1.Progress in monitoring and protection against electrosurgical smoke hazards and exposure risks in operating room
Pingping SHI ; Ya LUO ; Weimin XIAO ; Xiaohong HUANG
Journal of Environmental and Occupational Medicine 2025;42(10):1275-1280
The operating room is the core settings of various surgical treatments, and exhibits distinct attributes and systemic complexities. Medical staff who work long term in operating rooms face multiple exposures to potential health hazards. Especially with the progress of electrosurgical technology and the frequent use of electrosurgical equipment, the possible health effects of the resulting electrosurgical smoke to those working in operating rooms have gradually attracted attention. This paper reviewed the composition, hazard, exposure risk monitoring, and protective measures of electrosurgical smoke, aiming to deepen the understandings of potential health risks of electrosurgical smoke, improve the self-protection awareness of medical staff, strengthen attention to electrosurgical smoke protection in all hospitals, and ensure the occupational safety of medical staff.
2.Impact of early detection and management of emotional distress on length of stay in non-psychiatric inpatients: A retrospective hospital-based cohort study.
Wanjun GUO ; Huiyao WANG ; Wei DENG ; Zaiquan DONG ; Yang LIU ; Shanxia LUO ; Jianying YU ; Xia HUANG ; Yuezhu CHEN ; Jialu YE ; Jinping SONG ; Yan JIANG ; Dajiang LI ; Wen WANG ; Xin SUN ; Weihong KUANG ; Changjian QIU ; Nansheng CHENG ; Weimin LI ; Wei ZHANG ; Yansong LIU ; Zhen TANG ; Xiangdong DU ; Andrew J GREENSHAW ; Lan ZHANG ; Tao LI
Chinese Medical Journal 2025;138(22):2974-2983
BACKGROUND:
While emotional distress, encompassing anxiety and depression, has been associated with negative clinical outcomes, its impact across various clinical departments and general hospitals has been less explored. Previous studies with limited sample sizes have examined the effectiveness of specific treatments (e.g., antidepressants) rather than a systemic management strategy for outcome improvement in non-psychiatric inpatients. To enhance the understanding of the importance of addressing mental health care needs among non-psychiatric patients in general hospitals, this study retrospectively investigated the impacts of emotional distress and the effects of early detection and management of depression and anxiety on hospital length of stay (LOS) and rate of long LOS (LLOS, i.e., LOS >30 days) in a large sample of non-psychiatric inpatients.
METHODS:
This retrospective cohort study included 487,871 inpatients from 20 non-psychiatric departments of a general hospital. They were divided, according to whether they underwent a novel strategy to manage emotional distress which deployed the Huaxi Emotional Distress Index (HEI) for brief screening with grading psychological services (BS-GPS), into BS-GPS ( n = 178,883) and non-BS-GPS ( n = 308,988) cohorts. The LOS and rate of LLOS between the BS-GPS and non-BS-GPS cohorts and between subcohorts with and without clinically significant anxiety and/or depression (CSAD, i.e., HEI score ≥11 on admission to the hospital) in the BS-GPS cohort were compared using univariable analyses, multilevel analyses, and/or propensity score-matched analyses, respectively.
RESULTS:
The detection rate of CSAD in the BS-GPS cohort varied from 2.64% (95% confidence interval [CI]: 2.49%-2.81%) to 20.50% (95% CI: 19.43%-21.62%) across the 20 departments, with a average rate of 5.36%. Significant differences were observed in both the LOS and LLOS rates between the subcohorts with CSAD (12.7 days, 535/9590) and without CSAD (9.5 days, 3800/169,293) and between the BS-GPS (9.6 days, 4335/178,883) and non-BS-GPS (10.8 days, 11,483/308,988) cohorts. These differences remained significant after controlling for confounders using propensity score-matched comparisons. A multilevel analysis indicated that BS-GPS was negatively associated with both LOS and LLOS after controlling for sociodemographics and the departments of patient discharge and remained negatively associated with LLOS after controlling additionally for the year of patient discharge.
CONCLUSION
Emotional distress significantly prolonged the LOS and increased the LLOS of non-psychiatric inpatients across most departments and general hospitals. These impacts were moderated by the implementation of BS-GPS. Thus, BS-GPS has the potential as an effective, resource-saving strategy for enhancing mental health care and optimizing medical resources in general hospitals.
Humans
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Retrospective Studies
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Male
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Length of Stay/statistics & numerical data*
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Female
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Middle Aged
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Adult
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Psychological Distress
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Inpatients/psychology*
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Aged
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Anxiety/diagnosis*
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Depression/diagnosis*
3.NIR-II-activated whole-cell vaccine with ultra-efficient semiconducting diradical oligomers for breast carcinoma growth and metastasis inhibition.
Yijian GAO ; Yachao ZHANG ; Yujie MA ; Xiliang LI ; Yu WANG ; Huan CHEN ; Yingpeng WAN ; Zhongming HUANG ; Weimin LIU ; Pengfei WANG ; Lidai WANG ; Chun-Sing LEE ; Shengliang LI
Acta Pharmaceutica Sinica B 2025;15(2):1159-1170
High-performance phototheranostics with combined photothermal therapy and photoacoustic imaging have been considered promising approaches for efficient cancer diagnosis and treatment. However, developing phototheranostic materials with efficient photothermal conversion efficiency (PCE), especially over the second near-infrared window (NIR-II, 1000-1700 nm), remains challenging. Herein, we report an ultraefficient NIR-II-activated nanomedicine with phototheranostic and vaccination capability for highly efficient in vivo tumor elimination and metastasis inhibition. The NIR-II nanomedicine of a semiconducting biradical oligomer with a motor-flexible design was demonstrated with a record-breaking PCE of 87% upon NIR-II excitation. This nanomedicine inherently features extraordinary photothermal stability, good biocompatibility, and excellent photoacoustic performance, contributing to high-contrast photoacoustic imaging in living mice and high-performance photothermal elimination of tumors. Moreover, a whole-cell vaccine based on a NIR-II nanomedicine with NIR-II-activated performance was further designed to remotely activate the antitumor immunologic memory and effectively inhibit tumor occurrence and metastasis in vivo, with good biosafety. Thus, this work paves a new avenue for designing NIR-II active semiconducting biradical materials as a promising theranostics platform and further promotes the development of NIR-II nanomedicine for personalized cancer treatment.
4.Analysis of the efficacy of total knee arthroplasty with partial varus retention in the treatment of moderate knee varus
Xing'an BAO ; Youquan CHEN ; Hao ZHOU ; Hui YANG ; Yi HUANG ; Weimin FAN ; Feng LIU
Chinese Journal of Orthopaedics 2025;45(6):327-334
Objective:To analyze the efficacy of total knee arthroplasty (TKA) with partial varus retention in the treatment of moderate knee varus.Methods:A retrospective analysis was conducted on the data of 613 osteoarthritis patients with moderate knee varus who underwent TKA at the First Affiliated Hospital of Nanjing Medical University from January 2010 to October 2019. According to whether a 2°-3° of knee varus was retained, the patients were divided into the retained varus group and the mechanical alignment group. The retained varus group included 318 cases, with 63 males and 255 females, aged 68.51±6.95 years (range, 46-86 years), and BMI of 26.99±3.66 kg/m 2 (range, 17.40-39.01 kg/m 2). Preoperative Kellgren-Lawrence (K-L) classification of knee osteoarthritis was grade III in 113 cases and grade IV in 205 cases. The mechanical alignment group included 295 cases, with 75 males and 220 females, aged 69.60±7.12 years (range, 52-87 years), and BMI of 26.95±3.94 kg/m 2 (range, 16.60-41.90 kg/m 2). Preoperative K-L classification was grade III in 102 cases and grade IV in 193 cases. Surgical duration, total blood loss, preoperative and postoperative varus angle, lower limb swelling on the fifth postoperative day, and postoperative complications were recorded. Follow-up were arranged at 3 months, 6 months, 1 year, and 5 years postoperatively. At each follow-up point, the visual analogue score (VAS) for knee pain, Hospital for Special Surgery (HSS) score, Forgotten Joint Score (FJS-12), and MOS item short-form health survey (SF-36) were assessed. Results:All 613 patients were successfully followed up, with a follow-up period of 5.25±1.02 years (range, 5.0-6.0 years). There were no statistically significant differences in gender, age, BMI, and K-L classification between the two groups ( P>0.05). The differences in postoperative varus angle, VAS scores, and HSS score were statistically significant from the preoperative values in both groups( P<0.05). The surgical duration of the retained varus group was 77.40±18.55 min, total blood loss was 920.78±407.26 ml, and lower limb swelling on the fifth postoperative day was 1.18±0.51 cm, all of which were lower than those in the mechanical alignment group: 85.31±22.15 min, 1127.14±580.08 ml, 3.22±0.52 cm, respectively, with statistically significant differences ( P<0.05). The VAS scores at postoperative day 5 and 3 months in the retained varus group were 5.08±0.72 and 2.18±1.09, respectively, which were lower than those in the mechanical alignment group: 5.80±0.81, 3.00±1.04, with statistically significant differences ( P<0.05). There were no statistically significant differences in VAS scores at 6 months, 1 year, and 5 years postoperatively between the two groups ( P>0.05). The HSS scores at 3 months and 6 months postoperatively in the retained varus group were 68.57±4.98 and 79.04±3.26, respectively, which were higher than those in the mechanical alignment group: 64.14±3.99, 77.73±4.04, with statistically significant differences ( P<0.05). There were no statistically significant differences in HSS scores at 1 year and 5 years postoperatively between the two groups ( P>0.05). The FJS-12 scores at 3 months and 6 months postoperatively in the retained varus group were 18.06±3.50 and 27.50±1.80, respectively, which were higher than those in the mechanical alignment group: 13.45±2.44, 24.23±1.59, with statistically significant differences ( P<0.05). There were no statistically significant differences in FJS-12 scores at 1 year and 5 years postoperatively between the two groups ( P>0.05). The SF-36 scores at 3 months and 6 months postoperatively in the retained varus group were 40.85±8.07 and 52.15±6.01, respectively, which were higher than those in the mechanical alignment group: 35.87±6.83, 47.28±5.38, with statistically significant differences ( P<0.05). There were no statistically significant differences in SF-36 scores at 1 year and 5 years postoperatively between the two groups ( P>0.05). The incidence of deep vein thrombosis in the lower limbs was 3.8% (12/318) in the retained varus group, which was lower than the 7.8% (23/295) in the mechanical alignment group, with a statistically significant difference ( P<0.05). Conclusion:In osteoarthritis patients with moderate knee varus undergoing TKA, retaining approximately 3° of varus can reduce surgical trauma and total blood loss, shorten surgical duration, alleviate postoperative pain and limb swelling, facilitate functional recovery, and improve patient satisfaction.
5.Comparative study on clinical effect of medial plantar venous flap and lateral toe flap on reconstruction of defect of digit-pulps
Shiyu ZOU ; Kelie WANG ; Haiqian LING ; Chunsheng XIAO ; Yizhi ZHANG ; Lifeng MA ; Zirong HUANG ; Weimin ZHU
Chinese Journal of Microsurgery 2025;48(5):492-499
Objective:To systematically compares the medial plantar venous flap (MPVF) and the lateral toe flap (LTF) reconstruction of digit-pulp defect, aiming to establish whether there exist significant differences between the 2 flaps in flap survival rate, two-point discrimination (TPD), score of Vancouver Scar Scale (VSS) and score of digit-pulp defect reconstruction evaluation.Methods:With a prospective cohort design, this study enrolled 36 patients who were admitted in Department of Hand Surgery, Longgang Eighth People's Hospital of Shenzhen for digit-pulp defects with bone or tendon exposure between January 2024 and September 2024. According to the random grouping method, participants were divided into 2 groups. The MPVF group comprised 18 patients (21 digits) of 13 males (15 digits) and 5 females (6 digits), aged 13-58 (mean 44±12) years. The MPVF group included 9 left and 12 right digits, with distribution as follows: 2 thumbs, 5 index fingers, 7 middle fingers, 5 ring fingers and 2 little fingers. The soft tissue defect area ranged from 2.0 cm × 1.0 cm to 9.2 cm × 3.3 cm (mean 6.69 cm 2± 6.69 cm 2). Flap dimensions ranged from 2.1 cm×1.1 cm to 9.5 cm×3.5 cm (mean 7.54 cm 2±7.22 cm 2). Donor sites were closed primarily or by full-thickness skin grafts harvested from the leg. The LTF group included 18 patients (21 digits) of 15 males (17 digits) and 3 females (4 digits), aged 22-62 (mean 41±12) years. The affected digits in LTF group comprised 12 left and 9 right digits, with a distribution of: 3 thumbs, 9 index fingers, 5 middle fingers, 2 ring fingers and 2 little fingers. The area of soft tissue defect ranges from 1.4 cm × 1.0 cm to 3.9 cm × 1.8 cm (mean 3.93 cm 2± 1.80 cm 2). Flap dimensions ranged from 1.5 cm×1.2 cm to 4.0 cm×1.9 cm (mean 4.52 cm 2±1.89 cm 2). Donor sites were closed primarily, or by full-thickness skin grafts harvested through extension of proximal wound extension or from calf for defect coverage. Patients were contacted for postoperative follow-up by telephone or WeChat to arrange a visit of outpatient clinic or a home visit by surgeon. Statistical analysis was conducted to compare the 2 groups regarding: gender, age and flap dimensions, flap survival rate at 2 weeks after surgery and TPD of flaps, VSS scores, and digit-pulp defect reconstruction evaluation scale scores at 4 months and 6 months postoperatively. P<0.05 indicates a statistically significant difference. Results:The comparative analysis revealed no statistically significant differences between 2 groups in baseline characteristics: gender distribution ( χ2=0.53, P=0.47), mean age ( t=0.75, P=0.46), flap dimensions ( t=1.86, P=0.08), confirming a demographic and surgical parameter equivalence in subsequent outcome comparisons ( P>0.05). All flaps survived at 2 weeks after surgery. All skin grafts at donor sites demonstrated complete viability with uneventful primary wound healing. At 4 months after surgey, the TPD in the MPVF group were 14.71 mm±1.90 mm and 7.81 mm±1.78 mm, respectively, compared to 14.48 mm±1.57 mm and 7.67 mm±1.39 mm in the LTF group at 6 months after surgery. The VSS scores were 1.67±1.11 and 1.29±0.72 for MPVF versus 1.86±1.15 and 1.38±0.81 for LTF at corresponding time points. The digit-pulp defects reconstruction evaluation scale scores showed 88.43±2.62 and 91.43±3.59 for MPVF versus 88.19±2.70 and 91.19±3.50 for LTF. Statistical analysis revealed no significant differences (all P>0.05) at 2 postoperative time points. Conclusion:The MPVF demonstrated non-inferior clinical efficacy to the LTF in reconstruction of digit-pulp defects, with comparable outcomes in flap survival rate at 2 weeks, and in TPD, VSS scores, digit-pulp defect reconstruction evaluation scale scores at 4 months and at 6 month after surgey.
6.Exploring the Intervention Effect of Eriocitrin on Intracranial Aneurysm Model Rats Based on SDF-1α/CXCR4 Signaling Path-way
Ke LUO ; Wei HUANG ; Weimin LI
Journal of Zhejiang Chinese Medical University 2025;49(9):1085-1093
[Objective]To investigate the intervention effect of eriocitrin on intracranial aneurysm(IA)model rats based on stromal cell derived factor-1α(SDF-1α)/C-X-C motif chemokine receptor 4(CXCR4)signaling pathway.[Methods]IA rat model was established by isolating and ligating the left common carotid artery and renal artery,and removing both ovaries.The rats were randomly assigned into IA group(intragastric and intraperitoneal administration of 0.9%sodium chloride solution),eriocitrin low(intragastric 8 mg·kg-1 of eriocitrin),medium(intragastric 16 mg·kg-1 of eriocitrin)and high(intragastric 32 mg·kg-1 of eriocitrin)dose groups,and eriocitrin high dose(intragastric 32 mg·kg-1)+SDF-1α/CXCR4 pathway activator CTCE-0214(intraperitoneal administration of 10 mg·kg-1 CTCE-0214)group,and the other 10 rats only exposed the left common carotid artery,renal artery and ovaries,which were recorded as sham operation(intragastric and intraperitoneal administration of 0.9%sodium chloride solution)group.Each group was intervened once a day for 8 consecutive weeks.Tweenty-four hours after the last administration,enzyme-linked immunosorbent assay(ELISA)was used to detect the levels of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)and nitric oxide(NO)in each group.Elastica van Gieson staining was used to measure the length of aneurysms,the area of the aneurysm lumen and the length of internal elastic layer rupture.Hematoxylin-eosin(HE)staining was applied to detect pathological changes in arterial aneurysm tissue.Real time-polymerase chain reaction(RT-PCR)was applied to detect the mRNA expression of matrix metalloproteinase-9(MMP-9),vascular endothelial growth factor(VEGF)and MMP-2 in tissues.Western blot was applied to detect the expression of SDF-1α/CXCR4 related proteins in tissues.[Results]Compared with sham operation group,the levels of TNF-α,IL-6;aneurysm length,aneurysm cavity area,internal elastic layer rupture length;MMP-9,VEGF,MMP-2 mRNA expression;SDF-1α and CXCR4 protein expression were prominently higher in IA group,while the level of NO was obviously lower(P<0.05).Compared with IA group,the levels of TNF-α,IL-6;aneurysm length,aneurysm cavity area,internal elastic layer rupture length;MMP-9,VEGF,MMP-2 mRNA expression;SDF-1α and CXCR4 protein expression in eriocitrin low,medium and high dose groups were obviously lower,while the level of NO was prominently higher(P<0.05).Compared with eriocitrin high dose group,the levels of TNF-α,IL-6;aneurysm length,aneurysm cavity area,internal elastic layer rupture length;MMP-9,VEGF,MMP-2 mRNA expression;SDF-1α and CXCR4 protein expression in eriocitrin-high+CTCE-0214 group were prominently higher,while the level of NO was prominently lower(P<0.05).[Conclusion]Eriocitrin alleviates the inflammatory response in IA rats by regulating the SDF-1α/CXCR4 signaling pathway,improves the function of vascular endothelial cells and reduces the risk of aneurysm rupture.
7.Acute effects of blood flow restriction running warm-up on Achilles tendon morphology and function in basketball athletes
Jing LI ; Weimin PAN ; Jingyuan FAN ; Xiaoyu WEI ; Yan HUANG ; Huan FENG ; Longguo ZHANG ; Yingpeng JIANG ; Min LIU
Journal of Army Medical University 2025;47(18):2154-2162
Objective To determine the acute effects of blood flow restriction(BFR)running warm-up on Achilles tendon morphology and function in basketball players in order to provide a theoretical basis for optimizing warm-up protocols for military personnel and athletes susceptible to Achilles tendon injuries.Methods Twenty-seven male basketball players were subjected and asked to participate in 3 different running warm-up protocols:low-speed running(LSR),high-speed running(HSR),and BFR combined with LSR(BFR-LSR).The acute changes in Achilles tendon morphology,mechanical properties,and functional performance across the 3 testing sessions were analyzed and compared.Results Immediately after training,both HSR warm-up and BFR-LSR warm-up significantly improved Achilles tendon thickness,blood flow,stiffness,and gastrocnemius maximal voluntary isometric contraction(MVIC)when compared with LSR warm-up(P<0.05).No statistical differences were observed in above indicators between the BFR-LSR and HSR warm-ups(P>0.05).24 hours after training,compared with LSR warm-up,HSR warm-up still significantly improved Achilles tendon thickness,blood flow,stiffness,and gastrocnemius MVIC(P<0.05).Although BFR-LSR warm-up did not show statistically significant differences in these parameters compared to LSR warm-up,it still demonstrated positive trends.Immediately and 24 h after training,no obvious difference were found in jump performance among the 3 warm-up protocols(P>0.05),but,both BFR-LSR and HSR warm-ups exhibited superior performance than LSR warm-up.Conclusion Immediately after training,BFR-LSR warm-up demonstrates comparable effects to the HSR warm-up on improving Achilles tendon morphology and performance,as well as enhancing jump performance.However,its sustained and long-term effects require further investigation.
8.Role of Apolipoprotein E4 in the Pathogenesis of Alzheimer's Disease and Thoughts for Early Intervention with Traditional Chinese Medicine
Jingwen LIU ; Zijia ZHANG ; Kaili WANG ; Jiayan HUANG ; Weimin LI ; Xinxin ZHOU
Journal of Guangzhou University of Traditional Chinese Medicine 2025;42(2):512-517
Alzheimer's disease(AD)is a progressive neurodegenerative disease with hidden onset.Recent researches have shown that apolipoprotein E4(APOE4)is a high-risk genetic factor of AD,and the clinical symptoms in APOE4 genotype AD patients are closely related to metabolic disorders.This paper reviewed the role of APOE4 in the pathogenesis of AD,and it is indicated that APOE4 contributes to the injury of the cerebral blood-brain barrier,is associated with the disorder of cerebral glucose and lipid metabolism,and leads to the damage of the scavenging ability of microglia.Moreover,this paper explored the approach of early intervention of AD with traditional Chinese medicine(TCM)based on the APOE4 pathogenesis.Based on the pathogenesis of AD being deficiency in origin and excess in superficiality,and under the guidance of the principle of prevention before illness in TCM,it is proposed that early TCM intervention for APOE4 genotype AD patients with metabolic disorders can be performed through improving the phlegm-dampness constitution,by focusing on insulin resistance-related indicators,and with traditional Chinese drug therapy based on syndrome differentiation alone or together with comprehensive management of exercises,diet control and drug interventions,thus to reduce or delay the onset of APOE4 genotype AD.
9.Analysis of the efficacy of total knee arthroplasty with partial varus retention in the treatment of moderate knee varus
Xing'an BAO ; Youquan CHEN ; Hao ZHOU ; Hui YANG ; Yi HUANG ; Weimin FAN ; Feng LIU
Chinese Journal of Orthopaedics 2025;45(6):327-334
Objective:To analyze the efficacy of total knee arthroplasty (TKA) with partial varus retention in the treatment of moderate knee varus.Methods:A retrospective analysis was conducted on the data of 613 osteoarthritis patients with moderate knee varus who underwent TKA at the First Affiliated Hospital of Nanjing Medical University from January 2010 to October 2019. According to whether a 2°-3° of knee varus was retained, the patients were divided into the retained varus group and the mechanical alignment group. The retained varus group included 318 cases, with 63 males and 255 females, aged 68.51±6.95 years (range, 46-86 years), and BMI of 26.99±3.66 kg/m 2 (range, 17.40-39.01 kg/m 2). Preoperative Kellgren-Lawrence (K-L) classification of knee osteoarthritis was grade III in 113 cases and grade IV in 205 cases. The mechanical alignment group included 295 cases, with 75 males and 220 females, aged 69.60±7.12 years (range, 52-87 years), and BMI of 26.95±3.94 kg/m 2 (range, 16.60-41.90 kg/m 2). Preoperative K-L classification was grade III in 102 cases and grade IV in 193 cases. Surgical duration, total blood loss, preoperative and postoperative varus angle, lower limb swelling on the fifth postoperative day, and postoperative complications were recorded. Follow-up were arranged at 3 months, 6 months, 1 year, and 5 years postoperatively. At each follow-up point, the visual analogue score (VAS) for knee pain, Hospital for Special Surgery (HSS) score, Forgotten Joint Score (FJS-12), and MOS item short-form health survey (SF-36) were assessed. Results:All 613 patients were successfully followed up, with a follow-up period of 5.25±1.02 years (range, 5.0-6.0 years). There were no statistically significant differences in gender, age, BMI, and K-L classification between the two groups ( P>0.05). The differences in postoperative varus angle, VAS scores, and HSS score were statistically significant from the preoperative values in both groups( P<0.05). The surgical duration of the retained varus group was 77.40±18.55 min, total blood loss was 920.78±407.26 ml, and lower limb swelling on the fifth postoperative day was 1.18±0.51 cm, all of which were lower than those in the mechanical alignment group: 85.31±22.15 min, 1127.14±580.08 ml, 3.22±0.52 cm, respectively, with statistically significant differences ( P<0.05). The VAS scores at postoperative day 5 and 3 months in the retained varus group were 5.08±0.72 and 2.18±1.09, respectively, which were lower than those in the mechanical alignment group: 5.80±0.81, 3.00±1.04, with statistically significant differences ( P<0.05). There were no statistically significant differences in VAS scores at 6 months, 1 year, and 5 years postoperatively between the two groups ( P>0.05). The HSS scores at 3 months and 6 months postoperatively in the retained varus group were 68.57±4.98 and 79.04±3.26, respectively, which were higher than those in the mechanical alignment group: 64.14±3.99, 77.73±4.04, with statistically significant differences ( P<0.05). There were no statistically significant differences in HSS scores at 1 year and 5 years postoperatively between the two groups ( P>0.05). The FJS-12 scores at 3 months and 6 months postoperatively in the retained varus group were 18.06±3.50 and 27.50±1.80, respectively, which were higher than those in the mechanical alignment group: 13.45±2.44, 24.23±1.59, with statistically significant differences ( P<0.05). There were no statistically significant differences in FJS-12 scores at 1 year and 5 years postoperatively between the two groups ( P>0.05). The SF-36 scores at 3 months and 6 months postoperatively in the retained varus group were 40.85±8.07 and 52.15±6.01, respectively, which were higher than those in the mechanical alignment group: 35.87±6.83, 47.28±5.38, with statistically significant differences ( P<0.05). There were no statistically significant differences in SF-36 scores at 1 year and 5 years postoperatively between the two groups ( P>0.05). The incidence of deep vein thrombosis in the lower limbs was 3.8% (12/318) in the retained varus group, which was lower than the 7.8% (23/295) in the mechanical alignment group, with a statistically significant difference ( P<0.05). Conclusion:In osteoarthritis patients with moderate knee varus undergoing TKA, retaining approximately 3° of varus can reduce surgical trauma and total blood loss, shorten surgical duration, alleviate postoperative pain and limb swelling, facilitate functional recovery, and improve patient satisfaction.
10.Exploring the Intervention Effect of Eriocitrin on Intracranial Aneurysm Model Rats Based on SDF-1α/CXCR4 Signaling Path-way
Ke LUO ; Wei HUANG ; Weimin LI
Journal of Zhejiang Chinese Medical University 2025;49(9):1085-1093
[Objective]To investigate the intervention effect of eriocitrin on intracranial aneurysm(IA)model rats based on stromal cell derived factor-1α(SDF-1α)/C-X-C motif chemokine receptor 4(CXCR4)signaling pathway.[Methods]IA rat model was established by isolating and ligating the left common carotid artery and renal artery,and removing both ovaries.The rats were randomly assigned into IA group(intragastric and intraperitoneal administration of 0.9%sodium chloride solution),eriocitrin low(intragastric 8 mg·kg-1 of eriocitrin),medium(intragastric 16 mg·kg-1 of eriocitrin)and high(intragastric 32 mg·kg-1 of eriocitrin)dose groups,and eriocitrin high dose(intragastric 32 mg·kg-1)+SDF-1α/CXCR4 pathway activator CTCE-0214(intraperitoneal administration of 10 mg·kg-1 CTCE-0214)group,and the other 10 rats only exposed the left common carotid artery,renal artery and ovaries,which were recorded as sham operation(intragastric and intraperitoneal administration of 0.9%sodium chloride solution)group.Each group was intervened once a day for 8 consecutive weeks.Tweenty-four hours after the last administration,enzyme-linked immunosorbent assay(ELISA)was used to detect the levels of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)and nitric oxide(NO)in each group.Elastica van Gieson staining was used to measure the length of aneurysms,the area of the aneurysm lumen and the length of internal elastic layer rupture.Hematoxylin-eosin(HE)staining was applied to detect pathological changes in arterial aneurysm tissue.Real time-polymerase chain reaction(RT-PCR)was applied to detect the mRNA expression of matrix metalloproteinase-9(MMP-9),vascular endothelial growth factor(VEGF)and MMP-2 in tissues.Western blot was applied to detect the expression of SDF-1α/CXCR4 related proteins in tissues.[Results]Compared with sham operation group,the levels of TNF-α,IL-6;aneurysm length,aneurysm cavity area,internal elastic layer rupture length;MMP-9,VEGF,MMP-2 mRNA expression;SDF-1α and CXCR4 protein expression were prominently higher in IA group,while the level of NO was obviously lower(P<0.05).Compared with IA group,the levels of TNF-α,IL-6;aneurysm length,aneurysm cavity area,internal elastic layer rupture length;MMP-9,VEGF,MMP-2 mRNA expression;SDF-1α and CXCR4 protein expression in eriocitrin low,medium and high dose groups were obviously lower,while the level of NO was prominently higher(P<0.05).Compared with eriocitrin high dose group,the levels of TNF-α,IL-6;aneurysm length,aneurysm cavity area,internal elastic layer rupture length;MMP-9,VEGF,MMP-2 mRNA expression;SDF-1α and CXCR4 protein expression in eriocitrin-high+CTCE-0214 group were prominently higher,while the level of NO was prominently lower(P<0.05).[Conclusion]Eriocitrin alleviates the inflammatory response in IA rats by regulating the SDF-1α/CXCR4 signaling pathway,improves the function of vascular endothelial cells and reduces the risk of aneurysm rupture.

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