BACKGROUND:Poor prognosis of hip arthroplasty in patients with osteoporosis seriously affects the patients'quality of life.Accurately predicting the risk factors for poor prognosis of hip arthroplasty in patients with osteoporosis remains a major challenge for orthopedic surgeons.OBJECTIVE:To explore risk factors for poor prognosis after hip arthroplasty in patients with osteoporosis and construct a Nomogram prediction model.METHODS:A total of 192 patients with osteoporosis who underwent hip arthroplasty in Nanyang Second People's Hospital from July 2020 to June 2022 were selected as study subjects.Harris hip function scale was performed 6 months after operation.Patients with Harris score ≥ 80 were included in the good prognosis group(n=142),while patients with Harris score＜80 were included in the poor prognosis group(n=50).Clinical data of the two groups were collected and subjected to univariate analysis.Receiver operating characteristic curves were used to analyze the predictive value of the measures for poor prognosis after hip arthroplasty in patients with osteoporosis.Binary logistic regression was used to analyze the risk factors affecting poor prognosis after hip arthroplasty in patients with osteoporosis.The Nomogram prediction model for poor prognosis after hip arthroplasty in patients with osteoporosis was constructed.The calibration curve was internally validated and the concordance index was calculated,and the decision curve was evaluated for clinical predictive efficacy.RESULTS AND CONCLUSION:(1)The differences between the two groups were statistically significant in terms of age,body mass index,operative time,intraoperative bleeding,serum albumin,peripheral blood lymphocyte count,prognostic nutritional index,and complications(P＜0.05).(2)Area under the curve for age,body mass index,operative time,intraoperative bleeding,serum albumin,peripheral blood lymphocyte count,and prognostic nutritional index were 0.813,0.780,0.787,0.764,0.777,0.785,and 0.818.(3)Age,body mass index,intraoperative bleeding,and complications were risk factors for poor prognosis after hip arthroplasty in patients with osteoporosis.(4)The corrected,raw curve of the nomogram prediction model was close to the ideal curve with a concordance index of 0.851(0.815-0.886)and a good model fit,with a threshold of＞0.12 for the Nomogram prediction model to provide a net clinical benefit,and all net clinical benefits were higher than the independent predictors.(5)It is concluded that age,body mass index,intraoperative bleeding,and complications are risk factors affecting the poor prognosis of osteoporotic patients after hip arthroplasty.The Nomogram prediction model constructed based on this can help clinicians assess the prognosis of osteoporotic patients after hip arthroplasty,develop personalized interventions,improve prognosis,and enhance the quality of life.

Background:To compare the efficacy and safety of monthly administrations of gonadotropin releasing hormone (GnRH) agonists LY01005 and Zoladex ? in Chinese patients with premenopausal breast cancer. Methods:From October 2020 to November 2021, 188 premenopausal breast cancer patients were enrolled in 34 hospitals and randomized 1:1 to receive either LY01005 or Zoladex ? every 28 days for a total of three injections. All patients concomitantly received oral tamoxifen (TAM). The primary efficacy endpoint was cumulative probability of maintaining menopausal level [oestradiol (E2) ≤30 pg/ml] from day 29 to day 85. The second efficacy endpoint included changes in E2, luteinizing hormone (LH), and follicle-stimulating hormone (FSH) compared with the baseline. Pharmacokinetics (PK), pharmacodynamics (PD), and safety were analyzed. The study also evaluated the pharmacokinetic and pharmacodynamic characteristics of LY01005. Results:A total of 188 patients were randomised and 187 patients received either LY01005 or Zoladex ?. Cumulative probabilities of maintaining menopausal level (E2≤30 pg/ml) from day 29 to day 85 were 93.1% for LY01005 and 86.3% for Zoladex ?. The between-group difference was 6.8% (95% CI: -2.3%, 15.9%) and primary efficacy in the LY01005 group was not inferior to that in the Zoladex ? group. Changes in E2, LH, and FSH levels compared with the baseline were equivalent between the two groups (E2: 89.34% to 90.23% vs. 82.11% to 85.02%; LH: 88.89% to 95.52% vs. 89.70% to 97.02%; FSH: 75.36% to 80.85% vs.73.07% to 80.24%, respectively). After three consecutive doses of LY01005, the LH and FSH levels of the subjects showed a transient increase after the first dose, reached a peak on the second day and then started to decrease. The LH and FSH reached a lower level and remained at or below that level until the 85th day. Both treatments were well-tolerated. Conclusion:LY01005 is as effective as Zoladex ? in suppressing E2 to menopausal levels in Chinese patients with premenopausal breast cancer, with a similar safety profile.

BACKGROUND:Poor prognosis of hip arthroplasty in patients with osteoporosis seriously affects the patients'quality of life.Accurately predicting the risk factors for poor prognosis of hip arthroplasty in patients with osteoporosis remains a major challenge for orthopedic surgeons.OBJECTIVE:To explore risk factors for poor prognosis after hip arthroplasty in patients with osteoporosis and construct a Nomogram prediction model.METHODS:A total of 192 patients with osteoporosis who underwent hip arthroplasty in Nanyang Second People's Hospital from July 2020 to June 2022 were selected as study subjects.Harris hip function scale was performed 6 months after operation.Patients with Harris score ≥ 80 were included in the good prognosis group(n=142),while patients with Harris score＜80 were included in the poor prognosis group(n=50).Clinical data of the two groups were collected and subjected to univariate analysis.Receiver operating characteristic curves were used to analyze the predictive value of the measures for poor prognosis after hip arthroplasty in patients with osteoporosis.Binary logistic regression was used to analyze the risk factors affecting poor prognosis after hip arthroplasty in patients with osteoporosis.The Nomogram prediction model for poor prognosis after hip arthroplasty in patients with osteoporosis was constructed.The calibration curve was internally validated and the concordance index was calculated,and the decision curve was evaluated for clinical predictive efficacy.RESULTS AND CONCLUSION:(1)The differences between the two groups were statistically significant in terms of age,body mass index,operative time,intraoperative bleeding,serum albumin,peripheral blood lymphocyte count,prognostic nutritional index,and complications(P＜0.05).(2)Area under the curve for age,body mass index,operative time,intraoperative bleeding,serum albumin,peripheral blood lymphocyte count,and prognostic nutritional index were 0.813,0.780,0.787,0.764,0.777,0.785,and 0.818.(3)Age,body mass index,intraoperative bleeding,and complications were risk factors for poor prognosis after hip arthroplasty in patients with osteoporosis.(4)The corrected,raw curve of the nomogram prediction model was close to the ideal curve with a concordance index of 0.851(0.815-0.886)and a good model fit,with a threshold of＞0.12 for the Nomogram prediction model to provide a net clinical benefit,and all net clinical benefits were higher than the independent predictors.(5)It is concluded that age,body mass index,intraoperative bleeding,and complications are risk factors affecting the poor prognosis of osteoporotic patients after hip arthroplasty.The Nomogram prediction model constructed based on this can help clinicians assess the prognosis of osteoporotic patients after hip arthroplasty,develop personalized interventions,improve prognosis,and enhance the quality of life.

Background:To compare the efficacy and safety of monthly administrations of gonadotropin releasing hormone (GnRH) agonists LY01005 and Zoladex ? in Chinese patients with premenopausal breast cancer. Methods:From October 2020 to November 2021, 188 premenopausal breast cancer patients were enrolled in 34 hospitals and randomized 1:1 to receive either LY01005 or Zoladex ? every 28 days for a total of three injections. All patients concomitantly received oral tamoxifen (TAM). The primary efficacy endpoint was cumulative probability of maintaining menopausal level [oestradiol (E2) ≤30 pg/ml] from day 29 to day 85. The second efficacy endpoint included changes in E2, luteinizing hormone (LH), and follicle-stimulating hormone (FSH) compared with the baseline. Pharmacokinetics (PK), pharmacodynamics (PD), and safety were analyzed. The study also evaluated the pharmacokinetic and pharmacodynamic characteristics of LY01005. Results:A total of 188 patients were randomised and 187 patients received either LY01005 or Zoladex ?. Cumulative probabilities of maintaining menopausal level (E2≤30 pg/ml) from day 29 to day 85 were 93.1% for LY01005 and 86.3% for Zoladex ?. The between-group difference was 6.8% (95% CI: -2.3%, 15.9%) and primary efficacy in the LY01005 group was not inferior to that in the Zoladex ? group. Changes in E2, LH, and FSH levels compared with the baseline were equivalent between the two groups (E2: 89.34% to 90.23% vs. 82.11% to 85.02%; LH: 88.89% to 95.52% vs. 89.70% to 97.02%; FSH: 75.36% to 80.85% vs.73.07% to 80.24%, respectively). After three consecutive doses of LY01005, the LH and FSH levels of the subjects showed a transient increase after the first dose, reached a peak on the second day and then started to decrease. The LH and FSH reached a lower level and remained at or below that level until the 85th day. Both treatments were well-tolerated. Conclusion:LY01005 is as effective as Zoladex ? in suppressing E2 to menopausal levels in Chinese patients with premenopausal breast cancer, with a similar safety profile.

Objective: To systematically evaluate the willingness to receive influenza vaccines among Chinese medical staff, so as to provide the evidence for developing the influenza vaccination strategy and improving the coverage of influenza vaccination among medical staff. Methods: Publications pertaining to the willingness to receive influenza vaccines among Chinese medical staff were retrieved from international and national databases from January 1, 2010 to October 1, 2023, including CNKI, Wanfang Data, VIP, SinoMed, PubMed, Web of Science and Embase. A meta-analysis was performed using the software Stata 17.0, sensitivity analysis was performed using the leave-one-out method, and the publication bias was evaluated using Funnel plot. Results: Totally 674 publications were retrieved, and 17 case-control studies were finally enrolled, with 23 697 participants. Meta-analysis showed that the rate of willingness to receive influenza vaccines among medical staff in China was 52.8% (95%CI: 41.3%-64.4%). The rates of willingness to receive influenza vaccines were 40.2% (95%CI: 28.5%-51.8%) in 2019 and before and 67.2% (95%CI: 56.5%-77.9%) in 2020 and beyond; 54.6% (95%CI: 44.2%-65.0%) in men and 56.8% (95%CI: 49.3%-64.4%) in women; 53.6% (95%CI: 40.9%-66.2%) in doctors, 53.9% (95%CI: 41.0%-66.8%) in nurses, 62.8% (95%CI: 46.2%-79.3%) in technicians and 53.1% (95%CI: 36.1%-70.0%) in administrative and logistical staff; 77.4% (95%CI: 63.7%-91.2%) and 43.3% (95%CI: 30.5%-56.1%) in staff with and without a history of influenza vaccination; 49.8% (95%CI: 27.3%-72.3%) and 58.3% (95%CI: 43.9%-72.6%) in studies with a sample size of <1 000 and ≥1 000, and these differences were statistically significant (all P<0.05). Sensitivity analysis showed robustness of results, and Funnel plot showed publication bias. Conclusion The rates of willingness to receive influenza vaccines among medical staff in China ranged from 41.3% to 64.4%, and were lower in studies in 2019 and before, in men, in administrative and logistical staff and in staff without a history of influenza vaccination.

【Objective】 To explore the the potential risks of antiretroviral therapy(ART) drugs on blood safety among blood donors in Shenzhen. 【Methods】 High pressure liquid chromatography coupled with tandem mass spectrometry (HPLC-MS/MS) was used to measure ART drugs concentrations in the plasma of regular blood donors (negative control group, n=86) and anti-HIV positive individuals (experimental group, n=98, detected from approximately 440 000 blood donors during 2019—2023). The baseline plasma concentrations of ART drugs in the negative control group were clarified, and the impact of ART drugs on blood safety was analyzed. 【Results】 The baseline concentrations of ART drugs were not detected in 86 samples of negative control group. Four positive ART drugs samples were detected in 1∶2 pooled plasma samples of 98 anti-HIV positive blood donors plasma in the resolution test. The ART positive rate of anti-HIV positive donors was 4.08%, with tenofovir, lamivudine and efavirenz detected in three blood donors and lamivudine, lopinavir, ritonavir and zidovudine detected in one blood donor. 【Conclusion】 ART drugs were found among anti-HIV positive blood donors in Shenzhen. Additional research is needed to investigate the motivation of these specific donors, so as to ascertain the groups most susceptible to potential risks, and guarantee blood safety.

As a leading cause of chronic kidney disease, clinical demand for noninvasive biomarkers of diabetic kidney disease (DKD) beyond proteinuria is increasing. Metabolomics is a popular method to identify mechanisms and biomarkers. We investigated urinary targeted metabolomics in DKD patients. Methods: We conducted a targeted metabolomics study of 26 urinary metabolites in consecutive patients with DKD stage 1 to 5 (n = 208) and healthy controls (n = 26). The relationships between estimated glomerular filtration rate (eGFR) or urine protein-creatinine ratio (UPCR) and metabolites were evaluated. Multivariate Cox analysis was used to estimate relationships between urinary metabolites and the target outcome, end-stage renal disease (ESRD). C statistics and time-dependent receiver operating characteristics (ROC) were used to assess diagnostic validity. Results: During a median 4.5 years of follow-up, 103 patients (44.0%) progressed to ESRD and 65 (27.8%) died. The median fold changes of nine metabolites belonged to monosaccharide and tricarboxylic acid (TCA) cycle metabolites tended to increase with DKD stage. Myo-inositol, choline, and citrates were correlated with eGFR and choline, while mannose and myo-inositol were correlated with UPCR. Elevated urinary monosaccharide and TCA cycle metabolites showed associations with increased morality and ESRD progression. The predictive power of ESRD progression was high, in the order of choline, myo-inositol, and citrate. Although urinary metabolites alone were less predictive than serum creatinine or UPCR, myo-inositol had additive effect with serum creatinine and UPCR. In time-dependent ROC, myo-inositol was more predictive than UPCR of 1-year ESRD progression prediction. Conclusion: Myo-inositol can be used as an additive biomarker of ESRD progression in DKD.

OBJECTIVE: To explore the prognostic value of early multiple detection indicators in combination with sequential organ failure assessment (SOFA) in sepsis patients. METHODS: A retrospective analysis was conducted. Patients with sepsis admitted to the department of critical care medicine of Huanggang Central Hospital of Yangtze University from May 2020 to May 2022 were selected as the research subjects. Coagulation indicators, inflammatory factors, blood routine, liver and kidney function, and blood gas analysis were collected at admission. Organ dysfunction was assessed based on the SOFA score within 24 hours after admission. Patients were divided into a survival group and a death group according to the outcome of 28 days in ICU. Differences in the above indicators between the two groups were compared. Multifactorial Logistic regression analysis was used to analyze prognostic factors of 28-day mortality in sepsis patients. Receiver operator characteristic curve (ROC curve) was drawn to analyze the predictive performance of various indicators, the SOFA score, and the combine model for the 28-day outcome in patients with sepsis. RESULTS: A total of 101 patients with sepsis were enrolled, 56 patients survived and 45 patients died. Compared to the survival group, patients in the death group were older, the proportion of patients with septic shock was larger, the SOFA score, and the proportion of pulmonary infection were higher, the prothrombin time (PT) and activated partial thromboplastin time (APTT) were significantly prolonged, the prothrombin activity (PTA) was significantly shortened, and antithrombin (AT) was significantly decreased, the levels of hypersensitivity C-reactive protein (hs-CRP), blood urea nitrogen (BUN), total bilirubin (TBil), and lactic acid (Lac) were significantly increased, while the platelet count (PLT) was significantly decreased. Multifactorial Logistic regression analysis showed that pulmonary infection [odds ratio (OR) = 0.010, 95% confidence interval (95%CI) was 0.001-0.164, P = 0.001], AT (OR = 0.944, 95%CI was 0.910-0.978, P = 0.002), hs-CRP (OR = 1.008, 95%CI was 1.001-1.015, P = 0.017), Lac (OR = 1.619, 95%CI was 1.195-2.193, P = 0.002), and SOFA score (OR = 1.363, 95%CI was 1.076-1.727, P = 0.010) were independent prognostic factors for 28-day mortality in patients. A combined model was constructed using pulmonary infection, AT, hs-CRP, Lac, and SOFA score. ROC curve analysis showed that the area under the ROC curve (AUC) for the combine model in predicting sepsis prognosis was 0.936 (95%CI was 0.869-0.975, P < 0.001), which was higher in value compared to single indicators (AUC of AT, hs-CRP, Lac, and SOFA score were 0.775, 0.666, 0.802, 0.796, respectively, all P < 0.05). CONCLUSIONS The predictive ability of the SOFA score for sepsis patient outcomes is limited. The combine model combining infection site, AT, hs-CRP, and Lac shows better predictive ability.
Humans ; Organ Dysfunction Scores ; Retrospective Studies ; C-Reactive Protein ; ROC Curve ; Sepsis/metabolism* ; Prognosis ; Anticoagulants ; Antithrombin III ; Intensive Care Units

The outbreak of novel coronavirus pneumonia(NCP) caused by 2019 novel coronavirus has become a global public health challenge. Some patients accompany with liver function damage in addition to the main typical respiratory symptom. Here we analyzed the clinical features, susceptible population, potential causes and therapeutic strategies of NCP related liver injury.

Objective To understand the epidemic situation of tea-drinking-borne fluorosis among children in Haixi Prefecture of Qinghai Province,and to provide basis for taking pertinent prevention and control measures.Methods In 2017,three townships (towns) were selected from five counties (cities) in Golmud,Delingha,Dulan,Ulan and Tianjun,Haixi,and one village (villages excluding excessive water fluoride) was selected from each township (town) as the investigation site.Fluoride content in drinking water,tea fluoride content and dental fluorosis in children aged 8-12 years were investigated.Water fluoride was determined using "Standard Test Method for Drinking Water" (GB/T 5750.5-2006);brick tea fluoride content was detected using "The Fluoride Content in Brick Tea" (GB 19965-2005);children's dental fluorosis was diagnosed using "Diagnosis of Dental Standard for Fluorosis"(WS/T 208-2011).Results Totally 75 drinking water samples were collected from each county (city).The water fluoride content ranged from 0.35 to 0.41 mg/L,with an average value of 0.37 mg/L,which was lower than the national drinking water fluoride standard of 1.00 mg/L.The fluoride content of 150 brick tea samples ranged from 206.0 to 796.0 mg/kg,with an average value of 629.8 mg/kg.A total of 1 325 children aged 8-12 were examined.The detection rate of dental fluorosis was 13.43％ (178/1 325),the index of dental fluorosis was 0.27,and the overall epidemic intensity was negative.The epidemic intensity in Dulan and Tianjun counties was marginal.There were significant differences in the detection rate of dental fluorosis among children of different ages (x2=35.26,P ＜ 0.05),and dental fluorosis was increased with ages in children.The detection rate of dental fluorosis in boys and girls was 13.31％ (90/676) and 13.56％ (88/649),respectively,with no significant difference (x2 =0.02,P ＞ 0.05).Conclusions There is an epidemic of tea-drinking-borne fluorosis among children in 5 counties (cities) of Haixi Prefecture.Although the epidemic is mild,it should not be ignored.Health education and publicity work for tea-drinking-borne fluorosis should be strengthened.