1.Study on the mechanism of HNF-4α mediated by miR-29b-3p to inhibit the expression of coagulation factor Ⅹ in trauma induced coagulopathy
Liang CHEN ; Ci HE ; Jinhua LUO ; Zhitao HUANG
Chongqing Medicine 2025;54(3):573-579
Objective To investigate the function and mechanism of miR-29 family in trauma induced coagulopathy(TIC).Methods Bioinformatics was used to analyze the targeting relationship between miR-29 family members and hepatocyte nuclear factor-4α(HNF-4α).HE staining results,TEG parameters and coagu-lation parameters were used to verify the TIC rat model construction.Real-time quantitative fluorescent PCR(RT-qPCR)and Western blot were used to detect the expression of miR-29 family,HNF-4α and coagulation factor Ⅹ(FⅩ)in rat liver tissues.Overexpression of miR-29b-3p(miR-29b-3p mimics)or silence of miR-29b-3p(miR-29b-3p inhibitor)was transfected into hepatocytes,and the levels of miR-29b-3p,HNF-4α and FⅩ in hepatocytes were detected by RT-qPCR and Western blot.Double lucifase reporter gene assay verified the targeted regulation of miR-29b-3p on HNF-4α.The miR-29b-3p mimics and/or HNF-4α overexpression vector were transfected into hepatocytes,and the levels of miR-29b-3p,HNF-4α and FⅩ in hepatocytes were detected by RT-qPCR and Western blot.Results Bioinformatic prediction results from the miRDIP database identified that multiple members of the miR-29 family(miR-29a-3p,miR-29b-3p,miR-29b-5p,and miR-29c-3p)contain potential binding sites with HNF-4α.Histopathological evaluation through HE staining,combined with TEG parameters and coagulation profiles,confirmed successful establishment of the TIC rat model.Quantitative analyses using RT-qPCR and Western blot revealed that compared to controls,both HNF-4α and coagulation FⅩ expression levels were markedly suppressed in the model group,while miR-29b-3p expression showed significant elevation in TIC rats(P<0.01).In vitro functional studies demonstrated that neither overexpression nor silencing of miR-29b-3p significantly influenced hepatocyte proliferation(P>0.05).How-ever,forced expression of miR-29b-3p effectively downregulated HNF-4α and its downstream target FⅩ,whereas miR-29b-3p knockdown substantially upregulated these molecules(P<0.05).This regulatory rela-tionship was further validated by dual luciferase reporter assays confirming direct targeting between HNF-4α and miR-29b-3p.Notably,exogenous HNF-4α overexpression significantly rescued FⅩ suppression induced by miR-29b-3p overexpression(P<0.05).Conclusion miR-29b-3p is up-regulated in TIC,which can promote the progression of TIC by targeting HNF-4α to regulate FⅩ expression.
2.Expert consensus on management of instrument separation in root canal therapy.
Yi FAN ; Yuan GAO ; Xiangzhu WANG ; Bing FAN ; Zhi CHEN ; Qing YU ; Ming XUE ; Xiaoyan WANG ; Zhengwei HUANG ; Deqin YANG ; Zhengmei LIN ; Yihuai PAN ; Jin ZHAO ; Jinhua YU ; Zhuo CHEN ; Sijing XIE ; He YUAN ; Kehua QUE ; Shuang PAN ; Xiaojing HUANG ; Jun LUO ; Xiuping MENG ; Jin ZHANG ; Yi DU ; Lei ZHANG ; Hong LI ; Wenxia CHEN ; Jiayuan WU ; Xin XU ; Jing ZOU ; Jiyao LI ; Dingming HUANG ; Lei CHENG ; Tiemei WANG ; Benxiang HOU ; Xuedong ZHOU
International Journal of Oral Science 2025;17(1):46-46
Instrument separation is a critical complication during root canal therapy, impacting treatment success and long-term tooth preservation. The etiology of instrument separation is multifactorial, involving the intricate anatomy of the root canal system, instrument-related factors, and instrumentation techniques. Instrument separation can hinder thorough cleaning, shaping, and obturation of the root canal, posing challenges to successful treatment outcomes. Although retrieval of separated instrument is often feasible, it carries risks including perforation, excessive removal of tooth structure and root fractures. Effective management of separated instruments requires a comprehensive understanding of the contributing factors, meticulous preoperative assessment, and precise evaluation of the retrieval difficulty. The application of appropriate retrieval techniques is essential to minimize complications and optimize clinical outcomes. The current manuscript provides a framework for understanding the causes, risk factors, and clinical management principles of instrument separation. By integrating effective strategies, endodontists can enhance decision-making, improve endodontic treatment success and ensure the preservation of natural dentition.
Humans
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Root Canal Therapy/adverse effects*
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Consensus
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Root Canal Preparation/adverse effects*
3.Analysis of the association between the use of oral progesterone drugs in early pregnancy and gestational diabetes mellitus
Yan QIN ; Jinhua GU ; Jing ZHU ; Lin LUO ; Peng PING ; Lingqi GU
China Pharmacy 2025;36(6):721-726
OBJECTIVE To explore the association between the use of oral progesterone drugs in early pregnancy and gestational diabetes mellitus (GDM). METHODS Through real-world retrospective cohort research method, pregnant women who underwent the oral glucose tolerance test (OGTT) at the Affiliated Maternal and Child Health Hospital of Nantong University between January 2022 and January 2023 were enrolled. Based on whether oral progesterone drugs were used in early pregnancy, they were divided into treatment group and control group; propensity score matching (PSM) with a 1∶1 ratio was employed to control for confounding factors; Logistic regression and linear regression were employed to analyze the association between drug factors (whether use of oral progesterone drug, duration of medication, dosage, and drug type) and outcome indicators (occurrence of GDM, fasting blood glucose levels, and OGTT 1 and 2 h blood glucose levels in late pregnancy). RESULTS A total of 709 pregnant women were enrolled in the two groups before PSM; after PSM, 256 cases were included in both the treatment group and the control group. The results of association analysis indicated that there was no significant association between the use of oral progesterone drugs and GDM (P>0.05); but a significant correlation was found with OGTT 1 h blood glucose levels [β=0.965, 95%CI (0.007,1.922), P<0.05], specifically with Dydrogesterone tablets [β=0.977, 95%CI (0.009, 1.944), P<0.05] and Progesterone soft capsules [β =1.089, 95%CI (0.077, 2.102), P<0.05]. There was no significant correlation between other drug factors and outcome indicators (P>0.05). CONCLUSIONS The use of oral progestogen drugs in early pregnancy is not significantly associated with GDM. The blood glucose levels in late pregnancy, especially OGTT 1 h blood glucose levels, have a certain correlation with Progesterone soft capsules and Dydrogesterone tablets.
4.Study on the mechanism of apoptosis mediated by acid sensitive ion channel 1 through extracellular signal regulation of kinase 5 signaling pathway and mitochondrial disorder pathway.
Xian-Fang LUO ; Zheng-Yue JIN ; Chi ZHANG
China Journal of Orthopaedics and Traumatology 2025;38(3):298-305
OBJECTIVE:
To explore mechanisms of acid-sensing ion channel 1 (ASIC1) mediated lumbar nucleus pulposus cell apoptosis through extracellular-signalregulated protein kinase 5 (ERK5) signaling pathway and mitochondrial dysfunction pathway.
METHODS:
Totally 34 patients with degenerative lumbar disc herniation (LDH) admitted from January 2020 to December 2022 were collected as research objects, including 21 males and 13 females;aged from 29 to 52 years old with an average of (37.43±4.75) years old;22 patients with grade Ⅱ and 12 patients with grade Ⅳ, according to Pfirrmann grading criteria;15 patients with L4,5 and 19 patients with L5S1. The expression of ASIC1 in nucleus pulposus of LDH patients was measured by immunohistochemical staining. Nucleus pulposus cells were cultured by primary culture method, identified by toluidine blue staining and immunohistochemical staining, and the expression of ASIC1 protein was located by immunofluorescence staining. According to the addition of siRNA-ASIC1, ASIC1 overexpression plasmid, and ERK5 inhibitors, the nucleus pulpocyte was divided into three groups, named as SIRNA-silenced group, overexpression group, and inhibitor group, with 3 patients in each group. Cells of each group were collected at 72 h after intervention, expression of ASIC1, ERK5, BCL-xL/BCL-2-associated Death promoter (Bad), B-cell lymphoma-2 associated X (Bax) and B-cell lymphoblast-2 gene (Bcl-2) were detected by reverse transcription-polymerase chain reaction (RT-PCR);intracellular calcium ion levels were detected by calcium ion kit, mitochondrial membrane potential was detected by JC-1 kit, and apoptosis was observed by AV-PI kit.
RESULTS:
In LDH patients with grade Ⅳ, nucleus pulposus tissue removed during operation revealed poor elasticity, white color and poor ductility, and immunohistochemical results showed increased ASIC1 expression. There was no significant difference in mRNA relative expression of ASIC1 between siRNA silencing group (0.31±0.03) and inhibitor group (0.39±0.05) (P>0.05). The mRNA relative expression level of ERK5 in siRNA silencing group(0.32±0.05) was significantly higher than that in inhibitor group (0.15±0.04)(P<0.05), which suggested ERK5 was the downstream molecule of ASIC1. The mRNA relative expression levels of apoptosis promoting factor Bad and Bax in siRNA silencing group and inhibitor group were lower than those in overexpression group(P<0.05), the relative expression level of anti-apoptosis factor Bcl-2 mRNA was significantly increased (P<0.05). The calcium content in overexpression group was higher than that in siRNA silencing and inhibitor groups (P<0.05), the normal proportion of mitochondrial membrane potential in overexpression group was lower than that in siRNA silencing and inhibitor group (P<0.05), and the apoptosis rate in overexpression group was higher than that in siRNA silencing and inhibitor group (P<0.05).
CONCLUSION
After the activation of ASIC1 channel protein, calcium ions could enter the cells and act as a second messenger molecule to regulate apoptosis of nucleus pulposus cells by ERK5 signaling pathway and mitochondrial disorder pathway.
Humans
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Acid Sensing Ion Channels/physiology*
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Male
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Female
;
Apoptosis
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Middle Aged
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Adult
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Signal Transduction
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Mitogen-Activated Protein Kinase 7/physiology*
;
Mitochondrial Diseases/genetics*
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Nucleus Pulposus/metabolism*
;
Intervertebral Disc Degeneration/metabolism*
;
Mitochondria/metabolism*
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Intervertebral Disc Displacement/genetics*
5.Influence of irregular shape of hematoma on postoperative re-bleeding and prognosis in patients with spontaneous intracerebral hemorrhage undergoing craniotomy for hematoma evacuation
Yuanyuan FU ; Li LUO ; Jinhua YANG ; Likun WANG ; Lian HE ; Guofeng WU ; Siying REN ; Shiqi LIN
Chinese Journal of Cerebrovascular Diseases 2025;22(9):601-611
Objective To explore the impact of irregular shape of head CT hematomas on postoperative re-bleeding and prognosis of patients with spontaneous intracerebral hemorrhage(ICH)who undergo craniotomy for hematoma evacuation.Methods We retrospectively enrolled consecutive patients with ICH who underwent craniotomy for hematoma evacuation in the Department of Neurosurgery of the Second People's Hospital of Guiyang Affiliated to Guizhou Medical University from January 2019 to June 2024.Baseline and clinical data were collected form the patients,including age,gender,smoking history,drinking history,hypertension,diabetes,history of anticoagulant use,admission systolic and diastolic blood pressure,admission National Institutes of Health stroke scale(NIHSS)score,Glasgow coma scale(GCS)score,time from onset to the first head CT,neutrophil-to-lymphocyte ratio(NLR),and platelet-to-lymphocyte ratio(PLR).Admission head CT scans were used to assess hematoma shape(regular or irregular),hematoma location(basal ganglia,lobar,multifocal),hematoma volume,perihematomal edema volume,the presence of midline shift,and intraventricular extension.Volume of the hematoma was assessed 2 days after surgery.Postoperative re-bleeding is defined as an increase in the volume of the hematoma by 12.5 ml compared to the previous postoperative CT scan within 2 weeks after surgery,or the reappearance of high-density areas in the focal area of the head CT scan during follow-up after complete hematoma clearance.Conduct patients follow-ups via telephone at 6 months postoperatively to assess their modified Rankin scale(mRS)scores.The sliding dichotomy method was applied to define prognosis based on the patients' baseline characteristics and disease severity.The prognostic score was calculated using formula:10 × admission GCS score-age-0.64 × admission hematoma volume.A prognostic score>27.672 was considered potentially favorable,while a score ≤ 27.672 was considered potentially unfavorable.For patients with a potentially favorable prognosis,an mRS score of 0-2 was defined as a good outcome,and a score of 3-6 as a poor outcome.For those with a potentially unfavorable prognosis,an mRS score of 0-3 was defined as a good outcome,and a score of 4-6 as a poor outcome.In the comparison of baseline and clinical data between patients with regular and irregular hematoma shapes,factors with P<0.05 were included in propensity score matching(PSM)to adjust for confounding variables.A 1∶1 matching was performed using the nearest neighbor method with a caliper value set to 0.25.Variables with statistically significant differences between groups after PSM matching were included in the multivariate Logistic regression analysis to identify influencing factors for postoperative re-bleeding and poor prognosis in ICH patients undergoing craniotomy hematoma evacuation.The predictive value of irregular hematoma shape for postoperative rebleeding and poor prognosis in ICH patients was analyzed using receiver operating characteristic(ROC)curve analysis.Results(1)A total of 440 ICH patients were enrolled,including 342 males and 98 females,aged from 20 to 84 years with a mean age of(56±12)years.Statistically significant differences were observed in baseline and clinical data between patients with regular and irregular hematoma shapes before PSM,including age,admission GCS score,NIHSS score,NLR,proportion of patients with hematoma rupture into ventricles,preoperative hematoma volume,proportion of patients with midline shift,preoperative volume of hematoma surrounding edema,proportion of patients with hematoma located in multiple sites,and postoperative 2-day hematoma volume(all P<0.05).After propensity score matching of these factors,298 ICH patients were included in the statistical analysis,comprising 228 males and 70 females,with an age range of 20 to 84 years and a mean age of(57±12)years.Following PSM,no statistically significant differences were observed in the baseline and clinical characteristics between patients with irregular and regular hematoma shapes(all P>0.05).(2)After propensity score matching,28 patients experienced postoperative re-bleeding while 270 did not.Significant differences were observed between the two groups in the following factors:proportion of patients with a history of anticoagulant use,admission PLR,NLR,irregular hematoma shape,and hematoma volume at 2 days after operation(all P<0.05).No statistically significant differences were found in the remaining baseline and clinical characteristics(all P>0.05).Using postoperative re-bleeding as the dependent variable and incorporating factors with P<0.05 from the univariate analysis as independent variables,multivariate Logistic regression analysis identified irregular hematoma shape(OR,2.821,95%CI 1.142-6.968,P=0.025)and larger hematoma volume at 2 days post-operation(OR,1.062,95%CI 1.026-1.099,P<0.01)as independent risk factors for re-bleeding following intracranial hematoma evacuation in ICH patients.ROC curve analysis demonstrated that irregular hematoma shape predicted postoperative re-bleeding with an area under the curve(AUC)of 0.62,showing a sensitivity of 71.4%and a specificity of 52.2%.(3)After propensity score matching,174 patients had poor prognosis while 124 had good prognosis.Significant intergroup differences were observed in age,admission GCS score,NIHSS score,irregular hematoma shape,proportion of patients with hematomas located in the basal ganglia and cerebral lobes,and hematoma volume at 2 days post-operation(all P<0.05).No statistically significant differences were found in the remaining baseline and clinical characteristics(all P>0.05).Using poor prognosis as the dependent variable and incorporating factors with P<0.05 from univariate analysis as independent variables,multivariate Logistic regression analysis revealed that advanced age(OR,1.039,95%CI 1.015-1.064,P=0.002),high admission NIHSS score(OR,1.068,95%CI 1.025-1.113,P=0.002),irregular hematoma shape(OR,2.675,95%CI 1.582-4.524,P<0.01),and larger hematoma volume at 2 days post-operation(OR,1.033,95%CI 1.002-1.064,P=0.038)were independent risk factors for poor prognosis.Conversely,lobar hematoma location(OR,0.192,95%CI 0.073-0.504,P<0.01)was identified as a protective factor.ROC curve analysis showed that irregular hematoma shape predicted poor prognosis after intracranial hematoma evacuation with an AUC of 0.61,demonstrating a sensitivity of 59.2%and specificity of 62.9%.Conclusion Irregular hematoma shape on head CT is an independent risk factor for both postoperative re-bleeding and poor prognosis in ICH patients undergoing craniotomy for hematoma evacuation.
6.Mechanism of inhibition for Janus tyrosine kinase,signal transducer and activator of transcription on ferroptosis,myocardial remodeling,and MT1-Nrf2-GPX 4 signaling axis in rats with heart failure
Rui FENG ; Jianmei LUO ; Jinhua BIAN ; Mengen ZHAI
China Medical Equipment 2025;22(5):147-152
Objective:To investigate the mechanism of inhibition for Janus tyrosine kinase,signal transducer and activator of transcription(JAK/STAT)on ferroptosis,myocardial remodeling,and JAK/STAT melatonin receptor 1-nuclear factor E2-related factor 2-glutathione peroxidase 4(MT1-Nrf2-GPX4)signaling axis in rats with heart failure(HF)under echocardiography.Methods:Forty SD rats were selected,and they were randomly divided into blank control group,model group,interleukin-6(IL-6)group and tyrosine phosphorylation inhibitor(AG490)group according to random number table,with 10 rats in each group.HF rat models were established in three groups except the blank control group.The expression levels of JAK/STAT mRNA in myocardial tissue among 4 groups were compared and analyzed.The small animal ultrasound imaging system was used to measure a series of cardiac function indexes included interventricular septum(IVS)thickness,left ventricular posterior wall(LVPWs)thickness,left ventricular posterior wall(LVPWd)thickness,left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD)and ejection fraction(EF).The Fe2+concentration and lesions of myocardial tissue,as well as the expressions of MT1,Nrf2 and GPX4 proteins,in the four groups were compared and analyzed.Results:The increases of JAK1 and STAT3 mRNA levels,and Fe2+concentration in the model group,IL-6 group and AG490 group were higher than those in the blank control group,and the protein expression levels of MT1,Nrf2 and GPX4 in them were lower than those in the blank control group,and the differences of the above indicators between the model group and the blank control group were statistically significant(t=11.810,16.250,17.150,10.460,9.272,11.180,P<0.05),and the differences of the above indicators between the IL-6 group and the blank control group were statistically significant(t=9.834,19.030,16.320,14.450,13.250,14.070,P<0.05),and the differences of them between the AG490 group and the blank control group were statistically significant(t=8.025,11.050,17.590,4.173,4.179,4.183,P<0.05),respectively.The levels of STAT3 mRNA level and Fe2+concentration in IL-6 group were higher than those in the model group,and the expression levels of MT1,Nrf2 and GPX4 proteins in that were lower than those in the model group,and the differences were statistically significant(t=2.224,2.582,3.550,3.078,2.624,P<0.05),respectively.The levels of JAK1,STAT3 mRNA and Fe2+concentration in the AG490 group were lower than those in the model group,and the levels of MT1,Nrf2 and GPX4 in that were higher than those in the model group,and the differences were statistically significant(t=4.052,6.930,8.598,6.247,5.055,6.799,P<0.05),respectively.The IVS,LVPWs,LVPWd and EF of the model group,IL-6 group and AG490 group were lower than those of the blank control group,and the LVEDD and LVESD of them were higher than those of the blank control group,and the differences of these indicators between the model group and the blank control group were statistically significant(t=13.740,11.100,5.654,7.049,13.440,14.260,P<0.05),and the differences of them between the IL-6 group and the blank control group were statistically significant(t=16.090,13.140,8.103,9.174,15.940,17.010,P<0.05),and the differences of them between the AG490 group and the blank control group were statistically significant(t=5.474,4.947,2.682,4.071,8.608,13.300,P<0.05),respectively.The LVPWd and EF in the IL-6 group were lower than those in the model group,and the LVEDD and LVESD in the IL-6 group were higher than those in the model group,and the differences of them were statistically significant(t=2.417,2.327,2.236,2.818,P<0.05),respectively.The IVS,LVPWs,LVPWd and EF in the AG490 group were higher than those in the model group,and the LVEDD and LVESD in that were lower than those in the model group,and the differences were statistically significant(t=8.598,7.147,3.514,3.361,4.914,2.970,P<0.05),respectively.Conclusion:Inhibition of JAK/STAT expression can improve the cardiac structure of HF rats,and relieve ventricular remodeling,and inhibit ferroptosis of cardiomyocyte,and promote the expression of MT1,Nrf2 and GPX4 proteins.
7.Influence of irregular shape of hematoma on postoperative re-bleeding and prognosis in patients with spontaneous intracerebral hemorrhage undergoing craniotomy for hematoma evacuation
Yuanyuan FU ; Li LUO ; Jinhua YANG ; Likun WANG ; Lian HE ; Guofeng WU ; Siying REN ; Shiqi LIN
Chinese Journal of Cerebrovascular Diseases 2025;22(9):601-611
Objective To explore the impact of irregular shape of head CT hematomas on postoperative re-bleeding and prognosis of patients with spontaneous intracerebral hemorrhage(ICH)who undergo craniotomy for hematoma evacuation.Methods We retrospectively enrolled consecutive patients with ICH who underwent craniotomy for hematoma evacuation in the Department of Neurosurgery of the Second People's Hospital of Guiyang Affiliated to Guizhou Medical University from January 2019 to June 2024.Baseline and clinical data were collected form the patients,including age,gender,smoking history,drinking history,hypertension,diabetes,history of anticoagulant use,admission systolic and diastolic blood pressure,admission National Institutes of Health stroke scale(NIHSS)score,Glasgow coma scale(GCS)score,time from onset to the first head CT,neutrophil-to-lymphocyte ratio(NLR),and platelet-to-lymphocyte ratio(PLR).Admission head CT scans were used to assess hematoma shape(regular or irregular),hematoma location(basal ganglia,lobar,multifocal),hematoma volume,perihematomal edema volume,the presence of midline shift,and intraventricular extension.Volume of the hematoma was assessed 2 days after surgery.Postoperative re-bleeding is defined as an increase in the volume of the hematoma by 12.5 ml compared to the previous postoperative CT scan within 2 weeks after surgery,or the reappearance of high-density areas in the focal area of the head CT scan during follow-up after complete hematoma clearance.Conduct patients follow-ups via telephone at 6 months postoperatively to assess their modified Rankin scale(mRS)scores.The sliding dichotomy method was applied to define prognosis based on the patients' baseline characteristics and disease severity.The prognostic score was calculated using formula:10 × admission GCS score-age-0.64 × admission hematoma volume.A prognostic score>27.672 was considered potentially favorable,while a score ≤ 27.672 was considered potentially unfavorable.For patients with a potentially favorable prognosis,an mRS score of 0-2 was defined as a good outcome,and a score of 3-6 as a poor outcome.For those with a potentially unfavorable prognosis,an mRS score of 0-3 was defined as a good outcome,and a score of 4-6 as a poor outcome.In the comparison of baseline and clinical data between patients with regular and irregular hematoma shapes,factors with P<0.05 were included in propensity score matching(PSM)to adjust for confounding variables.A 1∶1 matching was performed using the nearest neighbor method with a caliper value set to 0.25.Variables with statistically significant differences between groups after PSM matching were included in the multivariate Logistic regression analysis to identify influencing factors for postoperative re-bleeding and poor prognosis in ICH patients undergoing craniotomy hematoma evacuation.The predictive value of irregular hematoma shape for postoperative rebleeding and poor prognosis in ICH patients was analyzed using receiver operating characteristic(ROC)curve analysis.Results(1)A total of 440 ICH patients were enrolled,including 342 males and 98 females,aged from 20 to 84 years with a mean age of(56±12)years.Statistically significant differences were observed in baseline and clinical data between patients with regular and irregular hematoma shapes before PSM,including age,admission GCS score,NIHSS score,NLR,proportion of patients with hematoma rupture into ventricles,preoperative hematoma volume,proportion of patients with midline shift,preoperative volume of hematoma surrounding edema,proportion of patients with hematoma located in multiple sites,and postoperative 2-day hematoma volume(all P<0.05).After propensity score matching of these factors,298 ICH patients were included in the statistical analysis,comprising 228 males and 70 females,with an age range of 20 to 84 years and a mean age of(57±12)years.Following PSM,no statistically significant differences were observed in the baseline and clinical characteristics between patients with irregular and regular hematoma shapes(all P>0.05).(2)After propensity score matching,28 patients experienced postoperative re-bleeding while 270 did not.Significant differences were observed between the two groups in the following factors:proportion of patients with a history of anticoagulant use,admission PLR,NLR,irregular hematoma shape,and hematoma volume at 2 days after operation(all P<0.05).No statistically significant differences were found in the remaining baseline and clinical characteristics(all P>0.05).Using postoperative re-bleeding as the dependent variable and incorporating factors with P<0.05 from the univariate analysis as independent variables,multivariate Logistic regression analysis identified irregular hematoma shape(OR,2.821,95%CI 1.142-6.968,P=0.025)and larger hematoma volume at 2 days post-operation(OR,1.062,95%CI 1.026-1.099,P<0.01)as independent risk factors for re-bleeding following intracranial hematoma evacuation in ICH patients.ROC curve analysis demonstrated that irregular hematoma shape predicted postoperative re-bleeding with an area under the curve(AUC)of 0.62,showing a sensitivity of 71.4%and a specificity of 52.2%.(3)After propensity score matching,174 patients had poor prognosis while 124 had good prognosis.Significant intergroup differences were observed in age,admission GCS score,NIHSS score,irregular hematoma shape,proportion of patients with hematomas located in the basal ganglia and cerebral lobes,and hematoma volume at 2 days post-operation(all P<0.05).No statistically significant differences were found in the remaining baseline and clinical characteristics(all P>0.05).Using poor prognosis as the dependent variable and incorporating factors with P<0.05 from univariate analysis as independent variables,multivariate Logistic regression analysis revealed that advanced age(OR,1.039,95%CI 1.015-1.064,P=0.002),high admission NIHSS score(OR,1.068,95%CI 1.025-1.113,P=0.002),irregular hematoma shape(OR,2.675,95%CI 1.582-4.524,P<0.01),and larger hematoma volume at 2 days post-operation(OR,1.033,95%CI 1.002-1.064,P=0.038)were independent risk factors for poor prognosis.Conversely,lobar hematoma location(OR,0.192,95%CI 0.073-0.504,P<0.01)was identified as a protective factor.ROC curve analysis showed that irregular hematoma shape predicted poor prognosis after intracranial hematoma evacuation with an AUC of 0.61,demonstrating a sensitivity of 59.2%and specificity of 62.9%.Conclusion Irregular hematoma shape on head CT is an independent risk factor for both postoperative re-bleeding and poor prognosis in ICH patients undergoing craniotomy for hematoma evacuation.
8.Chinese experts' consensus on principles of preoperative hair removal
Yiping MAO ; Jun ZHENG ; Lei LI ; Deyan YANG ; Bing ZHANG ; Lei YANG ; Wang JIA ; Peng KANG ; Hui JIAO ; Yun YANG ; Qi QI ; Shiqing FENG ; Xiao LONG ; Yuewei ZHANG ; Xiaohui WANG ; Lize WANG ; Yuan WEI ; Jichao ZHOU ; Minghui MAO ; Pengju XIN ; Hongyu TAN ; Dahong ZHANG ; Lianxin LIU ; Lei TAO ; Xietong WANG ; Xiaoning YUAN ; Mang CAI ; Li MU ; Fang DU ; Rongzhu CHEN ; Fengmao ZHAO ; Jiuzuo HUANG ; Mingzi ZHANG ; Jie ZHANG ; Baoguo WANG ; Kun WANG ; Fang LUO ; Jinhua ZHANG ; Nong HE ; Ling LYU ; Zhiyong ZONG
Chinese Journal of Nosocomiology 2025;35(10):1441-1449
To formulate an expert consensus on the principles of preoperative hair removal and provide scientific guidance for standardized removal of hair before surgical procedures so as to reduce the incidence of surgical site infections.METHODS Led by the Hospital Management Institute of National Health Commission of the People's Republic of China,this consensus was reached with the joint efforts from the expects of relevant fields such as surgeries,interventional therapies,nursing,and infection prevention and control.The consensus facilitates the classification and evaluation of literatures by following the evidence grade formulated by Oxford Evidence-based Medicine Center and focuses on the association of preoperative hair removal with surgical site infection,it reaches the evidence grade of expert consensus and recommendation intensity by integrating with discussions on meetings and clinical experience of the expects from relevant fields.RESULTS A total of 6 items of consensus were reached by summarizing the latest evidence on the aspects including the indications for preoperative hair removal,tools,range,timing and places.CONCLUSION The consensus,to some extent,make supplements to and complete the exiting regulations and standards.It provides guidance for the medical institutions to carry out the preoperative hair removal.
9.Case study on integrated traditional chinese and western medicine for treatment of orbital foreign body caused by ocular trauma
Zhenzhen GU ; Jinhua LUO ; Like XIE ; Xiaofeng HAO ; Xi CHEN
Journal of Clinical Medicine in Practice 2025;29(15):146-148
Ocular trauma is a leading cause of permanent visual impairment and loss of working a-bility.Among them,orbital foreign body injuries are often accompanied by multiple injuries to the eye-ball and surrounding tissues,adversely affecting the quality of life.This paper reported a 33-year-old male patient with right orbital foreign body resulting in eyeball contusion,extraocular muscle injury,and restricted ocular movement.After surgical removal of the foreign body combined with integrated traditional Chinese and western medicine treatment,the patient's visual acuity improved from 0.4 to 0.8,and ocular motility function significantly improved.This suggests that comprehensive treatment contributes to promoting functional recovery and enhancing clinical efficacy.
10.Mechanism of inhibition for Janus tyrosine kinase,signal transducer and activator of transcription on ferroptosis,myocardial remodeling,and MT1-Nrf2-GPX 4 signaling axis in rats with heart failure
Rui FENG ; Jianmei LUO ; Jinhua BIAN ; Mengen ZHAI
China Medical Equipment 2025;22(5):147-152
Objective:To investigate the mechanism of inhibition for Janus tyrosine kinase,signal transducer and activator of transcription(JAK/STAT)on ferroptosis,myocardial remodeling,and JAK/STAT melatonin receptor 1-nuclear factor E2-related factor 2-glutathione peroxidase 4(MT1-Nrf2-GPX4)signaling axis in rats with heart failure(HF)under echocardiography.Methods:Forty SD rats were selected,and they were randomly divided into blank control group,model group,interleukin-6(IL-6)group and tyrosine phosphorylation inhibitor(AG490)group according to random number table,with 10 rats in each group.HF rat models were established in three groups except the blank control group.The expression levels of JAK/STAT mRNA in myocardial tissue among 4 groups were compared and analyzed.The small animal ultrasound imaging system was used to measure a series of cardiac function indexes included interventricular septum(IVS)thickness,left ventricular posterior wall(LVPWs)thickness,left ventricular posterior wall(LVPWd)thickness,left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD)and ejection fraction(EF).The Fe2+concentration and lesions of myocardial tissue,as well as the expressions of MT1,Nrf2 and GPX4 proteins,in the four groups were compared and analyzed.Results:The increases of JAK1 and STAT3 mRNA levels,and Fe2+concentration in the model group,IL-6 group and AG490 group were higher than those in the blank control group,and the protein expression levels of MT1,Nrf2 and GPX4 in them were lower than those in the blank control group,and the differences of the above indicators between the model group and the blank control group were statistically significant(t=11.810,16.250,17.150,10.460,9.272,11.180,P<0.05),and the differences of the above indicators between the IL-6 group and the blank control group were statistically significant(t=9.834,19.030,16.320,14.450,13.250,14.070,P<0.05),and the differences of them between the AG490 group and the blank control group were statistically significant(t=8.025,11.050,17.590,4.173,4.179,4.183,P<0.05),respectively.The levels of STAT3 mRNA level and Fe2+concentration in IL-6 group were higher than those in the model group,and the expression levels of MT1,Nrf2 and GPX4 proteins in that were lower than those in the model group,and the differences were statistically significant(t=2.224,2.582,3.550,3.078,2.624,P<0.05),respectively.The levels of JAK1,STAT3 mRNA and Fe2+concentration in the AG490 group were lower than those in the model group,and the levels of MT1,Nrf2 and GPX4 in that were higher than those in the model group,and the differences were statistically significant(t=4.052,6.930,8.598,6.247,5.055,6.799,P<0.05),respectively.The IVS,LVPWs,LVPWd and EF of the model group,IL-6 group and AG490 group were lower than those of the blank control group,and the LVEDD and LVESD of them were higher than those of the blank control group,and the differences of these indicators between the model group and the blank control group were statistically significant(t=13.740,11.100,5.654,7.049,13.440,14.260,P<0.05),and the differences of them between the IL-6 group and the blank control group were statistically significant(t=16.090,13.140,8.103,9.174,15.940,17.010,P<0.05),and the differences of them between the AG490 group and the blank control group were statistically significant(t=5.474,4.947,2.682,4.071,8.608,13.300,P<0.05),respectively.The LVPWd and EF in the IL-6 group were lower than those in the model group,and the LVEDD and LVESD in the IL-6 group were higher than those in the model group,and the differences of them were statistically significant(t=2.417,2.327,2.236,2.818,P<0.05),respectively.The IVS,LVPWs,LVPWd and EF in the AG490 group were higher than those in the model group,and the LVEDD and LVESD in that were lower than those in the model group,and the differences were statistically significant(t=8.598,7.147,3.514,3.361,4.914,2.970,P<0.05),respectively.Conclusion:Inhibition of JAK/STAT expression can improve the cardiac structure of HF rats,and relieve ventricular remodeling,and inhibit ferroptosis of cardiomyocyte,and promote the expression of MT1,Nrf2 and GPX4 proteins.

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