OBJECTIVE: To evaluate the effect of biodegradable magnesium alloy materials in promoting tendon-bone healing during rotator cuff tear repair and to investigate their potential underlying biological mechanisms. METHODS: Forty-eight 8-week-old Sprague Dawley rats were taken and randomly divided into groups A, B, and C. Rotator cuff tear models were created and repaired using magnesium alloy sutures in group A and Vicryl Plus 4-0 absorbable sutures in group B, while only subcutaneous incisions and sutures were performed in group C. Organ samples of groups A and B were taken for HE staining at 1 and 2 weeks after operation to evaluate the safety of magnesium alloy, and specimens from the supraspinatus tendon and proximal humerus were harvested at 2, 4, 8, and 12 weeks after operation. The specimens were observed macroscopically at 4 and 12 weeks after operation. Biomechanical tests were performed at 4, 8, and 12 weeks to test the ultimate load and stiffness of the healing sites in groups A and B. At 2, 4, and 12 weeks, the specimens were subjected to the following tests: Micro-CT to evaluate the formation of bone tunnels in groups A and B, HE staining and Masson staining to observe the regeneration of fibrocartilage at the tendon-bone interface after decalcification and sectioning, and Goldner trichrome staining to evaluate the calcification. Immunohistochemical staining was performed to detect the expressions of angiogenic factors, including vascular endothelial growth factor (VEGF) and bone morphogenetic protein 2 (BMP-2), as well as osteogenic factors at the tendon-bone interface. Additionally, immunofluorescence staining was used to examine the expressions of Arginase 1 and Integrin beta-2 to assess M1 and M2 macrophage polarization at the tendon-bone interface. The role of the phosphatidylinositol 3-kinase (PI3K)/protein kinase B (AKT) signaling pathway in tendon-bone healing was further analyzed using real-time fluorescence quantitative PCR. RESULTS: Analysis of visceral sections revealed that magnesium ions released during the degradation of magnesium alloys did not cause significant toxic effects on organs such as the heart, liver, spleen, lungs, and kidneys, indicating good biosafety. Histological analysis further demonstrated that fibrocartilage regeneration at the tendon-bone interface in group A occurred earlier, and the amount of fibrocartilage was significantly greater compared to group B, suggesting a positive effect of magnesium alloy material on tendon-bone interface repair. Additionally, Micro-CT analysis results revealed that bone tunnel formation occurred more rapidly in group A compared to group B, further supporting the beneficial effect of magnesium alloy on bone healing. Biomechanical testing showed that the ultimate load in group A was consistently higher than in group B, and the stiffness of group A was also greater than that of group B at 4 weeks, indicating stronger tissue-carrying capacity following tendon-bone interface repair and highlighting the potential of magnesium alloy in enhancing tendon-bone healing. Immunohistochemical staining results indicated that the expressions of VEGF and BMP-2 were significantly upregulated during the early stages of healing, suggesting that magnesium alloy effectively promoted angiogenesis and bone formation, thereby accelerating the tendon-bone healing process. Immunofluorescence staining further revealed that magnesium ions exerted significant anti-inflammatory effects by regulating macrophage polarization, promoting their shift toward the M2 phenotype. Real-time fluorescence quantitative PCR results demonstrated that magnesium ions could facilitate tendon-bone healing by modulating the PI3K/AKT signaling pathway. CONCLUSION Biodegradable magnesium alloy material accelerated fibrocartilage regeneration and calcification at the tendon-bone interface in rat rotator cuff tear repair by regulating the PI3K/AKT signaling pathway, thereby significantly enhancing tendon-bone healing.
Animals ; Rotator Cuff Injuries/metabolism* ; Rats, Sprague-Dawley ; Signal Transduction ; Wound Healing/drug effects* ; Alloys/pharmacology* ; Rats ; Proto-Oncogene Proteins c-akt/metabolism* ; Rotator Cuff/metabolism* ; Macrophages/metabolism* ; Magnesium/pharmacology* ; Phosphatidylinositol 3-Kinases/metabolism* ; Vascular Endothelial Growth Factor A/metabolism* ; Male ; Biocompatible Materials ; Bone Morphogenetic Protein 2/metabolism*

To summarize the perioperative nursing experience of a patient with thoracic and abdominal aortic dissection aneurysm after Stanford type A aortic dissection surgery,who underwent intra-abdominal aortic aneurysm endovascular isolation,in situ fenestration branch covered stent placement,and artificial blood vessel bypass.The nursing points include regular evaluation of the intra-abdominal pressure of the patient,being on guard against the rupture of the dissection;specialist nurses participated in the preoperative multidisciplinary discussion;establishing an emergency plan for the rescue of ruptured aortic dissection;monitoring the vital signs of patients closely to prevent critical complications during surgery.After multidisciplinary treatment and meticulous care,the patient's surgery went smoothly and the postoperative recovery was good.The patient was discharged 8 days later.

Objective:To explore the correlation between triglyceride glucose index (TyGI) and hyperuricemia (HUA) in theindividuals undergoing physical examinations.Methods:It was a cross-sectional study. A total of 21 720 individuals who underwent health examinations at the Health Management Center of Xiangya Hospital, Central South University from October 2020 to March 2021 were selected as the research subjects. Based on whether uric acid levels exceeded the normal range, the participants were divided into a HUA group and a control group (normal uric acid group). The independent correlation between TyGI and HUA was determined with multiple logistic regression analysis, and stratified analysis was conducted to investigate population differences in the correlation. And finally, a further evaluation was conducted to determine whether there was a nonlinear relationship between TyGI and HUA through smooth curve fitting and threshold saturation effect analysis.Results:The TyGI in the HUA group was significantly higher than that in the control group ( t=-41.787, P<0.001). After adjusting for relevant factors, the multiple logistic regression analysis showed that there was a significant positive correlation between TyGI and risk of HUA ( OR=1.755, 95% CI: 1.632-1.887); and as TyGI increased, the risk of HUA gradually increased. Stratified analysis and interaction tests were conducted based on age, gender, body mass index, blood glucose abnormalities, hypertension, and estimated glomerular filtration rate (eGFR), it′s indicated that TyGI was positively correlated with the risk of HUA in various populations except for in the individuals with a eGFR less than 60 ml·min -1·(1.73 m 2) -1 and in females (all P>0.05). The smooth curve fitting between TyGI and HUA suggested that as TyGI increased, the risk of HUA tended to increase. However, when TyGI reached a certain threshold, the risk of HUA no longer increased. Further analysis of threshold saturation effects suggested that the inflection point of TyGI was 9.871. Conclusion:The correlation between TyGI and HUA in the population undergoing health examinations is nonlinear.

Objective To explore the influencing factors of reversible ischemic edema on cranial CT after mechanical thrombectomy for anterior circulation acute large vessel occlusive stroke(ALVOS).Methods A total of 142 patients with anterior circulation ALVOS who underwent mechanical thrombectomy in the First Hospital of Jiaxing from June 2022 to July 2024 were selected as research subjects.According to the results of the postoperative cranial CT scan after mechanical thrombectomy,they were divided into irreversible ischemic edema group(120 cases)and reversible ischemic edema group(22 cases).The baseline clinical data of the patients were collected.Multivariate Logistic regression analysis was used to identify the influencing factors for reversible ischemic edema on cranial CT after mechanical thrombectomy in patients with anterior circulation ALVOS.Receiver operating characteristic(ROC)curve was constructed to evaluate its predictive value for reversible ischemic edema.Results The results of multivariate Logistic regression analysis showed that age(OR=1.057,95％CI:1.018-1.102,P=0.005)and collateral circulation grade(OR=0.395,95％CI:0.186-0.769,P=0.010)were influencing factors for reversible ischemic edema on cranial CT after mechanical thrombectomy for anterior circulation ALVOS.ROC curve analysis results showed that age,collateral circulation grade and their combination had a certain predictive value for reversible ischemic edema on cranial CT after mechanical thrombectomy for anterior circulation ALVOS.The area under the curve(AUC)of age and collateral circulation grade was 0.664 and 0.715,respectively,and AUC of the combination was 0.785,the best cut-off value was 0.861,the sensitivity was 68.3％,and the specificity was 81.8％.Conclusion The low-density area in the ischemic region on cranial CT after mechanical thrombectomy for a small percentage of anterior circulation ALVOS may be reversible.Younger age and good collateral circulation compensation in patients undergoing mechanical thrombectomy are associated with reversible ischemic edema in postoperative cranial CT.

Objective To explore the influencing factors of reversible ischemic edema on cranial CT after mechanical thrombectomy for anterior circulation acute large vessel occlusive stroke(ALVOS).Methods A total of 142 patients with anterior circulation ALVOS who underwent mechanical thrombectomy in the First Hospital of Jiaxing from June 2022 to July 2024 were selected as research subjects.According to the results of the postoperative cranial CT scan after mechanical thrombectomy,they were divided into irreversible ischemic edema group(120 cases)and reversible ischemic edema group(22 cases).The baseline clinical data of the patients were collected.Multivariate Logistic regression analysis was used to identify the influencing factors for reversible ischemic edema on cranial CT after mechanical thrombectomy in patients with anterior circulation ALVOS.Receiver operating characteristic(ROC)curve was constructed to evaluate its predictive value for reversible ischemic edema.Results The results of multivariate Logistic regression analysis showed that age(OR=1.057,95％CI:1.018-1.102,P=0.005)and collateral circulation grade(OR=0.395,95％CI:0.186-0.769,P=0.010)were influencing factors for reversible ischemic edema on cranial CT after mechanical thrombectomy for anterior circulation ALVOS.ROC curve analysis results showed that age,collateral circulation grade and their combination had a certain predictive value for reversible ischemic edema on cranial CT after mechanical thrombectomy for anterior circulation ALVOS.The area under the curve(AUC)of age and collateral circulation grade was 0.664 and 0.715,respectively,and AUC of the combination was 0.785,the best cut-off value was 0.861,the sensitivity was 68.3％,and the specificity was 81.8％.Conclusion The low-density area in the ischemic region on cranial CT after mechanical thrombectomy for a small percentage of anterior circulation ALVOS may be reversible.Younger age and good collateral circulation compensation in patients undergoing mechanical thrombectomy are associated with reversible ischemic edema in postoperative cranial CT.

To summarize the perioperative nursing experience of a patient with thoracic and abdominal aortic dissection aneurysm after Stanford type A aortic dissection surgery,who underwent intra-abdominal aortic aneurysm endovascular isolation,in situ fenestration branch covered stent placement,and artificial blood vessel bypass.The nursing points include regular evaluation of the intra-abdominal pressure of the patient,being on guard against the rupture of the dissection;specialist nurses participated in the preoperative multidisciplinary discussion;establishing an emergency plan for the rescue of ruptured aortic dissection;monitoring the vital signs of patients closely to prevent critical complications during surgery.After multidisciplinary treatment and meticulous care,the patient's surgery went smoothly and the postoperative recovery was good.The patient was discharged 8 days later.

Objective:To explore the correlation between triglyceride glucose index (TyGI) and hyperuricemia (HUA) in theindividuals undergoing physical examinations.Methods:It was a cross-sectional study. A total of 21 720 individuals who underwent health examinations at the Health Management Center of Xiangya Hospital, Central South University from October 2020 to March 2021 were selected as the research subjects. Based on whether uric acid levels exceeded the normal range, the participants were divided into a HUA group and a control group (normal uric acid group). The independent correlation between TyGI and HUA was determined with multiple logistic regression analysis, and stratified analysis was conducted to investigate population differences in the correlation. And finally, a further evaluation was conducted to determine whether there was a nonlinear relationship between TyGI and HUA through smooth curve fitting and threshold saturation effect analysis.Results:The TyGI in the HUA group was significantly higher than that in the control group ( t=-41.787, P<0.001). After adjusting for relevant factors, the multiple logistic regression analysis showed that there was a significant positive correlation between TyGI and risk of HUA ( OR=1.755, 95% CI: 1.632-1.887); and as TyGI increased, the risk of HUA gradually increased. Stratified analysis and interaction tests were conducted based on age, gender, body mass index, blood glucose abnormalities, hypertension, and estimated glomerular filtration rate (eGFR), it′s indicated that TyGI was positively correlated with the risk of HUA in various populations except for in the individuals with a eGFR less than 60 ml·min -1·(1.73 m 2) -1 and in females (all P>0.05). The smooth curve fitting between TyGI and HUA suggested that as TyGI increased, the risk of HUA tended to increase. However, when TyGI reached a certain threshold, the risk of HUA no longer increased. Further analysis of threshold saturation effects suggested that the inflection point of TyGI was 9.871. Conclusion:The correlation between TyGI and HUA in the population undergoing health examinations is nonlinear.

Objective:To explore the role of active screening in the diagnosis and treatment of early lung cancer, and give health management recommendations.Methods:A retrospective study was conducted to collect lung cancer patients who had complete population sociology, clinical information, pathology and imaging characteristics in the Thoracic Surgery in Xiangya Hospital of Central South University from 2016 to 2019. According to different diagnostic modes, they were divided into an active screening group (1082 cases) and a passive case finding group (974 cases), to analyze their differences in demographic sociological, clinical information, pathology and imaging characteristics, and to discuss the key points of population management in the active screening group.Results:From 2016 to 2019, the proportion of lung cancer patients in the active screening group increased from 36.1% to 54.2%, and the proportion of patients found to have lung cancer by CT examination in the active screening group increased from 82.2% to 96.8%. Compared with the passive case finding group, the active screening group had a higher proportion of women, non-smokers, patients with precursor glandular lesions and adenocarcinoma, patients in stage 0 and stage I, patients with lesion diameter (d)≤1 cm and 1

OBJECTIVE: To investigate the feasibility of MRI three-dimensional (3D) reconstruction model in quantifying glenoid bone defect by comparing with CT 3D reconstruction model measurement. METHODS: Forty patients with shoulder anterior dislocation who met the selection criteria between December 2021 and December 2022 were admitted as study participants. There were 34 males and 6 females with an average age of 24.8 years (range, 19-32 years). The injury caused by sports injury in 29 cases and collision injury in 6 cases, and 5 cases had no obvious inducement. The time from injury to admission ranged from 4 to 72 months (mean, 28.5 months). CT and MRI were performed on the patients' shoulder joints, and a semi-automatic segmentation of the images was done with 3D slicer software to construct a glenoid model. The length of the glenoid bone defect was measured on the models by 2 physicians. The intra-group correlation coefficient ( ICC) was used to evaluate the consistency between the 2 physicians, and Bland-Altman plots were constructed to evaluate the consistency between the 2 methods. RESULTS: The length of the glenoid bone defects measured on MRI 3D reconstruction model was (3.83±1.36) mm/4.00 (0.58, 6.13) mm for physician 1 and (3.91±1.20) mm/3.86 (1.39, 5.96) mm for physician 2. The length of the glenoid bone defects measured on CT 3D reconstruction model was (3.81±1.38) mm/3.80 (0.60, 6.02) mm for physician 1 and (3.99±1.19) mm/4.00 (1.68, 6.38) mm for physician 2. ICC and Bland-Altman plot analysis showed good consistency. The ICC between the 2 physicians based on MRI and CT 3D reconstruction model measurements were 0.73 [95% CI (0.54, 0.85)] and 0.80 [95% CI (0.65, 0.89)], respectively. The 95% CI of the difference between the two measurements of physicians 1 and 2 were (-0.46, 0.49) and (-0.68, 0.53), respectively. CONCLUSION The measurement of glenoid bone defect based on MRI 3D reconstruction model is consistent with that based on CT 3D reconstruction model. MRI can be used instead of CT to measure glenoid bone defects in clinic, and the soft tissue of shoulder joint can be observed comprehensively while reducing radiation.
Male ; Female ; Humans ; Young Adult ; Adult ; Imaging, Three-Dimensional/methods* ; Tomography, X-Ray Computed/methods* ; Joint Instability ; Shoulder Joint/diagnostic imaging* ; Shoulder Dislocation ; Magnetic Resonance Imaging/methods*

Objective:To investigate the clinical efficacy of high-frequency repetitive transcranial magnetic stimulation combined with electrical stimulation in patients with dysphagia after stroke.Methods:Seventy-two stroke patients with dysphagia who received treatment in The First Hospital of Jiaxing from February 2019 to February 2020 were included in this study. They were randomly assigned to receive either electrical stimulation (control group, n = 36) or high-frequency repetitive transcranial magnetic stimulation combined with electrical stimulation (observation group, n = 36) for 2 weeks. Changes in serum brain-derived neurotrophic factor, neuron-specific enolase, and vascular endothelial growth factor levels after treatment relative to before treatment were observed in each group. Scores of the swallowing function assessment scale, neurological deficit, and quality of life were compared between the control and observation groups. Results:After treatment, serum levels of brain-derived neurotrophic factor and vascular endothelial growth factor in the observation group were (7.98 ± 1.14) μg/L, (168.78 ± 10.28) ng/L, respectively, which were significantly higher than those in the control group [(5.80 ± 1.10) μg/L, (110.34 ± 10.47) ng/L, t = 8.26, 23.90, both P < 0.01]. Serum neuron-specific enolase level was significantly lower in the observation group than in the control group [(7.57 ± 1.17) μg/L vs. (10.66 ± 1.30) μg/L, t = 10.60, P < 0.001). The scores of swallowing function assessment scale and neurological deficits in the observation group were (2.47 ± 1.16) points and (7.03 ± 1.14) points, respectively, which were significantly lower than those in the control group [(5.75 ± 1.10) points, (9.66 ± 1.20) points, t = 12.31, 9.53, both P < 0.001]. Total effective rate [97.22% (35/36) vs. 77.78% (28/36)] and the score of swallowing quality of life questionnaire [(160.40 ± 8.32) points vs. (146.74 ± 8.10) points] were significantly higher in the observation group than in the control group ( χ2 = 4.57, P = 0.03, t = 7.25, P < 0.001). Conclusion:High-frequency repetitive transcranial magnetic stimulation combined with electrical stimulation can greatly improve neurological function and swallowing function of stroke patients with dysphagia. The combined therapy is of certain clinical value and innovation.