Objective Based on Mendelian randomization(MR),the causal relationship between blood lipids and osteoporosis(OP)was explored,with the aim of providing a reference for the prevention and treatment of OP.Methods Data on the relevant lipid profiles and OP associated single nucleotide polymorphisms were extracted from publicly available genome-wide association study(GWAS)databases.Subsequent secondary analysis of the GWAS data was conducted,treating different lipid profiles as exposures and OP as the outcome.The analysis was performed using inverse variance weighted(IVW),MR-Egger,weighted median,and other methods,with Cochran's Q test employed to assess heterogeneity in the MR results.The reliability of the causal relationship was further assessed using the MR-Egger intercept test and the MR-PRESSO test.Results The univariable MR analysis demonstrated significant causal associations between OP and several lipid parameters:total cholesterol(P=0.007,OR=1.003,95％CI:1.001-1.005),triglycerides(P=0.013,OR=0.997,95％CI:0.995-0.999),low density lipoprotein cholesterol(P=0.029,OR=1.002,95％CI:1.000-1.002),and apolipoprotein B(P=0.014,OR=1.003,95％CI:1.001-1.003).There was no significant causal relationship between the other blood lipid types and OP.The multivariable MR analysis revealed no significant causal associations between the eight lipid parameters and OP,while the reverse univariable MR analysis similarly demonstrated no causal relationships between OP and the eight lipid measures.Conclusion Total cholesterol,low density lipoprotein cholesterol and apolipoprotein B are risk factors for OP and will increase the risk of OP onset.Triglycerides have a negative causal correlation with OP,suggesting that it has a potential protective effect.

Objective Based on Mendelian randomization(MR),the causal relationship between blood lipids and osteoporosis(OP)was explored,with the aim of providing a reference for the prevention and treatment of OP.Methods Data on the relevant lipid profiles and OP associated single nucleotide polymorphisms were extracted from publicly available genome-wide association study(GWAS)databases.Subsequent secondary analysis of the GWAS data was conducted,treating different lipid profiles as exposures and OP as the outcome.The analysis was performed using inverse variance weighted(IVW),MR-Egger,weighted median,and other methods,with Cochran's Q test employed to assess heterogeneity in the MR results.The reliability of the causal relationship was further assessed using the MR-Egger intercept test and the MR-PRESSO test.Results The univariable MR analysis demonstrated significant causal associations between OP and several lipid parameters:total cholesterol(P=0.007,OR=1.003,95％CI:1.001-1.005),triglycerides(P=0.013,OR=0.997,95％CI:0.995-0.999),low density lipoprotein cholesterol(P=0.029,OR=1.002,95％CI:1.000-1.002),and apolipoprotein B(P=0.014,OR=1.003,95％CI:1.001-1.003).There was no significant causal relationship between the other blood lipid types and OP.The multivariable MR analysis revealed no significant causal associations between the eight lipid parameters and OP,while the reverse univariable MR analysis similarly demonstrated no causal relationships between OP and the eight lipid measures.Conclusion Total cholesterol,low density lipoprotein cholesterol and apolipoprotein B are risk factors for OP and will increase the risk of OP onset.Triglycerides have a negative causal correlation with OP,suggesting that it has a potential protective effect.

OBJECTIVE To understand the safety of Ilaprazole sodium for injection in clinical practice. METHODS From Jan. 1st 2019 to Feb. 29th 2020， the data of 3 926 valid hospitalized patients receiving Ilaprazole sodium for injection were collected prospectively from 5 third-level hospitals through CHPS， and the post-marketing safety analysis was performed by using retrospective multicenter single cohort study. At the same time， a nested case-control study （the ratio of trial group and control group was 1∶4） was used to confirm the baseline stability of this study cohort and the correlation between adverse reactions and Ilaprazole sodium for injection. RESULTS Among 3 926 patients， 3 patients experienced 5 adverse drug events after using Ilaprazole sodium for injection， with the incidence of 0.076%. There was no serious adverse event， and the occurrence time was 2 days after medication； adverse drug events mainly include elevated liver function indicators （alanine transaminase， aspartate transaminase， total bilirubin）， which were mild and untreated， and all adverse drug events were improved. The results of the nested case-control study showed that the trial group and the control group belonged to the same background baseline， and the occurrence of adverse drug events was more closely related to Ilaprazole sodium for injection. CONCLUSIONS The overall safety of Ilaprazole sodium for injection is relatively high， and the occurrence of adverse events is more related to it.

Objective:To analyze the medication characteristics and prescription law of Ye Tianshi and Wu Jutong in the treatment of spleen and stomach diseases based on data mining method; To provide reference for clinical treatment of spleen and stomach diseases.Methods:Records related to spleen and stomach diseases in the Lin Zheng Zhi Nan Yi An and Wu Ju Tong Yi An were collected. SPSS Statistics 26.0, SPSS Modeler 18.0 and other software were used to conduct statistical analysis on the frequency, properties and efficacy of Chinese materia medica. The association analysis and clustering analysis were carried out on high-frequency drugs. Results:A total of 423 medical records, 231 kinds of Chinese materia medica (2 752 times) were included in the Lin Zheng Zhi Nan Yi An. A total of 83 medical records, 115 kinds of Chinese materia medica (753 times) were included in Wu Ju Tong Yi An. The Chinese materia medica used by Ye Tianshi and Wu Jutong to treat spleen and stomach diseases was mainly warm, mild and cold, with pungent, sweet and bitter as the main tastes; they mainly belonged to the spleen, lung and stomach meridians, and their main functions included clearing heat, diverting water and dampness, regulating qi, resolving phlegm, relieving cough, and tonifying deficiency. 6 second-order association rule combinations and 5 effective clusters were obtained for Ye Tianshi's treatment of spleen and stomach diseases, and 15 second-order association rule combinations and 6 effective clusters for Wu Jutong's treatment. Conclusions:Ye Tianshi and Wu Jutong's medication attributes in the treatment of spleen and stomach diseases are basically similar. They often use the method of bitter catharsis to regulate the qi movement of spleen and stomach, and the products of sweet and mild infiltration are used to eliminate dampness and heat. Compared with Ye Tianshi, Wu Jutong used few tonic, heat-clearing, phlegm-resolving, cough-relieving and asthma-relieving drugs, and more diuretics and qi-regulating drugs.

OBJECTIVE: To investigate the clinical efficacy of vertebral body stent (VBS) system and percutanous kyphoplasty (PKP) combined with zoledronic acid for the treatment of severely osteoporotic compression vertebral fractures (OVCFs). METHODS: The clinical data of 48 patients with osteoporotic thoracolumbar fractures treated from December 2017 to December 2018 were retrospectively analyzed, including 13 males and 35 females, aged 55 to 92 years old with an average (71.2±10.5) years. All patients were treated with VBS system PKP surgery, and zoledronic acid injection was used for anti-osteoporosis treatment after operation. The VAS scores ODI, the height of diseasedvertebral lost were compared before operation, 3 d and half a year after operation, and whether there was re-fracture of diseased or adjacent vertevrae after operation was observed. RESULTS: Before operation, 3 d and half a year after operation, VAS scores were 7.60±0.12, 3.00±0.46, 1.20±0.23, ODI were(82.00±0.32)%, (30.00±1.50) %, (18.00±0.16) %, the height of diseased vertebral lost were (12.00±0.43) mm, (3.00± 0.15) mm, (3.60±0.51) mm respectively. Postoperative VAS score, ODI, the height of diseased vertebral lost were obviously improved (<0.05), and there was no significant difference between 3 d and half a year after operation (>0.05). All the 48 patients were followed up with an average time of (6.6±0.5) months. All the incisions healed at grade A after operation, and no re-fracture of diseased vertebrae or adjacent vertebrae was found at the final follow-up. CONCLUSION VBS system and PKP combined with zoledronic acid in the treatment of OVCFs not only may effectively relieve the pain in the thoracolumbar back, improve the mobility of the thoracolumbar, but also can restore the height of the vertebral body to the maximum extent, and prevent the re-fracture of the affected vertebrae and adjacent vertebrae, which is worthy to spread in clinic.
Aged ; Aged, 80 and over ; Bone Cements ; Female ; Fractures, Compression ; Humans ; Kyphoplasty ; Male ; Middle Aged ; Osteoporotic Fractures ; Retrospective Studies ; Spinal Fractures ; Stents ; Treatment Outcome ; Zoledronic Acid

OBJECTIVE: To determine the incidence of surgical site infection (SSI) after abdominal surgery and to further evaluate the related risk factors of SSI in China. METHODS: The multicenter cross-sectional study collected clinical data of all adult patients who underwent abdominal surgery from May 1, 2018 to May 31, 2018 in 30 domestic hospitals, including basic information, perioperative parameters, and incisional microbial culture results. The primary outcome was the incidence of SSI within postoperative 30 days. SSI was classified into superficial incision infection, deep incision infection, and organ/gap infection according to the US Centers for Disease Control and Prevention (CDC) criteria. The secondary outcome variables were ICU stay, postoperative hospital stay, total hospital stay, 30-day mortality and treatment costs. Multivariate logistic regression was used to analyze the risk factors of SSI. RESULTS: A total of 1666 patients were enrolled in the study, including 263 cases of East War Zone Hospital of PLA, 140 cases of Affiliated Hospital of Qingdao University, 108 cases of The First Affiliated Hospital of Nanchang University, 87 cases of Central War Zone Hospital of PLA, 77 cases of West China Hospital, 74 cases of Guangdong General Hospital, 71 cases of Chenzhou First People's Hospital, 71 cases of Zigong First People's Hospital, 64 cases of Zhangjiagang First People's Hospital, 56 cases of Nanyang City Central Hospital, 56 cases of Lanzhou General Hospital of Lanzhou Military Command, 56 cases of Shandong Provincial Hospital, 52 cases of Shangqiu First People's Hospital, 52 cases of People's Hospital of Xinjiang Uygur Autonomous Region, 48 cases of The Second Xiangya Hospital of Central South University, 48 cases of Chinese PLA General Hospital, 44 cases of Affiliated Hospital of Xuzhou Medical University, 38 cases of Hunan Province People's Hospital, 36 cases of Dongguan Kanghua Hospital, 30 cases of Shaoxing Central Hospital, 30 cases of Northern Jiangsu People's Hospital, 29 vases of The First Affiliated Hospital of Zhengzhou University, 27 cases of General Hospital of Tianjin Medical University, 22 cases of Zigong Fourth People's Hospital, 21 cases of The Second Hospital of University of South China, 18 cases of Tongji Hospital, 15 cases of Nanchong Central Hospital, 12 cases of The 901th Hospital of PLA, 11 cases of Hunan Cancer Hospital, 10 cases of Lanzhou University Second Hospital. There were 1019 males and 647 females with mean age of (56.5±15.3) years old. SSI occurred in 80 patients (4.8%) after operation, including 39 cases of superficial incision infection, 16 cases of deep incision infection, and 25 cases of organ/interstitial infection. Escherichia coli was the main pathogen of SSI, and the positive rate was 32.5% (26/80). Compared with patients without SSI, those with SSI had significantly higher ICU occupancy rate [38.8%(31/80) vs. 13.9%(220/1586), P<0.001], postoperative hospital stay (median 17 days vs. 7 days, P<0.001) and total hospital stay (median 22 days vs. 13 days, P<0.001), and significantly higher cost of treatment (median 75 000 yuan vs. 44 000 yuan, P<0.001). Multivariate analysis showed that male rise(OR=2.110, 95%CI:1.175-3.791, P=0.012), preoperative blood glucose level rise(OR=1.100, 95%CI: 1.012-1.197, P=0.026), operative time (OR=1.006, 95%CI:1.003-1.009, P<0.001) and surgical incision grade (clean-contaminated incision:OR=10.207, 95%CI:1.369-76.120, P=0.023; contaminated incision: OR=10.617, 95%CI:1.298-86.865, P=0.028; infection incision: OR=20.173, 95%CI:1.768-230.121, P=0.016) were risk factors for SSI; and laparoscopic surgery (OR=0.348, 95%CI:0.192-0.631, P=0.001) and mechanical bowel preparation(OR=0.441,95%CI:0.221-0.879, P=0.020) were protective factors for SSI. CONCLUSIONS The incidence of postoperative SSI in patients with abdominal surgery in China is 4.8%. SSI can significantly increase the medical burden of patients. Preoperative control of blood glucose and mechanical bowel preparation are important measures to prevent SSI.
Abdomen ; surgery ; Adult ; Aged ; China ; Cross-Sectional Studies ; Female ; General Surgery ; statistics & numerical data ; Humans ; Male ; Middle Aged ; Operative Time ; Postoperative Complications ; prevention & control ; Preoperative Period ; Retrospective Studies ; Risk Factors ; Surgical Wound Infection ; prevention & control

Cortical bone is a kind of natural biological composite materials, which is mainly composed of tropocollagen molecules and nanoscale hydroxyapatite mineral crystals. It possesses high strength, stiffness and fracture toughness and has the ability to tolerate damage and self-heal. In the long process of evolution, bone tissues form the biomechanical strength and toughness to meet its functional needs. The excellent mechanical properties of cortical bone are closely related to its hierarchical microstructure. This paper reviewed the hierarchical microstructure of cortical bone and its toughening mechanisms, which would contribute to understanding the diagnosis, prevention and treatment of aging-related osteoporosis and the pathological mechanism of bone diseases.

Objective:To establish a database for pelvic trauma in Hunan Province,and to start the work of multicenter pelvic trauma registry.Methods:To establish the database,literatures relevant to pelvic trauma were screened,the experiences from the established trauma database in China and abroad were learned,and the actual situations for pelvic trauma rescue in Hunan Province were considered.The database for pelvic trauma was established based on the PostgreSQL and the advanced programming language Java 1.6.Results:The complex procedure for pelvic trauma rescue was described structurally.The contents for the database included general patient information,injurious condition,prehospital rescue,conditions in admission,treatment in hospital,status on discharge,diagnosis,classification,complication,trauma scoring and therapeutic effect.The database can be accessed through the internet by browser/servicer.The functions for the database include patient information management,data export,history query,progress report,video-image management and personal information management.Conclusion:The database with whole life cycle pelvic trauma is successfully established for the first time in China.It is scientific,functional,practical,and user-friendly.

BACKGROUND:Bone fragility and poor bone quality due to osteoporosis are a major and increasing concern. Bone microarchitecture and microdamage, the important factors of bone quality, their detection technology and instrument have experienced a long development process. OBJECTIVE:To give a brief introduction of the concept of the bone microarchitecture and microdamage, then to summarize the research progress of their detective methods. METHODS:PubMed and CNKI databases were retrieved for reviews and articles related to bone microarchitecture and microdamage published from January 1990 to June 2016 using the keywords of“bone microarchitecture, bone microdamage and detect/detective/detecting”in Chinese and English, respectively. Finaly a total of 65 articles were selected for overview. RESULTS AND CONCLUISON:(1) Bulk staining is a quick and useful way to confirm and assess linear microcracks and diffuse damage. Micro-CT and confocal microscopy al ow visualization at the micron scale, and are useful tools to understand the three-dimentional nature of bone microdamage. Scanning electron microscope lacks the ability to investigate large regions of microdamage, but al ows users to probe in extensive details at the nano scale. (2) Ultimately, we recommend the use of multiple imaging modalities according to the experimental needs to obtain useful information about bone quality and microdamage formation, across the scales of hierarchy in bone.

Objective To describe a technique to achieve primary donor-site closure, extend applications and minimize donor-site morbidity by applying the double skin paddle principle.Methods All 16 cases of the double skin paddle anterolateral thigh perforator flap reconstruction from May, 2008 to June, 2014 were reviewed.Defects locations included calf, dorsum pedis or planta pedis.A long anterolateral thigh perforator flap was marked out using standard points of reference.At least two separate cutaneous perforator vessles were identified on hand-held Doppler.Separating and dissecting flap at superficial layer of fascia lata was adopted in all cases.Then skin paddle was then divided between the two cutaneous perforators to give two separate paddles with a common vascular supply which was the descending branch of the lateral circumflex femoral artery.The skin paddles could be used to cover complex skin defects, whilst still allowing for primary donor-site closure.Results Fifteen patients were successfully treated with the double skin paddle anterolateral thigh perforator flap with no major complications.One case was suffered with partial skin flap necrosis.The type A dumbbell-like flaps was used to cover defects involving two different units of the foot.The type B pattern were stacked side by side on a flap inset, effectively doubling the width of the flap, to resurface a large defect of a single unit of the calf.The type C pattern was used to repair adjacent skin defects.In all cases, the donor site was closed directly.All patients were satisfied with their outcomes.Conclusion The double skin paddle anterolateral thigh perforator flap is an excellent method of resurfacing large defects of the extremity involving multiple subunits with improved morbidity and cosmesis of the donor site.