Objective To explore the association between rs3179060C/A polymorphism in the ex-on 1 of TNF-a gene and hyperandrogenism and polycystic ovary syndrome (PCOS). Methods One hundred thirty PCOS women and one hundred seventy five normal women as controls were enrolled in this study. The genotypes were screened by polymerase chain reaction-On/off switch and the product was isolated by e-lectrophoresis on a 2. 5% agarose gel containing ethidium bromide and visualized using an ultraviolet transil-luminator. The relationship of TNF-a alleles to serum testosterone level was analyzed in PCOS patients. Results Three genotypes were identified, corresponding to CC, CA, AA, and two alleles were screened, corresponding to C and A. The frequencies of the CC, CA, AA genotypes were 58. 4% ,23.1% ,18.5% vs. 72. 0% , 17.7% , 10. 3% in PCOS group and control group, showing statistically significant difference between two groups( P < 0.05 ). The allelic frequency was 70.0% for the C allele and 30.0% for the A in P-COS group, and 80. 9% for the C allele and 19. 1% for the A in control group, respectively, showing statistically significant between two groups ( P <0.05). The relationship was not observed between rs3179060C/ A polymorphism and serum testosterone level in PCOS patients in Han Chinese racial origin ( P >0.05). Conclusions The TNF-a gene rs3179060C/A polymorphism may be a risk factor for the pathogenesis of P-COS in Chinese women, but it was not effect on hyperandrogenism in PCOS women.

Objective To explore the distribution features of pathogenic spectra and antibiotic resistance of the isolates from blood cultures in hospital from June 2012 to June 2016.Methods A total of 4 238 blood samples from June 2012 to June 2016 were evaluated by BD Bactec FX-200,the identification results were used for retrospective analysis.Results A total of 455 positive pathogens were isolated from 4 238 blood cultures sample,the positive rate was 10.74％,Gram-positive accounts for 38.02％,Gram-negative bacilli accounts for 60.00％,Fungi accounts for 1.98％.Positive pathogens were distributed in newborn baby and middle-older patients,accounting for 6.78％ and 76.17％respectively.Which the Enterobacteriaceae accounting for 54.10％,the major consists were Escherichia coli and Klebsiellapneumoniae;Non-fermentative bacterial which consists of Pseudomonas aeruginosa and Acinetobacterbaumannii accounting for 2.90％.The major pathogens in Gram-positive cocci was Staphylococcus,accounting for 25.87％.Enterobacteriaceae were more sensitive to Meropenem,Imipenem and so all.Non-fermentative bacterial were more sensitive to Piperacillin/Tazobactam.Staphylococcus were more sensitive to Vancomycin and Linezolid.Streptococcus were sensitive to Vancomycin.Conclusion Combined with the distribution features of pathogenic spectra and antibiotic resistance,clinicians should pay attention to use of drugs reasonably to enhance the cure rate of bacteremia and Fungalemia.

Objective To investigate the difference of curative effects between the complete video assisted thoracic surgery (C-VATS)and traditional open surgery in the treatment of elderly patients with lung cancer,and to clarify the specially curative effect of C-VATS.Methods 80 patients with lung cancer without diabetes mellitus,chronic brouchitis and heart diseases aged over 65 years were enrolled in the study.They were divided into C-VATS group and open surgery for lobectomy (OPEN)group (n=40)according their wishes.The operation time,number of lymph nodes removed,amount of intraoperative blood loss,postoperative thoracic drainage,chest tube duration, postoperative hospitalized time, postoperative pain degree, incidence of postoperative complications, preoperative and postoperative sedentary heart rate (HR)of the patients in two groups were compared.Results The operation time in C-VATS group(193.12 min±59.06 min)was longer than that in OPEN group(167.17 min±54.01 min) (P<0.05),and the number of lymph nodes removed in C-VATS group(14.6±7.5)had no significant difference compared with OPEN group(15.2 ± 4.5)(P>0.05).The postoperative pain degree in C-VATS group(2.54 ± 0.12)was lower than that in OPEN group(4.61 ± 0.10)(P<0.05);the postoperative chest rube duration in C-VAS group(6.14 d ± 3.32 d)was short than that in OPEN group (11.67 d ± 4.13 d);the postperative hospitalized time in C-AVA group(8.52 d±3.25 d)was shorter than that in OPEN group (14.76 d±6.11 d)(P<0.05).There were no significant differences of intraoperative blood loss(231.28 mL±203.15 mL vs 213.33 mL± 187.18 mL),postoperative thoracic draginage(1 597.83 mL± 1 049.29 mL vs 1 690.68 mL± 1 043.37 mL), incidence of postoperative complications between C-VATS group and OPEN group(P>0.05).The postoperative sedentary HR in C-VATS group and OPEN group were significantly higher than preoperative;the postoperative sedentary HR recovered to the preoperative level 3 d after operation in C-VATS group and it recovered to the preoperative level 7 d after operation in OPEN group. Conclusion Compared with traditional open thoracic surgery, C-VATS owns the characteristics such as less trauma, less pain, less hospital stay and better postoperative recovery in the aged patients with lung cancer.

Objective: To systematically evaluate risk factors for cardiometabolic multimorbidity (CMM), so as to provide the evidence for formulating CMM prevention and control strategies. Methods: Publications pertaining to the risk factors for CMM were retrieved from databases, including SinoMed, CNKI, Wanfang Data, VIP, PubMed and Cochrane Library from inception to March 31, 2023. Meta-analysis was performed using the software RevMan 5.4 and Stata 16.0, and sensitivity analysis was performed using the leave-one-out method. The publication bias was evaluated using Egger's test. Results: Totally 494 publications were screened, and 20 publications were included in the final analysis, including 13 cohort studies (covering 1 940 000 participants) and 7 cross-sectional studies (covering 13 000 000 participants). Meta-analysis revealed that female (OR=1.54, 95%CI: 1.40-1.71), middle age (OR=3.80, 95%CI: 3.33-4.34), elderly (OR=2.82, 95%CI: 1.48-5.37), urban resident (OR=1.41, 95%CI: 1.27-1.57), higher education level (OR=2.01, 95%CI: 1.35-3.01), higher economic level (OR=1.21, 95%CI: 1.16-1.25), overweight (OR=1.92, 95%CI: 1.64-2.26), obesity (OR=3.01, 95%CI: 2.30-3.93), central obesity (OR=1.70, 95%CI: 1.12-2.56), smoking (OR=1.27, 95%CI: 1.07-1.51), alcohol consumption (OR=1.27, 95%CI: 1.01-1.59), irregular diet (OR=1.10, 95%CI: 1.02-1.18), insufficient intake of vegetables and fruits (OR=1.12, 95%CI: 1.07-1.17), lack of sleep at night (OR=1.17, 95%CI: 1.08-1.27), and depression (OR=1.50, 95%CI: 1.33-1.69) were risk factors for CMM. Sensitivity analysis of effects of central obesity and alcohol consumption were not robust. No publication bias was examined by Egger's test. Conclusions Female, middle age, elderly, urban resident, higher education level, higher economic level, overweight, obesity, central obesity, smoking, alcohol consumption, irregular diet, insufficient intake of vegetables and fruits, lack of sleep at night and depression are risk factors for CMM.

Objective To study the value of diffusion weighted imaging (DWI)in Marchiafava-Bignami disease.Methods (1)12 cases of Marchiafava-Bignami disease (MBD)patients with 6 month follow-up and 12 hedthy adults were clone MRI DWI;(2)MR imaging characteristics of 12 patients were observed on the corpus callosum and the other gray-white matters;(3)The ADC values of the central part and marginal area of the corpus callosum and the other gray-white matters were measured,data analysis were carried out completely by random design.Results Hyperintensity on the corpus callosum were showed in 12 patients on DWI,typical“sandwich sign”was seen on the sagittal T2 WI in 1 1 cases,and gray-white matters beside the corpus callosum were involved other in 6 cases;The ADC values of central and marginal area of the corpus callosum and the other gray-white matters had significant differ-ence between the improved clinical symptom group and,unimproved clinical symptom group and the control group (P < 0.05 ). There were no significant differences in the ADC values for the other white matters.Conclusion DWI can be used to reflect the change of MBD.Low ADC values in the corpus callosum and cortex are associated with a poor prognosis.

BACKGROUND:Tranexamic acid is a synthetic anti-fibrinolytic drug, and can effectively control blood loss after total knee arthroplasty through vein. OBJECTIVE:To evaluate the effectiveness and safety of tranexamic acid in reducing blood loss after primary unilateral total knee arthroplasty. METHODS:From 2014 to 2015, 100 patients from the Department of Lower Limb, Sichuan Orthopaedic Hospital underwent primary unilateral total knee arthroplasty, and randomly divided into test group which used tranexamic acid and control group which used tranexamic acid, with 50 cases in each group. 1 g tranexamic acid was infused into the vein at 10 minutes before total knee arthroplasty in the test group, but tranexamic acid was not given in the control group. RESULTS AND CONCLUSION:The amount of total blood loss, postoperative wound drainage in 24 hours, and the amount of blood transfusion were significantly less in the test group than in the control group (P < 0.05). No significant differences in intraoperative blood loss and the number of patients receiving blood transfusion were found between the test and control groups. No significant difference in preoperative hemoglobin levels was detected before surgery, but hemoglobin levels were decreased after surgery between the two groups. Postoperative hemoglobin levels were apparently higher in the test group than in the control group after surgery. At 24 hours after surgery, no significant difference in coagulation was detectable between the two groups. At 6 days, double lower limb vein color Doppler ultrasound examination did not reveal deep vein thrombosis in both groups. These findings verify that treatment with tranexamic acid in the vein before primary unilateral total knee arthroplasty can evidently diminish the amount of perioperative blood loss and blood transfusion, reduce the risk and cost of blood transfusion, which is good for rehabilitation and does not increase the risk of deep vein thrombosis.

Objective To compare the effects of peripatellar peripheral nerve partially and totally depolarized in total knee arthroplasty (TKA). Methods 66 TKA patients were divided into partially depolarized group (A, 42 knees) and totally depolarized group (B, 38 knees). The scores of knee-joint, Feller and Visual Analogue Scale were recorded. Results There was no significant difference in all the scores between 2 groups before operation (P>0.05). All the scores improved after operation (P<0.05), however, there was still no significant difference between 2 groups (P>0.05). Conclusion Patellar peripheral nerve partially depolarization technique can reduce postoperative knee pain, which has the same effect with totally depolarization.

Objective: To conduct a scoping review on prognostic prediction models for patients with comorbidity of chronic diseases, and understand modeling methods, predictive factors and predictive effect of the models, so as to provide the reference for prognostic evaluation on patients with comorbidity of chronic diseases. Methods: Literature on prognostic prediction models for patients with comorbidity of chronic diseases was collected through SinoMed, CNKI, Wanfang Data, VIP, PubMed, Embase, Cochrane Library and Web of Science published from the time of their establishment to November 1, 2023. The quality of literature was assessed using prediction model risk of bias assessment tool (PROBAST), then modeling methods, predictive factors and predictive effects were reviewed. Results: Totally 2 130 publications were retrieved, and nine publications were finally enrolled, with an overall high risk of bias. Thirteen models were involved, with three established using machine learning methods and ten established using logistic regression. The prediction results of four models were death, with main predictive factors being age, gender, body mass index (BMI), Barthel index and pressure ulcers; the prediction results of nine models were rehospitalization, with main predictive factors being age, BMI, hospitalization frequency, duration of hospital stay and hospitalization costs. Eleven models reported the area under the receiver operating characteristic curve (AUC), ranging from 0.663 to 0.991 6; two models reported the C-index, ranging from 0.64 to 0.70. Eight models performed internal validation, one model performed external validation, and four models did not reported verification methods. Conclusions The prognostic prediction models for patients with comorbidity of chronic diseases are established by logistic regression and machine learning methods with common nursing evaluation indicators, and perform well. Laboratory indicators should be considered to add in the models to further improve the predictive effects.

Objective The aim of this study was to investi-gate the changes of brain function in patients with drug-naive idiopath-ic epilepsy ( DNIE ) using resting-state functional MRI ( rs-fMRI ) amplitude of low-frequency fluctuation ( ALFF) , analyze the correlation of abnormal brain regions with the clinical variable ( disease course) , and gain a deeper insight into the pathophysiological mechanisms of idiopathic epilepsy. Methods This study included 25 cases of DNIE (15 males and 10 females) and 34 cases of drug idiopathic epilepsy (DIE, 22 males and 12 females).Another 25 healthy volunteers matched with the DNIE patients in sex, age, education and handedness were recruited as normal controls.The rs-fMRI data obtained from all the subjects were processed, subjected to ALFF analysis, and compared among the DNIE, DIE, and nor-mal control groups.The correlation was evaluated between the ALFF statistical brain mapping and the course of disease. Results Obvious differences were found in ALFF among the DNIE, DIE and control subjects.Compared with the normal controls, the DNIE pa-tients showed increased ALFF in the right inferior temporal gyrus, right lingual gyrus and right cuneus, but decreased ALFF in the right insula, left hippocampus, right midbrain, right middle frontal gyrus, left anterior cingulated gyrus, left middle cingulate gyrus and right inferior parietal lobule.In comparison with the DIE patients, those of the DNIE group exhibited increased ALFF in the left inferior occipital gyrus, right middle occipital gyrus and left middle occipital gyrus, but decreased ALFF in the right inferior frontal gyrus, left insula, right superior temporal gyrus and right middle frontal gyrus.In the DNIE patients, the disease course was found to be correlated positively with ALFF in the right cerebellum posterior lobe, left cerebellar tonsil, right lingual gyrus, left orbital gyrus, left middle oc-cipital gyrus, left corpus callosum, left caudate nuclear, left superior frontal gyrus, left medial frontal gyrus, right precuneus and left middle frontal gyrus, but negatively with ALFF in the right parahippocampal, right superior temporal gyrus, left superior temporal gyrus and right post-central gyrus. Conclusion The ALFF of resting-state cerebral function is abnormal in DNIE patients.The correlation between ALFF and the clinical variable ( disease course) provides a new insight into the pathophysiological mechanisms of epilepsy.

Objective: To explore the cross classification of tibial plateau fractures combined with avulsion fracture of medial femoral condyle. Methods: The 16 patients were retrospectively analysed as an observation group who had been treated at Department of Lower Limbs, Sichuan Orthopaedic Hospital for tibial plateau fracture and avulsion fracture of the medial condyle of the same femur from January 2015 to December 2018. They were 9 males and 7 females, aged from 27 to 78 years (average, 51.5 years). By the Schatzker classification, there were 2 cases of type Ⅰ, 8 cases of type Ⅱ, 3 cases of type Ⅲ and one case of type Ⅳ; by the cross classification, there were 10 cases of type Ⅰe, one case of type Ⅱe and 2 cases of type Ⅲe and 3 cases of type Ⅰv. The 332 patients were included as a control group who had been treated at the same department for simple tibial plateau fracture from January 2010 to December 2015. The imaging data of the 2 groups were compared to find out the charateristics of cross type distribution; the widened distance of the lateral tibial plateau, collapse depth of the tibial plateau, separation of avulsion fracture of medial femoral condyle, maximum clearance of the medial knee and eversion angle of the tibial plateau were investigated in the patients with cross types e and Ⅰv in the observation group. Results: In the observation group, the widened distance of the lateral tibial plateau averaged 7.18 mm, the collapse depth of the tibial plateau 8.74 mm, the separation of avulsion fracture of medial femoral condyle 3.44 mm, the maximum clearance of the medial knee 7.77 mm, and the eversion angle of the tibial plateau 87.03°. There was a significant difference in the cross type distribution of tibial plateau fractures between the 2 groups (P=0.002). In the observation group, the average widened distance of the lateral tibial platea for the 13 type e patients (8.49±4.26 mm)was significantly larger than that for the 3 type Ⅰv patients (1.51±2.11 mm) (t=2.706, P=0.017). Conclusion The cross classification of tibial plateau fractures with avulsion fracture of mediall condyle of the same femur may result mainly in types e and type Ⅰv. The widened distance of lateral tibial plateau helps distinction between types e and type Ⅰv.