injury, and 2, 5, 7 and 14 days postoperatively to monitor the lower extremity deep venous thrombosis, and the number and incidence of thrombosis in the two groups were recorded at different time points. The time of thrombosis occurred frequently after injury and surgery was determined through drawing the frequency distribution table and line chart.RESULTS AND CONCLUSION: (1) The incidence of thrombosis showed significant difference between anticoagulant (n=6, 8%) and non-anticoagulant (n=22, 21%)) groups (P < 0.05). (2) Thrombosis frequently occurred at 3 days after injury and 1 day postoperatively. (3) These results suggest that the thrombosis in patients with femoral neck fractures frequently occurs at 1-3 days after injury and 1 day after replacement. Additionally, active prevention measures after injury can significantly reduce the incidence of lower extremity venous thrombosis.

BACKGROUND:The risk of lower-extremity deep venous thrombosis was high in patients with the osteoporotic hip fracture. The aged age and hip fracture surgery are major risk factors for thrombosis. No study concerned the critical point in time course to the lower extremity deep venous thrombosis in the osteoporotic hip fracture patients.
OBJECTIVE:To analyze the incidence of the perioperative deep venous thrombosis of lower extremity limb at different time slots in senile osteoporotic intertrochanteric fracture patients repaired by proximal femoral nail antirotation fixation.
METHODS:From June 2012 to January 2016, 220 cases diagnosed as osteoporotic intertrochanteric fracture and performed closed reduction and proximal femoral nail antirotation fixation were selected from the Department of Orthopedics, the Affiliated Hospital of Chengde Medical Col ege in China. Based on administered low-molecular-weight heparins (LMWH) or not after trauma, there were two groups:LMWH group and the non-LMWH group. Vascular Doppler ultrasound was conducted at 1, 3 and 5 days after trauma, more than 5 days after trauma, 2, 5, 7 and 14 days after surgery. The total number of cases and incidence of thrombosis were recorded and compared between the two groups. The number of cases and the incidence of new thrombosis were recorded at different time points in both groups. Frequency distribution table was used to analyze the time of suffering thrombosis after injury and surgery.
RESULTS AND CONCLUSION:(1) Among 220 cases, 18 cases in the LMWH group (n=154) affected thrombosis, with an incidence of 12%, and 15 cases in the non-LMWH group (n=66) experienced deep vein thrombosis, with an incidence of 23%. Significant differences in the incidence of thrombosis were detected between the two groups (P=0.041). (2) Peak time of thrombus was 3 days before injury and 1 day after surgery in both groups. (3) Results suggested that the incidence of deep vein thrombosis was high in proximal femoral nail antirotation fixation for intertrochanteric fracture. The peak time of deep vein thrombosis was 3 days before injury and 1 day after surgery. The prevention of deep vein thrombosis should begin from injury. Prophylactic anticoagulation after injury can dramatical y decrease the incidence of deep vein thrombosis.

Objective To study the clinical manifestation,diagnosis and treatment of the renal myxofibromata.Methods Combined with reviewing the relevant literature,we retrospectively analyzed the clinical data of a case of renal myxofibromata.A 47-year-old female patient was found left renal cystic lesion by ultrasound 8 months before admission.CT showed a 4 cm cystic and solid lesions in the lower pole of left kidney,which was similar to the results of ultrasound.The enhanced abdominal CT and dynamic contrast-enhanced ultrasound showed that the lesions could be enhanced slowly with uneven density.The patient underwent left kidney exploration under the general anaesthesia.During operation,a round solid mass about 5 cm in diameter can been seen in the low part of renal sinus,which was a bit hard.The mass was close with surrounding tissue.Then,the left kidney was excised.Results The surface of the mass was full and smooth with pale yellow luster.In the HE section,the tumor was composed with fibroma like cell,which demonstrated the inhomogeneous size,shape and irregular organization.The nucleus showed the spindle shape,with rare mitosis phase.Large quantity of mucus and vascular tissue could be observed in the tumor.Few fibroblast cells could also be found in the section.The pathological result was myxofibromata (immature) with malignant tendency.No special treatment was given after surgery.Recurrence was not recorded within 6 months following-up.Conclusions Commonly,the myxofibromata is a kind of benign tumor.Only a few can result in the malignant transformation and distant metastasis.Primary renal myxofibromata is extremely rare.The preoperative imagine manifestation is difficult to provide the accurate diagnosis.Pathologic result is the gold standard in diagnosing this disease.Actively surgical treatment and regular following-up after surgery should be considered.

Objective:To explore the association of the total gestational weight gain (GWG) and GWG in different trimesters with adverse pregnancy outcomes during the second pregnancy in women with history of gestational diabetes mellitus (GDM).Methods:This retrospective cohort study recruited 441 singleton pregnant women with a history of GDM who gave birth at Beijing Obstetrics and Gynecology Hospital of Capital Medical University from January 2017 to December 2018 as the GDM history group. Another 1 637 singleton pregnant women without a history of GDM who gave birth at the same period were selected through the mechanical sampling method as the control group. Independent sample t-test and Chi-square test were used to compare the differences in general conditions, GWG and perinatal outcomes between the two groups. Based on the Institute of Medicine guidelines for GWG, the subjects were further divided into three subgroups: inadequate GWG, adequate GWG and excessive GWG groups. Multivariate logistic regression analysis was used to compare the pregnancy outcome in women with the same GWG in different periods of pregnancy between the two groups. Results:(1) Women with GDM history had lower GWG before and after oral glucose tolerance test (OGTT) and the whole pregnancy than those without [(6.3±3.3) vs (7.9±3.7) kg, (4.8±2.6) vs (5.6± 2.6) kg, (11.8±4.6) vs (14.4± 4.6) kg; t=8.074, 5.183, 10.277; all P<0.001]. The incidence of GDM, gestational hypertension, and large for gestational age (LGA) in the GDM history group were higher than those in the control group [46.5% (205/441) vs 18.1% (296/1 637), 8.4% (37/441) vs 5.4% (88/1 637), 12.9% (57/441) vs 9.7% (158/1 637); χ2=153.181, 5.583, 4.013; all P<0.05]. (2) Before OGTT: pregnant women with GDM history of different GWG categories had a higher risk of developing GDM [ OR and 95% CI for inadequate, adequate and excessive GWG were 4.02 (2.35-6.88), 3.92 (2.65-5.79) and 3.33 (2.11-5.25), respectively, all P<0.001]. Except for women with inadequate GWG, pregnancy with a history of GDM also had a higher risk of preeclampsia [ OR and 95% CI were 3.62 (1.47-9.23) and 2.22 (1.07-5.57) for adequate and excessive GWG, respectively, both P<0.05]. After OGTT: pregnant women with GDM history of different GWG categories had a higher risk of developing GDM [ OR and 95% CI for inadequate, adequate and excessive GWG were 2.48 (1.60-3.84), 4.63 (2.92-7.35) and 4.22 (2.73-6.51), respectively, all P<0.001]. Pregnant women with a history of GDM with excessive GWG had an increased risk of preeclampsia ( OR=2.46, 95% CI: 1.10-5.51, P<0.05). During pregnancy: pregnant women with GDM history of different GWG categories had a higher risk of developing GDM [ OR and 95% CI were 3.02(2.00-4.59), 4.08(2.76-6.04) and 2.66(1.54-4.59) for inadequate, adequate and excessive GWG, respectively, all P<0.001]. Women with GDM history had an increased risk of large for gestational age (LGA) in those with inadequate GWG and postpartum hemorrhage in those with excessive GWG [ OR and 95% CI were 1.94 (1.09-4.21) and 2.93 (1.31-6.55), respectively, both P<0.05]. Conclusions:The total GWG and GWG in different periods during the second pregnancy in women with a history of GDM are lower than those without, but with a higher risk of adverse outcomes. Even in women with the same range of GWG, GDM history still increases the risk of adverse pregnancy outcomes.

Objective:To investigate the effect of miR-425-5p on glucagon-like peptide-1(GLP-1) secretion in intestinal L cells induced by lipopolysaccharide(LPS), and to explore its mechanism.Methods:GLUTag cells of intestinal L cell line were incubated with LPS to determine the levels of miR-425-5p and GLP-1. Cell viability was determined by MTT assay, and cell apoptosis was detected by flow cytometry. Quantitative real time-PCR and western blot were performed to determine the expressions of miR-425-5p, phosphatase and tensin homology(PTEN), proglucagon, and GLP-1. Activity of Wnt/β-catenin signaling pathway was determined by detecting TOP/FOP ratio. Interaction among miR-425-5p, PTEN, and β-catenin was analyzed using luciferase activity assay and chromatin immunoprecipitation(ChIP)assay.Results:In GLUTag cells, with the elevation of LPS concentration, the expression of miR-425-5p and the apoptosis rate were increased, while the level of active GLP-1 and the cell viability were decreased. MiR-425-5p was involved in the regulation of LPS on GLP-1 secretion and intestinal L cell viability. Inhibition of miR-425-5p reduced the mRNA expression of proglucagon and the TOP/FOP ratio, increased PTEN protein level, and inhibited cell viability. In LPS-treated GLUTag cells, miR-425-5p increased the level of β-catenin by targeting PTEN, and β-catenin acted as a cis-acting element to induce the transcription of proglucagon and promote the secretion of GLP-1.Conclusion:In LPS-induced intestinal L cells, miR-425-5p promotes the expression of GLP-1 by targeting PTEN to modulate β-catenin.

Patients with acute heart failure (AHF) often experience dyspnea, and monitoring and quantifying their breathing patterns can provide reference information for disease and prognosis assessment. In this study, 39 AHF patients and 24 healthy subjects were included. Nighttime chest-abdominal respiratory signals were collected using wearable devices, and the differences in nocturnal breathing patterns between the two groups were quantitatively analyzed. Compared with the healthy group, the AHF group showed a higher mean breathing rate (BR_mean) [(21.03 ± 3.84) beat/min vs. (15.95 ± 3.08) beat/min, P < 0.001], and larger R_RSBI_cv [70.96% (54.34%-104.28)% vs. 58.48% (45.34%-65.95)%, P = 0.005], greater AB_ratio_cv [(22.52 ± 7.14)% vs. (17.10 ± 6.83)%, P = 0.004], and smaller SampEn (0.67 ± 0.37 vs. 1.01 ± 0.29, P < 0.001). Additionally, the mean inspiratory time (TI_mean) and expiration time (TE_mean) were shorter, TI_cv and TE_cv were greater. Furthermore, the LBI_cv was greater, while SD1 and SD2 on the Poincare plot were larger in the AHF group, all of which showed statistically significant differences. Logistic regression calibration revealed that the TI_mean reduction was a risk factor for AHF. The BR_ mean demonstrated the strongest ability to distinguish between the two groups, with an area under the curve (AUC) of 0.846. Parameters such as breathing period, amplitude, coordination, and nonlinear parameters effectively quantify abnormal breathing patterns in AHF patients. Specifically, the reduction in TI_mean serves as a risk factor for AHF, while the BR_mean distinguishes between the two groups. These findings have the potential to provide new information for the assessment of AHF patients.
Humans ; Heart Failure/diagnosis* ; Prognosis ; Respiration ; Wearable Electronic Devices ; Acute Disease