It has been found that the incidence of cardiovascular disease in patients with lower limb amputation is significantly higher than that in normal people, and the risk of developing coronary atherosclerosis is much higher than that in other high-risk groups. Numerous studies have confirmed that high systolic and diastolic blood pressures are potential risk factors for coronary artery disease, and it has been demonstrated that the ascending aortic pressure during diastole increases after amputation. However, the relationship between lower limb amputation and coronary atherosclerosis has not been fully explained from the perspective of hemodynamic environment. Therefore, in this study, a centralized parameter model of the human cardiovascular system and a three-dimensional model of the left coronary artery were established to investigate the effect of amputation on the hemodynamic environment of the coronary artery. The results showed that the abnormal hemodynamic environment induced by amputation, characterized by factors such as increased diastolic pressure in the ascending aorta, led to a significant expansion of the low wall shear stress (WSS) region on the outer lateral aspect of the left coronary artery bifurcation during diastole. The maximum observed increase in the area of low WSS reached up to 50.5%. This abnormal hemodynamic environment elevates the risk of plaque formation in the left coronary artery. Moreover, the more severe the lower limb atrophy, the greater the risk of coronary atherosclerosis in amputees. This study preliminarily reveals the effect of lower limb amputation on the hemodynamic environment of the left coronary artery.
Humans ; Hemodynamics/physiology* ; Amputation, Surgical/adverse effects* ; Coronary Vessels/physiology* ; Coronary Artery Disease/etiology* ; Lower Extremity/surgery* ; Models, Cardiovascular ; Blood Pressure

Aortic intramural hematoma and pulmonary embolism are two rapidly progressive and life-threatening diseases. A 65-year-old male patient with descending aortic intramural hematoma and pulmonary embolism underwent pulmonary embolectomy and descending aortic stent-graft placement, with good postoperative results.

Antimicrobial resistance (AMR), is regarded as one of the top 10 global public health threats. Addressing AMR through the One Health strategy has become a global consensus. AMR monitoring plays a crucial role as the cornerstone of AMR response strategies. This study thoroughly analyzed current situation and progress of AMR monitoring based on the One Health concept in China, the United Kingdom, the United States, and the European Union, and comprehensively compared the similarities and differences of AMR monitoring systems across these countries and regions. The research found that cross-national, cross-regional, and cross-sectoral cooperation in AMR monitoring is increasingly strengthening. However, notable discrepancies still exist among different countries and regions. Notably, most AMR monitoring systems prioritize human and animal health, with relatively insufficient monitoring in the environmental sector. Given the current landscape, China still needs to continue to promote standardized AMR monitoring data sharing and integration across the human, animal, food, and environmental fields, striving to construct a comprehensive and systematic "whole-chain" AMR monitoring system to better tackle this global public health challenge effectively.

Vascular injury resulting from lower limb amputation leads to the redistribution of blood flow and changes in vascular terminal resistance, which can affect the cardiovascular system. However, there was no clear understanding of how different amputation levels affect the cardiovascular system in animal experiments. Therefore, this study established two animal models of above-knee amputation (AKA) and below-knee amputation (BKA) to explore the effects of different amputation levels on the cardiovascular system through blood and histopathological examinations. The results showed that amputation caused pathological changes in the cardiovascular system of animals, including endothelial injury, inflammation, and angiosclerosis. The degree of cardiovascular injury was higher in the AKA group than in the BKA group. This study sheds light on the internal mechanisms of amputation's impact on the cardiovascular system. Based on the amputation level of patients, the findings recommend more comprehensive and targeted monitoring after surgery and necessary interventions to prevent cardiovascular diseases.
Animals ; Animal Experimentation ; Cardiovascular System ; Cardiovascular Diseases ; Hypertension ; Amputation, Surgical

Objective: To establish a hypertension risk assessment model among the middle-aged and elderly populations based on residents' electronic healthcare records of the basic public health service program, so as to provide insights into prevention of hypertension. Methods: Demographic features and physical examinations were collected among residents at ages of 40 years and older from residents' electronic healthcare records of the basic public health service program in a county of Zhejiang Province from 2019 to 2020. The risk factors of hypertension were identified using a multivariable logistic regression model, and the odds ratio (OR) for each risk factor was transformed into approximate relative risk (RR), which was included in the formula for calculation of the disease risk proposed by Harvard School of Public Health to create a hypertension risk assessment model. The predictive value of the model was evaluated using a receiver operator characteristic (ROC) curve. Results: Totally 7 275 subjects were enrolled, with a mean age of (66.15±7.91) years, and the participants included 3 189 males and 4 086 females, with a male-to-female ratio of 0.78∶1. There were 190 cases with new-onset hypertension (2.61%). Multivariable logistic regression analysis revealed that overweight, obesity, central obesity, borderline high triacylglycerol (TG), elevated TG, abnormal fasting plasma glucose (FPG), prehypertension and family history of hypertension were included in the hypertension risk assessment model, with approximate RR values of 1.66, 1.96, 1.54, 1.17, 1.64, 1.45, 1.69 and 1.11. The area under the ROC curve (AUC) of the model was 0.678 (95%CI: 0.641-0.715, P<0.001), and the optimal positive cut-off was 0.899. The model predicted 139 subjects with RR>0.899 for hypertension, with a sensitivity of 73.16% and specificity of 55.79%. Conclusions The hypertension risk assessment model created in this study is feasible to predict the RR for developing hypertension among the middle-aged and elderly populations, which has a predictive value in healthcare management.

Objective To investigate the regulation and mechanism of microRNA (miR)-98-5p on cisplatin sensitivity in cisplatin-resistant cervical cancer cells. Methods The cisplatin(DDP) +miR-NC group (transfected miR- NC), DDP + miR-98-5p group (transfected miR-98-5p mimics), DDP + si-NC group (transfected si-NC), DDP + si- ribonucleotide reductase subunit M2 (RRM2) group (transfected si-RRM2), DDP + miR-98-5p + pcDNA group (co- transfected miR-98-5p mimics and pcDNA), DDP + miR-98-5p + pcDNA-RRM2 group (co-transfected miR-98-5p mimics and pcDNA-RRM2) were transfected into HeLa/DDP cells by liposome method. Real-tim PCR, Western blotting, CCK-8, Transwell chamber and dual luciferase reports gene detection assay were used to detect the expression of miR-98-5p, RRM2, cyclin Dl, P21, matrix metalloproteinase (MMP)-2 and MMP-9 in cells, inhibition rate, half inhibitory concentration(IC

Arthroplasty, Replacement, Hip ; Female ; Femoral Neck Fractures/surgery* ; Humans ; Osteoporosis/surgery* ; Pregnancy

Objective    To summarize the perioperative outcome of patients undergoing robot-assisted thoracic surgery (RATS) or four-port single-direction video-assisted thoracic surgery (VATS) right upper lobectomy (RUL), and to discuss the safety and the essentials of the surgery. Methods    The clinical data of 579 patients with non-small cell lung cancer (NSCLC) undergoing minimally invasive RUL in Dr. Luo Qingquan’s team of our center from 2015 to 2018 were retrospectively analyzed. There were 246 males and 333 females aged 33-78 years. The 579 patients were divided into a RATS group (n=283) and a VATS group (n=296) according to surgical methods. Baseline characteristics and perioperative outcomes including dissected lymph nodes, postoperative duration of drainage, postoperative hospital stay, postoperative complications and surgery cost were compared between the two groups. Results    There was no significant difference in baseline data between the two groups (P>0.05), and no postoperative 30 d mortality or intraoperative blood transfusion was observed. Compared with VATS, RATS had shorter operation time (90.22±12.16 min vs. 92.68±12.26 min, P=0.016), postoperative hospital stay (4.67±1.43 d vs. 5.31±1.59 d, P<0.001) and time of drainage (3.55±1.38 d vs. 4.16±1.58 d, P<0.001). No significant difference was observed between the two groups in the lymph nodes dissection, blood loss volume, conversion rate or complications. The cost of RATS was much higher than that of VATS (93 275.46±13 276.69 yuan vs. 67 082.58±12 978.17 yuan, P<0.001). Conclusion    The safety and effectiveness of robot-assisted and video-assisted RUL are satisfactory, and they have similar perioperative outcomes. However, RATS costs relatively shorter operation time and postoperative hospital stay.

Objective To investigate the role of preoperative peripheral blood neutrophil to lymphocyte ratio (NLR) in the prognosis of patients with hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) after operation. Methods Clinical data of 299 patients with HBV-related HCC who underwent radical liver resection in Department of Hepatobiliary Surgery, the Afifliated Hospital of Medical College, Qingdao University from January 2005 to December 2010 were analyzed retrospectively. The informed consents of all patients were obtained and the ethical committee approval was received. There were 258 males and 41 females with age ranging from 23 to 82 years old and median age of 54 years old. NLR was calculated according to the blood routine examination result of peripheral blood collected 3 days before operation. All patients were regularly followed up after operation and the survival and tumor recurrence were recorded. Receiver operating characteristic (ROC) curve of NLR for diagnosing tumor recurrence was plotted and the cut-off value was deifned. The patients were divided into low NLR group and high NLR group according to the cut-off value of NLR. The differences of cumulative survival rates and disease-free survival rates between two groups were compared. Clinical parameters were included as the factors influencing patients' 5-year cumulative survival rates and independent risk factors were analyzed. The survival analysis was conducted using Kaplan-Meier method and Log-rank test. Independent risk factor analysis was conducted using Cox proportional-hazards regression model. Results When the cut-off value of NLR for diagnosing tumor recurrence after operation was deifned at 1.71, the sensitivity was 0.49 and speciifcity was 0.73. The 1, 3, 5-year cumulative survival rates were 90.8%, 82.6%, 61.8%in low NLR group (n=173) and was 83.3%, 72.2%, 46.2% in high NLR group (n=126), and the 1, 3, 5-year disease-free survival rates were 82.8%, 66.7%, 44.9%and 62.7%, 36.2%, 24.8%respectively. There were signiifcant differences between two groups in cumulative survival rates and disease-free survival rates (χ2=6.987, 19.970;P<0.05). The independent risk factors for 5-year cumulative survival rate were preoperative NLR>1.71, gamma-glutamyl transpeptidase (GGT)>64 U/L, alpha fetal protein (AFP)≥400μg/L and tumor diameter>5 cm (RR=1.504, 0.590, 1.540, 0.982; P<0.05). Conclusions The preoperative NLR is an independent risk factor for influencing the prognosis of patients with HBV-related HCC. Patients with preoperative NLR>1.71 have poor prognosis.

Objective To investigate the incidence and prognosis of patients with de novo extrahepatic malignant tumor (EHM) after resection of hepatocellular carcinoma (HCC). Methods Clinical data of 9 patients who were diagnosed with de novo EHM during the follow-up of 686 patients with HCC undergoing radical hepatic resection from March 1997 to December 2010 in Department of Hepatobiliary Surgery, the Afifliated Hospital of Medical College, Qingdao University were analyzed retrospectively. The informed consents of all patients were obtained and the ethics committee approval was received. All the 9 patients were male. The incidence of EHM, age when diagnosed, site of disease, tumor type, and survive were analyzed. The preoperative T lymphocyte subgroup detection of patients was traced. Results The incidence of EHM was 1.3%(9/686), including 3 cases of lung cancer, 2 cases of gastric carcinoma, 2 cases of colon cancer, 1 case of thyroid carcinoma and 1 case of prostate cancer. The patients' age when diagnosed with EHM was 54 to 72 years old with a median age of 63 years old. The median interval time from HCC resection to diagnosis of EHM was 55 months (range:17 to 114 months). The 1-, 3-year cumulative survival rates after diagnosis of EHM were 74.1%, 0%. The cluster of differentiation (CD)4+/CD8+ratio before radical resection was<1.4 in 5 cases, including 3 cases with ratio<1.0. Conclusions The incidence of EHM is low in patients with HCC after operation, and the prognosis is poor. The weakened immunity before operation may be an important inducing factor.