OBJECTIVE: To explore the early changes in various liver function indicators in critically injured trauma patients assessed by intelligent calculation method, aiming to develop more advantageous diagnostic and treatment strategies for traumatic liver injury. METHODS: A retrospective study was conducted. Critically injured trauma patients [injury severity score (ISS) ≥ 16, age > 18 years old] admitted to the Emergency Medical Center of Tianjin Fifth Central Hospital from January 1, 2022, to December 1, 2023 were enrolled. ISS score and acute physiology and chronic health evaluation II (APACHE II) assessed by intelligent calculation method were collected upon patient admission to the emergency medical center. Trends in liver function indicators in fasting venous serum were analyzed at 6, 24 and 72 hours after admission, including alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), γ-glutamyl transferase (GGT), lactate dehydrogenase (LDH), albumin (ALB), total bilirubin (TBil), prothrombin time (PT). Patients were grouped based on APACHE II scores into those with APACHE II < 15 and APACHE II ≤ 15, and liver function indicators within 6 hours of admission were compared between the two groups. RESULTS: A total of 112 critically injured trauma patients were included, with 83 males and 29 females, an average age of (47.78±14.84) years old. The median ISS score was 21.0 (18.0, 26.0). The most common cause of injury for critically injured trauma patients was road traffic accidents (68 cases, accounting for 60.71%), followed by falls from heights, compression injuries, heavy object injuries, knife stabs, and explosion injuries. The most common injured areas was the limbs and pelvis (97 cases, accounting for 86.61%), followed by chest injuries, surface skin and soft tissue injuries, abdominal and pelvic organ injuries, head injuries, and facial injuries. The proportion of elevated LDH, AST, and ALT within 6 hours of admission was 77.68%, 79.46%, and 52.68%, respectively, while the proportion of decreased ALB was 75.89%, the abnormal rates of ALP, GGT, TBil, and PT were all below 50%. The ALT and AST levels of patients at 24 hours and 72 hours after admission were significantly lower than those at 6 hours after admission [ALT (U/L): 37.0 (22.0, 66.0), 31.0 (21.2, 52.0) vs. 41.0 (25.0, 71.0), AST (U/L): 55.5 (30.0, 93.5), 40.0 (27.0, 63.2) vs. 69.5 (39.0, 130.8), all P < 0.05]. There was no statistically significant difference in ISS score between APACHE II > 15 group (45 cases) and APACHE II ≤ 15 group [67 cases; 21.0 (18.5, 26.5) vs. 20.0 (17.0, 22.0), P > 0.05]. Nevertheless, compared with patients with APACHE II ≤ 15, patients with APACHE II > 15 have a higher abnormality rate of ALT and AST within 6 hours of admission [ALT abnormal rate: 66.44% (29/45) vs. 44.78% (30/67), AST abnormal rate: 93.33% (42/45) vs. 70.15% (47/67), both P < 0.05], and the levels of ALT and AST were higher [ALT (U/L): 56.0 (30.0, 121.0) vs. 35.0 (21.0, 69.0), AST (U/L): 87.0 (48.0, 233.0) vs. 52.0 (31.0, 117.0), both P < 0.05]. CONCLUSIONS Severe trauma patients frequently exhibit a high incidence of reversible early liver function impairment. Based on intelligent calculation method, the utilization of both the ISS and APACHE II scores demonstrates a distinct advantage in the assessment of their early liver injury.
Humans ; Retrospective Studies ; Liver/physiopathology* ; Risk Assessment ; APACHE ; Wounds and Injuries ; Adult ; Injury Severity Score ; Male ; Middle Aged ; Female ; Liver Function Tests ; Alanine Transaminase/blood* ; Young Adult ; Aspartate Aminotransferases/blood*

Aortic aneurysm/dissection is the primary cause of mortality in patients with Marfan syndrome(MFS).Though aberrant activation of the transforming growth factor-β(TGF-β)pathway has been considered the central pathogenic mechanism for MFS aortic aneurysms,recent research has gradually revealed the involvement of other signaling pathways in MFS.This review summarizes the latest researches on the molecular mechanisms of MFS,including classical TGF-β and related signaling pathways such as Notch and nitric oxide(NO),as well as epigenetics and gene therapy,which provide new insights for the prevention and treatment of MFS.

Ankylosing spondylitis (AS) is a chronic inflammatory disease characterized by inflammation of the sacroiliac joints and the spinal attachment point and is the most common type of spondyloarthritis (SpA). The pathogenesis of AS is related to both the immune system and the skeletal system. The main pathological changes include enthesitis, osteogenesis changes, osteolytic bone destruction, and immune system changes. Bone cells interact with immune cells, secrete a series of inflammatory factors, and jointly regulate the pathogenesis of AS. The imbalance of various immune cells in AS and the changes in inflammatory cytokines lead to a disorder of bone metabolism. At the same time, the osteocytes express various inflammatory cytokines, which leads to an imbalance of the immune system. The interaction between the immune system and the skeletal system has become a hot spot in the pathogenesis of AS. Understanding the bone immunological mechanism of AS will help to understand the exact pathogenesis of the disease and explore new treatment methods for it. In this review, the changes of various immune cells and inflammatory cytokines in AS and their effects on the skeletal system, as well as the changes of various osteocytes in the skeletal system and their effects on the immune system, were reviewed, and the latest progress in the treatment of AS was summarized.

Objective To explore the effect of virtual reality video games on gross motor skills of children with cerebral palsy.Methods The 56 patients with cerebral palsy treated in the Fifth Affiliated Hospital of Zhengzhou University from April 2015 to April 2017 were selected as the subjects.The age of the patients was (5.4 ± 1.2) years old (5-7 years old).According to the results of Gross Motor Function Classification System (GMFCS) assessment,all patients belonged to level Ⅰ-Ⅱ.All patients were randomly divided-into 2 groups:video-game group and conventional exercise group for 6 weeks of functional exercise.The evaluation criteria included the average exercise time,the 6-minute walk test (6MWT) and general motion function challenge module (GMFMS-CM) measurement and evaluation.Results The average exercise time of video games in video game group was (44.2 ± 6.1) minutes.The encouragement from the therapists in the intervention process was very important.The technical problems also had a relatively high proportion,and the technical guidance and training should be emphasized at the beginning of the study.The average score of the Likert scale showed that the practice program was suitable for the patients;GMFMS-CM in video game group was significantly higher [mean difference was 4.8,the quartile (IQP) was 4.68,Z =-2.025,P =0.035],while conventional exercise group showed an increasing trend which was not significantly different;6MWTshowed a significant increase in the mean level of video-game group (mean difference was 69.1 m,IQR was 40.2 m,Z =-2.108,P =0.045),conventional exercise group was significantly lower than the average level of subjects in video-game group and there was no significant change in the study period.Conclusion For children with cerebral palsy,routine functional rehabilitation exercise plus family-style virtual reality video game practice,on the one hand to improve patient compliance with the treatment,on the other hand can significantly improve their physical movement function,which is conducive for the patients' quality of life and self-care ability.

Objective To evaluate the efficacy and safety of Qingpeng ointment for the treatment of localized eczema in children.Methods A multicenter,randomized,open-labeled,tacrolimus 0.03％ ointment-controlled clinical trial was conducted.A total of 442 children with localized eczema were enrolled into this study,and divided into 2 groups to topically apply Qingpeng ointment (Qingpeng group) and tacrolimus 0.03％ ointment (tacrolimus group) respectively twice a day for 2 weeks.The children were followed up before the treatment and 1,2 weeks after the treatment,and the efficacy and safety were evaluated at the same time.Results Clinical data from 426 children were included in the efficacy analysis.At 1,2 weeks after the treatment,there were no significant differences in the response rate between the Qingpeng group and tacrolimus group (1 week after the treatment:78.92％ vs.81.77％,x2 =0.545,P =0.460;2 weeks after the treatment:98.65％ vs.97.54％,x2 =0.721,P =0.396).However,the pruritus scores at 1,2 weeks after the treatment were both significantly lower in the Qingpeng group than in the tacrolimus group (1 week:F =14.001,P =0.000;2 weeks:F =11.252,P =0.001).At 1 week after the treatment,the incidence rate of adverse reactions was significantly lower in the Qingpeng group than in the tacrolimus group (P ＜ 0.05).Mild itching,burning sensation and other local irritant sensations were the most common adverse reactions.Conclusion Qingpeng ointment is safe and effective for the treatment of localized eczema in children with good tolerability.

Objective To study effect of a novel schiff base ruthenium coordination compound on cell proliferation and apoptosis of gastric cancer SGC-7901 cell.Method Gastric cancer SGC-7901 cell were divided into four groups according to different treatment of novel schiff base ruthenium coordination compound (concentration of 10, 30, 50μmol/L) and blank group with DMSO.Cell proliferation was detected by MTT assay, cell apoptosis and cell cycle were analysed by flow cytometry.ResuIts MTT results showed the inhibitory effect of novel schiff base ruthenium coordination compound on SGC-7901 cell enhanced with the increase of its concentration, and inhibitory rates were higher than that of blank group at 24, 48, 72 h.Flow cytometry results showed the apoptosis rate of novel ruthenium coordination compound groups of 10, 30, 50μmol/L were (17.64 ±1.21)%, (26.47 ± 0.61)%, (55.63 ±1.49)%, respectively, all higher than that of blank group (P<0.05).The cell proportion of G1 phase increased with the increasing of the novel schiff base ruthenium coordination.ConcIusion A novel schiff base ruthenium coordination compound could inhibit the growth of gastric cancer SGC-7901 cells, promote apoptosis and arrest gastric cancer SGC-7901 cells at G1.