1.Hypotension prediction index in the prediction of better outcomes: a systematic review and meta-analysis
Yi LIU ; Bei LIU ; Wei XIONG ; Chen WANG ; Kunxin YANG ; Wudi MA ; Liangtian LAN ; Ming WEI ; Nan JIANG ; Xia FENG
Korean Journal of Anesthesiology 2026;79(2):169-181
Background:
The hypotension prediction index (HPI) is an algorithm designed to predict hypotension. Some studies have reported that HPI-guided hemodynamic management strategies decrease intraoperative hypotension and complications; however, the effect of HPI on reducing perioperative complications is controversial. This meta-analysis aimed to assess the efficacy of the HPI in reducing major complications and intraoperative hypotension.
Methods:
We conducted this meta-analysis according to the PRISMA statement and Cochrane Handbook guidelines. A comprehensive literature review was conducted to identify studies focusing on the efficacy of HPI-guided management in reducing intraoperative hypotension and postoperative complications. The PubMed, Embase, Scopus, and Web of Science databases were searched, and the resulting data were combined to calculate the pooled mean differences or risk ratios (RRs) with 95% CIs of both randomized controlled trials (RCTs) and retrospective studies, as appropriate. Heterogeneity and potential publication bias were also assessed.
Results:
Nineteen articles (12 RCTs and 7 retrospective studies) with 2570 recruited patients were included in this meta-analysis. The critical evaluation of the study quality revealed a low risk of bias in the included RCTs. Among the non-randomized trials, one was rated 7, two were rated 8, and the remaining four were rated 9 on the Newcastle-Ottawa Scale, indicating high quality and a low risk of bias. HPI-guided management significantly reduced intraoperative hypotension and associated major complications (RR = 0.79, 95% CI [0.69–0.90], I2 = 0, P < 0.001). Blood loss and length of hospital stay were comparable between the groups.
Conclusions
HPI-guided management significantly reduced intraoperative hypotension and major complications.
2.The Refinement and Innovation of The UV Cross-linking and Immunoprecipitation
Jia-Min ZHAO ; Cheng-Jiang LU ; Ming YANG ; Nashun BUHE ; Gang WANG
Progress in Biochemistry and Biophysics 2025;52(4):1036-1052
RNA-binding proteins (RBPs) are ubiquitous components within cells, fulfilling essential functions in a myriad of biological processes. These proteins interact with RNA molecules to regulate gene expression at various levels, including transcription, splicing, transport, localization, translation, and degradation. Understanding the intricate network of RBP-RNA interactions is crucial for deciphering the complex regulatory mechanisms that govern cellular function and organismal development. Ultravidet (UV) cross-linking and immunoprecipitation (CLIP) stands out as a powerful approach designed to map the precise locations where RBPs bind to RNA. By using UV light to create covalent bonds between proteins and RNA, followed by immunoprecipitation to isolate the protein-RNA complexes, researchers can identify the direct targets of specific RBPs. The advent of high-throughput sequencing technologies has revolutionized CLIP, enabling the identification of not only the types but also the exact sequences of RNA bound by RBPs on a genome-wide scale. The evolution of CLIP has led to the development of specialized variants, each with unique features that address specific challenges and expand the scope of what can be studied. High-throughput sequencing CLIP (HITS-CLIP) was one of the first advancements, significantly increasing the throughput and resolution of RNA-protein interaction mapping. Photoactivatable-ribonucleoside-enhanced CLIP (PAR-CLIP) introduced the use of photoactivatable ribonucleosides to enhance cross-linking efficiency and specificity, reducing background noise and improving the detection of low-abundance RNA-protein interactions. Individual-nucleotide resolution CLIP (iCLIP) further refined the technique, achieving unprecedented precision by resolving individual nucleotides involved in RBP binding, which is particularly valuable for studying the fine details of RNA structure and function. Despite the remarkable progress, there remains room for improvement in CLIP technology. Researchers continue to seek methods to increase sensitivity, reduce technical variability, and improve the reproducibility of results. Advances in sample preparation, data analysis algorithms, and computational tools are critical for addressing these challenges. Moreover, the application of CLIP to more diverse biological systems, including non-model organisms and clinical samples, requires the development of tailored protocols and the optimization of existing ones. Looking forward, the field of RNA biology is poised to benefit greatly from ongoing innovations in CLIP technology. The exploration of non-canonical RNA-protein interactions, such as those involving long non-coding RNAs (lncRNAs) and circular RNAs (circRNAs), promises to reveal new layers of cellular regulation and may lead to the discovery of novel therapeutic targets. Furthermore, integrating CLIP data with other omics approaches, such as proteomics and metabolomics, will provide a more comprehensive understanding of the dynamic interplay between RNA and its binding partners within the cell. In conclusion, the continuous refinement and expansion of CLIP techniques have not only deepened our knowledge of RNA biology but have also opened up new avenues for investigating the molecular underpinnings of health and disease. As the technology matures, it is expected to play an increasingly pivotal role in both basic and applied research, contributing to the advancement of medical science and biotechnology.
3.Association between the non-treatment threshold or upper limit of normal of alanine aminotransferase and liver pathological injury in patients with chronic hepatitis B virus infection and a persistently low level of alanine aminotransferase
Ming SHU ; Suwen JIANG ; Airong HU ; Qin CHEN ; Jialan WANG ; Menghan JIN ; Haojin ZHANG ; Shiqi YANG ; Shiyang FAN
Journal of Clinical Hepatology 2025;41(10):2044-2053
ObjectiveTo investigate the significance of different non-treatment thresholds or upper limits of normal (ULN) of alanine aminotransferase (ALT) in evaluating significant liver pathological injury in patients with chronic hepatitis B virus (HBV) infection, and to provide guidance for clinical diagnosis and treatment. MethodsThis study was conducted among 733 patients with chronic HBV infection who were hospitalized in Ningbo No. 2 Hospital from January 2015 to December 2023 and underwent liver biopsy and histopathological examination, and all patients had a persistent ALT level of ≤40 U/L and positive HBV DNA (>30 IU/mL). According to the treatment threshold or ULN of ALT, the patients were divided into group 1 with 575 patients (≤35 U/L for male patients, ≤25 U/L for female patients), group 2 with 430 patients (≤30 U/L for male patients, ≤19 U/L for female patients), group 3 with 443 patients (≤27 U/L for male patients, ≤24 U/L for female patients), group 4 with 446 patients (≤25 U/L), group 5 with 158 patients (>35 U/L for male patients, >25 U/L for female patients), and group 6 with 145 patients (>30 — ≤35 U/L for male patients, >19 — ≤25 U/L for female patients). Groups 2, 5, and 6 were compared to analyze the severity of liver pathological injury in patients with different ALT levels and the constituent ratio of patients with significant liver pathological injury, and groups 1, 2, 3, and 4 were compared to investigate the value of different ULN or non-treatment thresholds of ALT in determining liver inflammation grade (G), liver fibrosis stage (S), and the treatment indication based on liver pathology. The independent-samples t test was used for comparison of normally distributed continuous data between two groups; a one-way analysis of variance was used for comparison between multiple groups, and the least significant difference t-test or the Tambane’s test was used for further comparison between two groups; the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups, and the Kruskal-Wallis H test was used for comparison between multiple groups and further comparison between two groups; the chi-square test or the Fisher’s exact test was used for comparison of categorical data between groups; a Ridit analysis was used for comparison of ranked data. A multivariate Logistic regression analysis (forward stepwise) was performed with whether liver pathology met the treatment indication (≥G2 and/or ≥S2) as the dependent variable and related factors with a significant impact on the dependent variable (P <0.05) as the independent variable. The receiver operating characteristic (ROC) curve was plotted, and the area under the ROC curve (AUC), as well as sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratio, was used to assess the diagnostic value of different non-treatment thresholds of ALT. ResultsAmong the 733 patients, 259 (35.33%) had ≥G2 liver inflammation, 211 (28.79%) had ≥S2 liver fibrosis, and 306 (41.75%) had treatment indication (≥G2 and/or ≥S2). There was a significant difference in liver inflammation grade (G0 — G4) between groups 2, 5, and 6 (χ2=22.869, P <0.001), and there were also significant differences in the constituent ratios of patients with ≥G2 or ≥G3 liver inflammation between the three groups (χ2=21.742 and 14.921, P<0.001 and P=0.001). There was a significant difference in liver fibrosis stage (S0 — S4) between groups 2, 5, and 6 (χ2=16.565, P<0.001), and there were also significant differences in the constituent ratios of patients with ≥S2, ≥S3 or S4 liver fibrosis between the three groups (χ2=13.264, 13.050, and 6.260, P=0.001, 0.001, and 0.044). There were significant differences between groups 2, 5, and 6 in the constituent ratios of patients with or without treatment indication based on liver pathology (χ2=20.728, P<0.001). There were significant differences between groups 2, 5, and 6 in the constituent ratio of male patients (χ2=24.836, P<0.05), age (F=5.710, P<0.05), ALT (F=473.193, P<0.05), aspartate aminotransferase (AST) (F=107.774, P<0.05), ALT/AST ratio (F=40.167, P<0.05), γ-glutamyl transpeptidase (GGT) (H=15.463, P<0.05), aspartate aminotransferase-to-platelet ratio index (APRI) (H=63.024, P<0.05), and LIF-5 (5 indicators for liver inflammation and fibrosis) (H=46.397, P<0.05). In groups 1 — 4, compared with the patients without treatment indication, the patients with treatment indication had a significantly lower constituent ratio of patients with positive HBeAg, significantly lower levels of platelet count (PLT) and HBV DNA, and significantly higher age, ALT, AST, GGT, APRI, FIB-4, and LIF-5 (all P<0.05). The Logistic regression analysis showed that age (odds ratio [OR]=1.044, 95% confidence interval [CI]: 1.025 — 1.063, P<0.001), GGT (OR=1.022, 95%CI: 1.007 — 1.038, P=0.003), and HBV DNA (OR=0.839, 95%CI: 0.765 — 0.919, P<0.001) were influencing factors for treatment indication based on liver pathology in group 1; HBeAg (OR=1.978, 95%CI: 1.269 — 3.082, P=0.003), age (OR=1.048, 95%CI: 1.025 — 1.071, P<0.001), GGT (OR=1.016, 95%CI: 1.001 — 1.031, P=0.041), and PLT (OR=0.995, 95%CI: 0.991 — 1.000, P=0.049) were influencing factors in group 2; age (OR=1.040, 95%CI: 1.014 — 1.066, P=0.002), ALT (OR=1.047, 95%CI: 1.005 — 1.092, P=0.029), HBV DNA (OR=0.817, 95%CI: 0.736 — 0.907, P<0.001), and LIF-5 (OR=7.382, 95%CI: 1.151 — 47.330, P=0.035) were influencing factors in group 3; age (OR=1.054, 95%CI: 1.031 — 1.077, P<0.001), ALT (OR=1.061, 95%CI: 1.016 — 1.107, P=0.008), and HBV DNA (OR=0.825, 95%CI: 0.743 — 0.917, P<0.001) were influencing factors in group 4. The diagnostic performance for identifying ≥G2 liver inflammation, ≥S2 liver fibrosis, and treatment indication in groups 1 — 4 had an AUC of >0.7; group 1 showed the lowest sensitivity (28.76%) and the highest specificity, positive predictive value, positive likelihood ratio, and negative likelihood ratio in judging treatment indication; group 2 had the highest sensitivity and negative predictive value and the lowest negative likelihood ratio; groups 3 and 4 had similar diagnostic indicators. ConclusionIn patients with chronic HBV infection and a persistently low ALT level, the severity of liver histopathological injury and the constituent ratio of significant liver histopathological injury decrease with the reduction in ALT level. A higher non-treatment threshold or ULN of ALT can help to identify the patients requiring treatment (with a higher specificity), while a lower non-treatment threshold or ULN of ALT can help to identify the patients who do not require treatment (with a higher sensitivity).
4.Clinical analysis of autologous hematopoietic stem cell transplantation for diffuse large B-cell lymphoma
Akebaer SAIBIYA ; Gang CHEN ; Jianli XU ; Kaile ZHANG ; Ruixue YANG ; Chunxia HAN ; Jia HOU ; Ming JIANG ; Hailong YUAN
Journal of Leukemia & Lymphoma 2025;34(6):342-348
Objective:To investigate the therapeutic efficacy of autologous hematopoietic stem cell transplantation (auto-HSCT) for treatment of diffuse large B-cell lymphoma (DLBCL) and the factors affecting the prognosis.Methods:A retrospective case series study was conducted. The clinical data of 51 patients with DLBCL who underwent auto-HSCT in the First Affiliated Hospital of Xinjiang Medical University from March 2019 to January 2024 were retrospectively analyzed. Patients were divided into high-risk group (19 cases) and non-high-risk group (low-risk, low-moderate-risk and moderate-high-risk groups, 32 cases) based on different risk stratifications; patients were divided into the germinal center B-cell (GCB) group (29 cases) and non-GCB group (22 cases) based on different cellular origins; patients were divided into BEAM group (39 cases) and BeEAM group (12 cases) based on different conditioning regimens before auto-HSCT; patients were divided into auto-HSCT consolidation therapy group (41 cases) and auto-HSCT after relapsed/refractory group (10 cases) based on different transplantation timings. The Kaplan-Meier method was used for survival analysis and log-rank was used for subgroup comparison.Results:All 51 patients achieved the hematopoietic reconstitution with no transplantation-related death within 100 d. Before auto-HSCT, 39 cases achieved complete remission and 12 cases (23.5%) achieved partial remission. After auto-HSCT, all cases achieved complete remission. Follow-up was until May 31, 2024, and the median follow-up time [ M ( Q1, Q3)] of 51 DLBCL patients was 33 (8, 43) months. After 51 DLBCL patients receiving auto-HSCT, 7 patients relapsed and 6 cases died including 3 cases with relapse-related death and 3 cases with non relapse-related death. The 3-year progression-free survival (PFS) and overall survival (OS) rates were 78.5% (95% CI: 64.4%-92.6%) and 85.5% (95% CI: 73.2%-97.8%), respectively. The 3-year PFS rate was 94.7% (95% CI: 84.7%-104.7%) in the high-risk group, 82.2% (95% CI: 67.9%-96.5%) in the non-high-risk group, and the difference in the PFS was not statistically significant between the high-risk group and the non-high-risk group ( P = 0.158). The 3-year PFS rate was 80.1% (95% CI: 64.4%-95.8%) in the GCB group, 88.1% (95% CI: 72.3%-104.2%) in the non-GCB group, and the difference in PFS was not statistically significant between the 2 groups ( P = 0.803). The 3-year PFS rate was 84.9% (95% CI: 72.6%-97.2%) in BEAM group, 61.1% (95% CI: 25.0%-97.2%) in the BeEAM group, and the difference in PFS was not statistically significant between the 2 groups ( P = 0.106). The 3-year PFS rate was 85.4% (95% CI: 73.4%-97.4%) in the auto-HSCT consolidation therapy group, 64.3% (95% CI: 31.4%-96.4%) in the auto-HSCT after relapsed/refractory group, and the difference in PFS was not statistically significant between the 2 groups ( P = 0.171). Conclusions:auto-HSCT is an effective therapy method for DLBCL.
5.Rapid Analysis of Cyanide Based on a Ratiometric Fluorescent Probe Using Gold Nanoclusters-Fluorescein
Tai-Shen HE ; Zhong-Jiang LÜ ; Yi-Ming SUN ; Yu-Yang LI ; Yi YE ; Yao LIN ; Lin-Chuan LIAO
Journal of Forensic Medicine 2025;41(4):340-347
Objective To establish a rapid analysis method for cyanide based on a ratiometric fluores-cent probe,providing a quantitative strategy for on-site visual and rapid detection of cyanide.Methods A dual-emission ratiometric fluorescent probe(AuNCs-FL)was constructed by using bovine serum al-bumin(BSA)-stabilized gold nanoclusters(AuNCs,fluorescence emission at 660 nm)as the responsive signal unit and fluorescein(FL,emission at 515 nm)as the internal reference.Results The etching effect of cyanide on AuNCs resulted in fluorescence quenching at 660 nm,while the fluorescence inten-sity of FL at 515 nm remained unchanged,enabling a rapid response analysis of cyanide shift from red to green fluorescence.The developed probe enabled rapid analysis of cyanide within 3 min,with a limit of detection(LOD)of 3.4 mg/L and a visual detection range of 10-100 mg/L.Conclusion The AuNCs-FL fluorescent probe is structurally simple,low-cost,and easy to operate,delivering rapid and accurate results.It also avoids the interference from sulfides encountered in commercial cyanide test kits,making it suitable for the on-site rapid detection of suspected powder samples in cyanide poisoning cases.
6.Efficacy of Transfer Energy Capacitive and Resistive Therapy Combined With β-Hydroxy-β-Methylbutyrate Nutritional Supplementation in Older Adults With Sarcopenic Obesity
Renjie WANG ; Yuxiang LIANG ; Liqiong WANG ; Ming YANG ; Jiaojiao JIANG
Journal of Sichuan University (Medical Sciences) 2025;56(4):964-970
Objective To investigate the comprehensive intervention effects of transfer energy capacitive and resistive(TECAR)therapy combined with β-hydroxy-β-methylbutyrate(HMB)nutritional supplementation in older patients with sarcopenic obesity(SO).Methods We conducted a randomized controlled trial,enrolling 140 older patients who met the Asian diagnostic criteria for SO.Participants were randomly assigned to 4 groups,including a double-placebo group(Group A),TECAR+placebo group(Group B),sham TECAR+HMB group(Group C),and TECAR+HMB group(Group D),with 35 patients in each group.The intervention lasted 12 weeks.The primary outcome measure was the total score of the Short Physical Performance Battery(SPPB).Secondary outcome indicators included the modified Barthel Index(MBI),scores of the Mini Nutritional Assessment-Short Form(MNA-SF),handgrip strength,body mass,and body mass index(BMI).A two-way analysis of variance(ANOVA)was used to assess the interaction effects between TECAR and HMB.Results After the intervention,Group D(TECAR+HMB)demonstrated significant improvements across all metrics.The SPPB total score increased from 6.29±1.34 to 8.06±1.51(P<0.001),with notable enhancements in walking speed(2.71±0.86 vs.1.97±0.82),chair stand(2.60±0.55 vs.2.11±0.47),and balance(2.74±0.74 vs.2.20±0.76).MBI improved from 71.74±14.41 to 79.91±10.52(P<0.001).Handgrip strength increased from(13.65±5.05)kg to(15.72±4.89)kg(P=0.001).Body mass decreased from(81.78±9.02)kg to(76.95±9.89)kg(P<0.001),and BMI reduced from(30.14±1.68)kg/m2 to(28.34±2.33)kg/m2(P<0.001).Interaction analysis revealed significant synergistic effects between TECAR and HMB in improving the SPPB total scores(F=16.374,P<0.001,η2=0.107)and reducing BMI(F=14.328,P<0.001,η2=0.095).Conclusion TECAR therapy combined with HMB supplementation significantly enhances physical function,activities of daily living,and body composition in elderly patients with sarcopenic obesity,demonstrating a synergistic effect.
7.Construction and validation of a risk prediction model for 28-day mortality in patients with sepsis-associated acute kidney injury
Jiang-Ming ZHANG ; Ze-Qian WANG ; Cun-Lian XU ; Pai DENG ; Yang WU ; Min-Jun QI ; Lu-Mei MA ; Wei-Qing YAO ; Dong LIU ; Dong-Mei LIU
Medical Journal of Chinese People's Liberation Army 2025;50(8):935-942
Objective To explore the risk factors for 28-day mortality of sepsis-associated acute kidney injury(SA-AKI)patients and to develop a nomogram risk prediction model.Methods A retrospective cohort study was conducted,involving 184 patients with SA-AKI admitted to the intensive care unit(ICU)of the 940th Hospital of Joint Logistic Support Force of PLA between January 2017 and December 2022.Patients were categorized into survival(n=135)and non-survival(n=49)groups based on 28-day mortality.Clinical data were collected,and statistically significant risk factors were preliminarily screened.Multivariate stepwise logistic regression analysis was performed to identify independent risk factors for 28-day mortality of SA-AKI patients.A nomogram predictive model was constructed using these factors,and internally validated with the Bootstrap method.The receiver operating characteristic curve(ROC curve)was drawn,and the area under the ROC curve(AUC)was calculated to verify the predictive value and accuracy of the model.Results The 28-day mortality rate among 184 SA-AKI patients was 26.6%(49/184).Multivariate stepwise logistic regression analysis identified multiple organ dysfunction syndrome(MODS)(OR=16.393,95%CI 4.317-62.254,P<0.001),high acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)score(OR=1.097,95%CI 1.036-1.161,P=0.002),low oxygenation index(OR=0.992,95%CI 0.986-0.998,P=0.015),low neutrophil count(OR=0.912,95%CI 0.860-0.968,P=0.002)and low fibrinogen concentration(OR=0.733,95%CI 0.549-0.978,P=0.034)as independent risk factors.The prediction model equation was P=1/1+e-logit(P),logit(P)=-1.626+2.797×MODS+0.092×AP ACHE Ⅱ+(-0.311)×fibrinogen+(-0.092)×neutrophil count+(-0.008)×oxygenation index.Internal validation with 1000 Bootstrap resamples showed high consistency between predicted and actual values.ROC analysis showed an AUC of 0.911(95%CI 0.868-0.955,P<0.05)for the model,with 93.9%sensitivity and 78.5%specificity at a cut-off of 0.194.The Hosmer-Lemeshow test confirmed good calibration(P=0.62),and decision-making curve analysis demonstrated clinical utility within the high-risk threshold range(0.1-0.9).Conclusions MODS,high APACHE Ⅱ score,low oxygenation index,low neutrophil count,and low fibrinogen concentration are independent risk factors for 28-day mortality in SA-AKI patients.The developed nomogram risk prediction model may provide important guidance for predicting 28-day mortality in SA-AKI patients.
8.Comparison of functional end-to-end esophagojejunostomy and side-to-side esophagojejunostomy with cis-peristalsis in laparoscopic radical resection for esophageal cancer
Feng YANG ; Tao JIANG ; Sanhu YANG ; Peng CHEN ; Lijun HUANG ; Ming LEI ; Liang ZHANG
Journal of Clinical Medicine in Practice 2025;29(13):7-12
Objective To compare the effects of functional end-to-end esophagojejunostomy(FETE method)and side-to-side esophagojejunostomy with cis-peristalsis(overlap method)on post-operative rehabilitation,anastomotic leakage,and inflammatory-oxidative stress factors in patients un-dergoing laparoscopic radical resection for esophageal cancer.Methods A total of 115 patients with esophageal cancer were selected as study subjects,and were randomly divided into overlap group(n=57)and FETE group(n=58)using random number table method,and both groups underwent lapa-roscopic radical resection for esophageal cancer.The overlap group received the overlap method,and the FETE group received the FETE method.The surgical-related indicators,postoperative recovery indicators,incidence of anastomotic leakage,inflammatory factors[interleukin-10(IL-10),interleu-kin-6(IL-6),tumor necrosis factor-α(TNF-α)],oxidative stress factors[malondialdehyde(MDA),superoxide dismutase(SOD)],pulmonary function indicators[forced vital capacity(FVC),forced expiratory volume in one second(FEV1),FEV1/FVC],and the scores of the esophageal cancer-specific quality of life questionnaire(QLQ-OES18)were compared between the two groups.Results There was no statistically significant difference in intraoperative blood loss between the two groups(P>0.05).The FETE group had shorter operative time and intraoperative anastomosis time,and a lar-ger number of lymph node dissection compared with the overlap group,with statistically significant differences(P<0.05).The FETE group had earlier postoperative first flatus time,first oral intake time,and drainage tube removal time compared with the overlap group,with statistically significant differences(P<0.05).The incidence of anastomotic leakage was 1.72%in the FETE group and 7.02%in the overlap group,with no statistically significant difference(P>0.05).One week after surgery,the serum levels of IL-10,IL-6,TNF-α and MDA in the FETE group were lower than those in the overlap group,while the serum SOD level was higher,with statistically significant differences(P<0.05).One week after surgery,the FVC,FEV,and FEV1/FVC in the FETE group were higher than those in the overlap group,with statistically significant differences(P<0.05).Three months after surgery,the QLQ-OES18 functional domain scores in the FETE group were higher than those in the overlap group,while the symptom domain and single symptom domain scores were low-er,with statistically significant differences(P<0.05).Conclusion Both the FETE method and the overlap method can reduce intraoperative blood loss and the incidence of anastomotic leakage when applied in laparoscopic radical resection for esophageal cancer.However,FETE method has shorter operative time,larger number of intraoperative lymph node dissections,faster postoperative recovery,and patients have less inflammatory-oxidative stress response and pulmonary function im-pairment,as well as higher quality of life after surgery,showing greater advantages compared with the overlap method.
9.Guideline for diagnosis and treatment of infection after internal fixation of closed lower limb fractures in adults (version 2025)
Bobin MI ; Faqi CAO ; Weixian HU ; Wu ZHOU ; Chenchen YAN ; Hui LI ; Yun SUN ; Yuan XIONG ; Jinmi ZHAO ; Qikai HUA ; Xinbao WU ; Xieyuan JIANG ; Dianying ZHANG ; Zhongguo FU ; Dankai WU ; Guangyao LIU ; Guodong LIU ; Tengbo YU ; Jinhai TAN ; Xi CHEN ; Fengfei LIN ; Zhangyuan LIN ; Dongfa LIAO ; Aiguo WANG ; Shiwu DONG ; Gaoxing LUO ; Zhao XIE ; Dong SUN ; Dehao FU ; Yunfeng CHEN ; Changqing ZHANG ; Kun LIU ; Deye SONG ; Yongjun RUI ; Fei WU ; Ximing LIU ; Junwen WANG ; Meng ZHAO ; Biao CHE ; Bing HU ; Chengjian HE ; Guanglin WANG ; Xiao CHEN ; Guandong DAI ; Shiyuan FANG ; Wenchao SONG ; Ming CHEN ; Guanghua GUO ; Yongqing XU ; Lei YANG ; Wenqian ZHANG ; Kun ZHANG ; Xin TANG ; Hua CHEN ; Weiguo XU ; Shuquan GUO ; Yong LIU ; Xiaodong GUO ; Zhewei YE ; Liming XIONG ; Tian XIA ; Hongbin WU ; Qisheng ZHOU ; Mengfei LIU ; Yiqiang HU ; Yanjiu HAN ; Hang XUE ; Kangkang ZHA ; Wei CHEN ; Zhiyong HOU ; Bin YU ; Jiacan SU ; Peifu TANG ; Baoguo JIANG ; Guohui LIU
Chinese Journal of Trauma 2025;41(5):421-432
Postoperative infection of internal fixation of closed fractures the lower limbs in adults represents a devastating complication, characterized by diagnostic challenges, prolonged treatment duration and high disability rates. Current management of these infections faces multiple challenges, such as difficulties in early accurate diagnosis, and various controversies about the treatment plan, leading to poor overall diagnosis and treatment results. To address these issues, based on evidence-based medicine and principles with emphasis on scientific rigor, clinical applicability and innovation, the Trauma Branch of the Chinese Medical Association, Orthopedic Branch of the Chinese Medical Doctor Association, Orthopedics Branch of the Chinese Medical Association, and Trauma Orthopedics and Polytrauma Group of the Resuscitation and Emergency Committee of the Chinese Medical Doctor Association have collaboratively organized a panel of relevant experts to develop the Guideline for diagnosis and treatment of infection after internal fixation of closed lower limb fractures in adults ( version 2025). The guideline proposed 10 recommendations, aiming to provide a foundation for standardized diagnosis and treatment of postoperative infection in adults with closed lower limb fractures.
10.Sarcopenic obesity and mortality risk in nursing home residents: a prospective cohort study based on six obesity indicators
Xiaoyan CHEN ; Mei LI ; Sha HUANG ; Shuyue LUO ; Wenyi ZHANG ; Wenhua JIANG ; Ming YANG
Chinese Journal of Geriatrics 2025;44(7):943-950
Objective:To investigate the relationship between sarcopenic obesity(SO), defined by various obesity indicators, and mortality risk in older adults based on a prospective cohort from multiple nursing homes.Methods:Sarcopenia was diagnosed according to the 2019 consensus of the Asian Working Group for Sarcopenia.Obesity was defined using six different indicators: waist circumference(WC), waist-hip ratio(WHR), waist-height ratio(WHTR), body mass index(BMI), visceral fat area(VFA), and percentage of body fat(PBF).A prospective cohort of adults aged 60 and above was established across 15 nursing homes in Zigong City, with annual follow-ups on survival status conducted over two consecutive years.Cox proportional hazards regression models were employed to analyze the association between SO, defined by different obesity indicators, and mortality risk, calculating hazard ratios( HR)and their 95% confidence intervals( CI). Results:A total of 695 older adults were included in the study, of whom 67.1% were male.During the 2-year follow-up period, 88 participants died.The prevalence of SO as defined by WC, WHR, WHTR, BMI, VFA, PBF was found to be 17.6%, 30.1%, 48.9%, 3.0%, 28.3%, and 58.7%, respectively.When SO was defined using WC, WHR, WHTR, BMI, and VFA, there was no statistically significant difference in mortality rates between the SO and non-SO groups.However, when defined by PBF, the SO group exhibited a significantly higher mortality rate compared to the non-SO group(16.9% vs.6.6%, P<0.01).Cox proportional hazards regression analysis revealed that, compared to the non-SO group, the SO group defined by PBF had a significantly increased mortality risk( HR=2.81, 95% CI: 1.67-4.73, P<0.001).After adjusting for potential confounding factors, the mortality risk for the SO group remained significantly higher than that of the non-SO group( HR=1.97, 95% CI: 1.14-3.38, P=0.015). Conclusions:The prevalence of SO varies significantly across different obesity indicators.SO defined by PBF is significantly associated with mortality risk in nursing home residents.This study provides new evidence for further optimizing the diagnostic criteria for SO in this population.

Result Analysis
Print
Save
E-mail