Objective To examine the causes of incision infections following lower extremity open fractures and develop a predictive model for assessing the risk.Methods A total of 104 patients with open fractures of the lower extremity,who received internal fixation from January 2022 to August 2023.According to whether there was incision infection after the operation,the patients were divided into infection group and non-infection group.The aim of the study was to analyze the distribution of pathogenic bacteria causing postoperative incision infections.Single-factor and multifactor Logistic regression analyses were employed to examine the factors influencing postoperative incisional infections.Subsequently,a risk prediction model for these infections was developed.The predictive capacity of this model was assessed using ROC curves.Results In the cohort of 104 patients with open fractures of the lower limb,the occurrence rate of postoperative incision infections was 19.23％.A total of 45 non-repeated pathogenic bacteria were isolated,among which gram-positive bacteria accounted for 53.33％,gram-negative bacteria 42.22％,fungi 4.44％.Gram-positive bacteria showed 100％resistance to ampicillin/sulbactam and penicillin,while resistance rates for erythromycin and clindamycin exceeded 90％.Among gram-negative bacteria,resistance rates to cefazolin,sulfamethoxazole/trimethoprim,levofloxacin,ampicillin/sulbactam,ciprofloxacin,and gentamicin were all above 67％.Notably,resistance rates for cefazolin,sulfamethoxazole,and trimethoprim surpassed 90％.Univariate and multifactorial logistic stepwise regression analysis highlighted that time elapsed from injury to surgery,duration of surgery,length of hospital stay,perioperative prophylactic medication,and Gustilo classification were significant risk factors for postoperative incisional infections in patients with the condition(P＜0.05).The ROC curves illustrated that the risk prediction model accurately forecasted the incidence of postoperative incisional infections in patients with open fractures of the lower extremity,with an area under the curve of 0.861(95％ CI:0.811 to 0.911),boasting a sensitivity of 90.50％and a specificity of 72.92％.Conclusion The main pathogen of wound infection after open fracture of lower extremity is Gram-negative,the time from injury to operation,operation time,hospitalization time,prophylactic medication during perioperative period and GUSTILO classification were the influencing factors of postoperative wound infection.In addition,the establishment of risk prediction model has a good prediction effect on the incidence of postoperative wound infection in patients with this disease.

Objective To investigate the expression changes and clinical significance of serum pepsinogen(PG)and triggering receptor expressed on myeloid cells-1(TREM-1)in patients with reflux esophagitis(RE).Methods A total of 140 patients with RE who were treated from October 2021 to October 2023 were selected as the observation group,and 140 healthy adults who underwent physical examination during the same period were selected as the control group.Serum PG(PGⅠ and PGⅡ)and TREM-1 were detected by ELISA.Multivariate logistic regression was used to analyze the influencing factors of RE.Receiver operating characteristic(ROC)was used to analyze the diagnostic efficacy of serum PGⅠ,PGⅡ and TREM-1 levels for RE.Results The levels of interleukin(IL)-2,IL-6,Il-1β,PGⅡ,TREM-1 and tumor necrosis factor-α(TNF-α)in the observation group were significantly higher than those in the control group,while the level of PGⅠ was significantly lower than that in the control group(P<0.01).Serum IL-2,IL-6,IL-1β,TNF-α,PGⅡ and TREM-1 were risk factors for RE,while serum PGⅠ was a protective factor for RE(P<0.01).ROC curve analysis showed that the area under the ROC curve(AUC)of combined detection of PGⅠ,PGⅡ and TREM-1 in the diagnosis of RE was significantly higher than that of PGⅠ alone(Z=5.940,P<0.001)and PGⅡ alone(Z=6.764,P<0.001)and TREM-1 alone(Z=6.791,P<0.001).Conclusion The expression levels of serum PGⅡ and TREM-1 in patients with RE are increased,while the expression level of PGⅠ is decreased.The combined detection of the three can improve the diagnostic efficacy of RE.

Objective To examine the causes of incision infections following lower extremity open fractures and develop a predictive model for assessing the risk.Methods A total of 104 patients with open fractures of the lower extremity,who received internal fixation from January 2022 to August 2023.According to whether there was incision infection after the operation,the patients were divided into infection group and non-infection group.The aim of the study was to analyze the distribution of pathogenic bacteria causing postoperative incision infections.Single-factor and multifactor Logistic regression analyses were employed to examine the factors influencing postoperative incisional infections.Subsequently,a risk prediction model for these infections was developed.The predictive capacity of this model was assessed using ROC curves.Results In the cohort of 104 patients with open fractures of the lower limb,the occurrence rate of postoperative incision infections was 19.23％.A total of 45 non-repeated pathogenic bacteria were isolated,among which gram-positive bacteria accounted for 53.33％,gram-negative bacteria 42.22％,fungi 4.44％.Gram-positive bacteria showed 100％resistance to ampicillin/sulbactam and penicillin,while resistance rates for erythromycin and clindamycin exceeded 90％.Among gram-negative bacteria,resistance rates to cefazolin,sulfamethoxazole/trimethoprim,levofloxacin,ampicillin/sulbactam,ciprofloxacin,and gentamicin were all above 67％.Notably,resistance rates for cefazolin,sulfamethoxazole,and trimethoprim surpassed 90％.Univariate and multifactorial logistic stepwise regression analysis highlighted that time elapsed from injury to surgery,duration of surgery,length of hospital stay,perioperative prophylactic medication,and Gustilo classification were significant risk factors for postoperative incisional infections in patients with the condition(P＜0.05).The ROC curves illustrated that the risk prediction model accurately forecasted the incidence of postoperative incisional infections in patients with open fractures of the lower extremity,with an area under the curve of 0.861(95％ CI:0.811 to 0.911),boasting a sensitivity of 90.50％and a specificity of 72.92％.Conclusion The main pathogen of wound infection after open fracture of lower extremity is Gram-negative,the time from injury to operation,operation time,hospitalization time,prophylactic medication during perioperative period and GUSTILO classification were the influencing factors of postoperative wound infection.In addition,the establishment of risk prediction model has a good prediction effect on the incidence of postoperative wound infection in patients with this disease.

Objective To investigate the expression changes and clinical significance of serum pepsinogen(PG)and triggering receptor expressed on myeloid cells-1(TREM-1)in patients with reflux esophagitis(RE).Methods A total of 140 patients with RE who were treated from October 2021 to October 2023 were selected as the observation group,and 140 healthy adults who underwent physical examination during the same period were selected as the control group.Serum PG(PGⅠ and PGⅡ)and TREM-1 were detected by ELISA.Multivariate logistic regression was used to analyze the influencing factors of RE.Receiver operating characteristic(ROC)was used to analyze the diagnostic efficacy of serum PGⅠ,PGⅡ and TREM-1 levels for RE.Results The levels of interleukin(IL)-2,IL-6,Il-1β,PGⅡ,TREM-1 and tumor necrosis factor-α(TNF-α)in the observation group were significantly higher than those in the control group,while the level of PGⅠ was significantly lower than that in the control group(P<0.01).Serum IL-2,IL-6,IL-1β,TNF-α,PGⅡ and TREM-1 were risk factors for RE,while serum PGⅠ was a protective factor for RE(P<0.01).ROC curve analysis showed that the area under the ROC curve(AUC)of combined detection of PGⅠ,PGⅡ and TREM-1 in the diagnosis of RE was significantly higher than that of PGⅠ alone(Z=5.940,P<0.001)and PGⅡ alone(Z=6.764,P<0.001)and TREM-1 alone(Z=6.791,P<0.001).Conclusion The expression levels of serum PGⅡ and TREM-1 in patients with RE are increased,while the expression level of PGⅠ is decreased.The combined detection of the three can improve the diagnostic efficacy of RE.

Objective To investigate the effects and mechanisms of oridonin(ORI)on human keloid-derived fi-broblasts(HKF).Methods The effects of ORI on the proliferation activity of HKF were assessed using the CCK-8 assay.The experiment was divided into control and experimental groups.Cell scratch and Transwell assays were conducted to evaluate the migration and invasion capabilities of HKF.Real-time quantitative PCR(RT-qPCR)and Western blot were used to examine the impact of ORI on the expression of extracellular matrix-related mRNA and fi-bronectin 1(FN1),α-smooth muscle actin(α-SMA),type Ⅰ collagen(COL Ⅰ),and COL Ⅲ in HKF.The ex-periment was also divided into control,model,and transforming growth factor(TGF)-β1+ORI groups.RT-qPCR and Western blot were utilized to determine the effects of ORI on the expression of TGF-β1-induced mRNA and nu-cleotide-binding oligomerization domain-like receptor protein 3(NLRP3),apoptosis-associated speck-like protein containing a CARD(ASC),Smad2,Smad3,phosphorylated Smad2(p-Smad2),and p-Smad3 in HKF.Results CCK-8 assay demonstrated that the cell inhibition rate of HKF progressively increased with increasing concentra-tions of ORI.Compared with the control group,the experimental group exhibited a significant reduction in the mi-gration area at 24 hours and a decrease in the number of invasive cells.Furthermore,there was a significant down-regulation in the expression levels of FN1,α-SMA,COL Ⅰ,and COL Ⅲ(P＜0.05).In comparison with the con-trol group,the model group showed a significant upregulation in the expression of NLRP3,ASC,Smad2,Smad3,p-Smad2,and p-Smad3(P＜0.05).Relative to the model group,the TGF-β1+ORI group demonstrated a signifi-cant downregulation in the expression of NLRP3,ASC,Smad2,Smad3,p-Smad2,and p-Smad3(P＜0.05).Conclusion ORI the proliferation,migration,and invasiveness of HKF,as well as the formation and deposition of the extracellular matrix,through the blockade of the TGF-β1/Smad signaling pathway and the NLRP3-mediated in-flammatory response.

BACKGROUND: Screening using low-dose computed tomography (LDCT) is a more effective approach and has the potential to detect lung cancer more accurately. We aimed to conduct a meta-analysis to estimate the accuracy of population-based screening studies primarily assessing baseline LDCT screening for lung cancer. METHODS: MEDLINE, Excerpta Medica Database, and Web of Science were searched for articles published up to April 10, 2022. According to the inclusion and exclusion criteria, the data of true positives, false-positives, false negatives, and true negatives in the screening test were extracted. Quality Assessment of Diagnostic Accuracy Studies-2 was used to evaluate the quality of the literature. A bivariate random effects model was used to estimate pooled sensitivity and specificity. The area under the curve (AUC) was calculated by using hierarchical summary receiver-operating characteristics analysis. Heterogeneity between studies was measured using the Higgins I2 statistic, and publication bias was evaluated using a Deeks' funnel plot and linear regression test. RESULTS: A total of 49 studies with 157,762 individuals were identified for the final qualitative synthesis; most of them were from Europe and America (38 studies), ten were from Asia, and one was from Oceania. The recruitment period was 1992 to 2018, and most of the subjects were 40 to 75 years old. The analysis showed that the AUC of lung cancer screening by LDCT was 0.98 (95% CI: 0.96-0.99), and the overall sensitivity and specificity were 0.97 (95% CI: 0.94-0.98) and 0.87 (95% CI: 0.82-0.91), respectively. The funnel plot and test results showed that there was no significant publication bias among the included studies. CONCLUSIONS Baseline LDCT has high sensitivity and specificity as a screening technique for lung cancer. However, long-term follow-up of the whole study population (including those with a negative baseline screening result) should be performed to enhance the accuracy of LDCT screening.
Humans ; Adult ; Middle Aged ; Aged ; Lung Neoplasms/diagnostic imaging* ; Early Detection of Cancer ; Sensitivity and Specificity ; Mass Screening ; Tomography, X-Ray Computed

Molecular knowledge of human gastric corpus epithelium remains incomplete. Here, by integrated analyses using single-cell RNA sequencing (scRNA-seq), spatial transcriptomics, and single-cell assay for transposase accessible chromatin sequencing (scATAC-seq) techniques, we uncovered the spatially resolved expression landscape and gene-regulatory network of human gastric corpus epithelium. Specifically, we identified a stem/progenitor cell population in the isthmus of human gastric corpus, where EGF and WNT signaling pathways were activated. Meanwhile, LGR4, but not LGR5, was responsible for the activation of WNT signaling pathway. Importantly, FABP5 and NME1 were identified and validated as crucial for both normal gastric stem/progenitor cells and gastric cancer cells. Finally, we explored the epigenetic regulation of critical genes for gastric corpus epithelium at chromatin state level, and identified several important cell-type-specific transcription factors. In summary, our work provides novel insights to systematically understand the cellular diversity and homeostasis of human gastric corpus epithelium in vivo.
Humans ; Epigenesis, Genetic ; Gastric Mucosa/metabolism* ; Chromatin/metabolism* ; Stem Cells ; Epithelium/metabolism* ; Fatty Acid-Binding Proteins/metabolism*

Central nervous system (CNS) injuries, including stroke, traumatic brain injury, and spinal cord injury, are leading causes of long-term disability. It is estimated that more than half of the survivors of severe unilateral injury are unable to use the denervated limb. Previous studies have focused on neuroprotective interventions in the affected hemisphere to limit brain lesions and neurorepair measures to promote recovery. However, the ability to increase plasticity in the injured brain is restricted and difficult to improve. Therefore, over several decades, researchers have been prompted to enhance the compensation by the unaffected hemisphere. Animal experiments have revealed that regrowth of ipsilateral descending fibers from the unaffected hemisphere to denervated motor neurons plays a significant role in the restoration of motor function. In addition, several clinical treatments have been designed to restore ipsilateral motor control, including brain stimulation, nerve transfer surgery, and brain-computer interface systems. Here, we comprehensively review the neural mechanisms as well as translational applications of ipsilateral motor control upon rehabilitation after CNS injuries.
Animals ; Spinal Cord Injuries/therapy* ; Motor Neurons/physiology* ; Brain ; Stroke ; Recovery of Function/physiology*

Prognostication of coma patients after brain injury is important, yet challenging. In this study, we evaluated the predictive value of amplitude-integrated electroencephalography (aEEG) for neurological outcomes in coma patients. From January 2013 to January 2016, 128 coma patients after acute brain injury were prospectively enrolled and monitored with aEEG. The 6-month neurological outcome was evaluated using the Cerebral Performance Category Scale. aEEG monitoring commenced at a median of 7.5 days after coma onset. Continuous normal voltage predicted a good 6-month neurological outcome with a sensitivity of 93.6% and specificity of 85.2%. In contrast, continuous extremely low voltage, burst-suppression, or a flat tracing was correlated with poor 6-month neurological outcome with a sensitivity of 76.5% and specificity of 100%. In conclusion, aEEG is a promising predictor of 6-month neurological outcome for coma patients after acute brain injury.
Brain ; physiopathology ; Brain Injuries ; complications ; diagnosis ; physiopathology ; Coma ; diagnosis ; etiology ; physiopathology ; Electroencephalography ; methods ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Neurophysiological Monitoring ; methods ; Prognosis ; Prospective Studies ; Sensitivity and Specificity ; Severity of Illness Index