Objective    To compare and analyze the postoperative quality of life in patients after minimally invasive coronary artery bypass grafting (MICABG) and conventional median thoracotomy off-pump coronary artery bypass grafting surgery (OPCABG). Methods    From November 2015 to January 2018, 94 patients who underwent MICABG in the Peking University Third Hospital were included in the MICABG group. During the same period 441 patients who received OPCABG were included in the OPCABG group. The patients were matched by using propensity score matching method with a ratio of 1∶1. The quality of life was compared between two groups at 1 month, 6 months and 12 months after the surgery using SF-36 scale. Results    A total of 82 patients were matched for each group. In the MICABG group, there were 66 males and 16 females with a mean age of 62.6±8.2 years. In the OPCABG group, there were 67 males and 15 females with a mean age of 63.2±13.2 years. One month after the operation, the physical health assessment (PCS) and mental health assessment (MCS) of the MICABG group were higher than those of the OPCABG group (50.3±10.6 points vs. 46.1±10.3 points, P=0.011; 59.5±9.3 points vs. 54.2±11.0 points, P=0.002). Scores of these following five dimensions: general health, physical functioning (PF), role-physical, social functioning (SF), role-emotion in the MICABG group were higher than those in the OPCABG group, while the score of body pain was inferior to that in the OPCABG group, and the differences were statistically significant (P<0.05). Six months after the surgery, the PCS and MCS of the two groups were not statistically different (80.0±13.1 points vs. 77.8±12.4 points, P=0.271; 81.6±13.5 points vs. 80.4±11.2 points, P=0.537). However, the scores of PF and SF in the MICABG group were still higher than those in the OPCABG group (P<0.05). Twelve months after the surgery, there was no statistical difference in the score of each dimension between the two groups (P>0.05). Conclusion    The improvement of quality of life within 6 months after MICABG is better than that of OPCABG, and it is similar between the two groups at 12 months after the surgery, indicating that MICABG has a certain effect of improving the short-term quality of life after the surgery, and the long-term quality of life is comparable to conventional surgery.

Objective:To investigate serum C-reactive protein (CRP) , procalcitonin (PCT) and neutrophil CD64 in predicting early infection after internal fixation of limb fractures.Methods:A total of 2 572 patients with limb fractures undergoing internal fixation in Taishun County People’s Hospital from January 2016 to December 2022 were enrolled. Postoperative infection occurred in 121 cases (infected group) and did not occur in 2 451 cases (uninfected group). Serum levels of PCT, CRP and CD64 were tested at admission and d1, d3, d5 and d7 after operation. Repeated measurement analysis of variance was used to compare the serum levels of PCT, CRP and CD64 at different time points between two groups, the receiver operating characteristic curve (ROC) was used to evaluate the predictive value of each index or in combination for early infection after internal fixation of limbs fractures.Results:The early infection rate after internal fixation was 4.70% (121/2 572). The levels of PCT, CRP and CD64 in the infection group began to rise after operation and decreased on d7; there were significant differences in PCT, CRP and CD64 levels between the two groups on d3, d5 and d7 after operation (PCT: Ftime=678.607, Fintergroup=2 218.323, Finteraction=653.150; CRP: Ftime=392.724, Fintergroup=1 812.502, FInteraction =379.577; CD64: Ftime=373.686, Fintergroup=4 817.438, Finteraction=528.353, all P< 0.001) . The area under the ROC curve of combined detection of PCT, CPR, and CD64 for predicting early infection was 0.856; the sensitivity and specificity of combined detection were 69.2% and 94.7%, respectively. The combined detection of three indicators showed better prediction values than PCT, CRP and CD64 alone ( Z=6.176, 3.838 and 2.431, P<0.01 or <0.05), and also better than combined detection of PCT and CRP ( Z=2.875, P=0.019). Conclusions:The combined detection of CD64, PCT and CRP is of value in prediction of postoperative infection after internal fixation of limb fractures, which is worthy of clinical application.

With the multi-directional differentiation potential such as osteogenic differentiation, chondrogenic differentiation and adipogenic differentiation, mesenchymal stem cells (MSCs) have been widely used in basic research and clinical applications. The differentiation potential of MSCs is altered during senescence. Osteogenic differentiation potential decreases, while the lipogenic differentiation potential increases in aging MSCs. Changes in differentiation potential of MSCs during senescence are accompanied with cell physical heterogeneity variation (cell size, cell stiffness and nucleoplasmic ratio). Studies have shown that changes in physical heterogeneity of stem cells may be a key factor leading to the differences in differentiation potential of MSCs. Therefore, studies on physical heterogeneity variation of MSCs during senescence will provide a new research direction in fate prediction of stem cell. In this review, the effects of physical heterogeneity variation on differentiation potential of MSCs were summarized, and the corresponding mechanism was also discussed.

Objective:To review the treatment experience of extremely premature infants (EPIs) with gestational age (GA) <23 weeks.Methods:From January to November 2021, EPIs with GA<23 weeks treated in our hospital was retrospectively analyzed.Results:A total of 3 patients with GA of 22 weeks were reviewed, including 2 boys and 1 girl. Their birth weight (BW) was 450~498 g. The duration of hospitalization was 112~126 d. The treatment included early "gentle" management strategies, respiratory management, anti-infection, patent ductus arteriosus treatment and parenteral + enteral nutrition. All 3 infants were discharged from the hospital without further oxygen therapy. All had satisfying oral feeding with no neurological sequelae on follow-up.Conclusions:Early "gentle" management is the key to successful treatment and good prognosis for EPIs with GA<23w

Biochemistry/history* ; China ; Exercise/physiology* ; History, 20th Century ; History, 21st Century ; Humans ; Sports Medicine/history*

BACKGROUND:Total knee arthroplasty is the main treatment for end-stage knee disease.However,knee prostheses are mostly imported from overseas,making the price expensive.Furthermore,ethnic differences mean that these prostheses designed for westerners are not designed to meet the needs of Orientals.OBJECTIVE:To verify the efficacy and safety of this novel knee prosthesis in total knee arthroplasty.METHODS:We propose to conduct a prospective,single-center,randomized,positive parallel controlled,non-inferiority,clinical trial at Shiyan Taihe Hospital,China.Seventy-two patients with knee disease who are scheduled to undergo knee arthroplasty will be equally randomized into the trial group or the control group using a randomized block design.The trial and control groups will undergo knee arthroplasty with knee prostheses purchased from Wuhan Yijiabao Biomaterial Co.,Ltd.,Wuhan,China (newly developed) and Beijing AKEC Medical Co.,Ltd.,Beijing,China (approved by the China Food and Drug Administration),respectively.All patients will be followed up for 12 months.The primary outcome will be the recovery of knee function as assessed by the rate of excellent and good Hospital for Special Surgery knee scores at postoperative 12 months (± 15 days).The secondary outcomes will be:the morphology of the knee as revealed by anteroposterior and lateral radiographic views taken preoperatively,and at postoperative 2 weeks (± 5 days),6 weeks (± 15 days),3 months (± 15 days),6 months (± 15 days),and 12 months (± 15 days);the incidence of adverse reactions at postoperative 2 weeks (± 5 days),6 weeks (± 15 days),3 months (± 15 days),6 months (± 15 days),and 12 months (± 15 days);and the correlation between various types of adverse reactions and each knee prosthesis type.This trial has been registered at ClinicalTrials.gov (identifier:03184129).The study protocol has been approved by the Ethics Committee of Taihe Hospital of China (approval number:2016 (34)).All protocols will be performed in accordance with the Ethical Principles for Medical Research Involving Human Subjects in the Declaration of Helsinki.Written informed consent was provided by each patient and their family members after they indicated that they fully understood the treatment plan.DISCUSSION:Participant recruitment began in February 2017 and will be finished in September 2017.Data analysis will be completed in November 2018.Wuhan Yijiabao Biomaterial Co.,Ltd.has developed a new knee prosthesis system.This system uses cobalt-chrome-molybdenum and high cross-linked polyethylene as the active friction interface,which has excellent wear resistance.This trial is designed to verify the efficacy and safety of this novel knee prosthesis in total knee arthroplasty.

Objective To compare the clinical effects of proximal femoral nail antirotation (PFNA) and dynamic hip screw (DHS) in the treatment of intertrochanteric fractures in elderly patients.And provide a reasonable basis for clinical treatment of elderly patients with intertrochanteric fractures.Methods The clinical and follow-up records of 58 elderly patients with intertrochanteric fractures treated by PFNA and DHS were retrospectively reviewed.For times of operation,blood loss in operation,length of incision,incidents of complication and Harris's hip functional standard score were compared and analyzed.Results PFNA group operation time[(59.61 ± 8.27)min],amount of bleeding[(234.51 ± 38.80)ml] were both better than the DHS group of[(83.54 ± 11.12)min and (446.57 ±54.01) ml] respectively.There were significant differences (t =9.80,18.10,all P ＜ 0.05).The satisfactory rate was 92.8％ in PFNA group,higher than the DHS group's 83.3 ％ (x2 =6.18,P ＜ 0.05).There was significant difference between two groups in the incident of complication,DHS group was higher.Conclusion PFNA internal fixation with a minimally invasive,fixed solid and recovery fast,is the better internal fixation in the treatment of elderly intertrochanteric fracture patients.

ObjectiveTo retrospectively evaluate the clinical efficacy of endoscopic submucosal tunnel resection for esophageal leiomyoma originating from muscularis propria.MethodsA total of 16 patients with esophageal mass originating from muscularis propria were recruited with informed consents from January 2011 to November 2011,and underwent esophageal submucosal tunneling endoscopic resection.ResultsAll lesions were completely resected.Histological examinations confirmed the diagnosis of leiomyona,and immunohistochemical staining indicated active hyperplasia in 9 cases.Intraoperative mediastinal,subcutaneous and retroperitoneal emphysema occurred in one patient,and the patient recovered one week later.No other complications or death were recorded.The patients were followed up for six months on average,and no cases of recurrence were found.ConclusionEndoscopic submncosal tunnel resection of esophageal leiomyoma originating from the muscularis propria is a minimally invasive,safe and effective procedure.

ObjectiveTo investigate the clinical value of endoscopic esophageal submucosal tunnel resection of gastric fundus-cardiac tumors originating from muscularis propria.Methods Clinical date of 18 patients with gastric fundus-cardiac submucosal tumors originating from muscularis propria who underwent endoscopic esophageal submucosal tunnel resection from January 2011 to December 2011 were retrospectively collected and analyzed.ResultsAll lesions were successfully and completely resected in 18 patients,with sizes ranging from 0.7 cm to 7.2 cm,mean (2.43 ± 1.91 ) cm.Pneumoretroperitoneum,pneumomediastinum and pneumohypoderma occured during the procedure in 2 cases,but spontaneously resolved in 3 days.Fever with increased WBC within 24 h after the procedure occurred in one patient,and was cured in two days with antibiotics.There were no severe complications including bleeding,perforation or death.All patients could have liquid diet 3 days later after the operation.Follow-up endoscopy at 1 week after the operation showed a healing of esophageal incision.ConclusionEndoscopic esophageal submucosal tunnel resection is a safe and effective method for gastric fundus-cardiac submucosal tumors originating from the muscularis propria,lessening the difficulty of traditional endoscopic resection.

OBJECTIVETo investigate the effect of calcium supplementation on bone mineral density (BMD) in Chinese women with different FokI vitamin D receptor (VDR) genotypes (FF, Ff, and ff) after weaning or resumption of menstruation during lactation.

METHODSA total of 40 subjects with the same FokI VDR genotype were randomly divided into two groups: one received calcium tablet (600 mg once daily as CaCO(3)) and the other placebo tablet once daily for 1 year. At baseline, BMD was measured by dual-energy X-ray absorptiometry at lumbar spine (L2-L4) and at left hip whereas serum PICP, serum OC, and urinary CTX, serum 25(OH)VitD(3), and serum estradiol were measured at weaning and 1 year thereafter.

RESULTSAfter the intervention, BMD at lumbar spine and at left hip increased significantly in all these women with a trend among different FokI VDR genotypes such as FF > Ff > ff (P<0.05, <0.01, and <0.001, respectively). BMD at lumbar spine in women with FF VDR genotype increased much more rapidly than in those with ff VDR genotype (P<0.05). Compared with the control group women with the FF genotype regained more BMD after calcium supplementation (P<0.05).

CONCLUSIONDaily calcium 600 mg supplementation has beneficial effect on the bone health of women with FF VDR genotype.

Adult ; Asian Continental Ancestry Group ; Bone Density ; drug effects ; Calcium, Dietary ; administration & dosage ; pharmacology ; Female ; Genotype ; Humans ; Menstruation ; physiology ; Weaning ; Young Adult