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*

Objective To explore the sex difference in clinical manifestations, echocardiographic features and prognosis of patients with bicuspid aortic valve (BAV) combined with moderate to severe aortic stenosis (AS). Methods The clinical data and echocardiographic follow-up parameters of patients diagnosed with BAV combined with moderate to severe AS at Zhongshan Hospital, Fudan University, from July 30, 2010 to August 1, 2015 were retrospectively collected. The composite endpoint was defined as all-cause mortality or surgical intervention. Kaplan-Meier survival curve and log-rank test were used to compare the risk of composite endpoint events between male and female patients, and Cox regression models were used to analyze independent risk factors for composite endpoint events. Results A total of 144 patients were included, with 69 males and 75 females, and a median age of 60 years. Compared to males, female patients were younger (58[46, 65] years vs 61[54, 67] years, P＝0.046), had a lower proportion of aortic valve calcification (61.1% vs 81.1%, P＝0.009), and a higher peak transvalvular pressure gradient (72[59, 88] mmHg vs 63[55, 72] mmHg, P＝0.002). In terms of left ventricular remodeling types, the proportion of concentric remodeling was higher in females than in males (36.0% vs 15.9%, P＝0.006), while the proportion of eccentric hypertrophy was lower in females than in males (10.7% vs 29.0%, P＝0.006). The proportion of female patients classified as New York Heart Association (NYHA) functional class Ⅲ-Ⅳ was higher than that of males (45.3% vs 17.4%, P＜0.001), and left ventricular ejection fraction was higher in females (68%[65%, 72%] vs 65%[60%, 70%], P＝0.003). With a median follow-up of 49 months, Kaplan-Meier survival analysis showed that the risk of composite endpoint events was higher in females than in males (P＜0.001). Independent risk factors for composite endpoint events included female (HR＝1.74, 95%CI 1.02-2.96, P＝0.042), severe AS (HR＝1.99, 95%CI 1.18-3.36, P＝0.010), and NYHA functional class Ⅲ-Ⅳ (HR＝2.08, 95% CI 1.24-3.47, P＝0.005). Conclusions Sex significantly affects the clinical manifestations, echocardiographic characteristics, and prognosis of patients with BAV combined with moderate to severe AS, suggesting that sex-specific echocardiographic assessment and follow-up monitoring should be conducted for these patients.

Objective:To investigate the efficacy and safety of combined catheter-directed thrombolysis and anticoagulation for acute pulmonary embolism combined with lower limb deep vein thrombosis.Methods:A retrospective analysis was conducted using a case-control study approach on the clinical data of 58 patients with acute pulmonary embolism who received treatment at the Inner Mongolia Autonomous Region People's Hospital from August 2021 to August 2023. These patients were categorized into two groups based on whether they had lower-limb deep vein thrombosis or not. The group with pulmonary embolism alone ( n = 14) underwent targeted catheter thrombolysis in combination with anticoagulation treatment using low molecular-weight heparin. The group with both pulmonary embolism and deep vein thrombosis in the lower limbs (combined group, n = 44) received inferior vena cava filter placement, along with targeted catheter thrombolysis and anticoagulation treatment with low-molecular weight heparin. The improvement in pulmonary circulation was observed before and after the surgical interventions in both groups. A comparison was made regarding the improvement in indicators including arterial oxygen pressure, fingertip oxygen saturation, the proportion of pulmonary artery trunk thrombosis area to pulmonary artery trunk area, and respiratory rate, both before and after pulmonary artery catheterization and thrombolysis in both groups. Results:The surgery was successful for all patients. The symptom of shortness of breath was obviously relieved after surgery. After surgery, in the pulmonary embolism alone group, the respiratory rate was (22.75 ± 4.38) beats/min, the mean pulmonary artery pressure was (32.53 ± 3.63) mmHg (1 mmHg = 0.133 kPa), the arterial oxygen partial pressure was (81.46 ± 7.24) mmHg, and the fingertip oxygen saturation was (90.53 ± 4.57)%, respectively. In the combined group, the respiratory rate, mean pulmonary artery pressure, arterial oxygen partial pressure, and fingertip oxygen saturation were (23.35 ± 5.8) beats/min, (31.34 ± 4.53) mmHg, (82.34 ± 4.62) mmHg, and (92.57 ± 3.45)%, respectively. After surgery, the respiratory rate, pulmonary artery pressure, arterial oxygen partial pressure, and fingertip oxygen saturation in each group were significantly higher compared with the corresponding levels before surgery ( t = 6.33, 12.12, 17.32, 8.13, 6.86, 13.02, 15.52, 7.20, all P < 0.001). The proportion of pulmonary artery trunk thrombosis area to pulmonary artery trunk area in the group with pulmonary embolism alone was (19.56 ± 7.53)%, while in the combined group, it was (20.63 ± 4.83)%. After surgery, the proportion of pulmonary artery trunk thrombosis area to pulmonary artery trunk area in each group decreased compared with the corresponding value before surgery ( t = 19.36, 18.23, both P < 0.001). Conclusion:The surgical method combining catheter-directed thrombolysis with inferior vena cava filter placement is effective and safe for the treatment of acute pulmonary embolism combined with deep vein thrombosis in the lower limbs.

Objective To observe the value of nomogram obtained with multivariate logistic regression based on ultrasound for predicting residue of benign thyroid nodules after microwave ablation(MWA).Methods Totally 101 patients with 133 benign thyroid nodules who underwent ultrasound-guided MWA were retrospectively enrolled.The nodules were divided into residual group(n=21)and non-residual group(n=112)according to follow-up results of contrast-enhanced ultrasound(CEUS)1 month after MWA.The ultrasonic performances of nodules before MWA were compared between groups,and those being statistically different were included in a multivariate logistic regression model to identify the independent predictors for residue after MWA,and the model was then visualized as a nomogram.The discrimination of the nomogram for predicting residue after MWA was assessed with receiver operating characteristic curve and area under the curve(AUC),and its calibration was assessed with Hosmer-Lemeshow goodness-of-fit test.Results High ablation risk and nodules volume shown with ultrasound were both independent predictors of residue of benign thyroid nodules after MWA(both P＜0.05),indicating that benign thyroid nodules with high ablation risk(OR=17.637[2.528,123.019])and large volume(OR=1.297[1.155,1.457])had relatively higher risk of residue after MWA.AUC of the nomogram was 0.756 for predicting residue of benign thyroid nodules after MWA,while Hosmer-Lemeshow test showed good fit(P=0.401).Conclusion Benign thyroid nodules with high ablation risk and large volume shown with ultrasound had relatively high risk of residue after MWA,which could be predicted conveniently and effectively with the obtained nomogram.

Objective To investigate the effects and mechanisms of LINC00657 on oxidative glucose deprivation (OGD)-induced injury in mouse hippocampal neurons. Methods Mouse hippocampal neuron cell line HT22 was given OGD treatment to establish an injury model, with normally cultured HT22 cells as controls. The si-NC, si-LINC00657, microRNA(miR)-NC, and miR-224-3p mimics were transfected into HT22 cells, followed by OGD treatment. Co-transfection of si-LINC00657 and anti-miR-NC, or co-transfection of si-LINC00657 and anti-miR-224-3p, was performed in HT22 cells before OGD treatment. Real-time quantitative reverse transcription-polymerase chain reaction (qRT-PCR) was used to detect the relative expression levels of LINC00657 and miR-224-3p. CCK-8 assay and flow cytometry were used to detect cell viability and apoptosis rate, respectively. Kits were used to detect the activities of lactate dehydrogenase (LDH), superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), and the level of malondialdehyde (MDA). Dual-luciferase reporter gene assay was used to detect the effect of miR-224-3p overexpression on the luciferase activity of wild-type LINC00657 vector (WT-LINC00657) and mutant LINC00657 vector (MUT-LINC00657). Results Compared with controls, the expression of LINC00657 was upregulated and the expression of miR-224-3p was downregulated in OGD-induced HT22 cells (P < 0.05). Compared with transfection of si-NC or miR-NC, transfection of si-LINC00657 or miR-224-3p mimics resulted in increased cell viability, SOD activity, and GSH-Px activity, as well as decreased apoptosis rate, LDH activity, and MDA level(P < 0.05). Overexpression of miR-224-3p reduced the luciferase activity of WT-LINC00657 (P < 0.05). Compared with cells co-transfected with si-LINC00657 and anti-miR-NC, cells co-transfected with si-LINC00657 and anti-miR-224-3p showed decreased cell viability, increased apoptosis rate, increased LDH activity and MDA level, and decreased SOD and GSH-Px activities (P < 0.05). Conclusion Interference with LINC00657 can promote cell proliferation, inhibit apoptosis and oxidative stress response by upregulating miR-224-3p, thereby alleviating OGD-induced injury in mouse hippocampal neurons.

【Objective】 To investigate the influencing factors of surgically induced astigmatism (SIA) in phacoemulsification. 【Methods】 Cataract phacoemulsification was performed in 69 patients with regular corneal astigmatism from December 2021 to March 2022. SIA of the anterior corneal surface, posterior corneal surface and simulated keratometry (SimK) in the diameter range of 3 mm, 5 mm and 7 mm centered at the apex of the cornea was observed. Pearson correlation analysis was used to analyze SIA with age, axial length (AL), anterior chamber depth (ACD), white-to-white (WTW), and central corneal thickness (CCT). Multiple linear regression was used to analyze the influencing factors of SIA. 【Results】 The mean age of the 69 patients was (63.25±14.74) years old, and 28 (40.58%) were male. The analysis found that the |SIA| of SimK was negatively correlated with WTW (r=-0.265, P=0.028), the |SIA| of 3 mm, 5 mm, 7 mm anterior surface was negatively correlated with WTW (r=-0.320, P=0.007; r=-0.337, P=0.005; r=-0.287, P=0.017), and the |SIA| of 3 mm, 5 mm, 7 mm posterior surface was negatively correlated with AL (r=-0.390, P=0.001; r=-0.352, P=0.003; r=-0.317, P=0.008). Multiple regression analysis showed that WTW was negatively correlated with |SIA| of SimK, 3 mm, 5 mm, 7 mm anterior surface and 3 mm posterior surface (B=-0.261, P=0.047; B=-0.387, P=0.016; B=-0.323, P=0.009; B=-0.297, P=0.041; B=-0.085, P=0.049). WTW was positively correlated with XSIA of 3 mm anterior surface, YSIA of 5 mm, and 7 mm anterior surface (B=0.347, P=0.040; B=0.318, P=0.034; B=0.403, P=0.010). AL was negatively correlated with |SIA| on the posterior surface of 3 mm and 5 mm (B=-0.023, P=0.021; B=-0.034, P=0.030). 【Conclusion】 During cataract surgery, the effect of ocular biological parameters such as axial length and corneal diameter on SIA should be considered.

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 investigate the voicing acoustic characteristics of sulcus vocalis patients with mini-mum glottal area(MGA) .Methods 60 normal subjects (30 male ,30 female) ,and 62 subjects with sulcus vocalis (33 male and 29 female)were recruited .They all had stroboscopic laryngoscopy ,and had MGA measured when say-ing /i:/using software supporting KIPS .The acoustic parameters consisted of vocal cord fundamental frequency (F0) ,jitter and shimmer ,normalized noise energy ( NNE) ,harmony to noise ratio (HNR) and signal noise ratio (SNR) ,maximum phonation time(MPT) and respectively make correlation analysis with voice MGA .Results The voicing MGA of male patients with sulcus vocalis was 434 .74 ± 112 .83 ,larger than the males with normal vocalis 298 .25 ± 93 .63 .This was statistically significant (P<0 .05) .The voicing MGA of females with sulcus vocalis was (484 .75 ± 143 .91) ,significantly larger than those of females with normal vocalis (293 .43 ± 93 .73) and the differ-ence was statistically significant (P<0 .05) .The voicing MGA on both males and females with sulcus vocalis was noticeably relation to the F0 (r=0 .972 ,P<0 .05) and (r=0 .928 ,P<0 .05) ,Jitter (r=0 .978 ,P<0 .05) and (r=0 .910 ,P<0 .910) and Shimmer (r=0 .973 ,P<0 .05) and (r=0 .921 ,P<0 .05) ,normalized noise energy(r=0 .883 ,P<0 .05) and (r=0 .960 ,P<0 .05) ;and negative relation to the signal noise ratio (r= -0 .947 ,P<0 .05) and (r = -0 .957 ,P<0 .05) ,signal noise ratio (r= -0 .959 ,P<0 .05) and (r= -0 .944 ,P<0 .05) ,max-imum phonation time (r= -0 .891 ,P<0 .05) and (r= -0 .936 ,P<0 .05) .Conclusion Patients with pathological sulcus vocalis have glottal areas larger than normal .Acoustic analysis of the voices of the sulcus vocalis can be used as an objective laboratory examination .

Objective To clone cDNA of trichosanthin (TCS) and purify TCS, and to study its influence on apoptosis and growth inhibition of colorectal carcinoma LoVo cells in vitro. Methods MTT assay was adopted to measure the growth inhibition ratio of LoVo cells treated with TCS, and apoptosis was assayed by agarose gel eletrophoresis. Results The results showed that the higher concentration of TCS and the longer testing time, the stronger growth inhibition of LoVo cells. DNA agarose gel eletrophoresis showed a gradient, which confirmed that TCS could induce the apoptosis of LoVo cells. Conclusions TCS can inhibit the growth of LoVo cells in vitro and induce its apoptosis. Our study provides evidence for the application of TCS in clinical treatment of human colorectal carcinoma.