Objective:To investigate the risk factors and their warning effectiveness for postoperative intestinal barrier dysfunction (IBD) in patients with severe traumatic brain injury (sTBI).Methods:A retrospective cohort study was conducted to analyze the clinical data of 101 patients with sTBI admitted to Wuxi Branch of Zhongda Hospital Affiliated to Southeast University from May 2020 to February 2023, including 63 males and 38 females, aged 21-81 years [(53.4±14.2)years]. All the patients underwent emergency surgery. The patients were divided into IBD group ( n=67) and non-IBD group ( n=34) according to whether or not they had IBD after surgery. The gender, age, basic diseases (hypertension and diabetes), types of intracranial hematoma (subdural, epidural, and intracerebral hematoma), preoperative Glasgow Coma Scale (GCS), cerebral hernia, intraoperative initial intracranial pressure (iICP), operation time, removal of bone flap, treatment time in ICU, initiation time of enteral nutrition, and use of broad-spectrum antibiotics were recorded in the two groups. Univariate and multivariate binary Logistic regression analyses were conducted to assess the correlations between above-mentioned indicators and incidence of postoperative IBD in sTBI patients and determine the independent risk factors for sTBI. Receiver operating characteristic (ROC) curve and area under the curve (AUC) were used to evaluate the warning effectiveness of each risk factor for IBD. Results:The results of the univariate analysis showed that preoperative GCS, cerebral hernia, intraoperative iICP, removal of bone flap, treatment time in ICU, initiation time of enteral nutrition, and use of broad-spectrum antibiotics were significantly correlated with the incidence of IBD in sTBI patients ( P<0.05 or 0.01), while there were no correlations of IBD with gender, age, basic diseases, types of intracranial hematoma and operation time ( P>0.05). The results of the multivariate binary Logistic regression analysis showed that preoperative GCS≤5 points ( OR=2.49, 95% CI 1.17, 5.32, P<0.05), intraoperative iICP>23 mmHg (1 mmHg=0.133 kPa)( OR=1.20, 95% CI 1.03, 1.39, P<0.05), and initiation time of enteral nutrition>24 hours ( OR=10.03, 95% CI 1.26, 80.21, P<0.05) were highly correlated with postoperative IBD in sTBI patients. The results of the ROC curve analysis showed that intraoperative iICP had the highest warning value (AUC=0.91, 95% CI 0.85, 0.96), followed by preoperative GCS (AUC=0.88, 95% CI 0.82, 0.95), and initiation time of enteral nutrition had the lowest warning value (AUC=0.78, 95% CI 0.69, 0.87). Conclusions:Preoperative GCS≤5 points, intraoperative iICP>23 mmHg, and initiation time of enteral nutrition>24 hours are independent risk factors for postoperative IBD in sTBI patients. The warning value of intraoperative iICP ranks the highest for postoperative IBD in sTBI patients, followed by preoperative GCS, with initiation time of enteral nutrition having the lowest warning value.

"Global cancer statistics 2022" based on the latest GLOBCAN data from the International Agency for Research on Cancer (IARC) was recently released, providing a systematic analysis of the incidence and mortality of 36 types of cancer across 185 countries worldwide. The international burden of cancer is expected to continue to increase over the next 30 years, posing a severe public health and social challenge for many countries, including China. This article offers a key point interpretation of the "Global cancer statistics 2022", focusing on the evolution of cancer epidemiology and future development trends. The aim is to broaden the international perspective on cancer prevention and treatment, with the hope of providing reference and guidance for cancer prevention and treatment efforts in our country.

Objective:To observe the effect of 3D-printed guide plate-assisted percutaneous bone cement-augmented sacroiliac screw fixation in the treatment of pelvic fragility fractures in the elderly.Methods:A total of 11 elderly patients with pelvic fragility fractures who underwent 3D-printed guide plate-assisted percutaneous cement-enhanced sacroiliac screw fixation (cemented group) in the Department of Traumatic Orthopaedics of the General Hospital of Ningxia Medical University from December 2022 to April 2024 were retrospectively analyzed. There were 3 males and 8 females, aged 73.18±4.42 years (range, 67-80 years). There were 4 cases of typeⅡand 7 cases of typeⅢ. At the same time, 10 elderly patients with pelvic fragility fractures who underwent percutaneous sacroiliac screw fixation assisted by 3D-printed guide plate (cementless group) were selected as control group, including 5 males and 5 females, aged 73.90±6.51 years (range, 67-85 years). Pelvic fragility fractures were classified as typeⅡin 5 cases and typeⅢin 5 cases. The perioperative indicators, visual analogue scale (VAS), Barthel index and postoperative complications were compared between the two groups.Results:All patients successfully completed the operation and were followed up for 17.05±5.48 months (range, 9-27 months). The operation time and fluoroscopy frequency in the bone cement group were 72.09±3.95 min and 12.45±0.93 times, which were significantly higher than those in the non-bone cement group 57.00±4.24 min and 8.50±0.97 times, the difference was statistically significant ( P<0.05). All patients' fractures healed in one stage, the healing time was 97.09±7.15 d in the cemented group and 103.00±13.14 d in the uncemented group, the difference was not statistically significant ( t=1.297, P=0.210), and there was no case of delayed healing or non-healing. The postoperative weight-bearing time of the bone cement group was 44.73±3.72 d, which was shorter than that of the non-bone cement group 59.10±7.37 d, and the difference was statistically significant ( P<0.05). The VAS scores of the bone cement group at 1 day, 1 week and 3 weeks after operation were 5.73±0.65, 4.64±0.51 and 3.27±0.65, respectively, which were lower than those of the non-bone cement group 6.80±0.42, 5.30±0.48 and 4.00±0.67. The difference was statistically significant ( P<0.05). The Barthel index of bone cement group was higher than that of non-bone cement group at 1 day, 1 week, 3 weeks, 6 weeks and 2 months after operation, and the difference was statistically significant ( P<0.05). Bone cement leakage occurred in 2 patients in the bone cement group, and they did not complain of special discomfort and were not treated. In the non-cemented group, two cases showed screw withdrawal and the sacroiliac screws were removed in a second operation; one case showed sacral plexus nerve injury, and the screws were removed and treated with oral methylcobalamin symptomatic therapy one month after the operation, and the symptoms were relieved after three months. Conclusion:3D-printed guide plate-assisted percutaneous cement-augmented sacroiliac screw fixation for the treatment of elderly pelvic fragility fracture can alleviate postoperative pain, shorten the weight-bearing time, and help to promote early recovery and improve postoperative quality of life.

Background::Carotid intima-media thickness (IMT) and diameter, stiffness, and wave reflections, are independent and important clinical biomarkers and risk predictors for cardiovascular diseases. The purpose of the present study was to establish nationwide reference values of carotid properties for healthy Chinese adults and to explore potential clinical determinants.Methods::A total of 3053 healthy Han Chinese adults (1922 women) aged 18-79 years were enrolled at 28 collaborating tertiary centers throughout China between April 2021 and July 2022. The real-time tracking of common carotid artery walls was achieved by the radio frequency (RF) ultrasound system. The IMT, diameter, compliance coefficient, β stiffness, local pulse wave velocity (PWV), local systolic blood pressure, augmented pressure (AP), and augmentation index (AIx) were then automatically measured and reported. Data were stratified by age groups and sex. The relationships between age and carotid property parameters were analyzed by Jonckheere-Terpstra test and simple linear regressions. The major clinical determinants of carotid properties were identified by Pearson’s correlation, multiple linear regression, and analyses of covariance.Results::All the parameters of carotid properties demonstrated significantly age-related trajectories. Women showed thinner IMT, smaller carotid diameter, larger AP, and AIx than men. The β stiffness and PWV were significantly higher in men than women before forties, but the differences reversed after that. The increase rate of carotid IMT (5.5 μm/year in women and 5.8 μm/year in men) and diameter (0.03 mm/year in both men and women) were similar between men and women. For the stiffness and wave reflections, women showed significantly larger age-related variations than men as demonstrated by steeper regression slopes (all P for age by sex interaction <0.05). The blood pressures, body mass index (BMI), and triglyceride levels were identified as major clinical determinants of carotid properties with adjustment of age and sex. Conclusions::The age- and sex-specific reference values of carotid properties measured by RF ultrasound for healthy Chinese adults were established. The blood pressures, BMI, and triglyceride levels should be considered for clinical application of corresponding reference values.

Objective:To analyze the relationship between CT attenuation value of pulmonary artery thrombi and the efficacy of interventional thrombolysis in patients with acute pulmonary embolism (APE).Methods:This was a single center cross-sectional study. The clinical and imaging data of 89 APE patients who underwent interventional thrombolysis in Affiliated Hospital of Xuzhou Medical University from January 2018 to December 2022, were retrospectively analyzed. All patients underwent CT pulmonary angiography (CTPA) before and after thrombolysis, the CT attenuation value of pulmonary artery thrombi and ratio of CT attenuation value of thrombi to left subscapularis muscle CT value were obtained; and the difference of Qanadli embolism index (ΔQ) before and after thrombolysis was calculated. According to the median ΔQ, patients were classified as good efficacy group (ΔQ>50%) and poor efficacy group (ΔQ≤50%). The clinical characteristics and quantitative parameters of CT were compared between the two groups, and the factors associated with efficacy of thrombolysis were analyzed with univariate and multivariate logistic regression. The correlation between CT attenuation value of pulmonary artery thrombi and ΔQ was analyzed by Spearman correlation analysis.Results:The CT attenuation value of thrombi and ratio of attenuation value of thrombi to left subscapularis muscle CT value showed significant difference between the two groups ( P<0.05). Multivariate analysis showed that compared with CT attenuation value of emboli≤53.47 HU, the value>53.47 HU might be associated with the good efficacy of thrombosysis ( OR=9.175, 95% CI: 0.937-89.846, P=0.057). There was a positive correlation between CT value of pulmonary artery thrombi and ΔQ ( r=0.365, P<0.001). Conclusion:The CT attenuation value of thrombi can predict the efficacy of interventional thrombolysis in APE patients, and patients with higher CT attenuation value would have a better treatment response.

Objective To investigate the effect of liver kinase B1(LKB1) on the radiosensitivity of subcutaneous xenograft tumor of lung cancer H460 cells in nude mice.Methods Human lung cancer H460 cells were implanted into female nude mice (BALB/c-nu) to establish a subcutaneous xenograft tumor model of lung cancer.A total of 24 female nude mice in which the model was successfully established were equally and randomly divided into four groups:pEGFP-Ctrl plasmid (empty vector plasmid) group, irradiation (IR)+pEGFP-Ctrl plasmid group, pEGFP-LKB1 plasmid (overexpressing LKB1) group, and IR+pEGFP-LKB1 plasmid group.The growth of xenograft tumors was observed and the tumor inhibition rate and enhancement factor (EF) were calculated.The expression of LKB1 in each group was measured by immunohistochemistry and Western blot to analyze the relationship between LKB1 and radiosensitivity.Results Compared with the pEGFP-Ctrl plasmid group, the IR+pEGFP-Ctrl plasmid group, pEGFP-LKB1 plasmid group, and IR+pEGFP-LKB1 plasmid group showed varying degrees of inhibition of tumor growth, particularly in the IR+pEGFP-LKB1 plasmid group, and the tumor inhibition rates were 31.30%, 14.78%, and 43.48%, respectively.The EF of LKB1 in the IR+pEGFP-LKB1 plasmid group was 1.18.The immunohistochemistry and Western blot showed that LKB1 could be effectively expressed in the pEGFP-LKB1 plasmid group and IR+pEGFP-LKB1 plasmid group, but not in the other two groups.Conclusions The subcutaneous xenograft tumor model of human lung cancer H460 cells has been successfully established in nude mice.LKB1 has a radiosensitizing effect on the subcutaneous xenograft tumor of lung cancer H460 cells in nude mice.

PurposeTo investigate the relationship between the serum oxidized low-density lipoprotein (ox-LDL) level and carotid vulnerable plaque in patients with acute cerebral ischemic stroke, and to evaluate the ability of serum ox-LDL in identifying vulnerable carotid plaques.Materials and Methods 181 patients with history of acute cerebral ischemic stroke were recruited. According to the results of carotid ultrasound patients were divided into non plaque group (n=48), stable plaque group (n=38) and vulnerable plaque group (n=95). The serum total cholesterol, triglyceride, high density lipoprotein-cholesterol, low density lipoprotein-cholesterol, fasting plasma glucose and ox-LDL were measured. Carotid intima-medial thickness (CIMT), total carotid plaque area (TPA) and the characters of plaque were examined with color Doppler ultrasound.Results The serum ox-LDL and the number of patients with hypertension in plaque group were significantly higher than that in the non-plaque group (P<0.05). The serum ox-LDL and TPA in the vulnerable plaque group were significantly higher than that in the stable plaque group (P<0.05). Serum ox-LDL in patients with acute cerebral infarction was positively correlated with CIMT, serum total cholesterol and LDL-C (r1=0.154,P<0.05;r2=0.338, P<0.05;r3=0.385,P<0.05). Logistic regression analysis showed that serum ox-LDL was an independent risk factor for carotid vulnerable plaque (OR=1.038, 95%CI 1.008-1.069, P<0.01).Conclusion The serum ox-LDL is independently associated with the formation of vulnerable plaque in patients with acute cerebral infarction. This study suggests that ox-LDL can be used as a biomarker in screening for vulnerable carotid plaque in clinical practice. Carotid ultrasound combined with serology can early identify carotid artery vulnerable plaque that may lead to cerebral ischemic events.

Objective To explore the association between the ABO blood group and the risk of myocardial infarction in Chinese people.Methods We retrospectively recruited 1 988 consecutive patients with acute myocardial infarction (AMI) and 1 856 non-coronary artery disease (non-CAD) subjects who hospitalized in our hospital between January 2013 and December 2013.The clinical features and ABO blood group were analyzed.Results Blood group distribution was A (27.1％,539/1 988),B (34.4％,684/1 988),AB(10.8％,215/1 988),O (27.7％,551/1 988) in patients with AMI and A (26.7％,496/1 856),B(32.2％,598/1 856),AB (10.8％,200/1 856),O (30.4％,564/1 856) in non-CAD group.The single factor analysis showed that blood group O tended to be more common in the non-CAD group than in AMI group (P =0.06).After adjustment for common cardiovascular risk factors such as age,gender,hypertension,diabetes,smoking and serum cholesterol level,the A,B,and AB blood groups were associated with increased risk of AMI compared with O blood group,and the difference was significant with A blood group (OR =1.229,95％ CI 1.019-1.482,P =0.031) and B blood groups (OR =1.214,95％ CI 1.017-1.449,P =0.032).In addition,non-O blood group remained significantly associated with the increased risk of AMI than O blood group after logistic regression analysis(OR =1.223,95％ CI 1.048-1.426,P =0.01).Conclusion Our results suggest that non-O blood group is associated with the increased risk of AMI.

Objective To analyze the diagnostic values of ultrasonography and computed tomography (CT)for gallbladder adenomyomatosis. Methods The ultrasound and CT findings of 28 cases of pathologically confirmed gallbladder adenomyomatosis in our hospital were retrospectively analyzed.The diagnostic values of the two imaging tools for gallbladder adenomyomatosis were analyzed with the pathological diagnosis as the gold standard.Comparison of rates was made by chi-square test;multiple comparisons of rates were made by partition of chi-square.Results Before operation,among the 28 patients,15 were diagnosed with gallbladder adenomyomatosis by ultrasonography,and 9 were diagnosed by CT;the diag-nostic rate of CT was 32.14%,and the diagnostic rate of ultrasonography was 53.57%.The chi-square test showed no difference between the di-agnostic rates of ultrasonography and CT for gallbladder adenomyomatosis (χ2 =2.63,P=0.10>0.05).In addition,the statistical results showed no differences between the diagnostic rates of ultrasonography and CT for various types of gallbladder adenomyomatosis (segmental type:χ2 =0,P=0.11>0.0125;diffuse type:χ2 =2.57,P=1.00>0.0125;focal type:χ2 =1.42,P=0.23>0.0125).Conclusion CT and ultrasonography are two important imaging methods for the diagnosis of gallbladder adenomyomatosis.The detection rate of gallbladder adenomyomatosis can be in-creased through the combination of convex array probe and linear array probe in ultrasonography.

10.3969/j.issn.2095-4344.2013.25.004