1.Gastric-soleal turndown flap and knotless anchor bridging fixation via a modified incision for chronic Achilles tendon rupture of Myerson type Ⅲ
Lin SHANG ; Zhiqiang LYU ; Litao CHU ; Shijun ZHAO ; Wei ZHANG ; Xinlei LIU ; Fuqiang MA ; Xiangyu WANG
Chinese Journal of Orthopaedic Trauma 2025;27(7):629-633
Objective:To investigate the effectiveness of gastric-soleal turndown flap and knotless anchor bridging fixation via a modified incision in the treatment of chronic Achilles tendon rupture of Myerson type Ⅲ.Methods:A retrospective case series study was conducted to analyze the clinical data of the 18 patients who had been treated at Department of Minimally Invasive Orthopedics, Zhengzhou Orthopaedic Hospital from February 2020 to July 2023 for chronic Achilles tendon rupture of Myerson type Ⅲ by means of gastric-soleal turndown flap and knotless anchor bridging fixation via a modified incision. There were 15 males and 3 females, with an age of (37.2±6.8) years. All patients suffered from unilateral injury, involving 13 left sides and 5 right sides. Their body mass index was (22.6±2.5) kg/m 2. The operation time, blood loss, incision length, wound healing and complications were documented. The ankle dorsiflexion and plantar flexion at the last follow-up were compared between the affected side and the healthy side. The American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and Achilles tendon total rupture score (ATRS) before operation were compared with those at the last follow-up. Results:All the 18 patients were followed up for (18.0±5.5) months. Their operation time was (69.1±5.2) minutes, blood loss (71.6±9.2) mL, incision at the broken end of the Achilles tendon (12.4±2.6) cm and incision at the proximal end (2.5±0.4) cm. At the last follow-up, the ankle dorsiflexion was 12.7°±1.9° and the ankle plantar flexion 35.2°±2.0° at the affected side, showing no significant difference from those at the healthy side (13.0°±2.1° and 34.7°±1.8°) ( P>0.05). The AOFAS ankle-hindfoot score was (89.4±3.4) points and the ATRS (85.3±3.2) points for the affected side at the last follow-up, showing significant improvements compared with the preoperative values [(54.2±4.2) points and (51.1±4.6) points] ( P<0.05). All the incisions healed at one stage after operation, with no such complications as incision infection or re-rupture of the Achilles tendon. One patient experienced mild pain at the anchor insertion site, but the pain disappeared 6 months after operation without any treatment. One patient had the symptoms of sural nerve injury which responded to 3 months of oral neurotrophic medication. Conclusion:In the treatment of chronic Achilles tendon rupture of Myerson type Ⅲ, gastric-soleal turndown flap and knotless anchor bridging fixation via a modified incision can result in limited invasion, a low incidence of complications, and definite effectiveness.
2.Gastric-soleal turndown flap and knotless anchor bridging fixation via a modified incision for chronic Achilles tendon rupture of Myerson type Ⅲ
Lin SHANG ; Zhiqiang LYU ; Litao CHU ; Shijun ZHAO ; Wei ZHANG ; Xinlei LIU ; Fuqiang MA ; Xiangyu WANG
Chinese Journal of Orthopaedic Trauma 2025;27(7):629-633
Objective:To investigate the effectiveness of gastric-soleal turndown flap and knotless anchor bridging fixation via a modified incision in the treatment of chronic Achilles tendon rupture of Myerson type Ⅲ.Methods:A retrospective case series study was conducted to analyze the clinical data of the 18 patients who had been treated at Department of Minimally Invasive Orthopedics, Zhengzhou Orthopaedic Hospital from February 2020 to July 2023 for chronic Achilles tendon rupture of Myerson type Ⅲ by means of gastric-soleal turndown flap and knotless anchor bridging fixation via a modified incision. There were 15 males and 3 females, with an age of (37.2±6.8) years. All patients suffered from unilateral injury, involving 13 left sides and 5 right sides. Their body mass index was (22.6±2.5) kg/m 2. The operation time, blood loss, incision length, wound healing and complications were documented. The ankle dorsiflexion and plantar flexion at the last follow-up were compared between the affected side and the healthy side. The American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and Achilles tendon total rupture score (ATRS) before operation were compared with those at the last follow-up. Results:All the 18 patients were followed up for (18.0±5.5) months. Their operation time was (69.1±5.2) minutes, blood loss (71.6±9.2) mL, incision at the broken end of the Achilles tendon (12.4±2.6) cm and incision at the proximal end (2.5±0.4) cm. At the last follow-up, the ankle dorsiflexion was 12.7°±1.9° and the ankle plantar flexion 35.2°±2.0° at the affected side, showing no significant difference from those at the healthy side (13.0°±2.1° and 34.7°±1.8°) ( P>0.05). The AOFAS ankle-hindfoot score was (89.4±3.4) points and the ATRS (85.3±3.2) points for the affected side at the last follow-up, showing significant improvements compared with the preoperative values [(54.2±4.2) points and (51.1±4.6) points] ( P<0.05). All the incisions healed at one stage after operation, with no such complications as incision infection or re-rupture of the Achilles tendon. One patient experienced mild pain at the anchor insertion site, but the pain disappeared 6 months after operation without any treatment. One patient had the symptoms of sural nerve injury which responded to 3 months of oral neurotrophic medication. Conclusion:In the treatment of chronic Achilles tendon rupture of Myerson type Ⅲ, gastric-soleal turndown flap and knotless anchor bridging fixation via a modified incision can result in limited invasion, a low incidence of complications, and definite effectiveness.
3.Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients (version 2024)
Yao LU ; Yang LI ; Leiying ZHANG ; Hao TANG ; Huidan JING ; Yaoli WANG ; Xiangzhi JIA ; Li BA ; Maohong BIAN ; Dan CAI ; Hui CAI ; Xiaohong CAI ; Zhanshan ZHA ; Bingyu CHEN ; Daqing CHEN ; Feng CHEN ; Guoan CHEN ; Haiming CHEN ; Jing CHEN ; Min CHEN ; Qing CHEN ; Shu CHEN ; Xi CHEN ; Jinfeng CHENG ; Xiaoling CHU ; Hongwang CUI ; Xin CUI ; Zhen DA ; Ying DAI ; Surong DENG ; Weiqun DONG ; Weimin FAN ; Ke FENG ; Danhui FU ; Yongshui FU ; Qi FU ; Xuemei FU ; Jia GAN ; Xinyu GAN ; Wei GAO ; Huaizheng GONG ; Rong GUI ; Geng GUO ; Ning HAN ; Yiwen HAO ; Wubing HE ; Qiang HONG ; Ruiqin HOU ; Wei HOU ; Jie HU ; Peiyang HU ; Xi HU ; Xiaoyu HU ; Guangbin HUANG ; Jie HUANG ; Xiangyan HUANG ; Yuanshuai HUANG ; Shouyong HUN ; Xuebing JIANG ; Ping JIN ; Dong LAI ; Aiping LE ; Hongmei LI ; Bijuan LI ; Cuiying LI ; Daihong LI ; Haihong LI ; He LI ; Hui LI ; Jianping LI ; Ning LI ; Xiying LI ; Xiangmin LI ; Xiaofei LI ; Xiaojuan LI ; Zhiqiang LI ; Zhongjun LI ; Zunyan LI ; Huaqin LIANG ; Xiaohua LIANG ; Dongfa LIAO ; Qun LIAO ; Yan LIAO ; Jiajin LIN ; Chunxia LIU ; Fenghua LIU ; Peixian LIU ; Tiemei LIU ; Xiaoxin LIU ; Zhiwei LIU ; Zhongdi LIU ; Hua LU ; Jianfeng LUAN ; Jianjun LUO ; Qun LUO ; Dingfeng LYU ; Qi LYU ; Xianping LYU ; Aijun MA ; Liqiang MA ; Shuxuan MA ; Xainjun MA ; Xiaogang MA ; Xiaoli MA ; Guoqing MAO ; Shijie MU ; Shaolin NIE ; Shujuan OUYANG ; Xilin OUYANG ; Chunqiu PAN ; Jian PAN ; Xiaohua PAN ; Lei PENG ; Tao PENG ; Baohua QIAN ; Shu QIAO ; Li QIN ; Ying REN ; Zhaoqi REN ; Ruiming RONG ; Changshan SU ; Mingwei SUN ; Wenwu SUN ; Zhenwei SUN ; Haiping TANG ; Xiaofeng TANG ; Changjiu TANG ; Cuihua TAO ; Zhibin TIAN ; Juan WANG ; Baoyan WANG ; Chunyan WANG ; Gefei WANG ; Haiyan WANG ; Hongjie WANG ; Peng WANG ; Pengli WANG ; Qiushi WANG ; Xiaoning WANG ; Xinhua WANG ; Xuefeng WANG ; Yong WANG ; Yongjun WANG ; Yuanjie WANG ; Zhihua WANG ; Shaojun WEI ; Yaming WEI ; Jianbo WEN ; Jun WEN ; Jiang WU ; Jufeng WU ; Aijun XIA ; Fei XIA ; Rong XIA ; Jue XIE ; Yanchao XING ; Yan XIONG ; Feng XU ; Yongzhu XU ; Yongan XU ; Yonghe YAN ; Beizhan YAN ; Jiang YANG ; Jiangcun YANG ; Jun YANG ; Xinwen YANG ; Yongyi YANG ; Chunyan YAO ; Mingliang YE ; Changlin YIN ; Ming YIN ; Wen YIN ; Lianling YU ; Shuhong YU ; Zebo YU ; Yigang YU ; Anyong YU ; Hong YUAN ; Yi YUAN ; Chan ZHANG ; Jinjun ZHANG ; Jun ZHANG ; Kai ZHANG ; Leibing ZHANG ; Quan ZHANG ; Rongjiang ZHANG ; Sanming ZHANG ; Shengji ZHANG ; Shuo ZHANG ; Wei ZHANG ; Weidong ZHANG ; Xi ZHANG ; Xingwen ZHANG ; Guixi ZHANG ; Xiaojun ZHANG ; Guoqing ZHAO ; Jianpeng ZHAO ; Shuming ZHAO ; Beibei ZHENG ; Shangen ZHENG ; Huayou ZHOU ; Jicheng ZHOU ; Lihong ZHOU ; Mou ZHOU ; Xiaoyu ZHOU ; Xuelian ZHOU ; Yuan ZHOU ; Zheng ZHOU ; Zuhuang ZHOU ; Haiyan ZHU ; Peiyuan ZHU ; Changju ZHU ; Lili ZHU ; Zhengguo WANG ; Jianxin JIANG ; Deqing WANG ; Jiongcai LAN ; Quanli WANG ; Yang YU ; Lianyang ZHANG ; Aiqing WEN
Chinese Journal of Trauma 2024;40(10):865-881
Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.
4.Development of a risk prediction model for postoperative depression in patients with esophageal cancer
Yunxu ZHOU ; Jiaojiao SUN ; Jinyou LI ; Jiayu LIU ; Ying CHEN ; Jiajin DI ; Tian WANG ; Jianjun CHU ; Zhiqiang WANG
Chinese Journal of Digestion 2024;44(7):467-475
Objective:To explore the risk factors of postoperative depression in patients with esophageal cancer, and to develop a risk prediction model which providing a theoretical basis for the early detection of depression in high-risk groups by clinical staff.Methods:From September 2022 to March 2023, at the South Campus of Affiliated Hospital of Jiangnan University, 269 hospitalized patients with esophageal cancer (191 in depression group, 78 in non-depression group) were selected as the model construction set. From March to May 2023, at the South Campus of Affiliated Hospital of Jiangnan University, 78 hospitalized patients with esophageal cancer were selected as the external validation set. The patients with Beck depression inventory-Ⅱ score ≥5 and depression diagnosed by two experts (chief psychiatrists of the Department of Psychiatry of Affiliated Hospital of Jiangnan University) were considered as depression and included in the depression group, and the other patients were enrolled in the non-depression group. The general data, blood routine examination, high-sensitivity C-reactive protein (hs-CRP), blood electrolytes, blood lipids, clinical symptoms (gastroesophageal reflux, sleep disturbance, appetite, etc.) and depression score were compared between the depression group and the non-depression group. Independent sample t-test and Mann-Whitney U test were used for statistical analysis. Multiple logistic regression model was performed to analyze the independent risk factors of postoperative depression in patients with esophageal cancer, and a risk warning model was constructed. The Hosmer-Lemeshow test and receiver operating characteristic curve (ROC) were used to evaluate the fitting degree and predictive efficiency of the model, and the cross-validation method was used to verify the effectiveness of the model. Results:The incidence of postoperative depression in patients with esophageal cancer was 71.0% (191/269). The total white blood cell count, hs-CRP, blood phosphorus β 2 microglobulin and the proportion of sleep disorders of the depression group were higher than those of the non-depression group (1.3 (1.1, 5.4) ×10 9/L vs. 0.9 (0.3, 1.1) ×10 9/L, 75.8 (54.8, 102.1) mg/L vs. 60.8 (3.6, 61.5) mg/L, (1.33±0.32) mmol/L vs. (1.02±0.19) mmol/L, (2.17±0.72) mg/L vs.(2.12±0.49) mg/L, 84.3% (161/191) vs. 33.3% (26/78), and the differences were statistically significant ( Z=9.24, 7.88, t=9.24, χ2=67.87 t=1.98; all P<0.001); hemoglobin, total platelet count, high-density lipoprotein (HDL) and the proportion of poor appetite were lower than those of the non-depression group ((119.91±24.51) g/L vs. (122.09±22.97) g/L, (203.43±58.45)×10 9/L vs. (311.55±83.54)×10 9/L, (1.04±0.30) mmol/L vs. (1.43±0.23) mmol/L, 73.3% (140/191) vs. 84.6% (66/78)), and the differences were statistically significant ( t=-2.00, -8.42 and -8.48, χ2=3.96; P=0.047, <0.001, <0.001, =0.047). The results of multifactorial logistic regression model analysis showed that sleep disorder ( OR=3.976, 95% confidence interval (95% CI 1.601 to 9.872)), loss of appetite ( OR=0.271, 95% CI 0.092 to 0.791), white blood cell count ( OR=31.808, 95% CI 2.879 to 351.401), hs-CRP ( OR=1.031, 95% CI 1.017 to 1.044), platelet count ( OR=0.990, 95% CI 0.982 to 0.997), and HDL ( OR=0.017, 95% CI 0.001 to 0.242) were independent influencing factors of postoperative depression in patients with esophageal cancer. The formula of risk warning model was probability of depression=1-1/{1+ exp[1.544+ 1.380×sleep disturbance (yes=1, no=0)-1.307×loss of appetite (yes=1, no=0)-0.010×platelet count (×10 9/L)-4.063×HDL (mmol/L)+ 0.030×hs-CRP (mg/L)+ 3.460×white blood cell count (×10 9/L)]}. The results of Hosmer-Lemeshow test showed that the model has a good fit ( χ2=2.01, P=0.981), with an area under the ROC of 0.949, a sensitivity of 0.874, and a specificity of 0.872. The cross-validation of the external validation set showed that the accuracy of the risk warning model was 67.9%. Conclusion:This study is a preliminary study on the risk warning model of postoperative depression in patients with esophageal cancer, which provides a novel approach for screening depression in patients with esophageal cancer after surgery.
5.Role and mechanism of nuclear factor erythroid 2-related factor 2 in reducing lung injury in mice with Staphylococcus aureus-induced sepsis
Hongyi WEI ; Sihao JIN ; Jiaojiao SUN ; Chuanxin LIU ; Rixiang HUANG ; Zhiqiang WANG ; Jianjun CHU
Chinese Journal of Infectious Diseases 2024;42(12):750-754
Objective:To explore the role and mechanism of nuclear factor erythroid 2-related factor 2 (NRF2) in lung injury in mice with Staphylococcus aureus-induced sepsis. Methods:A sepsis mouse model with Staphylococcus aureus infection was created using wild-type C57BL/6 male mice and NRF2 -/- male mice aged six to eight weeks. The mice were divided into four groups with five in each group. In WT control group and NRF2 -/- control group, the wild type mice and NRF2 -/- mice were intraperitoneally injected with 100 μL phosphate buffered saline (PBS) respectively. In WT model group and NRF2 -/- model group, the wild type mice and NRF2 -/- mice were intraperitoneally injected with 100 μL PBS containing Staphylococcus aureus (3×10 8 colony forming unit (CFU)/mL) respectively. The lung samples were taken under anesthesia six hours after injection, and hematoxylin and eosin staining was performed to observe tissuse lesions. The survival of the mice was evaluated. The protein concentrations and cell counts in the bronchoalveolar lavage fluid (BALF), the mRNA relative expressions of tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), and interleukin-1 beta (IL-1β) in lung tissues, and the serum levels of myeloperoxidase (MPO), malondialdehyde (MDA), and superoxide dismutase (SOD) were compared among the four groups. Independent samples t test was used for statistical comparison. Results:After six days of observation, no mice died in WT control group and NRF2 -/- control group, three mice died in WT model group on day 3, and four mice died in NRF2 -/- model group on day 4. The pathological staining showed that macrophage infiltration and alveolar structure damage occurred in the lung tissuse of WT model group, and the damage were more significant in NRF2 -/- model group. The protein concentrations and cell counts in BALF of mice in WT control group were (342±23) μg/mL and (5.78±2.67)×10 5/mL, respectively, those in WT model group were (657±39) μg/mL and (10.78±5.57)×10 5/mL, respectively, those in NRF2 -/- control group were (312±45) μg/mL and (5.67±1.46)×10 5/mL, respectively, and those in NRF2 -/- model group were (957±85) μg/mL and (13.85±3.72)×10 5/mL, respectively. The protein concentrations and cell counts in WT model group were higher than those in WT control group ( t=6.56, P<0.001 and t=8.21, P<0.001, respectively), while lower than NRF2 -/- model group ( t=2.32, P=0.001 and t=3.11, P=0.002, respectively). The differences were all statistically significant. Compared with the WT model group, the mRNA relative expressions of TNF-α (4.345±1.131 vs 12.375±4.534), IL-1β (5.395±2.112 vs 6.865±2.185), IL-6 (2.964±0.945 vs 5.467±1.855) in the lung tissues of NRF2 -/- model group increased, and the serum levels of MPO (2.956±1.211 vs 4.745±1.945) and MDA (4.333±1.652 vs 8.234±3.734) increased, while the level of SOD (17.121±8.183 vs 11.967±8.122) decreased, with statistically differences ( t=1.77, 4.67, 2.99, 7.99, 10.45 and 8.45, respectively, all P<0.05). Conclusions:The absence of NRF2 gene can exacerbate the inflammatory response and oxidative stress in mice with Staphylococcus aureus-induced sepsis, leading to more severe lung tissue damage.
6.Role and mechanism of nuclear factor erythroid 2-related factor 2 in reducing lung injury in mice with Staphylococcus aureus-induced sepsis
Hongyi WEI ; Sihao JIN ; Jiaojiao SUN ; Chuanxin LIU ; Rixiang HUANG ; Zhiqiang WANG ; Jianjun CHU
Chinese Journal of Infectious Diseases 2024;42(12):750-754
Objective:To explore the role and mechanism of nuclear factor erythroid 2-related factor 2 (NRF2) in lung injury in mice with Staphylococcus aureus-induced sepsis. Methods:A sepsis mouse model with Staphylococcus aureus infection was created using wild-type C57BL/6 male mice and NRF2 -/- male mice aged six to eight weeks. The mice were divided into four groups with five in each group. In WT control group and NRF2 -/- control group, the wild type mice and NRF2 -/- mice were intraperitoneally injected with 100 μL phosphate buffered saline (PBS) respectively. In WT model group and NRF2 -/- model group, the wild type mice and NRF2 -/- mice were intraperitoneally injected with 100 μL PBS containing Staphylococcus aureus (3×10 8 colony forming unit (CFU)/mL) respectively. The lung samples were taken under anesthesia six hours after injection, and hematoxylin and eosin staining was performed to observe tissuse lesions. The survival of the mice was evaluated. The protein concentrations and cell counts in the bronchoalveolar lavage fluid (BALF), the mRNA relative expressions of tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), and interleukin-1 beta (IL-1β) in lung tissues, and the serum levels of myeloperoxidase (MPO), malondialdehyde (MDA), and superoxide dismutase (SOD) were compared among the four groups. Independent samples t test was used for statistical comparison. Results:After six days of observation, no mice died in WT control group and NRF2 -/- control group, three mice died in WT model group on day 3, and four mice died in NRF2 -/- model group on day 4. The pathological staining showed that macrophage infiltration and alveolar structure damage occurred in the lung tissuse of WT model group, and the damage were more significant in NRF2 -/- model group. The protein concentrations and cell counts in BALF of mice in WT control group were (342±23) μg/mL and (5.78±2.67)×10 5/mL, respectively, those in WT model group were (657±39) μg/mL and (10.78±5.57)×10 5/mL, respectively, those in NRF2 -/- control group were (312±45) μg/mL and (5.67±1.46)×10 5/mL, respectively, and those in NRF2 -/- model group were (957±85) μg/mL and (13.85±3.72)×10 5/mL, respectively. The protein concentrations and cell counts in WT model group were higher than those in WT control group ( t=6.56, P<0.001 and t=8.21, P<0.001, respectively), while lower than NRF2 -/- model group ( t=2.32, P=0.001 and t=3.11, P=0.002, respectively). The differences were all statistically significant. Compared with the WT model group, the mRNA relative expressions of TNF-α (4.345±1.131 vs 12.375±4.534), IL-1β (5.395±2.112 vs 6.865±2.185), IL-6 (2.964±0.945 vs 5.467±1.855) in the lung tissues of NRF2 -/- model group increased, and the serum levels of MPO (2.956±1.211 vs 4.745±1.945) and MDA (4.333±1.652 vs 8.234±3.734) increased, while the level of SOD (17.121±8.183 vs 11.967±8.122) decreased, with statistically differences ( t=1.77, 4.67, 2.99, 7.99, 10.45 and 8.45, respectively, all P<0.05). Conclusions:The absence of NRF2 gene can exacerbate the inflammatory response and oxidative stress in mice with Staphylococcus aureus-induced sepsis, leading to more severe lung tissue damage.
7.Construction of a risk warning model for acute lung injury caused by Staphylococcus aureus infection
Jiaojiao SUN ; Tian WANG ; Xiaolin LI ; Sihao JIN ; Shengpeng LI ; Jianjun CHU ; Zhiqiang WANG
Chinese Journal of Infectious Diseases 2023;41(5):338-343
Objective:To investigate the risk factors of acute lung injury (ALI) caused by Staphylococcus aureus infection, and to construct a risk warning model. Methods:Patients with Staphylococcus aureus infection confirmed by sputum or blood culture admitted to the Affiliated Hospital of Jiangnan University from January 1, 2020 to May 10, 2022 were enrolled and divided into ALI group and non-ALI group. The age, smoking status, C-reactive protein (CRP), procalcitonin (PCT), neutrophil-to-lymphocyte ratio (NLR), albumin, oxygenation index and other clinical data were compared between the two groups. Univariate analysis was performed by using independent sample t test and chi-square test. Binary logistic regression analysis was used to screen the independent risk factors of ALI caused by Staphylococcus aureus infection, and a risk warning model was constructed. The receiver operator characteristic (ROC) curve was used to evaluate the predictive ability of the model. Results:There were 96 cases of Staphylococcus aureus infection, including 68 cases (70.8%) in ALI group, of which 41 cases (60.3%) were positive in sputum culture and 27 cases (39.7%) were positive in blood culture. Compared with the non-ALI group, the proportion of patients aged ≥60 years in ALI group was lower (58.8%(40/68) vs 64.3%(18/28)), the proportion of smoking was higher (58.8%(40/68) vs 35.7%(10/28)), and the differences were both statistically significant ( χ2=0.76 and 0.03, respectively, both P<0.05). The levels of CRP, PCT and NLR in the ALI group were all higher than those in non-ALI group, while oxygenation index and albumin level were both lower, and the differences were all statistically significant ( t=-5.28, -3.46, -9.87, 12.83 and 3.08, respectively, all P<0.05). Binary logistic regression analysis showed that CRP (odds ratio ( OR)=1.973, 95% confidence interval (95% CI) 0.956 to 2.989), PCT ( OR=3.734, 95% CI 1.014 to 13.746), NLR ( OR=1.152, 95% CI 1.058 to 2.254) and albumin ( OR=1.527, 95% CI 1.110 to 2.102) were independent risk factors for ALI caused by Staphylococcus aureus infection. The areas under the ROC curve of CRP, PCT, NLR, albumin and the risk warning model constructed from the combination of four risk factors were 0.69, 0.81, 0.83, 0.78 and 0.93, respectively. The sensitivities were 65.14%, 89.91%, 84.40%, 56.88% and 98.17%, respectively. The specificities were 62.37%, 60.22%, 65.59%, 80.64% and 93.55%, respectively. The accuracy of the effectiveness test of the risk warning model was 84.97%. Conclusions:CRP, PCT, NLR and albumin are the independent risk factors for ALI caused by Staphylococcus aureus infection. The risk warning model based on the above factors has a good early warning effect on ALI caused by Staphylococcus aureus infection.
8.Using diffusion tension imaging for evaluating the effects of warm ischemia-reperfusion injury on liver regeneration in rabbits
Yuling ZHANG ; Zhiqiang CHU ; Zhengzheng TAO ; Qian JI
Chinese Journal of Organ Transplantation 2021;42(4):239-244
Objective:To explore the value of diffusion tension imaging (DTI) in the evaluations of hepatic ischemia-reperfusion injury (WIRI) regulation of liver regeneration after partial hepatectomy.Methods:Thirty healthy adult male New Zealand white rabbits were randomly divided into five groups of control and 10/20/30/40 min warm ischemia time (A0-A4)( n=6 each). Routine magnetic resonance (MR) and diffusion tensor imaging (DTI) were performed at 6 h, 3 d, 7 d, 14 d, 30 d post-keratectomy. The serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST) and lactate dehydrogenase (LDH) were measured at Day 30 post-keratectomy. The levels of malondialdehyde (MDA), myeloperoxidase (MPO), superoxide dismutase (SOD), tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6) and proliferating cell nuclear antigen (PCNA) in frozen liver tissues were examined and histopathological examination was performed. The values of apparent diffusion coefficient (ADC), fractional anisotropy (FA) and liver volume were measured and liver regeneration rate (LRR) was calculated. Repeated measurement analysis of variance was employed for comparing the difference of DTI and LRR in different groups at different follow-up times. One-way analysis of variance was utilized for comparing the differences of DTI and LRR between groups at the same follow-up time. Pearson or Spearman correlation analysis was employed for evaluating the correlation between DTI, LRR and biochemical parameters. Results:The interaction between time and warm ischemic factor ( P<0.05) and the effect of both alone ( P<0.001) had statistically significant effects on ADC values. FA value and LRR interaction were not significant between time and warm ischemic factor. However, the dominant effect of time factor was significant ( P<0.05). A significant positive correlation existed between ADC value and LRR in the same warm ischemia group ( P<0.01). FA and LRR were negatively correlated ( P<0.05), except for A3 group. FA had a weak correlation with IL-6 at Day 30 post-operation. Conclusions:DTI can non-invasively and quantitatively evaluate the effect of hepatic WIRI on liver regeneration after partial hepatectomy in rabbits. A certain degree of WIRI (≤30 min) can promote liver regeneration after partial hepatectomy. The longer warm ischemia time, the more obvious promotion effect. However, the promotion effect declines significantly after 30 min.
9.Study of R2* value to evaluate regulation of liver regeneration by hepatic warm ischemia-reperfusion injury after partial hepatectomy in rabbits
Zhengzheng TAO ; Zhiqiang CHU ; Jiabing JIANG ; Qian JI
Chinese Journal of Hepatology 2021;29(6):539-544
Objective:To investigate the effect of R2* value on the evaluation of different degrees of hepatic warm ischemia-reperfusion injury (WIRI) and liver regeneration after partial hepatectomy in rabbits.Methods:Thirty healthy adult male New Zealand White rabbits were randomly divided into five groups. Hepatic caudal lobectomy was performed in both the control and the warm ischemia time-dependent variation group. After reperfusion, routine MRI and BOLD MRI scans were performed for each group at 6 h, 3 d, 7 d, 14 d and 30 d, respectively, and then R2* value and liver regeneration rate (LRR) were measured and calculated. After 30 days of scanning, the serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST) and lactate dehydrogenase (LDH), malondialdehyde (MDA), superoxide dismutase (SOD), myeloperoxidase (MPO), tumor necrosis factor - α (TNF - α), interleukin-6 (IL-6) and proliferating cell nuclear antigen (PCNA) were detected in frozen rabbit liver tissues, and the pathological sections were collected. Repeated measures analysis of variance was used to evaluate the changes of R2* value, LRR and its influencing factors at different follow-up time and warm ischemia time in each group. Pearson’s or Spearman’s correlation analysis was used to evaluate the correlation of R2* value with LRR and various biochemical indexes.Results:The interaction between different follow-up time and warm ischemia time ( F = 24.600, P < 0.001) and the single effect of the both on the R2* value had statistically significant difference ( P < 0.05). The interaction of different follow-up time and different warm ischemia time had no effect on LRR, and the difference was not statistically significant ( F = 0.925, P = 0.528), but the difference in the main effect of the both on LRR was statistically significant ( P < 0.05). At the same follow-up time, except for the 40-min ischemia group, the R2* values ??were significantly positively correlated with LRR (3, 7, 14, 30 days after operation, r = 0.510, 0.681, 0.612, 0.541 respectively, P < 0.05). At the same warm ischemia time, the R2* value were significantly negatively correlated with LRR (3, 7, 14, 30 and 40 days after operation, r = - 0.800, -0.852, -0.893, -0.648, -0.853, respectively, P < 0.05). There was no correlation between R2 * value and biochemical indexes at 30 days after operation ( P > 0.05). Conclusion:The R2* value may be used for noninvasive and quantitative evaluation of microstructural changes of WIRI and affect liver regeneration after partial hepatectomy in rabbits. A certain degree of WIRI (≤30 min) after partial hepatectomy can promote liver regeneration in rabbits. Furthermore, as the warm ischemia time prolongs, the promoting effect becomes more pronounced, and if the warm ischemic time exceeds 30 minutes, the promoting effect is significantly reduced.
10. Analysis of the results of investigation on iodine content of drinking water in Jiuquan City, Gansu Province in 2017
Zihui CHU ; Zhiqiang GAN ; Miaomiao CAI
Chinese Journal of Endemiology 2019;38(11):906-909
Objective:
To understand the iodine content of drinking water in Jiuquan City, and provide a theoretical basis for effective prevention and control of iodine deficiency disorders (IDD).
Methods:
In 92 townships (towns, streets) of 7 counties (cities, districts) in Jiuquan City, the investigation was carried out in 2017. According to different water supply methods, that was unified centralized water supply, partial centralized water supply, and distributed water supply, stratified sampling method was used to collect water samples, and water iodine content was determined. At the same time, in the two animal husbandry counties of Subei County and Akesai County with spring water and river water as water sources, the administrative villages were taken as units, and water samples were collected to analyze the difference of iodine content in water of different water sources and different wells. According to the "Division Standard for Iodine Deficiency Disorders" (GB 16005-2009), the iodine content of drinking water < 10 μg/L could be divided into areas of iodine deficiency.
Results:
A total of 392 water samples were collected from 273 administrative villages in 92 townships (towns, streets) in 7 counties (cities, districts) of Jiuquan City. The median water with iodine contents was 2.6 μg/L, ranging from 0.1 to 16.6 μg/L. And 372 water samples iodine < 10 μg/L, accounted for 94.90%; 20 samples ≥10 μg/L, accounted for 5.10%. Among the 392 water samples, 33 were centralized water supply samples, 311 were partial centralized water supply, and 48 were completely distributed water supply. The median water iodine was 1.6, 2.5, and 4.3 μg/L, respectively. There was a statistically significant difference in the median water iodine between different water supply methods (

Result Analysis
Print
Save
E-mail