1.Effect of improved posterolateral minimally invasive approach combined with modular femoral head prosthesis in treatment of femoral neck fractures in elderly patients
Zhitao RAO ; Shuqing WANG ; Jiaqi WANG ; Xiaohui MIN ; Peng ZHANG ; Jiong MEI
Chinese Journal of Trauma 2012;28(4):343-347
Objective To compare the clinical effects of improved posterolateral minimally invasive approach and traditional posterolateral approach combined with modular femoral head prosthesis in the treatment of femoral neck fractures in the elderly. Methods The study involved 70 patients with femoral neck fractures (26 males and 44 females; at age range of 67-95 years,mean 78.3 years) treated from October 2008 to June 2010.There were 62 patients with fresh femoral neck fractures and eight with old femoral neck fractures (2-4 months post-injury),all of whom were type Ⅲ or Ⅳ fractures according to the Garden' s classification.All surgeries were completed by the same operation group.The improved posterolateral minimally invasive approach group involved 32 patients including 12 males and 20 females and the traditional posterolateral approach group involved 38 patients including 14 males and 24 females.The two groups were compared in aspects of incision size,operative time,perioperative complications,prosthesis stability and hip functional recovery. Results All patients were followed up for an average of 16 weeks (range,12-18 weeks).The differences between the two groups were significant regarding the incision length,perioperative blood loss,and blood product transfusio amount (P <0.01 ),but insignificant in operative time ( P > 0.05 ).All patients were able to take weight-bearing walk six weeks postoperatively.The two groups showed significant difference in the hip joint function by Chamley's criteria six weeks postoperatively ( P < 0.05 ),but insignificant difference in the hip joint function by Harris' s criteria at the last follow-up ( P < 0.05). Conclusion The modified posterolateral minimally invasive approach combined with modular femoral head prosthesis is a satisfactory method in treatment of femoral neck fractures in senile patients,for it can result in less intra-operative soft tissue damage and blood loss,as well as shorter rehabilitation time.
2.The clinical comparative study on the therapeutic effects of NICU patients implemented by NICU professional doctors and non-NICU professional doctors
Linyue GUO ; Peng WANG ; Chuang GAO ; Wanqiang SU ; Jinhao HUANG ; Yu QIAN ; Jiaqi WANG ; Zhitao GONG ; Yiming SONG ; Jian SUN ; Rongcai JIANG
Tianjin Medical Journal 2017;45(8):833-837
Objective To explore the implementation styles on the therapeutic effects on the neurosurgical intensive care unit (NICU) patients. Methods Patients were enrolled during February 3, 2015 to February 3, 2016. The key point time was August 3, 2015 when the treatment in our NICU was fully implemented by NICU professional doctors. Based on this time point, all the enrolled patients were divided into non-NICU professional doctor implementing (NNPDI) group and NICU professional doctor implementing (NPDI) group. Thus non-NICU professional doctors and professional doctors were the leaders of diagnosis and treatment in tow groups. The length of hospital stay, complications, prognosis and other therapeutic outcomes were compared between two groups. Results The length of hospital stay was longer in NPDI group than that in NNPDI group (P<0.05). The incidence of water-electrolyte imbalance was lower in NPDI group than that in NNPDI group (P<0.05). There were no significant differences in the incidence of the ventilator-associated pneumonia (VAP), the hepatic and renal insufficiency, the intracranial infections and stress ulcers between the two groups (P>0.05). The proportion of referral to other wards and fatality rate were both lower in NPDI group than those in NNPDI group (P<0.05). And the discharge rate from NICU was higher in NPDI group than that of NNPDI group (P<0.05). There was no significant difference in the rate of patients left hospital without treatment between the two groups (P>0.05). Conclusion The NICU professional doctor implementing may be contribute to, at least in part, the improving of prognosis of NICU patients without obvious advantages in most complications. The level of professional management remains to be improved.
3.Analysis on Nutritional Status of Vitamin D Among Adults of 6 Ethnic Minority Groups Native to Yunnan Province
Nan ZHANG ; Yanling YANG ; Qingqing WAN ; Jiang ZHAO ; Min PENG ; Xiao ZHU ; Zhitao LIU ; Qiang ZHANG
Journal of Kunming Medical University 2024;45(2):105-111
Objective To assess the nutritional status of vitamin D and associated factors among adults of six ethnic minority groups native to Yunnan Province,and provide evidence for policy making.Methods Between May 2019 and August 2020,a total of 690 adults were selected from Jinuo,Bulang,Jingpo,Deang,Achang and Pumi ethnic groups according to the sex and age composition in the 6th national census.A questionnaire survey and an anthropometric examination were conducted by trained health workers,and serum 25(OH)D levels were determined with high-performance liquid chromatography-tandem mass spectrometry.Results The median of serum 25(OH)D was 28.7(P25~P75∶24.3~33.8)ng/mL,and the prevalence of vitamin D sufficiency,insufficiency and deficiency were 44.2%、47.5%and 8.3%,respectively.There were significant differences in serum 25(OH)D levels among the six ethnic groups(χ2=139.29,P<0.01).Multivariate logistic regression showed that ethnic groups living in higher latitude areas(Pumi,Jingpo,Deang,and Achang),women,and those whose BMI≥24.0 were more likely to be vitamin D insufficient or deficient.Conclusion More than half of the ethnic adults suffer from vitamin D malnutrition which also varies across ethnicities.Further surveillance and interventions among key areas and populations are needed.
4.Micro RNA-122 aggravates brain parenchymal injury in mice after ischemia-reperfusionby down-regulating insulin-like growth factor type 1 receptor
Bin LUO ; Yujue WANG ; Hengxing YOU ; Zhitao PENG ; Xiaowen LIAN
Chinese Journal of Neuromedicine 2018;17(12):1210-1216
Objective To investigate the effect of micro RNA (miR)-122 on cerebral ischemia/reperfusion (I/R) injury and its mechanism in mice. Methods Thirty-six male C57BL mice were randomly divided into a sham-operated group, a model group, a miR-122 mimics group and a miR-122 inhibitor group (n=9). The miR-122 NCs, inhibitor fragments and overexpression fragments were injected into the lateral ventricles of mice from the later 3 groups; 10 min after that, middle cerebral artery I/R injury models were induced by reforming Longa method. Twenty-four h after model making, real-time fluorescent quantitative PCR (qRT-PCR) was used to detect the miR-122 and insulin like growth factor 1-receptor (IGF-1R) mRNA expressions; cell apoptosis in the peripheral region of cerebral infarction was detected by immunofluorescent staining; the volumes of cerebral infarction and brain edema were measured by TTC staining; and IGF-1R protein expression was detected by Western blotting. Results As compared with the sham-operated group, the model group had significantly increased miR-122 expression and significantly increased brain infarction volume and edema volume (P<0.05). As compared with the model group, miR-122 mimics group had significantly increased miR-122 expression and significantly increased brain infarction volume and edema volume (P<0.05), while miR-122 inhibitor group had statically decreased miR-122 expression and significantly decreased brain infarction volume and edema volume (P<0.05). The number of apoptosis of peripheral cells in the cortical infarction area of mice in the sham-operated group, model group and miR-122 mimic group became lager successively, while the number of apoptosis of peripheral cells in the cortical infarction area of mice in the miR-122 inhibitor group was smaller than that in the model group. The IGF-1R mRNA and protein expressions in the cortical infracted peripheral zone of model group were significantly decreased as compared with those in the sham-operated group (P<0.05); the IGF-1R mRNA and protein expressions in the miR-122 mimics group were significantly decreased as compared with those in the model group (P<0.05), while those in the miR-122 inhibitor group were significantly increased as compared with those in the model group (P<0.05). Conclusion MiR-122 may be involved in the regulation of cerebral I/R for brain injury by inhibition of IGF-1R pathway.
5.Intervention effect of low temperature plasma air purifier in highway toll booths
Songrong LIU ; Shijun ZHOU ; Yanping XIAO ; Peng ZHOU ; Zhitao YAN ; Fei MA ; Yongli ZHONG ; Jiao CAI ; Wei LIU
Journal of Environmental and Occupational Medicine 2024;41(5):474-481
Background The serious air pollution of highway toll booths poses a high occupational exposure risk to toll collectors. It is urgent to develop purification methods suitable for airborne particles and microbial pathogens in highway toll booths. Objective To verify the purification effect of low temperature plasma air purifiers on airborne particles and microbes in highway toll booths. Methods Based on controlled-intervention design, we selected three toll booths in an expressway toll station as on-site experimental locations for 6 d (no-intervention period: the low-temperature plasma purifier was turned off in the first three days; intervention period: the purifier was turned on from 9:00 to 17:00 in the following three days). The indoor and outdoor PM2.5 and PM10 concentrations were continuously monitored during the study. At 9:00, 12:00, and 17:00 of every day during the experiment, indoor and outdoor air samples were collected to analyze the concentration of airborne culturable colonies with a plankton sampler. Airborne particle samples were collected in the outermost exit continuously from 9:00 to 17:00 every day during the experiment using a medium flow particulate sampler, and the species and relative abundance of fungi and bacteria contained in the samples were analyzed by gene sequencing. Independent-sample t test was used to compare the concentration of indoor PM2.5, PM10, and culturable colonies between the intervention period and the non-intervention period. α diversity analysis, β diversity analysis, and t test were used to compare the diversity and relative abundance of specific species of bacteria and fungi, as well as typical pathogenic bacteria and fungi in the samples between the non-intervention period and the intervention period to reflect the purification effect of low temperature plasma air purifier on airborne PM2.5, PM10, and microorganisms. Results During the intervention period, the mean indoor concentrations of PM2.5, PM10, and culturable colonies were lower than those of the no-intervention period (P<0.01 or P<0.001). The ratios of indoor to outdoor concentration (I/O) of PM2.5 and PM10 during the intervention period were significantly lower than those of the no-intervention period (P<0.001), except the I/O of culturable colonies. Compared with the average concentration at 9:00, the average cleaning rates at 12:00 and 17:00 for PM2.5 were 49.0% and 46.1%, for PM10 were 49.7% and 45.4%, for airborne culturable colonies were 50.8% and 49.9%, respectively. The β diversity analysis showed that there were significant differences in composition at the level of species of bacteria, and at the levels of genus and species of fungi between the intervention and the no-intervention periods. The relative abundances of 10 species of bacteria such as Lactobacillus and 7 species of fungi such as Torula in the intervention period were significantly lower than those in the non-intervention period, but the relative abundances of fungi such as unclassified_f_cladosporiaceae, trichomerium, and cercospora were higher (P<0.05). For typical pathogenic bacteria, the relative abundances of Lactobacillus and Clostridium_sensu_stricto_1 during the intervention period were 73.5% and 86.9% lower than those in the no-intervention period, and the relative abundance of Talaromyces was 53.5% lower (P<0.05). Conclusion Low temperature plasma air purifier has a good purification effect on indoor PM2.5, PM10, and culturable colonies in highway toll booths, and likely a limited effect on some fungi.
6.Evaluation of the effect of meteorological risk forecasting service intervention on acute onset and medical expenses of patients with COPD in Pudong New Area of Shanghai
Zhitao LI ; Xiaonan WANG ; Xiaolin LIU ; Juzhong KE ; Yang LIU ; Chaowei FU ; Qingping LIU ; Jiaojiao GAO ; Jiahui SONG ; Kang WU ; Li PENG ; Xiaofang YE ; Xiaonan RUAN
Shanghai Journal of Preventive Medicine 2024;36(2):197-202
ObjectiveTo evaluate the intervention effect of meteorological risk forecasting service on acute onset and medical expenses of chronic obstructive pulmonary disease(COPD) patients, and to provide scientific basis for the establishment of health management model for chronic obstructive pulmonary disease(COPD) patients. MethodsStudy subjects were recruited from chronic obstructive pulmonary patients aged ≥40 in Pudong New Area. Propensity score matching method was used to determine the intervention group and the control group. The control group received regular health education and follow-up management, and the intervention group was provided with meteorological and environmental risk forecasting services through WeChat, mobile phone short message service(SMS)and telephone. Finally, a total of2 589 subjects were included in the analysis, including 1 300 in the intervention group and 1 289 in the control group. General demographic data, past medical history and family history of COPD, COPD related knowledge and practice survey, COPD related symptom assessment, acute onset, health service utilization and medical expenses before and after intervention were collected through questionnaire survey. The differences of acute attack, health service utilization and related medical expenses between the two groups before and after intervention were compared to evaluate the intervention effect. ResultsIn terms of acute attacks, after intervention, the incidence of acute attacks in the intervention group was lower than that before intervention(χ2=52.901, P<0.001), and the incidence of acute attacks in the groups with different intervention methods was lower than that before intervention (P<0.001). WeChat had the best effect, decreasing the incidence by 14.4%, followed by mobile phone SMS SMS decreasing by 12.3%. In terms of utilization of health services, the outpatient rate due to acute attack was lower in the intervention group after intervention than that before intervention (χ2=7.129, P=0.008), and the outpatient rate due to acute attack was lower in the subjects who received the forecast service through mobile phone SMS than that before intervention (χ2=4.675, P<0.001). In terms of medical expenses, there was no significant difference between control group and intervention group with different intervention methods before intervention (P>0.05). After intervention, the difference between the control group and the intervention group with different intervention methods was statistically significant (H=11.864, P<0.05). The results of multiple comparisons showed that compared with the control group, the average annual medical expenses of patients receiving mobile phone SMS and telephone forecasting services after intervention were lower than those of the control group, and the difference was statistically significant (P<0.05). ConclusionMeteorological risk forecasting service can reduce the acute onset of COPD, reduce the rate of consultation and medical expenses due to acute onset, and provide scientific basis for the basic COPD health management model.