BACKGROUND:Sodium alginate,a natural polysaccharide,has become one of the ideal materials for preparing injectable hydrogels because it is an abundant and cheap resource,and has good biocompatibility and biodegradability.It has been widely used in the production of injectable hydrogels. OBJECTIVE:To review the properties of sodium alginate,the preparation of injectable sodium alginate hydrogel,and its application progress in tissue engineering. METHODS:Web of Science,PubMed,and CNKI were searched by computer.Chinese search terms were"sodium alginate;hydrogel;injectable",and English search terms were"alginate;hydrogel;inject".The time range of searching literature was mainly from June 2017 to June 2022. RESULTS AND CONCLUSION:Alginic acid comes from a wide range of sources,and there are many modifiable groups in its molecular structure,so many injectable hydrogels with excellent properties can be produced by various chemical crosslinking or physical crosslinking methods.Introducing other bioactive molecules or drugs into sodium alginate gel can adjust its properties and broaden its application fields.In addition,injectable sodium alginate hydrogels have great application prospects in biomedicine because of their good biocompatibility,biodegradability and other physical and chemical properties.Sodium alginate hydrogels are evenly mixed with various drugs,cells,factors or other biological molecules in vitro,and can form gels in the human body,which plays a pivotal role in gene carrier,cell scaffold and wound repair.

Purpose To investigate the value of T2WI MR-based radiomics nomogram for predicting deep stromal invasion of cervical cancer preoperatively.Materials and Methods Retrospective analysis of 164 consecutive patients with early-stage cervical cancer with postoperative pathological findings and preoperative MR images admitted to two medical centers in the Affiliated Hospital of Southwest Medical University(first center)and the Huaihe Hospital of Henan University(second center)from May 2018 to August 2022.The data in the first center(n=1 14)and the second center(n=50)were divided into the training and validation cohorts,respectively.To segment T2WI images in the 3D Slicer software and to extract image features in the python software.The radiomic features were selected in the training cohort.Based on the selected features,support vector machine prediction model was constructed.Univariate Logistic regression was used to select clinicopathological risk factors,then,multi-variate Logistic regression combined with radiomics score was used to construct radiomics nomogram,diagnostic performance of the radiomics model,clinical prediction model and radiomics nomogram model were assessed by receiver operating characteristic analysis.The predictive efficacy of the different models were compared.Results The 12 radiomics features were selected out.The FIGO staging and radiomics score were included in the multifactor Logistic regression to build the radiomics nomogram for predicting deep stromal invasion.The results showed that the predictive performance for the radiomics nomogram model was better than the clinical prediction model(in validation cohort:area under the curve was 0.845 vs.0.717;Z=2.728,P=0.006).Conclusion Radiomics nomogram based on T2WI is of high value for predicting deep stromal invasion of cervical cancer preoperatively.

Neuropathic pain (NP) is a common complication following spinal cord injury, with an incidence rate ranging from 38% to 70%. NP typically presents as sensation of burning, electric shocks, tingling or squeezing pain resulting from somatosensory nerve damage, which exerts a negative impact on patients′ physical and psychological well-being. After spinal cord injury, glial cells are activated to induce inflammatory cascade. Accordingly, various inflammatory mediators that may disrupt the neuronal function are released to promote abnormally increased neuronal excitability and pain signal transduction. Additionally, spinal cord injury can disrupt the release of neurotransmitters and neurotrophic factors, alter ion channel activity, and thereby impair the normal pain regulatory mechanisms and further increase pain perception. The interaction of these mechanisms contributes to the occurrence and persistence of NP after spinal cord injury. However, the precise pathogenesis of NP remains incompletely elucidated, making its therapeutic efficacy uncertain and clinical management difficult. It is of great significance to thoroughly understand the underlying pathophysiological mechanisms of NP following spinal cord injury for its treatment. For this reason, the authors reviewed the research progress on the characteristics and pathophysiological mechanisms of NP following spinal cord injury, aiming to serve as a reference for further research and development of more effective targeted therapies and management strategies.

OBJECTIVE: To review the research progress in the construction strategy and application of bone/cartilage immunomodulating hydrogels. METHODS: The literature related to bone/cartilage immunomodulating hydrogels at home and abroad in recent years was reviewed and summarized from the immune response mechanism of different immune cells, the construction strategy of immunomodulating hydrogels, and their practical applications. RESULTS: According to the immune response mechanism of different immune cells, the biological materials with immunoregulatory effect is designed, which can regulate the immune response of the body and thus promote the regeneration of bone/cartilage tissue. Immunomodulating hydrogels have good biocompatibility, adjustability, and multifunctionality. By regulating the physical and chemical properties of hydrogel and loading factors or cells, the immune system of the body can be purposively regulated, thus forming an immune microenvironment conducive to osteochondral regeneration. CONCLUSION Immunomodulating hydrogels can promote osteochondral repair by affecting the immunomodulation process of host organs or cells. It has shown a wide application prospect in the repair of osteochondral defects. However, more data support from basic and clinical experiments is needed for this material to further advance its clinical translation process.
Hydrogels ; Cartilage ; Bone and Bones ; Tissue Engineering/methods*

Objective To investigate the effect of flash glucose monitoring (FGM) on ambulatory glucose profile of only oral antidiabetic drugs treated patients with type 2 diabetes mellitus. Methods Twenty-eight type 2 diabetic mellitus patients with only oral antidiabetic drugs treatment from August 2017 to January 2018 were enrolled. All the patients were exposed to FGM for 14 d without changing the original treatment and encouraged to manage self-behavior by adjusting diet and activity based on the blood glucose data obtained from the real-time scanning. The changes in glucose profile during the FGM period were observed, including estimated glycated hemoglobin (HbA1c), standard deviation of blood glucose, variable coefficient of blood glucose, mean amplitude of glycemic excursions, time in range (blood glucose 3.9 to 10.0 mmol/L), area under the curve hyperglycemia (blood glucose> 10.0 mmol/L) and area under the curve hypoglycemia (blood glucose<3.9 mmol/L). The blood glucose levels on second day and thirteenth day were used as baseline and end point respectively. Results All of the 28 patients did not change their anti-diabetic drug therapy and there were no adverse events occurred. The estimated HbA1c was significantly lower than the baseline HbA1c: (6.90 ± 1.48)% vs. (7.57 ± 1.35)%, and there was statistical difference (P = 0.004). The standard deviation of blood glucose, variable coefficient of blood glucose, mean amplitude of glycemic excursions, area under the curve hyperglycemia and area under the curve hypoglycemia at end were significantly lower than those at baseline: (2.07 ± 0.86) mmol/L vs. (2.44 ± 0.86) mmol/L, 0.26 ± 0.11 vs. 0.30 ± 0.11, (5.32 ± 2.75) mmol/L vs. (6.76 ± 3.06) mmol/L, 265 (0, 1 310) vs. 351 (107, 2 177) and 0 (0, 0) vs. 0 (0, 19), the time in range at end was significantly higher than that at baseline: (1 069 ± 386) min vs. (921 ± 449) min, and there were statistical differences (P＜0.05 or＜0.01). The rate of scanning was (12.92 ± 4.87) times/d. Conclusions FGM could be applied by type 2 diabetic mellitus patients to make self-glycemic management without changing therapy, reduce the estimated HbA1c,and hypoglycemia, and improve the glucose fluctuations, which may result from real-time scanning to find abnormal glycemia and adjust daily behavior.

Objective To understand colonization of pathogens in nasal vestibular of health care workers (HCWs) in intensive care unit (ICU),and provide evidence for strengthening the prevention and control of healthcare-associated infection (HAI)in ICU.Methods On may 2015,colonization status of pathogens in nasal vestibular of uninfected HCWs in ICU were actively screened,bacterial culture,isolation and identification were performed.The surveyed results were analyzed and compared with antimicrobial resistance of pathogens from patients at the same stage.Results A total of 96 HCWs were surveyed,43 pathogenic strains were isolated from different HCWs’na-sal vestibular,isolation rate and carriage rate were both 44.79%.The main pathogenic bacteria was Staphylococcus aureus(n=15,34.88%),followed by Enterobacter aerogenes (n =9,20.93%)and Klebsiella pneumoniae (K . pneumoniae ,n=7,16.28%).There was a high detection rate of pathogens from nasal vestibular of doctors,HCWs who smoked frequently and those who never exercised (all P <0.05).There were 1 strain of imipenem-resistant K . pneumoniae among 43 pathogenic strains.Resistance rate of 7 K .pneumoniae from HCWs to ampicillin/sulbactam, cefazolin,and furantoin were all >50.00%,resistance rates to cefotaxime and imipenem were 28.57% and 14.29%respectively;resistance rates of 11 strains of K .pneumoniae from patients to furantoin was 100.00% during the same stage,but were sensitive to other commonly used antimicrobial agents.Resistance rate of 4 strains of Esche-richia coli (E.coli)to ampicillin was 75.00%,to gentamicin,tobramycin,levofloxacin,ciprofloxacin,and com-pound sulfamethoxazole were all 50.00%,6 strains of E.coli isolated from patients during the same period were found to be resistant to most commonly used antimicrobial agents.Conclusion Colonization rate of pathogens is high in nasal vestibular of HCWs in ICU,active screening and monitoring on colonization of pathogens in HCWs’ nasal vestibular is significant for preventing the occurrence and cross transmission of HAI among HCWs and pa-tients.

Objective To understand the specimen sources,clinical characteristics,and antimicrobial resistance of Burkholderia cepacia (B .cepacia )isolated from infected patients in intensive care unit(ICU),so as to provide reference for guiding rational use of antimicrobial agents.Methods Clinical data of patients with B .cepacia infec-tion in an ICU between 2011 and 2014 were analyzed retrospectively,antimicrobial resistance of strains was ana-lyzed.Results A total of 267 B .cepacia strains were isolated,the major specimen sources were sputum (80.15%, n=214),blood(14.23%,n =38),and urine(3.37%,n =9).Antimicrobial susceptibility testing results revealed that B .cepacia had multiple resistance,and was naturally resistant to multiple clinically used antimicrobial agents, such as ampicillin,cefazolin,ampicillin/sulbactam,nitrofurantoin,and cefuroxime,resistant rates were all 100%;resistant rates to ceftazidime and levofloxacin were 4.12% and 3.00% respectively;resistant rate to compound sulfa-methoxazole had increased tendency(χ2 =5.885,P =0.015).Conclusion Isolation of B .cepacia in ICU increased year by year,antimicrobial resistance is serious,management and targeted monitoring of prevention and control of healthcare-associated infection should be strengthened,antimicrobial agents should be chosen according to antimi-crobial susceptibility testing results.

ObjectiveTo evaluate the consistency of color Doppler ultrasonography (CDFI) and digital subtraction angiography (DSA) in diagnosis of carotid artery stenosis or occlusion. MethodsThe agreement and disagreement between CDFI and DSA examination results in 215 cases with unilateral carotid artery stenosis or occlusion were studied. By reviewing the CDFI sonogram and DSA dynamic image, the reason of discrepancy between two imaging modalities was analyzed.ResultsThe agreement rate was 90.7% (195 cases) between first CDFI scan and DSA, while disagreement rate was 9.3%(20 cases). Thus CDFI and DSA showed a good consistency (Kappa=0.7731,P<0.01). After reviewing the CDFI sonogram and DSA dynamic image, the discrepancy was attributed to treatment response in10 cases (4.7%), imaging principle difference in 3 cases (1.4%) , and inconsistent physician diagnoses in 7 cases (3.2%). ConclusionIn diagnosis of extracranial carotid artery stenosis or occlusion, the results of CDFI and DSA were highly consistent . In inconsistent cases, the examination results should be viewed under comprehensive and complementary analysis.

Objective To discuss the clinical results and surgical method in treatment of hypertensive intracerebral hemorrhage in basal ganglia. Methods From January 2007 to June 2013, the use of surgery treatment of hypertensive intracerebral hemorrhage in basal ganglia under direct vision assisted by the deep cold light suction in 104 cases,all the cases were done through lateral fissure-brain island approach,removing the hematoma with bipolar coagulation and hemostasis at sametime. This paper analyzed the group of patients with surgical methods and clinical efficacy. Results CT scan of intreatment group showed that there were 6 cases of secondary operation because of recurrent hemorrhage, and the hematoma-cleared rate>80% in 73 cases,50%-80% in 21 cases,<50% in 10 cases before operation within 6 hours. According to ADL classification,the 92 cases were alive after operation, good recovery in 65 cases, moderate disability in 22 cases, 5 cases of severe disability, death and give up treatment 12 cases. There was 12 cases of sec-ondary operation because of recurrent hemorrhage in control group, and the hematoma-cleared rate>80% in 16 cases,50%-80%in 23 cases,<50%in 24 cases before operation within 6 hours. According to ADL classification,the 45 cases were alive after operation in control group, good recovery in 14 cases,moderate disability in 16 cases,15 cases of se-vere disability,death and give up treatment 18 cases. There were significant differences between the two groups in op-eration time, intra-operative blood loss, the volume of blood transfusion, hematoma clearance rate, postoperative sur-vival rate and the survival quality ADL grading at half a year, and the indexes mentioned above in treatment group were better than those in control group. Conclusion Surgery treatment of hypertensive intracerebral hemorrhage in basal ganglia under direct vision by lateral fissure-brain island approach assisted by the deep cold light suction will shooter the operation time and lower the surgical injury,increase hematoma-cleared rate,it aslo has reliable hemostasis and more effective,so this method is worthy of clinical use.

BACKGROUNDPelvic fractures are uncommon in elderly patients and so are infrequently addressed in the literature. The purpose of this study was to investigate the management and outcome of pelvic fractures in elderly patients.

METHODSWe retrospectively reviewed the records of pelvic fractures in elderly patients (age ≥55 years) who were treated in our department from September 1997 to May 2010.

RESULTSA total of 40 elderly patients with pelvic fractures were identified. Their mean age was 65.8 years (range 55-87 years). About 68% (n = 27) were men. The average Injury Severity Score (ISS) was 17.8 (range 6-45). Twelve (30%) patients required blood transfusion (mean 10 units) during the first 24 hours. The fractures were most frequently due to falling from a standing position (48%). Almost half (48%) were grade I breaks. Associated injuries were present in 70% (n = 28) of patients, and 65% (n = 26) had medical co-morbidities. Altogether, 29 patients (73%) underwent non-surgical management of their pelvic fracture. The average hospital stay was 25 days. There were five in-hospital deaths and one death 10 months after discharge. High ISSs (>25) were associated with increased in-hospital mortality (P = 0.018). At the final assessment (mean follow-up 15 months), 52% of the surviving patients had experienced decreased self-sufficiency.

CONCLUSIONSPelvic fractures in elderly patients result in high morbidity and mortality rates. A high ISS (>25) can be used to identify a patient at high risk. We recommend aggressive resuscitation and intensive care for that patient. For patients with an unstable pelvic or displaced acetabular fracture (≥2 mm) who can endure surgery, open reduction and internal fixation can provide adequate fixation for early weight-bearing and restoration of the bone stock.

Aged ; Aged, 80 and over ; Blood Transfusion ; Female ; Fracture Fixation, Internal ; Fractures, Bone ; etiology ; surgery ; therapy ; Hospital Mortality ; Humans ; Male ; Middle Aged ; Pelvic Bones ; injuries ; Retrospective Studies