1.Risk factors for lower extremity deep vein thrombosis in patients with acute necrotizing pancreatitis and effectiveness of risk assessment models
Liu YANG ; Gang ZHU ; Longfei ZENG ; Benjian GAO ; Bo LI
Journal of Clinical Hepatology 2026;42(3):647-654
ObjectiveTo investigate the influencing factors and independent risk factors for lower extremity deep vein thrombosis (DVT) in patients with acute necrotizing pancreatitis (ANP), to analyze the effectiveness of three commonly used risk assessment models for thrombosis (Caprini score, Padua score, and Wells score), and to provide a reference for clinical identification of high-risk individuals and optimization of prevention and treatment strategies. MethodsA retrospective analysis was performed for the clinical data of 320 patients with ANP who were admitted to Luzhou People’s Hospital and The Affiliated Hospital of Southwest Medical University from April 2013 to April 2024, and according to the presence or absence of DVT during hospitalization, the patients were divided into thrombosis group with 25 patients and control group with 295 patients. After propensity score matching, the two groups were compared in terms of past history and various examination results during hospitalization. The risk factors for lower extremity DVT in ANP patients during hospitalization were analyzed through univariate and multivariate Logistic regression, and a DVT risk prediction model was established based on independent influencing factors. The receiver operating characteristic (ROC) curve was used to assess the performance of models, and the DeLong test was used for comparison of the area under the ROC curve (AUC), sensitivity, and specificity. The independent-samples t test or the Mann-Whitney U test was used for comparison of continuous data between two groups; the chi-square test was used for comparison of categorical data between groups. ResultsAfter matching, the patients were divided into thrombosis group with 24 patients and control group with 112 patients. The clinical characteristics analysis showed that compared with the control group, the thrombosis group had significantly higher degree of pancreatic necrosis, D-dimer level, Bedside Index for Severity in Acute Pancreatitis (BISAP) score, and proportion of patients undergoing dialysis (all P<0.05). The multivariable Logistic regression analysis showed that BISAP score, degree of pancreatic necrosis, and D-dimer level were independent risk factors for lower extremity DVT in ANP patients during hospitalization (all P<0.05). The BISAP-Caprini score model had an AUC of 0.832 (95% confidence interval: 0.722 — 0.942, P<0.001) in predicting the risk of lower extremity DVT, with a Youden index of 1.661, an optimal cut-off value of 0.26, a sensitivity of 75.0%, and a specificity of 91.1%. ConclusionD-dimer, BISAP score, and the degree of pancreatic necrosis are independent risk factors for lower extremity DVT in patients with ANP during hospitalization, and the BISAP-Caprini score model can effectively predict the risk of DVT in ANP patients.
2.Study on the role and mechanism of SPP1+ macrophages in the formation of chronic renal allograft fibrosis
Zexin YANG ; Zeping GUI ; Junqi ZHANG ; Gang ZHANG ; Hao CHEN ; Li SUN ; Shuang FEI ; Min GU ; Zijie WANG
Organ Transplantation 2026;17(3):413-421
Objective To investigate the role and potential mechanism of secreted phosphoprotein 1 (SPP1)+ macrophages in the formation of chronic renal allograft fibrosis. Methods The expression features of SPP1+ macrophages in renal allografts of chronic allograft dysfunction (CAD) patients were analyzed based on single-cell transcriptome data of renal tissues from patients with CAD. Transcription factor VIPER analysis and DoRothEA transcription factor activity analysis were performed on the single-cell transcriptome data. Renal tissue samples were collected from kidney transplant recipients, including the CAD group (n=5) and the non-renal allograft fibrosis group (CTL group, n=5). A mouse model of chronic allograft rejection was established and divided into the allogeneic kidney transplantation group (CAD group, n=3) and the syngeneic kidney transplantation group (SYN group, n=3). Hematoxylin-eosin staining was used to detect renal tissue injury in mice, and Masson staining was used to detect renal tissue fibrosis. Immunofluorescence staining was performed to detect SPP1 expression in renal tissues of transplant recipients and mouse renal allografts. Bone marrow-derived macrophages (BMDMs) were extracted from mice and subjected to hypoxia stimulation. The expression of hypoxia-inducible factor (HIF)-1α and SPP1 was detected by Western blot, and SPP1 expression was detected by flow cytometry. BMDMs were transfected with HIF-1α overexpression plasmid and HIF-1α small interfering RNA (siRNA) followed by hypoxia intervention, and the expression of HIF-1α and SPP1 was detected by Western blot. Mouse aortic endothelial cells (MAECs) were co-cultured with the supernatant of BMDMs, and the expression of endothelial-mesenchymal transition (EndMT)-related markers was detected by Western blot and immunofluorescence. Results Single-cell transcriptome analysis showed that the proportion of SPP1+ macrophages in renal allograft tissues was significantly higher in the CAD group than in the CTL group (P<0.05). The renal injury score and the percentage of interstitial fibrotic area in the CAD group were significantly higher than those in the SYN group (both P<0.05). Immunofluorescence staining showed that the proportion of SPP1+ macrophages was increased in the CAD group compared with the CTL group, and also increased in the CAD group compared with the SYN group (both P<0.05). VIPER analysis and DoRothEA transcription factor activity analysis revealed activation of the hypoxia pathway and upregulated expression of transcription factors such as HIF-1α in SPP1+ macrophages. SPP1 expression was elevated in BMDMs under hypoxic conditions. Knockdown of HIF-1α inhibited hypoxia-induced SPP1 protein expression, whereas overexpression of HIF-1α upregulated SPP1 protein levels. After co-culture of hypoxia-induced BMDMs with MAECs, the expression levels of EndMT-related markers were increased. Conclusions SPP1+ macrophages differentiated under hypoxia are significantly infiltrated in the formation of chronic renal allograft fibrosis, and may promote renal allograft fibrosis by inducing EndMT in renal vascular endothelial cells.
3.Analysis of the impact of intraoperative RhE antigen-matched transfusion on early prognosis in liver transplant patients
Xiaochao YU ; Xinyuan GAO ; Fan HAI ; Chao YANG ; Xingyu HOU ; Yaping XING ; Hongqiang GAO ; Hongwei ZHANG ; Gang SU ; Ronghua XU
Chinese Journal of Blood Transfusion 2026;39(1):44-50
Objective: To investigate the impact of RhE antigen-matched transfusion during liver transplantation on early postoperative recovery and complications. Methods: In this retrospective cohort study, ninety-five patients undergoing liver transplantation at Kunming First People's Hospital between January 2022 and July 2025 were enrolled. Patients were divided into two groups: Group 1 (RhE-mismatched transfusion, n=57) and Group 2 (RhE-matched transfusion, n=38). The baseline data, complete blood counts, hepatic and renal function, coagulation parameters, and complication rates between the two groups were compared at postoperative days 1, 3, 5, 7, and 10. Survival analysis was performed using the Kaplan-Meier method. Results: The baseline characteristics were well-balanced and comparable between the two groups (all P>0.05). The early postoperative mortality rate in the mismatched group (31.58%, 18/57) was significantly higher than that in the matched group (10.53%, 4/38) (P=0.017). The incidence of postoperative hepatic encephalopathy was significantly higher in the mismatched group (50.88%, 29/57) than in the matched group (10.53%, 4/38) (P<0.001). The incidence of postoperative haemorrhage in the mismatched group (24.56%, 14/57) was higher than that in the matched group (5.26%, 2/38), with a statistically significant difference (P=0.014). The incidence of perioperative infection in the mismatched group (28.07%, 16/57) was higher than that in the matched group (10.53%, 4/38), with a statistically significant difference (P=0.04). Corresponding odds ratios (OR) and 95% confidence intervals indicated a lower risk of these adverse events in the matched group. On postoperative day 1, the change in activated partial thromboplastin time (-1.6, 20.5) in the mismatched group was greater than in the matched group (-0.2, 5.5). The change in international normalised ratio (-0.56, 1.22) in the mismatched group was greater than in the matched group (-0.18, 0.32), while the change in albumin (-4.0, 4.8) was smaller in the mismatched group than in the matched group (-2.5, 8.8). On postoperative day 5, the change in albumin (-0.41±7.83) in the mismatched group was smaller than in the matched group (2.68±4.53). At postoperative day 7, the change in albumin in the mismatched group (-0.61±7.38) was smaller than that in the matched group (2.51±5.85), while the change in D-dimer in the mismatched group (0.73, 7.4) was greater than that in the matched group (-1.6, 4.3). On postoperative day 10, the mismatched group exhibited significantly higher fibrinogen levels (-1.21, 1.78) than the matched group (-0.49, 0.97), and significantly longer prothrombin times (-11.3, -2.7) than the matched group (-6.2, -0.8) (all P<0.05). The matched group exhibited a mean overall survival (OS) of 32.803 months (95% CI:29.171-36.436 months), significantly exceeding the mismatched group's 28.996 months (95% CI:24.202-33.790 months). The log-rank test yielded statistically significant results (χ
=4.307, P=0.038). Conclusion: Implementing RhE blood group-matched transfusion during liver transplantation may help reduce early postoperative mortality and the incidence of major complication rates, promote faster recovery of coagulation and liver function, and thereby improve short-term patient outcomes.
4.Mechanism of Wumeiwan on Inhibiting Fatty Acid Metabolism Reprogramming in Prevention and Treatment of Colorectal Cancer Based on Multi-omics Analysis
Gang XIAO ; Shusen YANG ; Mingming SI ; Yanyan YANG ; Hailiang WEI ; Shuguang YAN ; Hui LUO
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(9):21-30
ObjectiveTo investigate the mechanism by which Wumeiwan suppresses the development and progression of colorectal cancer(CRC) through the regulation of fatty acid metabolic reprogramming, thereby providing new experimental evidence for the prevention and treatment of CRC. MethodsA total of 120 C57BL/6 mice were randomly divided into the blank group, model group, Wumeiwan high-, medium-, and low-dose groups(54, 27, 13.5 g·kg-1), and the mesalazine group(0.01 g·kg-1), with 20 mice in each group. Except for the blank group, all mice were subjected to azoxymethane(AOM)/dextran sulfate sodium(DSS) treatment to establish an inflammation-associated CRC model. One week after AOM injection, mice in the treatment groups received intragastric administration of the designated drugs, while the blank and model groups received an equal volume of purified water, continuing until 20 d after the intervention endpoint. Hematoxylin-eosin(HE) staining was used to observe colonic histopathological alterations, and immunohistochemistry for vascular endothelial growth factor(VEGF) was performed to evaluate neovascularization and tumor invasion. Metabolomics combined with Kyoto Encyclopedia of Genes and Genomes(KEGG) and metabolite set enrichment analysis(MSEA) was applied to identify key CRC-related metabolic pathways, which were further validated by transcriptomic Gene Ontology(GO) enrichment and gene heatmap analysis. Subsequently, Western blot was performed to determine the expression levels of core proteins in these pathways, and immunofluorescence was used to analyze their localization and co-expression patterns in tissues, thereby elucidating the mechanism of Wumeiwan from multiple biological dimensions. ResultsCompared with the blank group, mice in the model group exhibited a significant decrease in body weight and a significant increase in the disease activity index(DAI) score(P<0.05), with pronounced colonic mucosal damage accompanied by aggravated tumor invasion. Compared with the model group, Wumeiwan intervention markedly improved body weight loss and reduced DAI score, attenuated mucosal injury, and significantly decreased VEGF expression level(P<0.05). Multi-omics analysis revealed that differential metabolites and genes across groups were commonly enriched in fatty acid metabolism, fatty acid biosynthesis, and other lipid-related pathways. Relative to the blank group, the model group showed significant upregulation levels of fatty acid synthesis-related genes, including sterol regulatory element-binding protein 1(SREBP1), fatty acid synthase(FASN), stearoyl-CoA desaturase 1(SCD1), as well as saturated fatty acids(P<0.05). Compared with the model group, treatment with Wumeiwan significantly reduced the expression of key genes involved in fatty acid metabolic pathways, including SREBP1, FASN, and SCD1(P<0.05). Western blot results further confirmed that proteins in this pathway were significantly elevated in the model group, whereas they were markedly downregulated following Wumeiwan treatment(P<0.05). Immunofluorescence analysis demonstrated enhanced co-localization of SREBP1 with the cancer-associated fibroblast(CAF) marker α-smooth muscle actin(SMA) in the model group, whereas this co-localization signal was attenuated after Wumeiwan intervention(P<0.05). ConclusionWumeiwan can improve survival outcomes and alleviate colonic pathological damage in CRC mice, its therapeutic mechanism may be closely associated with the regulation of fatty acid metabolic reprogramming mediated by the SREBP1/FASN/SCD1 signaling pathway.
5.Role of miRNA in prostate cancer and research progress of traditional Chinese medicine intervention.
Sheng-Long LI ; Yong-Lin LIANG ; Xiu-Juan YANG ; Yong-Qiang ZHAO ; Hui LI ; Gang-Gang LU ; Xu MA ; Da-Cheng TIAN
China Journal of Chinese Materia Medica 2025;50(10):2619-2630
Prostate cancer(PCa) is a common malignant tumor among elderly men, with high incidence and mortality rates worldwide, posing a serious threat to human health. Traditional treatments face limitations, highlighting the urgent need for novel therapeutic strategies. Recent studies on the regulatory mechanisms of micro ribonucleic acid(microRNA, miRNA) in tumor development has identified miRNA as new targets for PCa diagnosis and treatment. Traditional Chinese medicine(TCM), with its multi-mechanism, multi-target, and multi-pathway regulatory properties, shows promising potential in miRNA-based PCa therapy. This review summarized recent findings on miRNA' roles in PCa and research progress of TCM intervention and found that a variety of miRNA played important regulatory roles in cell differentiation, proliferation, apoptosis, invasion, metastasis, immune microenvironment, and drug resistance, and their potential as biomarkers for PCa diagnosis, prognosis, and therapy, indicating the potential to be a biomarker for the diagnosis, prognosis evaluation, and treatment of PCa. The review concluded that the active components of TCM(terpenoids, flavonoids, alkaloids, and others) and compounds(Yishen Tonglong Decoction, Shenhu Decoction, Zhoushi Qiling Decoction, Fuzheng Yiliu Decoction, and Qilan Formula) could regulate the expression of their downstream target genes by acting on specific miRNA and affect the above biological behaviors of PCa cells, thus playing a role in the treatment of PCa. This review aims to provide a theoretical basis for miRNA as potential biomarkers and therapeutic targets for PCa and suggest new avenues for further development of targeted therapy strategies against miRNA.
Humans
;
MicroRNAs/metabolism*
;
Prostatic Neoplasms/metabolism*
;
Male
;
Drugs, Chinese Herbal/therapeutic use*
;
Medicine, Chinese Traditional
;
Animals
;
Gene Expression Regulation, Neoplastic/drug effects*
6.Research progress in traditional Chinese medicine treatment of kidney-Yang deficiency syndrome by regulating neuro-endocrine-immune system.
Xiao YANG ; Jia-Geng GUO ; Yu DUAN ; Zhen-Dong QIU ; Min-Qi CHEN ; Wei WEI ; Xiao-Tao HOU ; Er-Wei HAO ; Jia-Gang DENG
China Journal of Chinese Materia Medica 2025;50(15):4153-4165
Kidney-Yang deficiency syndrome is a common geriatric disease that underlies chronic conditions such as diabetic nephropathy, chronic kidney disease, and osteoporosis. As age progresses, the kidney-Yang deficiency syndrome showcases increasingly pronounced manifestations, emerging as a key factor in the comorbidities experienced by elderly patients and affecting their quality of life and overall health status. Traditional Chinese medicine(TCM) has been extensively utilized in the treatment of kidney-Yang deficiency syndrome, with Epimedii Folium, Cinnamomi Cortex, and Lycii Fructus widely used in clinical settings. Despite the complexity of the molecular mechanisms involved in treating kidney-Yang deficiency syndrome, the potential therapeutic value of TCM remains compelling. Delving into the mechanisms of TCM treatment of kidney-Yang deficiency syndrome by regulating the neuro-endocrine-immune system can provide a scientific basis for targeted treatments of this syndrome and lay a foundation for the modernization of TCM. The pathophysiology of kidney-Yang deficiency syndrome involves multiple systems, including the interaction of the neuro-endocrine-immune system, the decline in renal function, the intensification of oxidative stress responses, and energy metabolism disorders. Understanding these mechanisms and their interrelationships can help untangle the etiology of kidney-Yang deficiency syndrome, aiding clinicians in making more precise diagnoses and treatments. Furthermore, the research on the specific applications of TCM in research on these pathological mechanisms can enhance the international recognition and status of TCM, enabling it to exert a greater global influence.
Humans
;
Yang Deficiency/physiopathology*
;
Drugs, Chinese Herbal/therapeutic use*
;
Medicine, Chinese Traditional
;
Kidney Diseases/physiopathology*
;
Neurosecretory Systems/physiopathology*
;
Animals
;
Kidney/physiopathology*
;
Endocrine System/physiopathology*
;
Immune System/physiopathology*
7.AI-Ready Competency Framework for Biomedical Scientific Data Literacy.
Zhe WANG ; Zhi-Gang WANG ; Wen-Ya ZHAO ; Wei ZHOU ; Sheng-Fa ZHANG ; Xiao-Lin YANG
Chinese Medical Sciences Journal 2025;40(3):203-210
With the rise of data-intensive research, data literacy has become a critical capability for improving scientific data quality and achieving artificial intelligence (AI) readiness. In the biomedical domain, data are characterized by high complexity and privacy sensitivity, calling for robust and systematic data management skills. This paper reviews current trends in scientific data governance and the evolving policy landscape, highlighting persistent challenges such as inconsistent standards, semantic misalignment, and limited awareness of compliance. These issues are largely rooted in the lack of structured training and practical support for researchers. In response, this study builds on existing data literacy frameworks and integrates the specific demands of biomedical research to propose a comprehensive, lifecycle-oriented data literacy competency model with an emphasis on ethics and regulatory awareness. Furthermore, it outlines a tiered training strategy tailored to different research stages-undergraduate, graduate, and professional, offering theoretical foundations and practical pathways for universities and research institutions to advance data literacy education.
Artificial Intelligence
;
Humans
;
Biomedical Research
8.Prediction of Protein Thermodynamic Stability Based on Artificial Intelligence
Lin-Jie TAO ; Fan-Ding XU ; Yu GUO ; Jian-Gang LONG ; Zhuo-Yang LU
Progress in Biochemistry and Biophysics 2025;52(8):1972-1985
In recent years, the application of artificial intelligence (AI) in the field of biology has witnessed remarkable advancements. Among these, the most notable achievements have emerged in the domain of protein structure prediction and design, with AlphaFold and related innovations earning the 2024 Nobel Prize in Chemistry. These breakthroughs have transformed our ability to understand protein folding and molecular interactions, marking a pivotal milestone in computational biology. Looking ahead, it is foreseeable that the accurate prediction of various physicochemical properties of proteins—beyond static structure—will become the next critical frontier in this rapidly evolving field. One of the most important protein properties is thermodynamic stability, which refers to a protein’s ability to maintain its native conformation under physiological or stress conditions. Accurate prediction of protein stability, especially upon single-point mutations, plays a vital role in numerous scientific and industrial domains. These include understanding the molecular basis of disease, rational drug design, development of therapeutic proteins, design of more robust industrial enzymes, and engineering of biosensors. Consequently, the ability to reliably forecast the stability changes caused by mutations has broad and transformative implications across biomedical and biotechnological applications. Historically, protein stability was assessed via experimental methods such as differential scanning calorimetry (DSC) and circular dichroism (CD), which, while precise, are time-consuming and resource-intensive. This prompted the development of computational approaches, including empirical energy functions and physics-based simulations. However, these traditional models often fall short in capturing the complex, high-dimensional nature of protein conformational landscapes and mutational effects. Recent advances in machine learning (ML) have significantly improved predictive performance in this area. Early ML models used handcrafted features derived from sequence and structure, whereas modern deep learning models leverage massive datasets and learn representations directly from data. Deep neural networks (DNNs), graph neural networks (GNNs), and attention-based architectures such as transformers have shown particular promise. GNNs, in particular, excel at modeling spatial and topological relationships in molecular structures, making them well-suited for protein modeling tasks. Furthermore, attention mechanisms enable models to dynamically weigh the contribution of specific residues or regions, capturing long-range interactions and allosteric effects. Nevertheless, several key challenges remain. These include the imbalance and scarcity of high-quality experimental datasets, particularly for rare or functionally significant mutations, which can lead to biased or overfitted models. Additionally, the inherently dynamic nature of proteins—their conformational flexibility and context-dependent behavior—is difficult to encode in static structural representations. Current models often rely on a single structure or average conformation, which may overlook important aspects of stability modulation. Efforts are ongoing to incorporate multi-conformational ensembles, molecular dynamics simulations, and physics-informed learning frameworks into predictive models. This paper presents a comprehensive review of the evolution of protein thermodynamic stability prediction techniques, with emphasis on the recent progress enabled by machine learning. It highlights representative datasets, modeling strategies, evaluation benchmarks, and the integration of structural and biochemical features. The aim is to provide researchers with a structured and up-to-date reference, guiding the development of more robust, generalizable, and interpretable models for predicting protein stability changes upon mutation. As the field moves forward, the synergy between data-driven AI methods and domain-specific biological knowledge will be key to unlocking deeper understanding and broader applications of protein engineering.
9.Interposition of acellular amniotic membrane at the tendon to bone interface would be better for healing than overlaying above the tendon to bone junction in the repair of rotator cuff injury.
Jiang-Tao WANG ; Chun-Bao LI ; Jia-Ting ZHANG ; Ming-Yang AN ; Gang ZHAO ; Yu-Jie LIU
Chinese Journal of Traumatology 2025;28(3):187-192
PURPOSE:
The retear rate of rotator cuff (RC) after surgery is high, and the rapid and functional enthesis regeneration remains a challenge. Whether acellular amniotic membrane (AAM) helps to promote the healing of tendon to bone and which treatment is better are both unclear. The study aims to investigate the effect of AAM on the healing of RC and the best treatment for RC repair.
METHODS:
Thirty-three Sprague Dawley rats underwent RC transection and repair using microsurgical techniques and were randomly divided into the suturing repair only (SRO) group (n = 11), the AAM overlaying (AOL) group (n = 11), and the AAM interposition (AIP) group (n = 11), respectively. Rats were sacrificed at 4 weeks, then examined by subsequent micro-CT, and evaluated by histologic and biomechanical tests. The statistical analyses of one-way ANOVA or Kruskal-Wallis test were performed using with SPSS 23.0. A p < 0.05 was considered a significant difference.
RESULTS:
AAM being intervened between tendon and bone (AIP group) or overlaid over tendon to bone junction (AOL group) in a rat model, promoted enthesis regeneration, increased new bone and cartilage generation, and improved collagen arrangement and biomechanical properties in comparison with suturing repair only (SRO group) (AOL vs. SRO, p < 0.001, p = 0.004, p = 0.003; AIP vs. SRO, p < 0.001, p < 0.001, p < 0.001). Compared with the AOL group, the AIP group had better results in micro-CT evaluation, histological score, and biomechanical testing (p = 0 0.039, p = 0.011, p = 0.003, respectively).
CONCLUSION
In the RC repair model, AAM enhanced regeneration of the tendon to bone junction. This regeneration was more effective when the AAM was intervened at the tendon to bone interface than overlaid above the tendon to bone junction.
Animals
;
Rats, Sprague-Dawley
;
Rotator Cuff Injuries/surgery*
;
Amnion/transplantation*
;
Rats
;
Wound Healing
;
Rotator Cuff/surgery*
;
Male
;
X-Ray Microtomography
;
Tendons/surgery*
;
Biomechanical Phenomena
10.Complications among patients undergoing orthopedic surgery after infection with the SARS-CoV-2 Omicron strain and a preliminary nomogram for predicting patient outcomes.
Liang ZHANG ; Wen-Long GOU ; Ke-Yu LUO ; Jun ZHU ; Yi-Bo GAN ; Xiang YIN ; Jun-Gang PU ; Huai-Jian JIN ; Xian-Qing ZHANG ; Wan-Fei WU ; Zi-Ming WANG ; Yao-Yao LIU ; Yang LI ; Peng LIU
Chinese Journal of Traumatology 2025;28(6):445-453
PURPOSE:
The rate of complications among patients undergoing surgery has increased due to infection with SARS-CoV-2 and other variants of concern. However, Omicron has shown decreased pathogenicity, raising questions about the risk of postoperative complications among patients who are infected with this variant. This study aimed to investigate complications and related factors among patients with recent Omicron infection prior to undergoing orthopedic surgery.
METHODS:
A historical control study was conducted. Data were collected from all patients who underwent surgery during 2 distinct periods: (1) between Dec 12, 2022 and Jan 31, 2023 (COVID-19 positive group), (2) between Dec 12, 2021 and Jan 31, 2022 (COVID-19 negative control group). The patients were at least 18 years old. Patients who received conservative treatment after admission or had high-risk diseases or special circumstances (use of anticoagulants before surgery) were excluded from the study. The study outcomes were the total complication rate and related factors. Binary logistic regression analysis was used to identify related factors, and odds ratio (OR) and 95% confidence interval (CI) were calculated to assess the impact of COVID-19 infection on complications.
RESULTS:
In the analysis, a total of 847 patients who underwent surgery were included, with 275 of these patients testing positive for COVID-19 and 572 testing negative. The COVID-19-positive group had a significantly higher rate of total complications (11.27%) than the control group (4.90%, p < 0.001). After adjusting for relevant factors, the OR was 3.08 (95% CI: 1.45-6.53). Patients who were diagnosed with COVID-19 at 3-4 weeks (OR = 0.20 (95% CI: 0.06-0.59), p = 0.005), 5-6 weeks (OR = 0.16 (95% CI: 0.04-0.59), p = 0.010), or ≥7 weeks (OR = 0.26 (95% CI: 0.06-1.02), p = 0.069) prior to surgery had a lower risk of complications than those who were diagnosed at 0-2 weeks prior to surgery. Seven factors (age, indications for surgery, time of operation, time of COVID-19 diagnosis prior to surgery, C-reactive protein levels, alanine transaminase levels, and aspartate aminotransferase levels) were found to be associated with complications; thus, these factors were used to create a nomogram.
CONCLUSION
Omicron continues to be a significant factor in the incidence of postoperative complications among patients undergoing orthopedic surgery. By identifying the factors associated with these complications, we can determine the optimal surgical timing, provide more accurate prognostic information, and offer appropriate consultation for orthopedic surgery patients who have been infected with Omicron.
Humans
;
COVID-19/complications*
;
Male
;
Female
;
Middle Aged
;
Postoperative Complications/epidemiology*
;
SARS-CoV-2
;
Orthopedic Procedures/adverse effects*
;
Aged
;
Nomograms
;
Adult
;
Retrospective Studies
;
Risk Factors

Result Analysis
Print
Save
E-mail