Objective To analyze the risk factors of incision infection and spinal canal hematoma after lumbar spinal posterior surgery.Methods Data of 33 patients with incision infection and 25 patients with spinal canal hematoma after posterior surgery for lumbar spinal disease from January 2010 to December 2014 were retrospectively analyzed.For the patients with incision infection,20 of them were males and 13 were females,with an average age of 58.85±8.76 years (range 38-79 years).Of these patients,5 were diagnosed with lumbar disc herniation,9 with lumbar spondylolisthesis,15 with lumbar spinal stenosis and 4 with lumbar vertebral fracture.For patients with spinal canal hematoma,17 of them were males and 8 were females,with a mean age of 60.96±11.37 (range,38-77).The diagnoses of them were lumbar disc herniation in 18 patients,spondylolisthesis in 3 patients and spinal stenosis in 4 patients.From the same period database,patients who underwent lumbar posterior lumbar surgery with no postoperative complications were selected by 3:1 ratio as the control group according to age,gender and diagnosis.Results For patients with incision infection,it was found that diabetes mellitus,preoperative RBC,hemoglobin,total protein,albumin,serum calcium,operation time,number of segment fusion,intraoperative blood loss,postoperative WBC,RBC,hemoglobin and platelet were significantly different from those with non-infection group.Moreover,multivariate logistic analysis showed that diabetes mellitus (OR=3.716,P=0.032),preoperative serum calcium (OR＜ 0.001,P=0.001),intraoperative blood loss (OR=1.002,P=0.014),postoperative hemoglobin (OR=0.923,P=0.018) and postoperative platelet (OR=1.007,P=0.017) were independent risk factors for postoperative incision infection.For patients with spinal canal hematoma,it was found that patients' preoperative total protein,albumin,serum calcium,platelet,operation time,intraoperative blood loss and postoperative total protein were significantly different from non-hematoma group.Multivariate logistic analysis showed that preoperative serum calcium (OR＜ 0.001,P=0.001),preoperative total protein (OR=1.298,P=0.043),intraoperative blood loss (OR=1.003,P=0.021) and postoperative total protein (OR=1.080,P=0.028) were independent risk factors for postoperative spinal canal hematoma.Conclusion The preoperative diabetes mellitus,serum calcium,intraoperative blood loss,postoperative hemoglobin and platelet were important risk factors for lumbar incision infection.And preoperative serum calcium,total protein,intraoperative blood loss and postoperative total protein were the risk factors for spinal canal hematoma.

BACKGROUND: For patients with myocardial infarction occupied most of the heart, the effect of coronary artery bridge is not obvious. Currently, myocardial and vascular regeneration by stem cells has become a focus of ischemic cardiovascular disease. Myocardial survival directly correlates with improvement of blood perfusion following stem cell transplantation.OBJECTIVE: To investigate the feasibility of ~(18)F-FDG and ~(99)Tc~m-MIBI single photon emission computed tomography imaging in assessing myocardial glucose metabolism and perfusion with old myocardial infarction after coronary artery bypass grafting (CABG) and CD34~+ stem cell transplanting. METHODS: Bone marrow was extracted from the anterior superior iliac spine 1 day before surgery. Mononuclear cells were isolated by Ficoll density gradient centrifugation. CD34~+ cells were isolated and purified by immunomagnetic bead system. Coronary artery pathological changes were examined under general anesthesia. The end-to-side anastomosis of graft vessel and coronary artery was performed. 1×10~(11)/L CD34~+ cell suspension was extracted, and injected into the surrounding and center of the infarct (blood flow/metabolism matching depletion) at 6 points, with 0.2 mL in each point. According to preoperative perfusion/metabolism imaging, myocardium segments were divided into two groups: match group: blood perfusion and metabolism images were sparse or normal, i.e. infarction or normal myocardium; mismatch group: blood perfusion image displayed depletion, but metabolism images were normal or radially distributed, i.e. surviving myocardium. ~(18)F-FDG and ~(99)Tc~m-MIBI dual-isotopic imaging were performed before and 4 months after CABG. Circumferential count profiles from ~(18)F-FDG and ~(99)Tc~m-MIBI short axis slices were generated to assess myocardial blood perfusion and glucose metabolism. RESULTS AND CONCLUSION: The 31 patients were divided into 279 segments, and 145 segments were in myocardial perfusion-metabolism mismatch (MM). ~(99)Tc~m-MIBI and ~(18)F-FDG uptake fraction was significantly increased 4 months before operation (P < 0.01); match group without transplanting had 81 segments, and the ~(99)Tc~m-MIBI and ~(18)F-FDG uptake fraction remained unchanged after operation (P > 0.05). Match group undergoing transplanting had 54 segments, and their ~(99)Tc~m-MIBI and ~(18)F-FDG uptake fraction increased remarkably 4 months after operation (P < 0.01). CABG can improve the function of survival myocardial segments, but it is helpless to infraction myocardium. The autologous CD34~+ stem cell transplantation can improve myocardial blood perfusion and glucose metabolism of the distributions of infract myocardium.

Objective High expression of the valosin-containing protein ( VCP) gene can enhance the metastasis of osteosar-coma via the AKT/PI3K/NF-KappaB/MMP-9 signaling pathway, but the molecular mechanisms underlying the up-regulation of VCP in osteosarcoma cells remains unknown .This study aimed to determine whether miRNA-129-5p can regulate the VCP expression and its targets in human osteosarcoma cells . Methods The microRNA target-predicting software TargetScanhuman 6.2 ( http://www.tar-getscan.org/) was used to predict the possible targets of miRNA-129-5p on the VCP gene.Then, two recombinant gene report vectors containing the wild VCP gene 3′UTR ( psi-VCP vector ) and mutant VCP gene 3′UTR ( psi-VCPmut vector ) were constructed , se-quenced, and identified.The human osteosarcoma U2-OS cells were co-transfected with miRNA-129-5p mimic and psi-VCP vector or psi-VCPmut vector, respectively.A non-specificity mimic transfection served as negative control , and the luciferase activity was detec-ted in each group. Results The software prediction showed only one conserved function site of miRNA-129-5p on the VCP gene 3′UTR163-169 bp.Luciferase activity was significantly lower in the psi-VCP vector +miRNA-129-5p transfection group (15.529 ± 1.902) than in the VCP control group (21.781 ±0.854), VCP mutation experimental group (19.978 ±1.377), and VCP mutation control group (21.952 ±1.516) (P<0.05), with no remarkable difference between the VCP mutation control and VCP control groups (P=0.276). Conclusion miRNA-129-5p can probably regulate the targets of the VCP gene in human osteosarcoma U 2-OS cells.

Objective To investigate the clinical effects of scaphoid nonunion fractures by vascularized bone graft which can reconstruct fracture blood circulation. Methods From March 2013 to December 2014, 28 cases of patients with scaphoid fractures and nonunions were studied, including 16 males and 12 females whose age arranged from 19 to 33 years with a mean age of 26.2 years, for whom waist fractures and nonunions accounted 25 cases, and proximal end of scaphoid accounted 3 cases. The patients received treatments, vascularized radial periosteum graft was transversely implanted after radial periosteal flap pedicled on their current branch of the radial artery between the first and second tendinous sheath had been separated. Then 15 cases were fixed by Kirschner wire and 13 by Herbert screw. X?ray films were taken and checked regularly and periodically at 1th, 2nd, 3rd, 6th, 12th month after the operation to follow up fracture union and wrist function rehabilitation. Results All 28 cases of patients were followed up after operation for a period ranging from 5 to 12 months (with an average of 8 months). All patients with scaphoid fractures and nonunions were cured. The fractures and nonunions were clinically healed within 3 to 5 months and the patients didn't suffer from wrist pain basically. The wrist functions of those patients were evaluated according to modified Mayo wrist score:21 were rated as excellent, 5 as fine, 2 as fair, the excellent and good rate was 93%(26/28). The excellent and good rate of Kirsch?ner wire group was 93%(14/15), and the Herbert screw group was 92%(12/13). The difference in the excellent and good rate was not statistically significant between Kirschner wire group and Herbert screw group (χ2=0.011, P=0.916). Conclusion Fixed with Kirschner wire or Herbert screw, using vascularized radial periosteum graft to treat scaphoid fractures and nonunions has good short?term clinical effects. The operation manner with simple operation is an effective treatment, which can improve the blood sup?ply of the scaphoid fracture.

Objective To assess the diagnostic value of 18 F?FDG PET/CT imaging for primary pul?monary lymphoepithelioma?like carcinoma (LELC). Methods A total of 19 patients (10 males, 9 fe?males;average age 56.4 years) with suspected primary pulmonary LELC undergone whole?body 18F?FDG PET/CT and chest contrast CT scan were enrolled in this retrospective study. The SUVmax and uptake pat?terns of FDG, the histological types and the clinical stages were recorded. Image characteristics of contrast CT and FDG PET/CT were observed, and the diagnostic efficiency was calculated. Two?sample t test and one?way analysis of variance were used to analyze the results. Results The diagnostic sensitivity and spe?cificity of LELC were 12/13 and 4/6 for FDG PET/CT. The SUVmax of LELC lesions was significantly differ?ent from that of other lung malignant tumors or lung benign lesions (F=3.67, P<0?05). The lesion had longer diameter, lower CT density, higher SUVmax in stage Ⅳ patients, compared with that in stageⅠ-Ⅲpatients ( F=7.01, P<0.05) . The significant difference of SUVmax was found between lesions with ring up?take and lesions with other uptake types (3.94±0.67 vs 2.86±0.35; t=4.07, P<0?05). The SUVmax was higher in Schmincke tumors when compared with that in tumors of Regaud subtype ( 3. 61 ± 0. 71 vs 2. 76 ± 0?29; t=2.99, P<0.05) . Conclusion 18 F?FDG PET/CT could be an accurate method in differential diag?noses of primary pulmonary LELC.

BACKGROUND AND PURPOSE: The objective of this study was to determine the prevalence of and risk factors for dementia in residents aged 65 years and older in a Chinese nursing home. METHODS: A cross-sectional study was carried out in a nursing home located in Hangzhou, Zhejiang Province, China. Cognitive status, including the presence of dementia and mild cognitive impairment (MCI), was measured using a combination of medical history and objective cognitive assessments. Logistic regression analysis was conducted to predict the associated risk factors. RESULTS: In total, 943 residents (334 males and 609 females) aged 84.00±6.67 years (mean±SD) were included. Dementia was diagnosed in 420 (44.5%) residents, and MCI was diagnosed in 195 (20.7%). Mild, moderate, and severe dementia were present in 20.3%, 14.0%, and 65.7% of those in the dementia group, respectively. Logistic regression analysis revealed that dementia was associated with a low education level (p=0.000), an advanced age (p=0.010), and a history of stroke (p=0.023). CONCLUSIONS: Our study found a high prevalence of dementia in a Chinese nursing home, and a high prevalence of patients with severe dementia. Risk factors for dementia included a low educational level, an advanced age, and a history of stroke. Appropriate interventions need to be applied to this population.
Asian Continental Ancestry Group* ; China ; Cross-Sectional Studies ; Dementia* ; Education ; Humans ; Logistic Models ; Male ; Mild Cognitive Impairment ; Nursing Homes* ; Nursing* ; Prevalence* ; Risk Factors* ; Stroke

The chitosan scaffolds with different deacetylated degree were prepared in this study. The morphology of scaffolds were observed using SEM, and the porosity, the water absorbing swelling ratio and the degradation were examined both in vitro and in vitro. The results showed that the chitosan scaffolds with different deacetylated degree exhibited three-dimensional structure with high porosity. With increasing of deacetylated degree, their porosities were 93.46%, 90.02% and 86.71%, respectively. The swelling ratios of chitosan scaffolds were 820%, 803% and 772%, respectively. At the fourth week, the degradation rates were 30.44%, 22.08% and 17.10% in vitro, respectively; while the corresponding rates were 57.48%, 40.23%, 29.53% in vivo respectively. The degradation rate of chitosan scaffold was negatively correlated to deacetylated degree. Furthermore, it showed that the speed of degradation in vivo was faster than that in vitro. We concluded that controlling the deacetylated degree of chitosan can provide a well-matched degradable scaffold material for the reparation of cartilage defects.
Absorbable Implants ; Acetylation ; Animals ; Biocompatible Materials ; Chitosan ; analogs & derivatives ; chemical synthesis ; chemistry ; Female ; Male ; Materials Testing ; Rats ; Rats, Sprague-Dawley ; Tissue Engineering ; Tissue Scaffolds ; chemistry

Objective:To explore the relationship between metabolic score for insulin resistance (METS-IR) and chronic kidney disease (CKD) and albuminuria in the Chinese population.Methods:This cross-sectional study was conducted from January to December 2018 among residents aged 20 to 70 years in ten regions of eight provinces in China; all residents had lived in their region for more than 5 years. Various parameters were measured, included fasting blood glucose, 2-hour postprandial blood glucose, glycosylated hemoglobin (HbA 1c), blood lipids, renal function, urinary albumin/creatinine ratio (UACR), etc. Data of 5 060 subjects meeting the criteria were included in the study. CKD was defined as estimated glomerular filtration rate (eGFR)<60 ml·min -1·1.73 m -2 or UACR≥30 mg/g. Albuminuria was defined as UACR≥30 mg/g. METS-IR was calculated and categorized into quartiles: Q1, METS-IR≤32.19; Q2, METS-IR 32.20-37.10; Q3, METS-IR 37.11-42.58; and Q4, METS-IR>42.58. The correlation between METS-IR and CKD and albuminuria was analyzed by binary logistic regression, and subgroup analyses were performed. Results:There were 1 266, 1 266, 1 265, and 1 263 participants included in Q1-Q4 groups, respectively. With the increase of METS-IR quartile, various parameters increased, including age, fasting blood glucose, HbA 1c, triglycerides, serum uric acid, waist circumference, body mass index, and systolic and diastolic blood pressure, and the proportion of males also increased (all P<0.05). The proportion of patients with CKD and albuminuria increased significantly with the increase in interquartile range (Q) of METS-IR (all P<0.05). Logistic regression analysis showed that for every 1-unit increment of METS-IR, the risk of CKD and albuminuria were both increased by 2% [for both: odds ratio ( OR)=1.02, 95% confidence interval ( CI) 1.01-1.03]. Compared with the lowest METS-IR group (Q1), the ORs for CKD and albuminuria in the highest METS-IR group (Q4) were 1.57 (95% CI 1.17-2.10) and 1.46 (95% CI 1.09-1.96), respectively. In the subgroup analyses, increased METS-IR was significantly associated with CKD and albuminuria among women (CKD: OR=1.62, 95% CI 1.14-2.31; albuminuria: OR=1.53, 95% CI 1.07-2.18), individuals with HbA 1c<7% ( OR=1.64, 95% CI 1.21-2.23; OR=1.55, 95% CI 1.14-2.11), individuals with eGFR≥90 ml·min -1·1.73 m -2 ( OR=1.78, 95% CI 1.27-2.49; OR=1.80, 95% CI 1.28-2.53), and the Chinese Han population ( OR=1.56, 95% CI 1.13-2.17; OR=1.41, 95% CI 1.01-1.96). Conclusions:METS-IR is significantly associated with CKD and albuminuria in a Chinese population. Furthermore, the higher the METS-IR, the higher the risk of CKD and albuminuria.

Background: Prediabetes leads to declines in physical function in older adults, but the impact of prediabetes progression or regression on physical function is unknown. This study assessed this longitudinal association, with physical function objectivelymeasured by grip strength, walking speed, and standing balance, based on the Health and Retirement Study enrolling United States adults aged >50 years. Methods: Participants with prediabetes were followed-up for 4-year to ascertain prediabetes status alteration (maintained, regressed, or progressed), and another 4-year to assess their impacts on physical function. Weak grip strength was defined as <26 kg for men and <16 kg for women, slow walking speed was as <0.8 m/sec, and poor standing balance was as an uncompleted fulltandem standing testing. Logistic and linear regression analyses were performed. Results: Of the included 1,511 participants with prediabetes, 700 maintained as prediabetes, 306 progressed to diabetes, and 505 regressed to normoglycemia over 4 years. Grip strength and walking speed were declined from baseline during the 4-year followup, regardless of prediabetes status alteration. Compared with prediabetes maintenance, prediabetes progression increased the odds of developing weak grip strength by 89% (95% confidence interval [CI], 0.04 to 2.44) and exhibited larger declines in grip strength by 0.85 kg (95% CI, –1.65 to –0.04). However, prediabetes progression was not related to impairments in walking speed or standing balance. Prediabetes regression also did not affect any measures of physical function. Conclusion Prediabetes progression accelerates grip strength decline in aging population, while prediabetes regression may not prevent physical function decline due to aging.