OBJECTIVE: To investigate the characteristics of Vitamin D (VitD) and bone metabolism in patients with knee osteoarthritis (KOA) concurrent with osteoporosis (OP). METHODS: A retrospective analysis was performed on 240 patients who were admitted to the orthopedics department between March 2019 and March 2024. Patients were stratified into four distinct groups according to their respective disease categories.There were 90 patients in the simple KOA group, comprising 13 males and 77 females, age ranged from 50 to 91 years old with an average of (68.48±8.96) years old. There were 90 patients in the simple OP group, comprising 7 males and 83 females, age ranged from 52 to 88 years old with an average of (69.60±8.94 )years old. There were 30 patients in the KOA with OP group, comprising 1 male and 29 females, age ranged from 51 to 91 years old with an average of(69.03±7.93) years old. There were 30 patients in the physical examination group, comprising 5 males and 25 females, age ranged from 53 to 79 years old with an average of(64.93±6.51) years old. The general data and the levels of osteocalcin (OC), β-CrossLaps, parathyroid hormone(PTH) and VitD in each group were observed. RESULTS: The level of VitD in KOA with OP group (19.62±10.38) ng·ml^-1 and OP group (20.65±10.50) ng·ml^-1 was lower than that in physical examination group (27.46±8.00) ng·ml^-1 and KOA group (24.01±9.11) ng·ml^-1 (P<0.05). There were significant differences in β- CrossLaps and PTH levels among the four groups (P<0.001, P=0.019, respectively), while there was no significant difference in OC levels (P=0.763). Compared with the two simple disease groups, the KOA with OP group had higher levels of β - CrossLaps(0.81±0.30) ng·ml^-1 (P<0.001). There were significant differences in β-CrossLaps and PTH between the simple KOA group(0.54±0.22) ng·ml^-1, (46.03±18.08) pg·ml^-1 and the physical examination group (0.44±0.19) ng·ml^-1, (36.65±9.63) pg·mL^-1(P=0.038;P=0.006). There was a significant difference in PTH between the OP group(43.85±14.30) ng·ml-1, and the physical examination group, P=0.004. There was a significant difference in Kallgren-Lawrence grading between KOA with OP group and KOA group (P=0.006). Within KOA with OP group, the differences of β-CrossLaps and VitD levels among different K-L grades were statistically significant (P=0.016). The level of OC, β-CrossLaps and PTH within KOA with OP group was significantly different at different VitD levels (P=0.013, P=0.033, P=0.046). CONCLUSION Patients with KOA complicated by OP exhibit greater disturbances in bone metabolism and reduced VitD levels, particularly reflected by elevated β-CrossLaps. These findings underscore the importance of early monitoring of bone turnover and VitD supplementation in advanced-stage KOA with bone loss.
Humans ; Female ; Male ; Middle Aged ; Aged ; Vitamin D/blood* ; Osteoporosis/complications* ; Aged, 80 and over ; Osteoarthritis, Knee/complications* ; Retrospective Studies ; Bone and Bones/metabolism* ; Parathyroid Hormone/metabolism* ; Osteocalcin/metabolism*

Objective:To analyze the risk factors affecting the efficacy of arterial balloon occlusion intervention in cesarean sections for women with placenta accreta spectrum (PAS).Methods:A retrospective study was conducted on 55 PAS patients who underwent arterial balloon occlusion during cesarean sections in the obstetrics department of the First Affiliated Hospital of Guangxi Medical University from January 2015 to March 2021. The patients were divided into two groups based on surgical blood loss: ≥2 000 ml group (27 cases) and <2 000 ml group (28 cases). Baseline data, surgical management, and pregnancy outcomes were analyzed between the two groups. For patients who underwent MRI, prenatal MRI characteristics were analyzed. Intergroup comparisons were performed using independent samples t-test, Mann-Whitney U test, or Chi-square test (or Fisher's exact test). Bonferroni correction was used for multiple comparisons. Results:(1) The variation in patients' bleeding volume across different years during the study period was not statistically significant. The proportion of placenta percreta in the ≥2 000 ml blood loss group was significantly higher than in the <2 000 ml group [placenta accreta, increta, and percreta in both groups were 0.0% (0/27) vs. 7.1% (2/28); 25.9% (7/27) vs. 53.6% (15/28); and 74.1% (20/27) vs. 39.3% (11/28), respectively; Fisher's exact test, P=0.019]. (2) The ≥2 000 ml group showed a trend towards higher rates of hysterectomy and failed uterine preservation after placental removal compared to the <2 000 ml group [25.9% (7/27) vs. 3.6% (1/28), Fisher's exact test], but the difference was not statistically significant ( P=0.074). (3) The ≥2 000 ml group had significantly higher blood loss, transfusion of ≥5 units of red blood cells, incidence of disseminated intravascular coagulation, longer surgery time, and higher postoperative transfer to intensive care unit rates compared to the <2 000 ml group [3 600 ml (2 550-5 050 ml) vs. 1 100 ml (600-1 500 ml), Z=756.00; 77.8% (21/27) vs. 21.4% (6/28), χ2=17.40; 33.3% (9/27) vs. 0.0% (0/28), Fisher's exact test; (253±94) min vs. (150±57) min, t=4.92; 40.7% (11/27) vs. 3.6% (1/28), χ2=11.13; all P<0.05]. The bladder injury rate in the ≥2 000 ml group showed a trend towards being higher than in the <2 000 ml group, but the difference was not statistically significant [22.2% (6/27) vs. 3.6% (1/28), Fisher's exact test, P=0.051]. There were no statistically significant differences in other maternal and neonatal outcomes between the two groups. (4) Among the study subjects, 50 patients had prenatal MRI data, with 22 in the ≥2 000 ml group and 28 in the <2 000 ml group. The ≥2 000 ml group had a significantly higher proportion of local exophytic masses, asymmetric placental thickening/shape, and placental invasion in the S2 region compared to the <2 000 ml group [81.8% (18/22) vs. 53.6% (15/28), χ2=4.38; 81.8% (18/22) vs. 50.0% (14/28), χ2=5.41; 95.5% (21/22) vs. 53.6% (15/28), χ2=10.72; all P<0.05]. Conclusions:When the placenta invades the S2 region and the depth is invasive, arterial balloon occlusion in cesarean sections for PAS still faces a high risk of massive hemorrhage. Prenatal MRI should focus on assessing the extent and depth of placental invasion to identify potentially severe PAS cases, thereby optimizing the clinical application of arterial balloon occlusion.

Objective To investigate the epidemic features and pathogen spectrum distribution of diarrhea cases in Minhang District of Shanghai City so as to provide scientific evidence for developing prevention and control measures. Methods Surveillance on diarrhea was conducted in sentinel hospitals in Minghang District from 2018 to 2020. According to the quantity of outpatients in the monitoring hospital, the stool samples were collected by systematic sampling method according to the fixed interval proportion in the case queue which met the requirements of the monitored cases, and the pathogenic composition and epidemiological characteristics were analyzed. Results Among the 721 samples detected , 307(42.58%) were pathogen positive, The main positive bacteria was Vibrio parahaemolyticus, which accounted for 36.11%(39/108) among all positive bacteria.The main positive virus was norovirus GII, which accounted for 24.43%(75/307) among all positive virus. Positive cases were detected among all age groups. 81 positive cases (26.38%) were detected among 31-40 years old, with the highest detection rate. There was no difference in the positive detection rate between genders(χ²= 1.95, P = 0.16). The positive cases showed two peaks during the season of winter and spring. The positive rate of bacteria was highest in the third quarter and positive rate of viruses was highest in the first quarter. The mixed infection rate of bacteria and viruses was highest in the second quarter. Conclusions Diarrhea cases in Minhang District of Shanghai from 2018 to 2020 is caused by a variety of pathogens and related seasonality is obvious in Minghang District, Shanghai City in 2018-2020. It is necessary to take specific prevention based on various pathogens to reduce the incidence of diarrhea.

Objective To investigate the risk factors for bronchopulmonary dysplasia(BPD)in twin preterm infants with a gestational age of<34 weeks,and to provide a basis for early identification of BPD in twin preterm infants in clinical practice.Methods A retrospective analysis was performed for the twin preterm infants with a gestational age of<34 weeks who were admitted to 22 hospitals nationwide from January 2018 to December 2020.According to their conditions,they were divided into group A(both twins had BPD),group B(only one twin had BPD),and group C(neither twin had BPD).The risk factors for BPD in twin preterm infants were analyzed.Further analysis was conducted on group B to investigate the postnatal risk factors for BPD within twins.Results A total of 904 pairs of twins with a gestational age of<34 weeks were included in this study.The multivariate logistic regression analysis showed that compared with group C,birth weight discordance of>25%between the twins was an independent risk factor for BPD in one of the twins(OR=3.370,95%CI:1.500-7.568,P<0.05),and high gestational age at birth was a protective factor against BPD(P<0.05).The conditional logistic regression analysis of group B showed that small-for-gestational-age(SGA)birth was an independent risk factor for BPD in individual twins(OR=5.017,95%CI:1.040-24.190,P<0.05).Conclusions The development of BPD in twin preterm infants is associated with gestational age,birth weight discordance between the twins,and SGA birth.

Plant natural products have a wide range of pharmacological properties, not only can they be used as plant dietary supplements to meet the nutritional needs of the human body in the accelerated pace of life, but also occupy an important position in the research and development of therapeutic drugs for the treatment of tumors, inflammation and other diseases, and have been widely accepted by the public due to their good safety. However, despite the above advantages of plant natural products, limiting factors such as low solubility, poor stability, lack of targeting, high toxicity and side effects, and unacceptable odor have greatly impeded their conversion to clinical applications. Therefore, the development of new avenues for the application of new natural products has become an urgent problem to be solved at present. In recent years, with the continuous development of research, various strategies have been developed to improve the bioavailability of natural products. Among them, nanocarrier delivery system is one of the most attractive strategies at present. In past studies, a large number of nanomaterials (organic, inorganic, etc.) have been developed to encapsulate plant-derived natural products for their efficient delivery to specific organs and cells. Up to now, nanotechnology has not only been limited to pharmaceutical applications, but is also competing in the fields of nanofood processing technology and nanoemulsions. Among the various nanocarriers, liposomes are the largest nanocarriers with the largest market share at present. Liposomes are bilayer nanovesicles synthesized from amphiphilic substances, which have advantages such as high drug loading capacity and stability. Attractively, the flexible surface of liposomes can be modified with various functional elements. Functionalized modification of liposomes with different functional elements such as antibodies, nucleic acids, peptides, and stimuli-responsive moieties can bring out the excellent drug delivery function of liposomes to a greater extent. For example, the modification of functional elements with targeting function such as nucleic acids and antibodies on the surface of liposomes can deliver natural products to the target location and improve the bioavailability of drugs; the modification of stimulus-responsive groups such as photosensitizers, magnetic nanoparticles, pH-responsive groups, and temperature sensitizers on the surface of liposomes can achieve controlled release of drugs, localized targeting, and synergistic thermotherapy. In addition to the above properties, by using functionalized liposomes to encapsulate natural products with irritating properties can also effectively mask the irritating properties of natural products, improve public acceptance, and increase the possibility of application of irritating natural products. There are various strategies for modifying liposomes with functional elements, and the properties of functionalized liposomes constructed by different construction strategies differ. The commonly used construction strategies for functionalized liposomes include covalent modification and non-covalent modification. These two types of construction strategies have their own advantages and disadvantages. Covalent modification has better stability than non-covalent modification, but its operation is cumbersome. With the above background, this review focuses on the three typical problems faced by plant natural products at present, and summarizes the specific applications of functionalized liposomes in them. In addition, this paper summarizes the construction strategies for building different types of functionalized liposomes. Finally, this paper will also review the opportunities and challenges faced by functionalized liposomes to enter clinical therapy, and explore the opportunities to overcome these problems, with a view to better realizing the precise control of plant nanomedicines, and providing ideas and inspirations for researchers in related fields as well as relevant industrial staff.

Objective:To analyze the risk factors affecting the efficacy of arterial balloon occlusion intervention in cesarean sections for women with placenta accreta spectrum (PAS).Methods:A retrospective study was conducted on 55 PAS patients who underwent arterial balloon occlusion during cesarean sections in the obstetrics department of the First Affiliated Hospital of Guangxi Medical University from January 2015 to March 2021. The patients were divided into two groups based on surgical blood loss: ≥2 000 ml group (27 cases) and <2 000 ml group (28 cases). Baseline data, surgical management, and pregnancy outcomes were analyzed between the two groups. For patients who underwent MRI, prenatal MRI characteristics were analyzed. Intergroup comparisons were performed using independent samples t-test, Mann-Whitney U test, or Chi-square test (or Fisher's exact test). Bonferroni correction was used for multiple comparisons. Results:(1) The variation in patients' bleeding volume across different years during the study period was not statistically significant. The proportion of placenta percreta in the ≥2 000 ml blood loss group was significantly higher than in the <2 000 ml group [placenta accreta, increta, and percreta in both groups were 0.0% (0/27) vs. 7.1% (2/28); 25.9% (7/27) vs. 53.6% (15/28); and 74.1% (20/27) vs. 39.3% (11/28), respectively; Fisher's exact test, P=0.019]. (2) The ≥2 000 ml group showed a trend towards higher rates of hysterectomy and failed uterine preservation after placental removal compared to the <2 000 ml group [25.9% (7/27) vs. 3.6% (1/28), Fisher's exact test], but the difference was not statistically significant ( P=0.074). (3) The ≥2 000 ml group had significantly higher blood loss, transfusion of ≥5 units of red blood cells, incidence of disseminated intravascular coagulation, longer surgery time, and higher postoperative transfer to intensive care unit rates compared to the <2 000 ml group [3 600 ml (2 550-5 050 ml) vs. 1 100 ml (600-1 500 ml), Z=756.00; 77.8% (21/27) vs. 21.4% (6/28), χ2=17.40; 33.3% (9/27) vs. 0.0% (0/28), Fisher's exact test; (253±94) min vs. (150±57) min, t=4.92; 40.7% (11/27) vs. 3.6% (1/28), χ2=11.13; all P<0.05]. The bladder injury rate in the ≥2 000 ml group showed a trend towards being higher than in the <2 000 ml group, but the difference was not statistically significant [22.2% (6/27) vs. 3.6% (1/28), Fisher's exact test, P=0.051]. There were no statistically significant differences in other maternal and neonatal outcomes between the two groups. (4) Among the study subjects, 50 patients had prenatal MRI data, with 22 in the ≥2 000 ml group and 28 in the <2 000 ml group. The ≥2 000 ml group had a significantly higher proportion of local exophytic masses, asymmetric placental thickening/shape, and placental invasion in the S2 region compared to the <2 000 ml group [81.8% (18/22) vs. 53.6% (15/28), χ2=4.38; 81.8% (18/22) vs. 50.0% (14/28), χ2=5.41; 95.5% (21/22) vs. 53.6% (15/28), χ2=10.72; all P<0.05]. Conclusions:When the placenta invades the S2 region and the depth is invasive, arterial balloon occlusion in cesarean sections for PAS still faces a high risk of massive hemorrhage. Prenatal MRI should focus on assessing the extent and depth of placental invasion to identify potentially severe PAS cases, thereby optimizing the clinical application of arterial balloon occlusion.

Objectives: This study sought to describe our institutional experience of repeated percutaneous stellate ganglion blockade (R-SGB) as a treatment option for drug-refractory electrical storm in patients with nonischemic cardiomyopathy (NICM). Methods: This prospective observational study included 8 consecutive NICM patients who had drug-refractory electrical storm and underwent R-SGB between June 1, 2021 and January 31, 2022. Lidocaine (5 ml, 1%) was injected in the vicinity of the left stellate ganglion under the guidance of ultrasound, once per day for 7 days. Data including clinical characteristics, immediate and long-term outcomes, and procedure related complications were collected. Results: The mean age was (51.5±13.6) years. All patients were male. 5 patients were diagnosed as dilated cardiomyopathy, 2 patients as arrhythmogenic right ventricular cardiomyopathy and 1 patient as hypertrophic cardiomyopathy. The left ventricular ejection fraction was 37.8%±6.6%. After the treatment of R-SGB, 6 (75%) patients were free of electrical storm. 24 hours Holter monitoring showed significant reduction in ventricular tachycardia (VT) episodes from 43.0 (13.3, 276.3) to 1.0 (0.3, 34.0) on the first day following R-SGB (P<0.05) and 0.5 (0.0, 19.3) after whole R-SGB process (P<0.05). There were no procedure-related major complications. The mean follow-up was (4.8±1.1) months, and the median time of recurrent VT was 2 months. Conclusion: Minimally invasive R-SGB is a safe and effective method to treat electrical storm in patients with NICM.
Humans ; Male ; Adult ; Middle Aged ; Aged ; Female ; Stroke Volume ; Stellate Ganglion/surgery* ; Ventricular Function, Left ; Cardiomyopathies/complications* ; Tachycardia, Ventricular/therapy* ; Treatment Outcome ; Catheter Ablation

This study collected epidemic data of COVID-19 in Zhengzhou from January 1 to January 20 in 2022. The epidemiological characteristics of the local epidemic in Zhengzhou High-tech Zone caused by the SARS-CoV-2 Delta variant were analyzed through epidemiological survey and big data analysis, which could provide a scientific basis for the prevention and control of the Delta variant. In detail, a total of 276 close contacts and 599 secondary close contacts were found in this study. The attack rate of close contacts and secondary close contacts was 5.43% (15/276) and 0.17% (1/599), respectively. There were 10 confirmed cases associated with the chain of transmission. Among them, the attack rates in close contacts of the first, second, third, fourth and fifth generation cases were 20.00% (5/25), 17.86% (5/28), 0.72% (1/139) and 14.81% (4/27), 0 (0/57), respectively. The attack rates in close contacts after sharing rooms/beds, having meals, having neighbor contacts, sharing vehicles with the patients, having same space contacts, and having work contacts were 26.67%, 9.10%, 8.33%, 4.55%, 1.43%, and 0 respectively. Collectively, the local epidemic situation in Zhengzhou High-tech Zone has an obvious family cluster. Prevention and control work should focus on decreasing family clusters of cases and community transmission.
Humans ; SARS-CoV-2 ; COVID-19 ; Epidemics ; Incidence

To investigate the regulation of N6- methyladenosine ( m6A ) modification on L-type calcium channels in atrial myocytes under high hydrostatic pressure, mediated by methyltransferase-like protein 3 ( METTL3 ). Methods C57BL/6J mice were randomly assigned to the control group and the hypertension group ( treated with continuous administration of angiotensin for four weeks ). Masson staining was used to observe the fibrosis of mouse atrial tissue, while dot blot assay and Western blot were used to detect the levels of m6A, METTL3, and Cavi1 2 in the atrial tissue. A high hydrostatic pressure model was constructed using the HL-1 cell line cultured in vitro, and METTL3 was intervened to observe changes in m6A expression levels, METTL3 and Cavi1 2 levels in cells,and action potential duration ( APD ) and L-type calcium current ( I