Objective To investigate the changes of C1q tumor necrosis factor-related protein-12(CTRP12)levels in serum of the pa-tients with acute myocardial infarction(AMI)before and after percutaneous coronary intervention(PCI),and explore its clinical sig-nificance.Methods A total of 50 patients with AMI who underwent emergency PCI and 35 patients with normal coronary angiography results in Danyang People's Hospital from November 2021 to October 2022 were enrolled.The CTRP12 levels in peripheral venous ser-um were compared between the two groups.The levels of serum CTRP12 levels were measured before,during and on the 3rd,5th and 7th day after PCI.The serum CTRP12 levels in culprit coronary ostium and peripheral vein were compared.CTRP12 levels in peripher-al venous serum were compared at different time points after PCI.The severity of coronary artery disease was evaluated by SYNTAX score system,and the AMI patients were divided into two groups:SYNTAX score ≤22 and SYNTAX score＞22.The serum CTRP12 levels were compared between the two groups and before and after PCI.The correlation between CTRP12 and age,body mass index(BMI),fasting blood glucose,blood lipid and other factors was analyzed.The influencing factors of the severity of coronary artery le-sions were analyzed by logistic regression.Results The serum CTRP12 level in the patients with AMI was significantly lower than that in healthy controls(P＜0.05).There was no significant difference between the serum CTRP12 levels between preoperative peripheral vein and intraoperative culprit coronary orifice(P＞0.05).Compared with that before PCI,the serum CTRP12 level was lower on the 3rd day after PCI(P＜0.05),and increased on the 5th and 7th days after PCI,but no statistically significant difference was found(P＞0.05).Compared with those on the 3rd day after PCI,the serum CTRP12 levels were increased on the 5th and 7th day after PCI,but no statistically significant differences were found(all P＞0.05).Compared with that in the SYNTAX≤22 group,the CTRP12 levels were significantly lower than those before PCI and on the 3rd day after PCI(all P＜0.05),while there was no significant difference on the 5th and 7th day after PCI in SYNTAX＞22 group(all P＞0.05).CTRP12 was negatively correlated with the level of total cholesterol(TC)and positively correlated with high-density lipoprotein cholesterol(HDL-C).Univariate logistic regression analysis showed that CTRP12 was an independent influencing factor for the severity of coronary artery disease in the patients with AMI(β=-1.671,OR=0.188,P＜0.05).After adjusting for the effects of age,gender,BMI,smoking,hypertension,diabetes,fasting blood glucose,total cholesterol(TC),triglyceride(TG),HDL-C and low-density lipoprotein cholesterol(LDL-C),CTRP12 was still an independent in-fluencing factor for the severity of coronary artery disease in the patients with AMI(β=-3.441,OR=0.032,P＜0.05).Conclusion The serum CTRP12 level was significantly decreased in the patients with AMI before PCI,and showed continuous decline on the 3rd day after PCI,but increased on the 5th and 7th day after PCI.CTRP12 should be an independent influencing factor for the severity of coronary artery disease in the patients with AMI.

The American College of Gastroenterology Guidelines:Management of Acute Pancreatitis(referred to as the"2024 guidelines"),released in March 2024,presents 11 recommendations and 23 key concepts for the management of acute pancreatitis(AP)based on different levels of evidence quality.The 2024 guidelines provide detailed explanations regarding the diagnostic criteria,etiology,initial assessment,severity stratification,initial management,endoscopic retrograde cholangiopancreatography,antibiotic use,nutritional support,and surgical interventions for AP.Compared to the 2023 edition of the American College of Gastroenterology Guidelines,the 2024 edition offers more detailed recommendations and comprehensive evidence-based medical data,which is of great significance in optimizing the diagnosis and treatment process for AP patients and improving patient outcomes.

Objective To investigate changes in serum complement C1 tumor necrosis factor-related pro-tein family 12(CTRP12)level before and after percutaneous coronary intervention(PCI)in patients with acute myocardial infarction(AMI)and the relationship of CTRP12 level with in-stent restenosis(ISR).Methods A total of 104 patients who had been diagnosed with AMI and had undergone PCI at Danyang People's Hospital in Jiangsu Province from January 2021 to June 2023 were selected.The incidence of ISR within 12 months after PCI was counted,and they were divided into an ISR group and a non-ISR group according to the results of reviewed coronary angiography.Serum CTRP12 levels were compared between the two groups before PCI and on one day before discharge.Logistic regression was used to analyze the influencing factors of ISR in AMI patients after PCI.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of CTRP12 for ISR in AMI patients after PCI.Results The incidence of ISR in 104 AMI patients at 12 months after PCI was 14.4%(15/104).As compared with the non-ISR group,the ISR group had significant increases in preoperative TIMI flow of≤1,white blood cell count,neutrophil count,TC,and LDL-C,and a significant decline in serum CTRP12 level on one day before discharge(P<0.05).In the non-ISR group,serum CTRP12 level was significantly higher on one day before discharge than its baseline(P<0.05).In the ISR group,serum CTRP12 level on one day before discharge was lower than its baseline,but the difference was not statistically significant(P>0.05).Logistic regression analysis showed that a lower CTRP12 level on one day before discharge was an independent risk factor for ISR in AMI patients after PCI(P<0.05).ROC curve analysis showed that the optimal cut-off point of serum CTRP12 on one day before discharge for predicting ISR in AMI patients after PCI was 3.89 ng/mL(sensitivity 93.3%and speci-ficity 73.0%),and the area under the ROC curve(AUC)was 0.849.Conclusions Serum CTRP12 level inone day before discharge has certain predictive value for ISR in AMI patients after PCI.CTRP12 may be a therapeutic target for ISR in AMI patients after PCI.

OBJECTIVE: To explore the design points of a three-dimensional (3D) printed customized cementless intercalary endoprosthesis with an intra-neck curved stem and to evaluate the key points and mid-term effectiveness of its application in the reconstruction of ultrashort bone segments in the proximal femur. METHODS: Between October 2015 and January 2021, 17 patients underwent reconstruction with a 3D printed-customized cementless intercalary endoprosthesis with an intra-neck curved stem. There were 11 males and 6 females, the age ranged from 10 to 76 years, with an average of 30.1 years. There were 9 cases of osteosarcoma, 4 cases of Ewing sarcoma, 2 cases of chondrosarcoma, 1 case of liposarcoma, and 1 case of myofibroblastoma. The disease duration was 5-14 months, with an average of 9.5 months. Enneking staging included 16 cases of stage ⅡB and 1 case of stage ⅢB. The distances from the center of the femoral head to the body midline and the acetabular apex were measured preoperatively on X-ray images. Additionally, the distances from the tip of the intra-neck curved stem to the body midline and the acetabular apex were measured at immediate postoperatively and last follow-up. The neck-shaft angle was also measured preoperatively, at immediate postoperatively, and at last follow-up. The status of osseointegration at the bone-prosthesis interface and bone growth into the prosthesis surface were assessed by X-ray films, CT, and Tomosynthesis-Shimadzu metal artefact reduction technology (T-SMART). The survival status of the patients, presence of local recurrence or distant metastasis, and occurrence of postoperative complications were assessed. The recovery of lower limb function was evaluated pre- and post-operatively using the Musculoskeletal Tumor Society (MSTS) scoring system, and pain relief was evaluated using the visual analogue scale (VAS) scores. RESULTS: The patient's femoral resection length was (163.1±57.5) mm, the remaining proximal femoral length was (69.6±9.3) mm, and the percentage of femoral resection length/total femoral length was 38.7%±14.6%. All 17 patients were followed up 25-86 months with an average of 58.1 months. During the follow-up, 1 patient died of lung metastasis at 46 months postoperatively, and the remaining 16 patients survived tumor-free. There was no complication such as periprosthetic infection, delayed incision healing, aseptic loosening, prosthesis fracture, or periprosthetic fracture. No evidence of micromotion or wear around the implanted stem of the prosthesis was detected in X-ray and T-SMART evaluations. There was no significant radiolucent lines, and radiographic evidence of bone ingrowth into the bone-prosthesis interface was observed in all stems. There was no significant difference in the distance from the tip of the curved stem to the body midline and the apex of the acetabulum at immediate postoperatively and last follow-up compared with the distance from the center of the femoral head to the body midline and the apex of the acetabulum before operation, respectively (P>0.05), and there was no significant difference in the above indexes between immediate postoperatively and last follow-up (P>0.05). The differences in the neck-shaft angle at various time points before and after operation were also not significant (P>0.05). At last follow-up, the MSTS score was 26.1±1.2 and the VAS score was 0.1±0.5, which were significantly improved when compared with those before operation [19.4±2.1 and 5.7±1.0, respectively] (t=14.735, P<0.001; t=21.301, P<0.001). At last follow-up, none of the patients walked with the aid of crutches or other walkers. CONCLUSION The 3D printed customized cementless intercalary endoprosthesis with an intra-neck curved stem is an effective method for reconstructing ultrashort bone segments in the proximal femur following malignant tumor resection. The operation is reliable, the postoperative lower limb function is satisfactory, and the incidence of complications is low.
Female ; Male ; Humans ; Child ; Adolescent ; Young Adult ; Adult ; Middle Aged ; Aged ; Femur/surgery* ; Lower Extremity ; Bone-Implant Interface ; Femur Head ; Artificial Limbs

Objective To observe the clinical efficacy of glucocorticoidcombined with the eradication of helicobactepylori (HP) in the treatmenof idiopathithrombocytopenipurpura(ITP) and itinfluence on platelecounand cell subset.MethodNinety-foucaseof ITP were randomly divided into two group.The control group(47 cases) wagiven prednisone treatmen, while the observation group(47 cases) wagiven prednisone combined with HP eradication treatmen.The clinical effecand recur-rence rate within 1 yeawere observed ,and the changeof platelecounand cell subsetwere tested .ResultThe total effective rate of the observation group wa89 .36% ,which wasignificantly highethan 70 .21% in the control group ;the 1-yearecurrence rate in the observation group wa36 .17% ,which wasignificantly lowethan 72 .34% in the control group ,the differencebetween the two grouphad statistical significance (P＜0 .05) .The platelecounaftetreatmenin the two groupwere significantly in-creased ,platelet-associated antibody(PAIgG) level wasignificantly decreased ,buthe improvemenin the observation group wamore significant(P＜0 .05) .The percentage of CD3+CD4+ % increased significantly ,the percentage of CD3+CD8+ % wadecreased significantly ,buthe improvemenin the observation group wamore obviou(P＜0 .05) .Conclusion Glucocorticoidcombined with HP eradication treatmenin treating ITP hadefinitely clinical efficacy ,can increase the platelecoun,improve cell subsetimbalance ,and iworthy to be clinically promoted .

Objective To investigate the frequent species of pathogenic bacteria causing infections in burn patients and their re‐sistance to commonly used antibacterial agents ,so as to provide references for rational use of antibacterials in clinic .Methods The distribution and drug susceptibility of pathogenic bacteria isolated from secretions of wound surfaces of 140 cases of burn patients from January 2012 to December 2014 were retrospectively analyzed .Results A total of 152 strains of pathogenic bacteria were iso‐lated .The gram‐negative bacteria accounted for 59 .2% ,in which Pseudomonas aeruginosa ,Proteus mirabilis and Acinetobacter bau‐mannii were the most common isolates ;the gram‐positive bacteria accounted for 34 .2% ,in which Staphylococcus aures ,Staphylo‐coccus haemolyticus and Enterococcus faecalis were the most common isolates ;and fungi were accounted for 6 .6% .A majority of these isolates were multiple resistant to the antibacterial agents .Conclusion Culturing ,identifing and carring out drug‐sensitivity test of pathogenic bacteria isolated from burn patients could provide basis for rational application of antibacterial agents and effec‐tive control of infection .

Objective To investigate the availability and strategy of breast reconstruction for patients with caesarotomy scar using pedicled TRAM flap.Methods From January 2007 to May 2011,12 cases of breast reconstruction with caesarotomy scar were carried out with pedicled TRAM flaps.All the patients that were classified as the class Ⅱ that was 0.5 or less by score were operated on by using the inverted trapezoid incision,of which the upper edge was 2 or 3 cm down to the umbilicus.Double pedicles were adopted for the patient with the longest vertical scar; single pedicle of the breast contralateral side and the muscle sheath of the breast ipsilateral side were harvested for the rest of the patients.A synthetic mesh was used for the enforcement of the muscle and sheath defect.Results No flap necrosis or abdominal complications were observed.With the follow-up from 3 months to 4 years and 4 months,the overall satisfactory rate was 100 ％.Conclusions The strict patient selection and the operating strategy are the keys to the successful breast reconstruction for patients with caesarotomy scar using pedicled TRAM flap.

Objective To investigate the copy number changes of A20 and TNF genes,and determine the contribution of the two genes in the development of ocular adnexal MALT lymphoma.Methods Forty-one cases of archive paraffin-embedded ocular adnexal MALT lymphoma tissues were detected by interphase fluorescence in situ hybridization (FISH) using the commercial chromosome 6 centromere probe (CEP6),and house-made site-specific probe of A20 and TNF. Results Of the 41 ocular adnexal MALT lymphoma cases,loss of heterozygosity (LOH)in A20 locus was detected in 2 cases (4.88 ％).TNF extra copies were found in 5 cases (12.20 ％),of which three cases simultaneously had extra CEP6 signals.No A20 deletion were found coexistence with TNF extra copies in any case.Conclusion A20 gene deletion is present in the small part of ocular adnexal MALT lymphoma, and might contribute to the development of Chinese ocular adnexal MALT lymphoma.A20 deletion is not associated with extra copies of TNF locus.

Objective To explore the CT manifestation and the diagnostic value of leiomyomatous tmnor of gastrointestinal tract in 8 patients.Methods 8 patients with gastrointestinnal tract leiomyoma tumor were scaned with GE HISPEED CT/I.proceeding to scan with contrast agent when detected and ascertained the nidus.Results There were 4 eases gastric smooth muscle tumors in 8 patients,and 1 case was leiomyosarcoma of stomach,1 case was duodenal muscle tumors,1 case as jejuna muscle tumors and another is leiomyosarcoma of jejunum.Conclusion The location,contour and characteristic of imaging is important standard of leiomyomatous tumor of gastrointestinal tract.

Objective To investigate whether angiotensin Ⅱ type 1 receptor(AT1R)gene polymorphism is associated with essential hypertension(EH). Methods A total of 200 hypertension patients and 192 normotensive controls were enrolled. The AT1R gene 1166A/C and -810A/T polymorphism were determined by polymerase chain reaction-restriction fragment length polymorphism (PCR-PFLP), and the association between the SNPs and the EH were analyzed statistically. Some biochemical index such as serum glucose (GLU) and total cholesterol (TC),triglyceride (TG), high density lipoprotein (HDL-C) and low density lipoprotein (LDL-C) were also measured. Results There was no significant difference between two groups of 1166A/C polymorphisms of AT1R gene(P ＞ 0.05 ). However, for the -810A/T polymorphism of AT1R gene, -810 AT and TT genotypes frequencies were significantly higher in EH patients than control (P = 0. 004). The -810T allele frequencies were higher in case than in control (22.5% vs. 11.5% ;P =0.000). We also found an association between EH and -810AT and TT genotypes by logistic regression analysis ( P = 0. 003 ), adjusted for other risk factors. The odds ratio was 2.57 (95% CI:1. 37 ～4. 84). Conclusions AT1R -810A/T polymorphism is associated with EH and -810T allele may be a risk factor of hypertension