1.Application of fracture liaison service after augmentation surgery for vertebral fragility fracture
Zai-Hai YANG ; Qun-Bo WANG ; Yi-Ming QU ; Yang TANG ; Mei-Chao DENG ; Gao-Hai SHAO
Journal of Regional Anatomy and Operative Surgery 2024;33(5):435-439
Objective To evaluate the clinical application effect of fracture liaison service(FLS)mode after percutaneous vertebroplasty(PVP)/percutaneous kyphoplasty(PKP)for thoracolumbar fragility fracture.Methods A prospective study was conducted,and 762 patients with thoracolumbar fragility fracture who underwent PVP/PKP in the department of orthopedics in our hospital from January 2018 to May 2021 were included and divided into the control group(374 cases)and the observation group(388 cases)according to the random number table method.Patients in the control group received routine osteoporosis intervention,while the patients in the observation group implemented FLS through Blue Bull Medical Care or Chronic Health APP on the basis of the control group to systematically manage the osteoporosis treatment after discharge.The follow-up lasted for 12 months,and the 8-item Morisky medication adherence scale(MMAS-8)score,pain visual analogue scale(VAS)score,Oswestry disability index(ODI)score and Hamilton depression rating scale(HAMD)score at discharge,and 6 months and 12 months after discharge of the two groups were compared.The incidences of re-fracture and constipation 6 months and 12 months after discharge of the two groups were compared.The Cobb angle and bone mineral density T-value of injured vertebrae 6 months and 12 months after discharge of the two groups were compared.Results There was no statistically significant difference in the MMAS-8 score,VAS score,ODI score or HAMD score at discharge of patients between the two groups(P>0.05).The VAS score,ODI score and HAMD score 6 months and 12 months after discharge in the observation group were lower than those in the control group(P<0.05),the MMAS-8 score in the observation group was higher than that in the control group(P<0.05),and the incidences of re-fracture and constipation in the observation group were lower than those in the control group(P<0.05).There was no statistically significant difference in the Cobb angle of injured vertebrae 12 months after discharge of patients between the two groups(P>0.05).The bone mineral density T-value 12 months after discharge in the observation group was higher than that in the control group(P<0.05).Conclusion The FLS mode can significantly improve the medication compliance of patients,relieve pain,depression and constipation,improve bone mineral density,and significantly reduce the incidence of vertebral re-fracture in patients after vertebral augmentation surgery;however,it has no significant effect on the Cobb angle of injured vertebrae.
2.Advances in the classification and treatment of isolated superior mesenteric artery dissection.
Chao Chen WANG ; Yu Dong SUN ; Xiao Long WEI ; Zai Ping JING ; Zhi Qing ZHAO
Chinese Journal of Surgery 2023;61(1):81-85
Isolated superior mesenteric artery dissection (ISMAD) has attracted more and more clinicians' attention in recent years. Patients onset of ISMAD often present with abdominal pain. The misdiagnosis or miss diagnosis is common because of the non-specific symptoms and signs, which even can endanger lives in serious cases. Imaging classification is of great significance for diagnosis and treatment of ISMAD. The Sakamoto classification and the Yun classification are two classical classified methods. However, with the further study of ISMAD, various new classifications emerge. Conservative treatment was once considered as the preferred. As the rapid development of endovascular therapy and the great progress of new devices, stenting therapy can significantly improve symptoms and achieve satisfactory long-term effects, and be even expected to become the preferred method for clinical therapy of ISMAD. However, the long-term effects of endovascular therapy still need a large number of follow-up data, and complications after stent implantation can't be ignored.
Humans
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Mesenteric Artery, Superior
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Treatment Outcome
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Tomography, X-Ray Computed
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Aortic Dissection/therapy*
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Stents
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Endovascular Procedures
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Retrospective Studies
3.Prognostic values of stromal tumor-infiltrating lymphocytes and lymphocyte-activation gene-3 in advanced gastric adenocarcinoma.
Zhi Da WU ; Jian Chao WANG ; He Jun ZHANG ; Jie Qiong LIN ; Zai Zeng WU ; Xiong Wei ZHENG ; Gang CHEN
Chinese Journal of Pathology 2022;51(10):1007-1012
Objective: To analyze density of stromal tumor-infiltrating lymphocytes (sTIL) and expression of lymphocyte-activation gene-3 (LAG-3) protein in advanced gastric adenocarcinomas, and to investigate the correlation of sTIL and LAG-3 with the prognosis in patients with advanced gastric adenocarcinoma. Methods: The clinicopathological characteristics and follow-up data of 260 patients with advanced gastric adenocarcinoma were collected at Fujian Cancer Hospital, from January 2011 to December 2014. The percentage of sTILs was reported semi-quantitatively using histological section evaluation, the LAG-3 protein was detected using immunohistochemistry, and the expression was correlated with the clinicopathological features and patient outcomes. Results: Among the 260 cases, high density of sTIL was detected in 173 cases (66.5%) while LAG-3 high expression was observed in 160 cases (61.5%). These cases were divided into four groups. Group Ⅰ: 48 cases (18.5%) were sTIL low/LAG-3 low; group Ⅱ: 52 cases (20.0%) were sTIL high/LAG-3 low; group Ⅲ: 39 cases (15.0%) were sTIL low/LAG-3 high; group Ⅳ: 121 cases (46.5%) were sTIL high/LAG-3 high. Kaplan-Meier survival analyses showed that patient prognoses were related to age, tumor size, tumor location, Lauren classification, perineural invasion, vascular invasion, TNM staging, postoperative adjuvant chemotherapy and molecular classification (P<0.05). Meanwhile, higher densities of sTIL and higher expression of LAG-3 were associated with better prognosis. Multivariate survival analysis showed age, tumor size, Lauren classification and postoperative adjuvant chemotherapy were independent prognostic factors for patient survival. The results showed a poor prognosis in low-sTIL/low-LAG-3 patients. Conclusions: Compared with low density of sTIL and low expression of LAG-3, high density of sTIL and high expression of LAG-3 are associated with better outcomes in patients with advanced gastric adenocarcinoma, respectively. Combined detecton of sTIL and LAG-3 may be more useful in gastric cancer than using either alone. Age, tumor size, Lauren classification and postoperative adjuvant chemotherapy are independent prognostic factors for patients with advanced gastric adenocarcinoma.
Adenocarcinoma/pathology*
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Humans
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Immunohistochemistry
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Lymphocytes, Tumor-Infiltrating/metabolism*
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Neoplasm Staging
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Prognosis
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Retrospective Studies
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Stomach Neoplasms/pathology*
4.Forensic Analysis of 133 Cases of Knee Injuries.
Chao ZAI ; Ling Li ZHANG ; Fang Gang HE
Journal of Forensic Medicine 2020;36(5):688-690
Objective To discuss the types, characteristics, and the evaluation of disability of knee injuries. Methods The data of 133 cases of knee injury from 2017 to 2019 were collected and statistically analyzed according to the region of injury, the degree of disability, etc. Results One hundred and twenty-five cases of injury were compound, and 8 cases were simple. The incidences of ligament injury, meniscus injury and fracture were 88.72%, 75.19% and 57.89%, respectively. Of the cruciate ligament injuries, 12 cases were posterior cruciate ligament injury while 51 cases were anterior cruciate ligament injury, and the differences between the two kinds of injury had statistical significance (P<0.05); 32 cases were secondary traumatic arthritis. The rates of disability of knee injuries were 38.35% (Grade Ⅸ and Ⅹ). Conclusion Compound knee injuries are common, and traumatic arthritis has a relatively high rate. Multiple injuries can affect the stability and weight-bearing of the knee joint. It is suggested that in addition to evaluating the range of motion of knee joint, multiple factors should be considered to assess disability.
Anterior Cruciate Ligament
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Anterior Cruciate Ligament Injuries/epidemiology*
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Humans
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Knee Injuries/epidemiology*
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Knee Joint
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Posterior Cruciate Ligament
5.Diversity, antibacterial activites and growth promoting characteristics of endophytic fungi from sandal (Santalum album).
Jun LIU ; Yan-Ming LIU ; Zai-Chao XU ; Zhuo-Ya WANG ; Ya-Li HUANG ; Zu-Jun DENG
China Journal of Chinese Materia Medica 2018;43(17):3477-3483
The aim of this study was to investigated the biological diversity, antibacterial activites and the plant growth-promoting traits of endophytic fungi of sandal (Santalum album), and to assess their potential in the development of antibacterial substances and rapid cultivation of sandal. The results of isolation and taxa analysis of endophytic fungi from sandal showed that 325 strains of endophytic fungi belonging to 16 genera of endophytic fungi were isolated from sandal (of which 86 from roots, 105 from stems and 134 from leaves). The isolation rate and colonization rate of endophytic fungi in different sandal parts showed the same pattern of change: leave>stems>roots. The diversity index of endophytic fungi in sandal roots was significantly higher than that of stems and leaves. The dominant endophytic fungi of sandal roots, stems and leaves showed significant differences. The dominant endophytic fungi of roots were Fusarium (50.00%) and Alternaria (10.47%), Alternaria (58.11%) and Acremonium (20.00%) for stems, and Pantoea (74.63%) for leaves. The antibacterial activity of 40 representative strains of sandal endophytic fungi were analyzed and the results showed that 90% of endophytic fungi exhibited inhibitory activity against at least one of the tested bacteria strains, and the strains with inhibitory activity to Escherichia coli, Enterobacter aerogenes, Shigella dysenteriae, Salmonella typhimurium, Staphylococcus aureus, and Bacillus subtilis accounted for 45.0%, 30%, 47.5%, 55%, 72.5%, and 62.5%, respectively. The sandal fungal endophytes with plant growth-promoting characteristics were screened, and 5 strains of endophytic fungi with phosphorus-solubilizing activity, 8 strains of endophytic fungi producing IAA, and 4 strains of endophytic fungi producing siderophores were found. Among them, endophytic fungus Monilia sp TXRF45 clould produced IAA and siderophores, and also show phosphate-solubilizing activity. The results indicated that the endophytic fungi of Sandal were rich in species diversity and their distribution had a certain tissue specificity. Some strains showed good antibacterial activity and growth-promoting properties, which could potentially applicable for the development of antibacterial substances and rapid cultivation of sandal.
6.DNA Methylation and Uveal Melanoma.
Zhi-Kun YANG ; Jing-Yun YANG ; ; Zhuo-Zai XU ; Wei-Hong YU
Chinese Medical Journal 2018;131(7):845-851
ObjectiveThe objective of the study was to summarize the role of DNA methylation in the development and metastasis of uveal melanoma (UM).
Data SourcesThe relevant studies in MEDLINE were searched.
Study SelectionIn this review, we performed a comprehensive literature search in MEDLINE using "uveal melanoma" AND ("DNA methylation" OR "epigenetics") for original research/review articles published before February 2018 on the relationship between DNA methylation and UM. References of the retrieved studies were also examined to search for potentially relevant papers.
ResultsPrevious studies on the relationship between DNA methylation and UM covered many genes including tumor suppressor genes (TSGs), cyclin-dependent kinase genes, and other genes. Among them, the TSG genes such as RASSF1A and p16INK4a, which encodes a cyclin-dependent kinase inhibitor, are relatively well-studied genes. Specifically, a high percentage of promoter methylation of RASSF1A was observed in UM cell lines and/or patients with UM. Promoter methylation of RASSF1A was also associated with the development of metastasis. Similarly, a high percentage of promoter hypermethylation of p16INK4a was found in UM cell lines. DNA promoter methylation can control the expression of p16INK4a, which affect cell growth, migration, and invasion in UM. Many other genes might also be involved in the pathogenesis of UM such as the Ras and EF-hand domain containing (RASEF) gene, RAB31, hTERT, embryonal fyn-associated substrate, and deleted in split-hand/split-foot 1.
ConclusionsOur review reveals the complex mechanisms underlying the tumorigenesis of UM and highlights the great needs of future studies to discover more genes/5'-C-phosphate-G-3' sites contributing to the development/metastasis of UM and explore the mechanisms through which epigenetic changes exert their function in UM.
Cell Transformation, Neoplastic ; genetics ; DNA Methylation ; genetics ; Epigenesis, Genetic ; genetics ; Humans ; Melanoma ; genetics ; Promoter Regions, Genetic ; genetics ; Uveal Neoplasms ; genetics
7.Forensic analysis of 109 cases of traumatic visual loss
Chinese Journal of Forensic Medicine 2017;32(1):63-65
Objective To analyze types, mechanism and forensic identification for traumatic visual loss. Methods 109 cases of the evaluation for impairment and disability on traumatic visual loss were retrospectively analyzed, including interocular differences, anisometropia, left or right eye and the distributions of visual acuity, etc. Results The male-to-female ratio was 5.8:1, mainly 30~59 years of age. The ratio of monocular versus binocular injuries was 17.17:1. The ratio of left versus right injured eye was 1.39:1 in intentional injury cases. 115 eyes were injured, 83 of which were in low vision or blindness. 95 patients(87.16%) had large interocular differences( ≥ 3 lines). There were 9 patients with anisometropia from 2.25D to 6.00D and 23 patients with anisometropia larger than 6.00D. Conclusion Interocular differences and anisometropia are common in practice, which are not included in the expertise standard yet. Functional vision should be considered when developing the expertise standard.
8.Analysis on the Difficulty and the Countermeasures in the Process of Preparation and Revision of Traditional Chinese Medicine Nursing Management Information Standard
chao Zai WANG ; Qiong ZHOU ; Ying HU ; wu Shao SHEN
Journal of Medical Informatics 2017;38(8):59-63
The paper introduces the research background of preparation and revision of Traditional Chinese Medicine (TCM) nursing management information standard,analyzes the difficulties in the process of preparation and revision of the standard,including the building of the nursing management information model,handling of problems of multi-source and interdisciplinary management information,embodiment of features of TCM and innovation of the current health information standard,and puts forward countermeasures to solve corresponding problems on this basis.
9.Study on binocular acuity and the effect on disability evaluation
Chao ZAI ; Lan WANG ; Yu WANG ; Guangfeng WU
Chinese Journal of Forensic Medicine 2016;31(4):373-375
Objective To research the relationship between binocular acuity and monocular acuity,and their effect on the evaluation of visual impairment and disability. Methods 1006 patients, aged between 18 and 60 years, are measured monocular and binocular acuities after the best lens correction. Results Binocular vision is higher than, equal to and less than monocular vision, three accounted for 27.14%, 70.78% and 70.78% respectively. Interocular difference has certain correlation with binocular interactions (χ2=54.939,P<0.05,r=0.228). Thirty-three patients have same binocular acuity but different monocular acuity. Conclusion Binocular acuity associated with the monocular acuity and the better eye vision plays a special role in visual disability evaluation.
10.Progress on treatment of transverse patella fractures with tension band fixation.
Xiu-ling YU ; Chao XU ; Shun-dong LI ; Jian-dong ZHAN ; Zai-qiang XU
China Journal of Orthopaedics and Traumatology 2015;28(11):1069-1074
Transverse fracture is the most common in patella fracture and tension band fixation is one of the most effective methods. Surgical wire tension band technique is simple, the use of materials is also simple, but it is not strong and difficult to promote. Kirschner tension band technique can get satisfactory reduction with reliable fixation, but it is easy to complicate with steel wire breakage and Kirschner loosening. Screw tension band technique inherits the traditional advantages of simple manipulation and reliable fixation, also overcomes the disadvantages of early activity limitations caused soft tissue irritation of tension band around knee, the slippage and breakage of internal fixation, and the technique can be popularized generally.
Bone Wires
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Fracture Fixation, Internal
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methods
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Humans
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Patella
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injuries
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surgery
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Stress, Mechanical

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