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

Objective To investigate the cardiac structural and functional characteristics in the patients with heart failure with preserved ejection fraction (HFpEF) and type 2 diabetes mellitus (T2DM),and predict the factors influencing the characteristics. Methods A total of 783 HFpEF patients diagnosed in the Department of Geriatric Cardiology,the First Hospital of Lanzhou University from April 2009 to December 2020 were enrolled in this study.Echocardiography and tissue Doppler technique were employed to evaluate cardiac structure and function.According to the occurrence of T2DM,the patients were assigned into a HFpEF+T2DM group (n=332) and a HFpEF group (n=451).Propensity score matching (PSM)(in a 1∶1 ratio) was adopted to minimize confounding effect.According to urinary albumin excretion rate (UAER),the HFpEF+T2DM group was further divided into three subgroups with UAER<20 μg/min,of 20-200 μg/min,and>200 μg/min,respectively.The comorbidities,symptoms and signs,and cardiac structure and function were compared among the groups to clarify the features of diabetes related HFpEF.Multivariate linear regression was conducted to probe the relationship of systolic blood pressure,blood glucose,glycosylated hemoglobin,and UARE with cardiac structural and functional impairment. Results The HFpEF+T2DM group had higher prevalence of hypertension (P=0.001) and coronary heart disease (P=0.036),younger age (P=0.020),and larger body mass index (P=0.005) than the HFpEF group,with the median diabetic course of 10 (3,17) years.After PSM,the prevalence of hypertension and coronary heart disease,body mass index,and age had no significant differences between the two groups(all P>0.05).In addition,the HFpEF+T2DM group had higher interventricular septal thickness (P=0.015),left ventricular posterior wall thickness (P=0.040),and left ventricular mass (P=0.012) and lower early diastole velocity of mitral annular septum (P=0.030) and lateral wall (P=0.011) than the HFpEF group.Compared with the HFpEF group,the HFpEF+T2DM group showed increased ratio of early diastolic mitral filling velocity to early diastolic mitral annular velocity (E/e') (P=0.036).Glycosylated hemoglobin was correlated with left ventricular mass (P=0.011),and the natural logarithm of UAER with interventricular septal thickness (P=0.004),left ventricular posterior wall thickness (P=0.006),left ventricular mass (P<0.001),and E/e' ratio (P=0.049). Conclusion The patients with both T2DM and HFpEF have thicker left ventricular wall,larger left ventricular mass,more advanced left ventricular remodeling,severer impaired left ventricular diastolic function,and higher left ventricular filling pressure than the HFpEF patients without T2DM.Elevated blood glucose and diabetic microvascular diseases might play a role in the development of the detrimental structural and functional changes of the heart.
Humans ; Aged ; Heart Failure/diagnosis* ; Diabetes Mellitus, Type 2 ; Stroke Volume ; Glycated Hemoglobin ; Blood Glucose ; Propensity Score ; Ventricular Function, Left ; Hypertension

Humans ; Liver Neoplasms ; Carcinoma

AIM: To investigate the effect of Conbercept on serum lncRNA MALAT1 levels, central macular thickness(CMT)and best corrected visual acuity(BCVA)in patients with diabetic macular edema(DME), and to observe its efficacy and safety.METHODS: A total of 300 patients(300 eyes)with DME were included in this study, all of whom had monocular lesions. They were divided into non-injection group with 100 patients(100 eyes), control group with 100 patients(100 eyes)treated with Ranibizumab injections and study group with 100 patients(100 eyes)treated with Conbercept injections according to a random numbers table.RESULTS: The BCVA, serum lncRNA MALAT1 level and CMT were measured before and 1, 2 and 3mo after treatment. In addition, the clinical efficacy was assessed and the patients were followed up to record the adverse reactions. There were no significant changes in BCVA(LogMAR), serum lncRNA MALAT1 level and CMT in the non- injection group(P>0.05). The BCVA(LogMAR)in the control group and study group at 1, 2 and 3mo after treatment was significantly higher than that before treatment(all P<0.05). The BCVA(LogMAR)of patients in the study group at 1, 2 and 3mo after treatment was significantly higher than that before treatment(all P<0.05), but there was no significant difference between the study group and control group. The level of serum lncRNA MALAT1 in the control group decreased at 1, 2 and 3mo after treatment, and it decreased more significantly in the study group at 1, 2 and 3mo after treatment. The level of serum lncRNA MALAT1 in the study group was significantly lower than that in the control group(all P<0.05).The CMT of patients in the control group decreased at 1, 2 and 3mo after treatment; however, the CMT of patients in the study group decreased more significantly at 1, 2 and 3mo after treatment. The CMT of the study group was significantly lower than that of the control group(all P<0.05).The incidence of adverse reactions in the study group(2.0%)was significantly lower than that in the control group(11.0%).CONCLUSION: Conbercept can significantly reduce the level of serum lncRNA MALAT1, CMT and macular edema and improve BCVA in patients with DME. Its therapeutic efficacy and safety are significantly better than Ranibizumab.

As a primary treatment for strabismus, extraocular muscle surgery can achieve the purpose of correcting the eye position, improving the appearance and reconstructing the third-level visual function. Previous studies have found that the vascular density(VD)and thickness of retina increased in the early stage after extraocular muscle surgery, where multiple mechanisms involved. In recent years, with the appearance of detection means such as optical coherence tomography angiography(OCTA), our quantitative understanding of retinal microscopic changes and their mechanisms brought about by traditional extraocular muscle surgery has become more and more profound. The increase of retinal VD in the early postoperative period may be closely related to the recovery of postoperative visual function. However, the related studies are few, and the association between microscopic changes and visual function after extraocular muscle surgery and its mechanism need to be further clarified. This article will review the microscopic changes of retina and their mechanisms after extraocular muscle surgery from multiple perspectives to improve our understanding of the relationship between the mechanism of its influence and visual function, with a view to provide references for the choice of extraocular muscle surgery scheme and related clinical research.

OBJECTIVE: To observe the changes of symptoms, Chinese medicine (CM) syndrome, and lung inflammation absorption during convalescence in patients with coronavirus disease 2019 (COVID-19) who had not totally recovered after hospital discharge and whether CM could promote the improvement process. METHODS: This study was designed as a prospective cohort and nested case-control study. A total of 96 eligible patients with COVID-19 in convalescence were enrolled from Beijing Youan Hospital and Beijing Huimin Hospital and followed up from the hospital discharged day. Patients were divided into the CM (64 cases) and the control groups (32 cases) based on the treatment with or without CM and followed up at 14, 28, 56, and 84 days after discharge. In the CM group, patients received the 28-day CM treatment according to two types of CM syndrome. Improvements in clinical symptoms, CM syndrome, and absorption of lung inflammation were observed. RESULTS: All the 96 patients completed the 84-day follow-up from January 21 to March 28, 2020. By the 84th day of follow-up, respiratory symptoms were less than 5%. There was no significant difference in the improvement rates of symptoms, including fatigue, sputum, cough, dry throat, thirst, and upset, between the two groups (P>0.05). Totally 82 patients (85.42%) showed complete lung inflammation absorption at the 84-day follow-up. On day 14, the CM group had a significantly higher absorption rate than the control group (P<0.05) and the relative risk of absorption for CM vs. control group was 3.029 (95% confidence interval: 1.026-8.940). The proportions of CM syndrome types changed with time prolonging: the proportion of the pathogen residue syndrome gradually decreased, and the proportion of both qi and yin deficiency syndrome gradually increased. CONCLUSIONS Patients with COVID-19 in convalescence had symptoms and lung inflammation after hospital discharge and recovered with time prolonging. CM could improve lung inflammation for early recovery. The types of CM syndrome can be transformed with time prolonging. (Registration No. ChiCTR2000029430).
Adult ; Aged ; COVID-19/drug therapy* ; Case-Control Studies ; Convalescence ; Female ; Follow-Up Studies ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Patient Discharge ; Pneumonia/drug therapy* ; Prospective Studies ; SARS-CoV-2

OBJECTIVETo evaluate the middle-long-term clinical effects of unilateral and bilateral percutaneous kyphoplasty(PKP) for vertebral fragility fracture in the elderly.

METHODSThe clinical data in elderly patients with vertebral fragility fracture treated by unilateral and bilateral PKP between January 2008 and January 2010 was retrospective analyzed. According to a unified criteria to divided into two groups for 104 patients(44 males and 60 females), of them, 50 cases were divided in unilateral group using unilateral pedicle surgical approach for PKP and 54 cases were in bilateral group using bilateral pedicle approach. VAS score, Cobb angle, and the height of anterior and posterior vertebral body were respectively analyzed peroperatively and at 3 d, 3 months, 1 year, 3 years postoperatively and final follow-up. Clinical effects and safety were assessed in two groups.

RESULTSAll the operations were successful. Operative time and bone cement injection volume in unilateral group were less than those of bilateral group(<0.05). Postoperative VAS scores, Cobb angle, and the height of anterior and posterior vertebral body were obviously improved in two groups(<0.05), and there was no significant difference between two groups(>0.05). Bone cement leakage occurred in 12 cases(11.5%), recurrent fracture of vertebral body occurred in 5 cases(4.8%), cerebrospinal leak occurred in 2 cases(1.9%), and nerve root irritation occurred in 3 cases(2.9%). The above complications were transient and released after symptomatic treament.

CONCLUSIONSMiddle-long-term clinical effects of unilateral and bilateral percutaneous kyphoplasty for vertebral fragility fracture are safe and satisfactory, and may be extended as a minimally invasive method. Unilateral approach for PKP has advantages of short operation time, relative less trauma, thus is a more ideal method.

Objective To propose an approach for developing a physical examination information system by analyzing the requirements for physical examination and the implementation of the system.Methods The development was realized from four aspects of customer service platform,system integration and data sharing,data processing and statistical analysis,external examination flow design and data archiving.Physical examination flow was modified accordingly,and the business flow and data flow were integrated from the physical examination system,HIS,PACS and LIS.Results The system established a human-oriented customer service platform,realized data sharing and automatic processing,and transformed external examination into digital mode from manual mode.Conclusion The system needs continuously improving and gifting with multi functions to provide enhanced service to the customer.

Soil microbes are the important indicator of soil quality. For exploring Chuanminshen violaceum planting to microbial effects in tobacco soil, this paper adopted Illumina MiSeq high-throughput sequencing to research the change of bacteria and fungi at the phylum and genus in the soil. The results showed that the Ch. violaceum planting increased the biodiversity of bacteria and fungi. The influence on fungi was greater than that on bacteria. It greatly increased the sequence of fungi, it obtained 32 978 16S rDNA and 32 229 18S rDNA sequence number. There was no change of the top three phylums in bacteria, but the content changed, Proteobacteria and Acidobacteria reduced by 1.73% and 1.4% respectively, and Actinobacteria increased by 0.65%. The advantage phylum Ascomycete in tobacco reduced by 27.99% to be second advantage phylum after Ch. violaceum planting, and the second advantage phylum Basidiomycete increased by 23.69% to become the first dominant fungi. At the genus, Ch. violaceum planting changed the order of dominant genus and the abundance was also changed. Some changed largely such as uncultured Acidobacteriaceae Subgroup-1, Gemmatimonas, Subgroup-2,uncultured Nitrosomonadaceae for bacteria, norank Sordariales, norank Agaricomycetes, Phialophora for fungi. Especially the rotation increased antagonistic microbes and physiological microbes and decreased pathogenic microbes. So the Ch. violaceum planting can improve the microbe community in tobacco soil.

Abstract? AIM: To evaluate the efficiency of two different operation ways, vitrectomy and vitrectomy combined with inferior scleral buckling, for a complex kind of retinal detachment.?METHODS:The complex kind of retinal detachment were diagnosed in 100 cases ( 100 eyes ) , with the common features:1)the course of more than 1mo;2) at least one retinal hole located in the inferior marginal retina;3) the detachment of retina was found proliferated, there was at least 1 retinal fold in retinal detachment area. The patients were randomly divided into two groups: the treatment group ( 50 eyes ) who received vitrectomy combined with inferior scleral buckling;the control group ( 50 eyes ) who received vitrectomy without scleral buckling. The retinal anatomic reattachment, visual function recovery, macular central fovea thickness and complications in two groups were observed.? RESULTS: There were 49 eyes ( 98%) with retinal anatomic reattachment in the treatment group while 42 eyes(84%)in control group(χ2=4.2605, P<0.05);the best corrected visual acuity ( BCVA) was 0.254 ±0.238 in the treatment group while it was 0.219±0.229 in control group (t=1.8879,P>0.05);the macular central fovea thickness was 272 ±32.21μm in the treat group while it was 316 ± 33.46μm(t=12.597,P<0.01).Intraocular pressure in 12 eyes ( 24%) was more than 30mmHg in the treatment group while 4 eyes ( 8%) in control group within 1wk postoperation (χ2=4.7619,P<0.05); intraocular pressure in 100 eyes were controlled below 21mmHg 1mo postoperatively.? CONCLUSION: It is a more effective method to vitrectomy combined with inferior scleral buckling than the single vitrectomy for the special kind of retinal detachment.It can increase the rate of retinal anatomic reattachment and reduce macular edema.