Objective To investigate the risk factors of incision infection in elderly patients of general surgery.Methods The clinical data of 306 elderly patients of general surgery were analyzed retrospectively.The risk factors of incision infection were analyzed.Results The rate of incision infection was 10.5％ (32/306).The rate of incision infection in chronic disease patients was higher than that in non-chronic disease patients [12.9％(27/210) vs.5.2％(5/96)],the rate of incision infection in summer was significantly higher than that in spring,autumn and winter[16.3％(15/92) vs.8.4％(7/83),8.5％(6/71) and 6.7％ (4/60)],the rate of incision infection in operative time longer than 120 min patients was higher than that in operative time less than 120 min patients [15.0％ (18/120) vs.7.5％ (14/186)],the rate of incision infection in emergency surgery patients was higher than that in non-emergency surgery patients [12.3％ (20/162) vs.8.3％(12/144)],there had significantly difference (P＜ 0.05).Conclusion Chronic disease,summer,operative time longer than 120 min,emergency surgery in elderly patients are the mainly risk factors of incision infection in general surgery.

Objective To investigate the potentiality of D3-creatine dilution method to be used in detection of skeletal muscle mass, so as to provide a new method for skeletal muscle mass detection in mice.Methods Four weeks, 10 weeks and 13 months old male C57BL/6 mice (10 each) were used in the present study. All mice were fed with a single dose of D3-creatine (2mg/kg) after testing body composition by EchoMRITM. Urine was collected at 24h, 48h and 72h after creatine administration, and analyzed by liquid chromatography-tandem mass spectrometry mass spectrometry (LC-MS/MS) that was used to determine the creatine pool size. The relationship between creatine pool size and the skeletal muscle mass determined by EchoMRITM was analyzed.Results Both lean body mass and total creatine pool size were aged mice > adult mice > juvenile mice. There was a significant correlation (r=0.687,P=0.000) between the lean body mass measured by EchoMRITM and the total creatine pool size calculated by D3-creatine dilution method.ConclusionThe D3-creatine dilution method may be used to determine the skeletal muscle mass of mice.

Objective To master the current situation of Keshan disease(KD) and its trend in Yunnan Province,and scientifically evaluate the control and prevention measures.Methods According to the 2011 Endemic Disease Prevention and Control Project Implementation Plan and National Keshan Disease Mornitoring Program,choose Eryuang,Dali,Xiangyun,Wuding,Nanhua,Chuxiong and Mouding Counties(Cities)in Yunnan Province,that were seriously affected by Keshan disease,monitoring was carried out; 2 towns were selected in each county,and 1 village was selected as surveillance site in each selected town.All the residents were clinically examined and Electrocardiography tracing was taken.Suspected cases were given filmed chest X-ray and color echocardiography.KD cases were correctly diagnosed according to the diagnostic criteria.Results A total of 6 022 residents were investigated in the 14 investigation sites; 25 cases of KD were found,and the total incidence rate was 0.42％.Among the 25 KD cases,22 cases were latent KD,and the incidence rate was 0.37％; women(15 cases) were more than men (10 cases),and 10 patients were 3-14 years old,accounted for 40.00％(10/25).Potential KD 22 cases,including 10 cases of 3-14 years old; slow type of KD 3 cases,including 2 cases 45-54 years old.Electrocardiographic examination 6 022 residents,the abnormal rate was 20.44％.Among 32 X-ray films,28 cases had a cardiothoracic ratio less than or equal to 0.50,2 cases from 0.51 to 0.55,1 case from 0.56 to 0.60,and 1 case more than or equal to 0.61.Conclusions The results of KD surveillance have presented a downward trend in Yunnan Province,and the incidence rate of KD is lower.But the pathogenic factors are still active,which is harmful to children health in KD areas.In future,surveillance of children KD should be strengthened,control measures should be implemented,in order to guarantee the health of people who lived in KD areas.

Objective In order to master the current prevalence situation of dilated cardiomyopathy in Yunnan Province.Methods An investigation of dilated cardiomyopathy was carried out in 17 counties from August to December in 2011 in non-Keshan disease areas.Two townships (towns) that similar to Keshan disease areas in natural environment,pattern of production and lifestyle in non-Keshan disease areas were selected in each project county,and 1 village was selected as surveillance site in each selected township(town).The number of resident in each village no less than 500 people was appropriate and deficiency was supplemented from neighboring villages.The sampling rate was no less than 80％.Clinical examination and electrocardiographic tracings were carried out.The patients with suspected dilated cardiomyopathy and latent Keshan disease were taken anteroposterior chest X-ray in accordance with the National Non-Keshan Disease Area Dilated Cardiomyopathy Condition Survey Program.The surveillance was carried out based on The National Investigation Scheme of Dilated Cardiomyopathy in Non-Keshan Disease Areas.Cases were diagnosed based on the diagnostic standard of dilated cardiomyopathy and suspected latent Keshan disease.Results In the 34 villages of 17 selected counties,14 545 people were investigated.Twenty-six cases of latent dilated cardiomyopathy and suspected latent Keshan disease were detected,and the total detection rate was 17.88/million.One case was dilated cardiomyopathy,and 25 cases were suspected latent Keshan disease,detection rates were 0.69/million and 17.19/million,respectively.Male and female cases were 15 and 11,respectively.The ratio of people aged 65 and older accounted for 42.31％(11/26),among them suspected latent Keshan disease accounted for 44.00％(11/25),and 1 case of dilated cardiomyopathy was in the 45 to 54 years old group.Electrocardiographic examination of 14 519 people,the abnormal rate was 8.13％(1 180/14 519).Among 112 chest X-ray films,104 cases had a cardiothoracic ratio less than or equal to 0.50,4 cases from 0.51 to 0.55,3 cases from 0.56 to 0.60,and 1 case more than or equal to 0.61.Conclusion The detection rate of dilated cardiomyopathy cases is lower in non-Keshan disease area of Yunnan Province,but suspected latent Keshan disease is detected.

Objective To explore the clinicopathological characteristics of hereditary ovarian cancer syndrome(HOCS). Methods From Jan. 2000 to Jan. 2007, among 580 cases of primary ovarian cancer, 42 cases(herediatary group),who had a positive family history of ovarian cancer and met the diagnostic criteria of HOCS, were analyzed retrospectively. One hundred cases without a family history of ovarian cancer were enrolled randomizely as control group (sporadic group). Results The incidence of HOCS was 7.2% (42/580). Forty-two cases associated tumors affected at least 2 successive generations in 31 families and affected 1 generation in 8 families. Eighty-seven percent (27/31)was from maternal lineage, while 13% (4/31)from paternal lineage. Earlier age of onset was significantly difference between two groups[(49±10) years vs. (55±10) years, P<0.05]. There were 90% belong to serous adenocarcinoma in the herediatary group, while 84% in the sporadic group. There was statistical difference in the proportion of mucinous adenocarcinoma (0 vs. 11%, P<0.05). The most common clinical manifestations were abdominal distention and anorexia (64% vs. 70%, P>0.05), International Federational of Gynecology Obstetrics(FIGO)stage Ⅲ (62% vs. 63%, P>0.05) between two groups. Fourteen cases (33%,14/42) were previously untreated in the herediatary group, while 40 cases (40%, 40/100) in the sporadic group. There were 15 cases (36%, 15/42) underwent secondary surgery and 15 cases (36%, 15/42) underwent third surgery or more in berediatary group, while 50 cases (50%, 50/100) and 27 cases(27%, 27/100) in the sporadic group. The mean number of ehemotberapy cycles received in two groups was 13.3 and 11.8 (P>0.05). The 3-year and 5-year survival rate in herediatary group were 73.6% and 54.9% respectively, compared with 47.4% and 21.2% (P<0.05) in sporadic group. Conclusion Hereditary ovarian cancer mostly from maternal lineage are featuring in early age of onset, serous adenocarcinoma, advanced stage (stage Ⅲ), and better prognosis after the comprehensive treated by cytoreductive surgery plus with chemotherapy.

Yunnan unexplained sudden death is mostly cardiac sudden death caused by malignant arrhythmia, which is a special endemic disease that seriously threatens the health of people in the disease area, and is one of the important public health problems in Yunnan Province. The epidemiological characteristics of Yunnan unexplained sudden death are characterized by a high incidence of young and middle-aged people, and a clear clustering of ethnic groups, families, and villages. The etiology of this disease is not yet fully understood, and the main etiological studies include Trogia venenata poisoning, enterovirus infection, and hereditary heart disease, and hypothesis of the etiology of Keshan disease. After the implementation of comprehensive intervention measures such as health education based on abstinence from Trogia venenata, improving of production and living conditions in the disease area, and strengthening of health monitoring of the population in the disease area, the incidence has shown a significant downward trend in recent years.

The etiology of Yunnan unexplained sudden death (YUSD) is still unknown, and it has been a serious endemic public health problem in Yunnan Province for a long time. Currently, known studies have shown that this disease is caused by multiple etiological factors. Due to limited study methods in the past, there are still certain limitations in understanding this disease. This article systematically reviews the etiological theories of YUSD since its first report, elaborates on the correlation between this disease and enterovirus infection, and combines metagenomic next-generation sequencing technology to make a prospect, in order to provide reference for future etiological studies.

Objective To analyze the characteristic of Yunnan unexpected sudden death (YUSD) cases by pathological diagnosis of arrhythmogenic right ventricular cardiomyopathy (ARVC),in order to offer clue for ARVC etiologic research of YUSD.Methods The pathological diagnosis results of 9 cases of sudden death of ARVC in Yunnan,as well as epidemiological investigation data,were used to comprehensively analyze the pathological features of the pathological diagnosis of ARVC in Yunnan.Results The 9 cases including 8 females and 1 male,aged 16-47 years.The sudden death time was from June to August,mainly distributed in 8 families from the disease seriously ridden 7 villages.Three of them had a genetic history of family YUSD,2 cases had a history of mental stimulation,1 case had eaten Trogia venenata;and acute symptoms and signs were palpitation,chest tightness,shortness of breath,and loss of consciousness.Pathological observations were the typical ARVC change,mainly right ventricular lesions,with different degrees of cardiac enlargement and extensive adipose tissue infiltration in the ventricular wall.Among them,6 cases of fat infiltration almost reached the full thickness of the heart wall.In addition to the pathological changes of ARVC,8 cases were accompanied by one or several pathological changes in myocarditis,cardiac dysplasia,nephropathy,pulmonary edema,pneumonia and pancreatitis.Of the 9 cases,5 cases were diagnosed with ARVC,2 cases with ARVC and pulmonary edema,1 case with ARVC and acute hemorrhagic necrotizing pancreatitis,and 1 case with ARVC and Trogia venenata poisoning.The clinical examination abnormalities of the family members of the cases mainly showed arrhythmogenic electrocardiography changes and abnormal myocardial enzymes.Conclusions The nine cases have showed typical epidemiology characteristics of YUSD,and cardiachistological changes are consistent with the ARVC pathological diagnostic criteria.A part of YUSD cases may be caused by ARVC,and the inference will be proved by cadaveric pathologic examination and related pathogenic gene detection.

Objective:To understand the electrocardiogram and echocardiography examination results of population in key areas of unexplained sudden death in Yunnan Province (referred to as Yunnan sudden death).Methods:From 2014 to 2022, electrocardiogram examination was performed on population (including same incident cases, relatives of the cases, villagers of the affected villages, and control individuals) in key areas of Yunnan sudden death from May to October each year. Echocardiography examination was performed on relatives of the cases and villagers of the affected villages, and the types of electrocardiogram and echocardiography changes were sorted out and analyzed.Results:Electrocardiogram examination was conducted on 1 same incident case, 241 relatives of the cases, 464 villagers of the affected villages, and 99 control individuals, respectively. The types of electrocardiogram changes in the same incident case were Q-T interval prolongation and sinus tachycardia. A total of 17 types of electrocardiogram changes were detected in the relatives of the cases, mainly including sinus arrhythmia (12.45%, 30/241), sinus bradycardia (11.20%, 27/241), and left axis deviation (8.30%, 20/241). A total of 21 types of electrocardiogram changes were detected in the villagers of the affected villages, mainly including left axis deviation (9.48%, 44/464), sinus bradycardia (8.19%, 38/464), and T-wave abnormalities (7.76%, 36/464). A total of 10 types of electrocardiogram changes were detected in the control individuals, mainly including sinus arrhythmia (12.12%, 12/99), T-wave abnormalities (9.09%, 9/99), and sinus bradycardia (7.07%, 7/99). Echocardiography examination was conducted on 49 relatives of the cases and 365 villagers of the affected villages, respectively. A total of 12 types of echocardiography changes were detected in the relatives of the cases, mainly including tricuspid regurgitation (18.37%, 9/49), decreased right ventricular diastolic function (8.16%, 4/49), aortic regurgitation (6.12%, 3/49), and atrial septal defect (6.12%, 3/49). A total of 15 types of echocardiography changes were detected in the villagers of the affected villages, mainly including tricuspid regurgitation (8.77%, 32/365), aortic regurgitation (6.85%, 25/365), and decreased left ventricular diastolic function (6.58%, 24/365).Conclusion:There are many types of changes in electrocardiogram and echocardiography in the population of key areas of Yunnan sudden death.

Objective:To study the expression and clinical significance of alpha-1 antitrypsin (A1AT) in the serum of patients with antiphospholipid syndrome (APS).Methods:The study recruited 131 patients with APS, 48 patients with other autoimmune diseases (8 patients with rheumatoid arthritis, 8 with osteoarthritis, and 32 with systemic erythematous sores), and 49 healthy people were recruited. The patients were admitted to Peking University People's Hospital during January 2019 to June 2022. A1AT expression in the serum of patients with APS and its clinical significance were investigated. Blood samples were collected and the concentration of A1AT in the samples was determined by enzyme-linked immunosorbent assay (ELISA). The correlation between A1AT and clinical and laboratory parameters of APS patients was analyzed. Statistical analysis and graphing were performed using GraphPadPrism 10.1.2. The categorical variables were subjected to the χ2 test, and the continuous variables were subjected to the normal distribution test. If the sample were normally distributed, the independent sample t-test (with homogeneity of variance) or the Welch's t-test (with heterogeneity of variance) was used for comparison between the 2 groups, and one-way analysis of variance (ANOVA) was used for comparison among multiple groups; Otherwise, and the variables were described as M( Q1, Q3), the Mann Whitney U-test was used for comparison between 2 groups, and the Kruskal-Wallis U-test was used for comparison among multiple groups. The Kruskal-Wallis H test was used for multiple comparisons. If the samples were normally distributed, Spearman correlation analysis was used to determine the correlation, otherwise, Pearson correlation analysis was used. Results:The serum A1AT concentrations were significantly higher in APS patients than in patients with other autoimmune diseases [2 048.0(670.6, 2 904.0) μg/ml vs. 1 099.0(0, 1 855.0) μg/ml, U=1 990, P<0.001] and healthy people [2 048.0(670.6, 2 904.0) μg/ml vs. 739.5 (0, 1 232.0) μg/ml, U=1 485, P<0.001]. No statistically significant difference was observed between patients with other autoimmune diseases and healthy people [1 099.0(0, 1 855.0) μg/ml vs. 739.5 (0, 1 232.0) μg/ml, U=924, P=0.060]. Mean serum A1AT concentrations were also higher in patients with both a history of adverse pregnancy and thrombosis than in those with morbid pregnancy only [(3 212 ±1 744)μg/ml vs. (1 965 ±1 500) μg/ml, t=2.27, P=0.026] and thrombosis only [(3 212 ±1 744)μg/ml vs. (1 963 ±1745)μg/ml, t=2.01, P=0.048]. Mean serum A1AT concentrations were higher in patients with both arterial and venous thrombosis than in those with only venous thrombosis [(3 390 ±2 286) μg/ml vs. (2 148 ±1 648) μg/ml, t=3.04, P=0.004]. The mean A1AT concentration was higher in patients with recurrent thrombosis than in patients with single thrombosis [(2 709 ±1 941) μg/ml vs. (1 805 ±1 627) μg/ml, t=2.10, P=0.040]. Using the 95% upper limit of A1AT concentration in healthy controls (1 066 μg/ml) as a cut-off value, the risk of recurrent thrombosis was higher in A1AT-positive than negative TAPS patients [51.0%(25/49) vs. 26.1%(6/23), χ2=3.97, P=0.046]. In terms of laboratory indicators, there was a significant positive correlation between serum A1AT concentration and ESR level ( r=0.28, P=0.045), a significant negative correlation with C4 level ( r=-0.24, P=0.025). There was a significant positive correlation with fibrinogen (FIB) concentration( r=0.25, P=0.027). A1AT was an effective diagnostic marker of APS [AUC(95% CI)=0.769(0.699, 0.847), P<0.001], with a sensitivity of 71.8%, a specificity of 73.7%, and Youden index of 0.452. Conclusion:A1AT was is significantly elevated in the serum of patients with APS and may be associated with the severity of thrombotic event.