Objective To observe plasma resistin levels in patients with essential hypertension (HT) of Xinjiang Kazakans and Han nationalities, and explore its association with insulin resistance (IR), blood glucose, blood lipids, blood pressure and obesity. Methods Total 127 Kazakan cases and 131 Han cases were selected as the subjects. According to their blood pressure, they were divided into HT group of Kazakans, control group of Kazakans, HT group of Hans and control group of Hans. Blood pressure, height, weight, waist circum-ference (WC) and hip were measured. Plasma resistin, fasting insulin(FINS), fasting plasma glucose (FPG), total cholesterol (TC), tri-glyceride (TG), high-density lipoprotein cholesterol ( HDL-C), low-density lipoprotein cholesterol ( LDL-C), apoprotein-A1( Apo-A1)and apoprotein-B(Apo-B) were determined. Body mass index (BMI), waist-hip ratio ( WHR), body fat percentage ( BF% )and homeostasis model assessment of insulin resistance index ( HOMA-IR) were calculated. Results Plasma resistin levels in the HT groups of Kazakans and Hans were significantly higher than those in their control groups ( P<0.01 ). There were no significant difference in the comparison of plasma resistin levels in HT groups or control groups between Kazakans and Hans ( P>0.05). Plasma resistin was posi-tively and significandy correlated with age, systolic blood pressure (SBP), WC, BMI, WHR, BF%, FlaG, FINS, HOMA-IR, TG in HT groups of Kazakans and Hans ( HT group of Kazakans, r=0.492,0.296,0.281,0.648,0.263,0.515,0.742,0.759,0.797,0.595; HT group of Hans, r=0.417,0.275,0.391,0.483,0.278,0.318,0.453,0.560,0.641,0.310; P<0.05). After the influential factors such as age, blood glucose, blood lipids and obesity were adjusted, plasma resistin level in four groups were still positively and significantly corre-lated with FINS and HOMA-IR ( HT group of Kazakans, r=0.432,0.410 ; control group of Kazakans, r=0.327,0.305 ; HT group of Hans, r=0.426,0.425 ; control group of Hans, r=0.377,0.392 ; P<0.05), but not correlated with SBP or DBP( P>0.05 ). HOMA-IR, FPG and BMI were independent factors for plasma resistin level in HT group of Kazakans, while HOMA-IR, FlaG and BF% were inde-pendent factors for plasma resistin level in HT group of Hans. Conclusion Plasma resistin level was increased in patients with HT of Kaza-karts and Hans. Close correlations between resistin and obesity, blood glucose and IR were found, and there may be indirect correlation be-tween resistin and blood pressure.

Objective To explore the effects of multidisciplinary comprehensive pulmonary rehabilitation on aged patients with pneumo-coniosis. Methods From January, 2012 to January, 2015, 85 old stable inpatients with pneumoconiosis were divided into control group (n=40) and rehabilitation group (n=45). Both groups accepted routine medicine, while the rehabilitation group received multidisciplinary com-prehensive pulmonary rehabilitation for twelve weeks. They were assessed with cardiopulmonary exercise test, BODE index and quality of life before and after treatment. Results The maximum work, maximal oxygen uptake, 6-minute walk distance, scores of modified Version of the British Medical Researsh Council Respiratory Questionnaire, BODE index, activities of daily living, social activities, depression and anx-iety improved in the rehabilitation group after treatment (t>3.379, P<0.01), and were better than those in the control group (t>2.201, P<0.05). No imporvement was found in all the indices in the control group after treatment (t<2.339, P>0.05). Conclusion Multidisciplinary comprehensive pulmonary rehabilitation can effectively improve exercise tolerance and quality of life in aged patients with pneumoconiosis.

Multistage sampling is a frequently-used method in random sampling survey in public health.Clustering or independence between observations often exists in the sampling,often called complex sample,generated by multistage sampling.Sampling error may be underestimated and the probability of type Ⅰ error may be increased if the multistage sample design was not taken into considerationin analysis.As variance (error) estimator in complex sample is often complicated,statistical software usually adopt ultimate cluster variance estimate (UCVE) to approximate the estimation,which simply assume that the sample comes from one-stage sampling.However,with increased sampling fraction of primary sampling unit,contribution from subsequent sampling stages is no more trivial,and the ultimate cluster variance estimate may,therefore,lead to invalid variance estimation.This paper summarize a method of variance estimation considering multistage sampling design.The performances are compared with UCVE and the method considering multistage sampling design by simulating random sampling under different sampling schemes using real world data.Simulation showed that as primary sampling unit (PSU) sampling fraction increased,UCVE tended to generate increasingly biased estimation,whereas accurate estimates were obtained by using the method considering multistage sampling design.

Objective:To evaluate the safety and effectiveness of the accurate puncture during sacral neuromodulation (SNM) guided with 3D printing navigation template based on reconstruction techniques using fusing sacral CT and MRI images.Methods:Totally 42 patients operated with SNM were selected in Renji Hospital, School of Medicine, Shanghai Jiaotong University from July 2016 to August 2017. The patients were randomly divided into control group ( n=22) and experimental group ( n=20) using random number table. The conventional cross-positioning technique under X-ray was used for puncture during SNM in the control group. While in the experimental group, the sacral CT and MRI images were fused for reconstruction and design of the navigation template, printed by 3D technique for the puncture in SNM. The times of punctures, the average time for puncture operation, the time of intraoperative testing of the stimulator device, the minimum onset voltage of the stimulator, the X-ray radiation dose, postoperative curative effect (rate of secondary transformation) and the incidence rate of complications were compared between the two methods using independent-simple t test or χ 2 test. Results:Compared to control group, fewer times of punctures, shorter time needed for puncture operation, shorter time of intraoperative testing of the stimulator, smaller radiation dose and minimum effective voltage were found in the experimental group ( P<0.05). There were 15 and 16 patients who completed the secondary transformation in the control group and experimental group, and there was no significant difference between the two groups (χ2=0.757, P=0.384). There were 3 cases of complications in the control group, including 2 cases of infection and 1 case of bleeding, while no complications in the experimental group. Conclusions:CT and MRI images fusion reconstruction-guided 3D printing navigation template can help perform accurate and safe punctures in SNM. Compared to conventional puncture positioned under X-ray, it can effectively improve the puncture efficiency, and reduce the radiation dose in the operation.

OBJECTIVETo compare design-based and model-based methods in descriptive analysis of complex sample.

METHODSA total of 1 000 samples were selected and a multistage random sampling design was used in the analysis of the 2010 China chronic disease and risk factors surveillance. For each simulated sample, cases with probability proportional age were randomly deleted so that sample age structure was deviated systematically from that of the target population. Mean systolic blood pressure (SBP) and prevalence of raised blood pressure, as well as their 95% confidence intervals (95%CI) were determined using design-based and model-based methods (routine method and multi-level model). For estimators generated from those 3 methods, mean squared error(MSE) was computed to evaluate their validity. To compare performance of statistical inference of these methods, the probability of 95%CI covering the true parameter(mean SBP and raised blood pressure prevalence of the population) was used.

RESULTSMSE of mean estimator for routine method, design-based analysis and multilevel model was 6.41, 1.38, and 5.86, respectively; and the probability of 95%CI covering the true parameter was 24.7%, 97.5% and 84.3%, respectively. The routine method and multi-level model probably led to an increased probability of type I error in statistical inference. MSE of prevalence estimator was 4.80 for design-based method, which was far lower than those for routine method (20.9) and multilevel model (17.2). Probability of 95%CI covering the true prevalence for routine method was only 29.4%, and 86.4% for multilevel model, both of which were lower than that for design-based method (97.3%).

CONCLUSIONCompared to routine method and multi-level model, design-based method had the best performance both in point estimation and confidence interval construction. Design-based method should be the first choice when doing statistical description of complex samples with a systematically biased sample structure.

Objective To compare the safety and clinical efficacy of lesion removal combined with percutaneous pedicle screw fixation with classical posterior lesion removal in the treatment of lumbar brucelli spondylitis(LBS)by unilateral biportal endoscopic technique with transforaminal lumbar interbody fusion(UBE-LIF)technique.Methods The clinical data of 32 patients with LBS admitted by the Department of Spine and Orthopedics of Gansu Provincial Hospital of Traditional Chinese Medicine from January 2020 to January 2022 were retrospectively analyzed,and the clinical data of the 32 LBS patients were divided into 15 cases in the UBE-LIF group and 17 cases in the posterior group.The general data,surgery-related indexes,and postoperative pathological HE staining of the two groups were recorded and analyzed.The patients'clinical recovery was assessed according to their erythrocyte sedimentation rate(ESR)and C-reactive protein(CRP),low back pain visual analogue score(VAS),Japanese Orthopaedic Association(JOA)score,and Oswestry Dysfunction Index(ODI)preoperative,1 week after surgery,1,3,6 months and 1 year after surgery.Lumbar lordosis angle(LL)and intervertebral space height(DH)were measured by imaging before surgery and at the last follow-up,and intervertebral bone graft fusion was assessed using Suk grading criteria.Results Both groups successfully completed the operation and no serious postoperative complications occurred.There were no significant differences in gender,age,surgical segment,operation time,preoperative ESR and CRP,preoperative VAS,JOA score and ODI index,preoperative LL and DH(P＞0.05).The intraoperative blood loss,postoperative drainage,postoperative getting out of bed,and postoperative hospital stay in UBE-LIF group were significantly lower than those in the posterior group(P＜0.001).Pathological examination of diseased tissues was performed during surgery,all of which was consistent with brucellosis changes.Patients in both groups were followed up for 12-18 months,with an average of 14.8 months.The VAS,JOA score,and ODI index at all postoperative time points in the two groups were significantly improved compared with the preoperative period(P＜0.05).The difference between the two groups was significantly greater than that in the postoperative group:VAS score was lower in UBE-LIF group than in the posterior group(P＜0.01),CRP in both groups was higher than that in the preoperative group,and the elevation level was significantly lower in UBE-LIF group than in the posterior group(P＜0.001).There was no significant difference in ESR between the two groups compared with that before surgery(P＞0.05).There were no significant differences in VAS,JOA score,ODI index,CRP or ESR between the remaining time points after surgery(P＞0.05).At the last follow-up,imaging examination showed that the overall fusion rate of intervertebral bone graft in UBE-LIF group was 93.3％and 94.1％in the posterior group,without significant difference(x2=0.246,P=0.884).LL and DH were significantly improved in both groups compared with preoperative ones(P＜0.01),and the two groups did not significantly differ before and after surgery(P＞0.05).Conclusion Both surgical treatments for LBS are safe effect.Compared with posterior lesion removal bone graft fusion internal fixation,UBE-LIF technology combined with percutaneous pedicle screw internal fixation has the advantages of clear intraoperative vision,less blood loss,faster early postoperative recovery,and shorter postoperative hospital stay,and thus is a feasible surgical method for the minimally invasive treatment of LBS.

Objective:To explore the influences of times of venous thromboembolism (VTE) drug prophylaxis in formation of deep vein thrombosis (DVT) in patients with severe craniocerebral injury after surgical treatment.Methods:Ninety patients with severe craniocerebral injury, admitted to our hospital from February 2021 to December 2021, were chosen in our study; they were divided into early group ( n=47, less than 48 h from the time of admission) and late group ( n=43, more than 48 h from the time of admission) according to the times of initiation for VTE drug prophylaxis (low molecular weight heparin calcium injection [LMWH] 100 IU/Kg was injected subcutaneously once a d). One week after injection, the DVT formation in the lower limbs, intracranial rebleeding, gastrointestinal bleeding and death were compared in the two groups. Results:The times of initiation for drug prophylaxis in the early group and late group were (28.91±4.50) h and (71.56±8.89) h. The DVT formation in the early group was significantly lower than that in the late group (12.8% vs. 34.9%, P<0.05). There was no difference in the incidence of intracranial rebleeding, mortality or gastrointestinal bleeding between the two groups ( P>0.05). Conclusion:Early initiation of VTE drug prophylaxis can significantly reduce the incidence of DVT in patients with severe craniocerebral injury after surgical treatment, enjoying high safety.

Homeostasis ; Taste/physiology* ; Zinc

OBJECTIVE: To prepare customized porous silicone orbital implants using embedded 3D printing and assess the effect of surface modification on the properties of the implants. METHODS: The transparency, fluidity and rheological properties of the supporting media were tested to determine the optimal printing parameters of silicone. The morphological changes of silicone after modification were analyzed by scanning electron microscopy, and the hydrophilicity and hydrophobicity of silicone surface were evaluated by measuring the water contact angle. The compression modulus of porous silicone was measured using compression test. Porcine aortic endothelial cells (PAOECs) were co-cultured with porous silicone scaffolds for 1, 3 and 5 days to test the biocompatibility of silicone. The local inflammatory response to subcutaneous porous silicone implants was evaluated in rats. RESULTS: The optimal printing parameters of silicone orbital implants were determined as the following: supporting medium 4% (mass ratio), printing pressure 1.0 bar and printing speed 6 mm/s. Scanning electron microscopy showed that the silicone surface was successfully modified with polydopamine and collagen, which significantly improved hydrophilicity of the silicone surface (P < 0.05) without causing significant changes in the compression modulus (P > 0.05). The modified porous silicone scaffold had no obvious cytotoxicity and obviously promoted adhesion and proliferation of PAOECs (P < 0.05). In rats bearing the subcutaneous implants, no obvious inflammation was observed in the local tissue. CONCLUSION Poprous silicone orbital implants with uniform pores can be prepared using embedded 3D printing technology, and surface modification obviously improves hydrophilicity and biocompatibility of the silicone implants for potential clinical application.
Animals ; Rats ; Swine ; Silicon ; Orbital Implants ; Endothelial Cells ; Porosity ; Silicones ; Printing, Three-Dimensional