1.Risk factors and their predictive efficacy for early postoperative infection in elderly patients with intertrochanteric femur fracture
Mingwei CHEN ; Wenteng SI ; Yali YU ; Xiang LI ; Shijun ZHAO ; Aiguo WANG
Chinese Journal of Trauma 2025;41(9):840-846
Objective:To investigate the risk factors and their predictive efficacy for early postoperative infection in elderly patients with intertrochanteric femur fracture.Methods:A retrospective cohort study was conducted to analyze the clinical data of 286 elderly patients with intertrochanteric femur fracture admitted to Zhengzhou Orthopedic Hospital between August 2021 and August 2024, including 154 males and 132 females, aged 60-80 years [(72.5±5.8)years]. Fracture involved the left side in 148 patients and the right side in 138 patients. Internal fixation was performed on 214 patients and joint replacement on 72. Based on the occurrence of infection within two weeks postoperatively, the patients were divided into infection group ( n=25) and non-infection group ( n=261). Data were collected from the two groups, including basic information [gender, age, body mass index (BMI), cause of injury, fracture side], admission data (fasting blood glucose, diastolic blood pressure, systolic blood pressure), preoperative data [American Society of Anesthesiologists (ASA) classification, AO classification, serum C-reactive protein (CRP), serum albumin (Alb), serum CRP/Alb ratio, time from injury to surgery], and treatment-related information (surgical type, duration of surgery, intraoperative blood loss, quality of intraoperative reduction, postoperative antibiotic use). Univariate analysis and multivariate Logistic stepwise regression analysis were used to identify independent risk factors for early postoperative infection in elderly patients with intertrochanteric femur fracture. The receiver operating characteristic (ROC) curve was plotted and the area under the curve (AUC) was calculated to evaluate the predictive efficacy of each factor. Results:Univariate analysis showed significant differences between the two groups in fasting blood glucose on admission, preoperative serum CRP, preoperative serum Alb, preoperative serum CRP/Alb ratio, and duration of surgery ( P<0.01). There were no significant differences between the two groups in the remaining variables ( P>0.05). Multivariate Logistic stepwise regression analysis indicated that fasting blood glucose on admission ( OR=2.65, 95% CI 1.32, 5.32, P<0.01), preoperative serum CRP ( OR=1.10, 95% CI 1.04, 1.18, P<0.01), preoperative serum Alb ( OR=0.79, 95% CI 0.70, 0.90, P<0.01), preoperative serum CRP/Alb ( OR=143.78, 95% CI 4.46, 46.77, P<0.01), and duration of surgery ( OR=1.07, 95% CI 1.02, 1.11, P<0.01) were significantly associated with early postoperative infection in elderly patients with intertrochanteric femur fracture. ROC curve analysis showed that the sensitivity and specificity of preoperative serum CRP/Alb in predicting early postoperative infection in elderly patients with intertrochanteric femur fracture were 88.00% and 88.10%, and that the AUC of preoperative serum CRP/Alb prediction was 0.92, significantly greater than the AUC predicted separately by fasting blood glucose at admission, preoperative serum CRP, preoperative serum Alb and duration of surgery (0.76, 0.75, 0.77, 0.76, respectively). The optimal cut-off value for the preoperative serum CRP/Alb ratio was 1.78. Conclusions:Fasting blood glucose on admission, preoperative serum CRP, Alb, CRP/Alb ratio, and duration of surgery are independent risk factors for early postoperative infection in elderly patients with intertrochanteric femur fracture. These factors all possess certain predictive value for early postoperative infection, but the preoperative serum CRP/Alb ratio demonstrates the best predictive efficacy.
2.Risk factors and their predictive efficacy for early postoperative infection in elderly patients with intertrochanteric femur fracture
Mingwei CHEN ; Wenteng SI ; Yali YU ; Xiang LI ; Shijun ZHAO ; Aiguo WANG
Chinese Journal of Trauma 2025;41(9):840-846
Objective:To investigate the risk factors and their predictive efficacy for early postoperative infection in elderly patients with intertrochanteric femur fracture.Methods:A retrospective cohort study was conducted to analyze the clinical data of 286 elderly patients with intertrochanteric femur fracture admitted to Zhengzhou Orthopedic Hospital between August 2021 and August 2024, including 154 males and 132 females, aged 60-80 years [(72.5±5.8)years]. Fracture involved the left side in 148 patients and the right side in 138 patients. Internal fixation was performed on 214 patients and joint replacement on 72. Based on the occurrence of infection within two weeks postoperatively, the patients were divided into infection group ( n=25) and non-infection group ( n=261). Data were collected from the two groups, including basic information [gender, age, body mass index (BMI), cause of injury, fracture side], admission data (fasting blood glucose, diastolic blood pressure, systolic blood pressure), preoperative data [American Society of Anesthesiologists (ASA) classification, AO classification, serum C-reactive protein (CRP), serum albumin (Alb), serum CRP/Alb ratio, time from injury to surgery], and treatment-related information (surgical type, duration of surgery, intraoperative blood loss, quality of intraoperative reduction, postoperative antibiotic use). Univariate analysis and multivariate Logistic stepwise regression analysis were used to identify independent risk factors for early postoperative infection in elderly patients with intertrochanteric femur fracture. The receiver operating characteristic (ROC) curve was plotted and the area under the curve (AUC) was calculated to evaluate the predictive efficacy of each factor. Results:Univariate analysis showed significant differences between the two groups in fasting blood glucose on admission, preoperative serum CRP, preoperative serum Alb, preoperative serum CRP/Alb ratio, and duration of surgery ( P<0.01). There were no significant differences between the two groups in the remaining variables ( P>0.05). Multivariate Logistic stepwise regression analysis indicated that fasting blood glucose on admission ( OR=2.65, 95% CI 1.32, 5.32, P<0.01), preoperative serum CRP ( OR=1.10, 95% CI 1.04, 1.18, P<0.01), preoperative serum Alb ( OR=0.79, 95% CI 0.70, 0.90, P<0.01), preoperative serum CRP/Alb ( OR=143.78, 95% CI 4.46, 46.77, P<0.01), and duration of surgery ( OR=1.07, 95% CI 1.02, 1.11, P<0.01) were significantly associated with early postoperative infection in elderly patients with intertrochanteric femur fracture. ROC curve analysis showed that the sensitivity and specificity of preoperative serum CRP/Alb in predicting early postoperative infection in elderly patients with intertrochanteric femur fracture were 88.00% and 88.10%, and that the AUC of preoperative serum CRP/Alb prediction was 0.92, significantly greater than the AUC predicted separately by fasting blood glucose at admission, preoperative serum CRP, preoperative serum Alb and duration of surgery (0.76, 0.75, 0.77, 0.76, respectively). The optimal cut-off value for the preoperative serum CRP/Alb ratio was 1.78. Conclusions:Fasting blood glucose on admission, preoperative serum CRP, Alb, CRP/Alb ratio, and duration of surgery are independent risk factors for early postoperative infection in elderly patients with intertrochanteric femur fracture. These factors all possess certain predictive value for early postoperative infection, but the preoperative serum CRP/Alb ratio demonstrates the best predictive efficacy.
3.Effect analysis of antibody dependent enhancement effect induced by anti-SARS-CoV-2 antibody positive plasma infusion in patients with COVID-19 complicating liver dysfunction
Zhen LEI ; Zhijuan SI ; Yali ZONG ; Shumei WANG
Chongqing Medicine 2024;53(19):2960-2964,2969
Objective To investigate whether or not the infusion of anti-SARS-CoV-2 antibody-positive stock plasma inducing the antibody-dependent enhancement(ADE)effect in the patients with COVID-19 complicating liver dysfunction.Methods The clinical data of 26 patients with COVID-19 complicating liver dysfunction infused with SARS-CoV-2 antibody-positive stock plasma in this hospital from December 15,2022 to January 20,2023 were analyzed retrospectively.The changes of peripheral blood mononuclear cells(MONO)count and cytokines IL-2,IL-4,IL-6,IL-10,TNF-α and IFN-γ levels were compared and analyzed before and after plasma infusion.Thirty-seven patients with COVID-19 without plasma infusion during the same period served as the control group.The situation such as peripheral blood MONO count,cytokines lev-els,throat swab SARS-CoV-2 nucleic acid test,pulmonary infection lesion absorption on 5 d of treatment were compared between the two groups.Results The proportions of peripheral blood MONO count increase in the observation group and control group were 69.23%and 59.56%respectively,the proportions of cytokines in-crease were 66.67%vs.76.92%for IL-2,22.22%vs.46.15%for IL-4,33.33%vs.38.46%for IL-6,33.33%vs.30.27%for IL-10,33.33%vs.46.15%for TNF-α and 44.44%vs.61.54%for IFN-γ,the throat swab SARS-CoV-2 nucleic acid detection negative ratio was 46.67%vs.59.09%.The proportion of the pa-tients with lesion absorption beginning was 87.50%vs.84.85%,and the differences were not statistically sig-nificant(P>0.05).Conclusion Infusion of stock plasma containing anti-SARS-CoV-2 polyclonal antibodies in the patients with COVID-19 complicating liver dysfunction does not induce significant ADE.
4.Research Progress on the Interaction Mechanism Between Nociceptors and Immunity in Pain
Yali LI ; Shaomeng SI ; Fanglong HAN
Acta Medicinae Universitatis Scientiae et Technologiae Huazhong 2024;53(5):687-692
Nociceptive sensory neurons are widely distributed throughout various parts of the body to detect harmful stimu-li and transmit pain sensations.In recent years,the interactions between nociceptive sensory neurons and the immune system have garnered increasing attention from researchers.Immune cells and inflammatory factors promote the activation of nocicep-tors and the transmission of pain;conversely,nociceptors also participate in regulating the body's immune functions.The bal-ance between these two systems is beneficial for self-protection under harmful stimuli and infection.Moreover,this neuroim-mune interaction may underlie the coexistence and mutual promotion of hyperalgesia and inflammation.This review primarily discusses the role of interactions between nociceptors in various body regions and the immune system in pain,as well as the po-tential molecular mechanisms involved.This study aims to provide insights and theoretical foundations for developing new strat-egies for pain management.
5.Effect of individualized PEEP on postoperative lung complications in patients undergoing cardiac valve replacement
Youran WANG ; Yali GE ; Lihai CHEN ; Yanna SI
Chinese Journal of Anesthesiology 2021;41(8):910-914
Objective:To investigate the effect of individualized positive end-expiratory pressure (PEEP) on postoperative lung complications in patients undergoing cardiac valve replacement.Methods:Sixty-four patients of both sexes, aged 40-70 yr, with body mass index of 18-26 kg/m 2, of American Society of Anesthesiologists physical status Ⅱ or Ⅲ, with New York Heart Association class Ⅱ or Ⅲ, undergoing elective cardiac valve replacement (single or double) from July to October 2020, were enrolled in this study.The patients were divided into 2 groups ( n=32 each) using a random number table method: control group (group C) and individualized PEEP group (group P). After recruitment maneuver, group C was set with a fixed PEEP of 4 cmH 2O, group P was titrated using a PEEP-step method, and PEEP was set at 4 cmH 2O after admission to intensive care unit (ICU). Before induction of anesthesia (T 0), before recruitment maneuver (T 1), at 20 min after PEEP ventilation (T 2), at 2 h after surgery (T 3), and at 24 h after surgery (T 4), arterial blood samples were taken for determination of serum interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) concentrations.The hemodynamic indicators (heart rate, mean arterial pressure and central venous pressure) at T 1-T 4 were recorded.Pulmonary complications were diagnosed according to clinical manifestations, imaging and blood gas analysis during the postoperative hospitalization.The postoperative length of hospital stay, extubation time and duration of ICU stay were recorded. Results:PEEP in group P [(6.1±1.4)cmH 2O] was significantly higher than that in group C ( P<0.05). Compared with group C, the concentrations of serum IL-6 and TNF-α at T 3 were significantly decreased, central venous pressure at T 2 was increased, and the incidence of postoperative pulmonary complications was decreased ( P<0.05), and no significant change was found in the length of hospital stay, extubation time and duration of ICU stay in group P ( P>0.05). Conclusion:Early application of individualized PEEP after termination of cardiopulmonary bypass can decrease the risk of postoperative pulmonary complications in patients undergoing cardiac valve replacement.
6.Accuracy of different biomarkers for early diagnosis of acute kidney injury in patients undergoing cardiovascular surgery under cardiopulmonary bypass
Yanna SI ; Zhaojing FANG ; Hongwei SHI ; Yali GE ; Ling JING ; Lingqing ZENG ; Hongguang BAO
Chinese Journal of Anesthesiology 2018;38(9):1038-1041
Objective To evaluate the accuracy of different biomarkers for early diagnosis of acute kidney injury ( AKI ) in the patients undergoing cardiovascular surgery under cardiopulmonary bypass ( CPB) . Methods A total of 200 patients, aged 22-86 yr, weighing 46-87 kg, scheduled for elective cardiovascular surgery under CPB, were enrolled in this study. The concentration of serum creatinine was determined at 1 day before operation and 1-7 days after operation. At 1 day before operation and 0, 2, 6 and 12 h after operation, the concentrations of urine neutrophil gelatinase-associated lipocalin (NGAL), cystatin C ( Cys C) , tissue inhibitor of matrix metalloproteinase type 2 ( TIMP-2) and insulin-like growth factor binding protein-7 ( IGFBP-7) were determined. The TIMP-2 and IGFBP-7 product ( TI) was calcu-lated. AKI was diagnosed after surgery according to Kidney Disease Improving Global Outcomes criteria. The receiver operating characteristic curve was plotted, and the area under receiver operating characteristic curve ( AUC) was calculated. Results The incidence of AKI was 20. 5%. The AUC of AKI diagnosed by the concentration of urine NGAL was 0. 689, 0. 709, 0. 713 and 0. 803 at 0, 2, 6 and 12 h after opera-tion, respectively ( P<0. 05) . The AUC of AKI diagnosed by the concentration of urine Cys C was 0. 639, 0. 762, 0. 774 and 0. 812 at 0, 2, 6 and 12 h after operation, respectively ( P<0. 05) . The AUC of AKIdiagnosed by TI was 0. 687, 0. 721, 0. 740 and 0. 779 at 0, 2, 6 and 12 h after operation, respectively ( P<0. 05) . The AUC of AKI diagnosed by combined three indices the parallel test was 0. 694, 0. 773 and 0. 794 at 0, 2 and 6 h after operation, respectively ( P<0. 05) . The AUC of AKI diagnosed by the serial test was 0. 610, 0. 631 and 0. 667 at 0, 2 and 6 h after operation, respectively. Conclusion Urine NGAL or Cys C concentrations or TI single detection and parallel test have a certain accuracy for early diag-nosis of AKI in the patients undergoing cardiovascular surgery under CPB.
7.Rescuing Bombyx mori bidensovirus in BmN cells in vitro.
Miaomiao ZHANG ; Ying MA ; Xiaoli PAN ; Zhaoyang HU ; Guohui LI ; Yayun SI ; Yali XING ; Keping CHEN ; Qin YAO
Chinese Journal of Biotechnology 2015;31(1):86-95
Bombyx mori bidensovirus (BmBDV) has been identified as causing chronic densonucleosis in Bombyx mori specifically. The replication mechanism of BmBDV remains unknown. Its genome comprises two single stands DNA (VD1 and VD2). In order to rescue infectious virions in vitro, we obtained the total viral DNA extracted from the BmBDV-infected larvae midguts, subsequently cloned the full-length sequence of BmBDV genome fragments by PCR and constructed recombinant plasmids pMD18T-VD1 and pUC-VD2. The linear genome fragments were obtained by digesting recombinant plasmids with corresponding restriction enzymes, and then collectively transfected BmN cells by the method of liposome-embedding. We determined the replication of the virus gene by PCR with the template of demethylated total DNA extracted from the post-transfect BmN cells. Meanwhile, we collected the total proteins from the post-transfect BmN cells and the larvae midgut of feeding the post-transfect BmN cells to perform Western blotting analysis, and detected the expression of viral genes. Here we firstly confirm that infectious virions can be rescued in BmN cells by linear co-transfect method.
Animals
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Bombyx
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DNA, Viral
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Densovirus
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growth & development
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Larva
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Transfection
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Virion
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Virus Cultivation
8.MicroRNA target predicition based on SVM and the optimized feature set.
Baowen WANG ; Xiaoyang QI ; Changwu WANG ; Wenyuan LIU ; Yali SI
Journal of Biomedical Engineering 2013;30(6):1213-1218
MicroRNA (miRNA) is a family of endogenous single-stranded RNA about 22 nucleotides in length. Through targeting 3' UTR of message RNA (mRNA), they play important roles in post-transcriptional regulatory functions. For further research of miRNA function, the identification of more miRNA positive targets is needed urgently. Aiming at the high-dimensional small sample data sets in miRNA target prediction, an algorithm of eliminating redundant features is proposed based on v-SVM in this paper, and classification and features selection are also fused. The algorithm of eliminating redundant features optimizes the combination of features, and then constructs the best features combination which can represent miRNA and targets interaction model. The prior parameter v (0 < u < or = 1) controls the compression proportion of data set and selects more distinguishing support vectors. Finally, the classifier model of miRNA target prediction is built. The unbiased assessment of the classifier is achieved with a completely independent test dataset. Experiment results indicated that in both classification recognition and generalization performance of miRNA targets predicition, this model was superior to the present machine learning algorithms such as miTarget, NBmiRTar and TargetMiner, etc.
MicroRNAs
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Models, Theoretical
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Support Vector Machine
9.Construction of a LRP16 gene targeting vector and screening of homologously recombinant clone of embryonic stem cells
Zhiqiang WU ; Weidong HAN ; Yali ZHAO ; Yiling SI ; Yiming MU ; Yuanguan MENG ; Nomura MASATOSHI
Chinese Journal of Tissue Engineering Research 2008;12(12):2391-2395
BACKGROUND: Previous studies have demonstrated that LRP16 is an estrogen-responsive gene. Its expression level is strongly associated with the proliferation and invasive growth of human breast cancer cells.OBJECTIVE: To construct a LRP16 targeting vector and screen mouse embryonic stem cell clones with homolougous recombination of an inactive LRP16 gene.DESIGN: Constructing an inserting inactivation target by inserting SA-RIES-β geo expression cassette.SETTING: Bioregulatory Laboratory of the Third Medical Department of Kyushu University in Japan and Department of Molecular Biology, General Hospital of Chinese PLA.MATERIALS: The materials used here were mainly provided by the Bioregulatory Laboratory, the Third Medical Department of Kyushu University in Japan. The mouse genomic library in pBeloBAC11 Vector was purchased from lnvitrogen Corp. The competent TopF10 was purchased from Beijing Tiangen Biotech Corp. pcDNA3.1(+) vector was kept in our laboratory. Mouse ES cells were provided by Kyushu University.METHODS: The experiment was performed in Kyushu University and Department of Molecular Biology of PLA General Hospital from November 2004 to May 2005. Targeting sequence of LRP16 gene was obtained from 129 mouse genomic Bacterial Artificial Chromosomes library based on polymerase chain reaction (PCR) screening. The SA-RIES-β geo fragment was inserted within LRP16 fifth exon to inactivate LRP16. ES cells were screened with G418 and the homologously recombinant clone was identified by Southern blot analysis.MAIN OUTCOME MEASURES: Clones with homologous recombination.RESULTS: The LRP16 fragment including exon 5 to 11 was subcloned into the pBluescript SK Ⅱvector. Restriction map demonstrated that the SA-IRES-β geo fragment was correctly inserted into the LRP16 fifth exon. Southern blot results showed that there was an ES clone with targeting sequence homologously inserted.CONCLUSION: A LRP16 gene targeting vector is constructed and a homologous recombinant is obtained.
10.The influence of anti-sense hTERT on the expression of VEGF and Flt in SGC7901 cells
Yiling SI ; Weidong HAN ; Yali ZHAO
Medical Journal of Chinese People's Liberation Army 2001;0(12):-
Objective To investigate the effects of anti-sense hTERT on the expression of VEGF and the receptor in SGC7901 cells, and study the influence in angiogenesis and progression in gastric carcinoma. Methods SGC7901 cell line was transfected by the recombinant virus containing sense and anti-sense hTERT cDNA. Then the expression of VEGF-C and Flt-4 was observed with RT-PCR, distribution of cell cycles was determined with flow cytometry. The expression of VEGF-C and Flt-4 protein was assessed with immunohistochemistry. Result The distribution of cell cycle of antisense hTERT transfected SGC7901 cells was changed, and the mRNA and protein expression of VEGF-C and Flt-4 was significantly down-regulated. Conclusion Anti-sense hTERT can act as an agent for inhibiting VEGF-C and Flt-4 mRNA and protein level, and it blocks tumor angiogenesis and lymphogenous metastasis.

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