[Objective] To explore the relationship between neutrophil activation under cardiopulmonary bypass (CPB) and the incidence of cardiac surgery-associated acute kidney injury (CS-AKI). [Methods] This prospective cohort study enrolled adult patients who scheduled for cardiac surgery under CPB at West China Hospital between May 1, 2022 and March 31, 2023. The primary outcome was acute kidney injury (AKI). Blood samples (5 mL) were obtained from the central vein before surgery, at rewarming, at the end of CPB, and 24 hours after surgery. Neutrophils were labeled with CD11b, CD54 and other markers. To assess the effect of neutrophils activation on AKI, propensity score matching (PSM) was employed to equilibrate covariates between the groups. [Results] A total of 120 patients included into the study, and 17 (14.2%) developed AKI. Both CD11b⁺ and CD54⁺ neutrophils significantly increased during the rewarming phase and the increases were kept until 24 hours after surgery. During rewarming, the numbers of CD11b⁺ neutrophils were significantly higher in AKI compared to non-AKI (4.71×10⁹/L vs 3.31×10⁹/L, Z=-2.14, P<0.05). Similarly, the CD54⁺ neutrophils counts were also significantly higher in AKI than in non-AKI before surgery (2.75×10⁹/L vs 1.79×10⁹/L, Z=-2.99, P<0.05), during rewarming (3.12×10⁹/L vs 1.62×10⁹/L, Z=-4.34, P<0.05), and at the end of CPB (4.28×10⁹/L vs 2.14×10⁹/L, Z=-3.91, P<0.05). An analysis of 32 matched patients (16 in each group) revealed that CD11b⁺ and CD54⁺ neutrophil levels of AKI were 1.74 folds (4.83×10⁹/L vs 2.77×10⁹/L, Z=-2.72, P<0.05) and 2.34 folds (3.32×10⁹/L vs 1.42×10⁹/L, Z=-4.12, P<0.05), respectively, of non-AKI at rewarming phase. [Conclusion] Neutrophils are activated during CPB, and they can be identified by CD11b/CD54 markers. The activated neutrophils of AKI patients are approximately 2 folds of non-AKI during the rewarming phase, with disparity reached peak between groups during rewarming. These findings suggest the removal of 50% of activated neutrophils during the rewarming phase may be effective to reduce the risk of AKI.

OBJECTIVE: To investigate short-term effectiveness of robot-assisted fracture reduction and fixation combined with arthroscopic exploration for posterolateral depressed tibial plateau fractures. METHODS: Between January 2022 and January 2024, 8 patients with posterolateral depressed tibial plateau fractures (Schatzker type Ⅲ) were treated using robot-assisted fracture reduction and fixation combined with arthroscopic exploration, with simultaneous treatment of concomitant ligament or meniscus tears. There were 3 males and 5 females with an average age of 54.1 years (range, 42-68 years). Injury mechanisms included traffic accidents (3 cases) and falls (5 cases). The time from injury to operation ranged from 2 to 4 days (mean, 3.1 days). Operation time, intraoperative blood loss, hospital stay duration, visual analogue scale (VAS) score for pain, and complications were recorded. Fracture healing and knee Rasmussen scores were assessed radiographically, while knee function was evaluated using range of motion and Hospital for Special Surgery (HSS) scores. RESULTS: All operations were successfully completed. The operation time was 108-129 minutes (mean, 120.1 minutes). The intraoperative blood loss was 10-100 mL (mean, 41.3 mL). The hospital stay duration was 4-7 days (mean, 5.6 days). All incisions healed by first intention without complication such as peroneal nerve injury, vascular damage, or infection. All patients were followed up 32-48 weeks (mean, 40 weeks). Radiographic follow-up confirmed that the knee Rasmussen scores rated as excellent in 8 patients and all fractures healed with the healing time of 12-16 weeks (mean, 13.5 weeks). The VAS score for pain was 2-4 (mean, 2.8) at discharge and improved to 0 at 1 month after operation. The knee range of motion was 80°-110° (mean, 96.1°) at discharge and increased to 135°-140° (mean, 137.9°) at 1 month after operation. At 3 months after operation, the HSS score was 91-94 (mean, 92.8), all graded as excellent. No severe complication, including implant failure, occurred during follow-up. CONCLUSION For posterolateral depressed tibial plateau fractures, the minimally invasive approach combining robot-assisted fracture reduction and fixation with arthroscopic exploration demonstrates multiple advantages, including shorter operation time, reduced intraoperative blood loss, excellent wound healing, fewer complications, and rapid recovery of knee function. This technique achieves satisfactory short-term effectiveness, while its long-term effectiveness requires further evaluation.
Humans ; Male ; Tibial Fractures/surgery* ; Female ; Middle Aged ; Adult ; Arthroscopy/methods* ; Minimally Invasive Surgical Procedures/methods* ; Fracture Fixation, Internal/methods* ; Aged ; Treatment Outcome ; Robotic Surgical Procedures/methods* ; Operative Time ; Range of Motion, Articular ; Fracture Healing ; Length of Stay ; Tibial Plateau Fractures

Objective To investigate the predictive value of preoperative blood inflammatory markers for the recurrence risk in patients with basal cell carcinoma(BCC).Methods A total of 225 patients with BCC were divided into the high-risk recurrence group(155 cases)and the low-risk recurrence group(70 cases).General information and preoperative hematological indicators were collected in the two groups of patients.The neutrophil-to-lymphocyte ratio(NLR),lymphocyte-to-monocyte ratio(LMR),systemic inflammation marker(SIM)and platelet-to-lymphocyte ratio(PLR)were calculated.Receiver operating characteristic(ROC)curves were used to determine the predictive value of hematological markers with statistically significant differences between the two groups for BCC recurrence and to establish optimal cutoff values.Univariate and multivariate Logistic regression analyses were conducted to identify factors influencing BCC recurrence.A multivariate Logistic regression model was established to predict the recurrence risk of BCC.Area under the curve(AUC)and the Hosmer-Lemeshow test were used to evaluate the prediction efficiency and goodness-of-fit of the model.Results ROC analysis identified that optimal cutoff values for LMR and SIM were 5.12 and 0.86,respectively.Univariate Logistic regression analysis showed that LMR,SIM,ulceration at the primary tumor site,UV exposure and tumor maximum diameter were factors influencing BCC recurrence.Multivariate Logistic regression revealed that SIM≥0.86,tumor maximum diameter≥2.0 cm and UV exposure were risk factors for BCC recurrence,while LMR≥5.12 had a protective effect.The Logistic prediction model for BCC recurrence risk was Logit(P)=-1.598-1.517×LMR+1.323×SIM+2.406×UV exposure+3.465×tumor maximum diameter,with good model fit(P=0.725)and an AUC of 0.869(95%CI:0.822-0.917)for predicting BCC recurrence risk.Conclusion Monitoring preoperative LMR and SIM levels can assist in assessing the risk of recurrence in BCC patients and provide important guidance for clinical decision-making.

Objective To explore the correlation between serum levels of miR-193a-3p,activated transcription factor 5(ATF5),clinicopathological characteristics and chemotherapy efficacy in patients with triple negative breast cancer(TNBC).Methods A total of 120 patients with TNBC admitted to our hospital were collected as the research group.In the same period,120 cases with benign breast disease in our hospital were selected as the control group.Serum levels of miR-193a-3p and ATF5 were detected,and the relationship between them and clinicopathological characteristics were detected in two groups.According to the therapeutic effect,TNBC patients were divided into the treatment ineffective group(n=50)and the treatment effective group(n=70).The expression levels of miR-193a-3p and ATF5 were compared between the two groups,and factors affecting the chemotherapy efficacy of TNBC patients were analyzed.Results Compared with before chemotherapy,the serum miR-193a-3p level increased and ATF5 level decreased in TNBC patients after chemotherapy(P＜0.05).Compared with the control group,the serum miR-193a-3p level of TNBC patients decreased in the research group before chemotherapy,and ATF5 level increased(P＜0.05).The expression level of miR-193a-3p was lower and the expression level of ATF5 was higher in patients with tumor diameter≥3 cm,lymph node metastasis,low histological grade,clinical stage Ⅲ and Ki-67＞30%(P＜0.05).In TNBC patients,compared with the treatment effective group,patients in the treatment ineffective group showed a decreased serum miR-193a-3p level and an increased ATF5 level(P＜0.05).Lower level of miR-193a-3p,higher level of ATF5,lymph node metastasis,tumor diameter≥3 cm,low histological grade,and TNM stage Ⅲ were risk factors affecting the efficacy of chemotherapy in TNBC patients(P＜0.05).Conclusion Low level of miR-193a-3p and high level of ATF5 in the serum of TNBC patients are risk factors for chemotherapy efficacy.

Objective:To isolate a potassium ion channel Kv4.1 inhibitor from centipede venom,and to determine its sequence and structure.Methods:Ion-exchange chromatography and reversed-phase high-performance liquid chromatography were performed to separate and purify peptide components of centipede venom,and their inhibiting effect on Kv4.1 channel was determined by whole-cell patch clamp recording.The molecular weight of isolated peptide Kv4.1 channel inhibitor was identified with matrix assisted laser desorption ionization-time-of-flight mass spectrometry;its primary sequence was determined by Edman degradation sequencing and two-dimensional mass spectrometry;its structure was established based on iterative thread assembly refinement online analysis.Results:A peptide SsTx-P2 was separated from centipede venom with the molecular weight of 6122.8,and its primary sequence consists of 53 amino acid residues NH2-ELTWDFVRTCCKLFPDKSECTKACATEFTGGDESRLKDVWPRKLRSG DSRLKD-OH.Peptide SsTx-P2 potently inhibited the current of Kv4.1 channel transiently transfected in HEK293 cell,with 1.0 μmol/L SsTx-P2 suppressing 95%current of Kv4.1 channel.Its structure showed that SsTx-P2 shared a conserved helical structure.Conclusion:The study has isolated a novel peptide SsTx-P2 from centipede venom,which can potently inhibit the potassium ion channel Kv4.1 and displays structural conservation.

Objective:To isolate a potassium ion channel Kv4.1 inhibitor from centipede venom,and to determine its sequence and structure.Methods:Ion-exchange chromatography and reversed-phase high-performance liquid chromatography were performed to separate and purify peptide components of centipede venom,and their inhibiting effect on Kv4.1 channel was determined by whole-cell patch clamp recording.The molecular weight of isolated peptide Kv4.1 channel inhibitor was identified with matrix assisted laser desorption ionization-time-of-flight mass spectrometry;its primary sequence was determined by Edman degradation sequencing and two-dimensional mass spectrometry;its structure was established based on iterative thread assembly refinement online analysis.Results:A peptide SsTx-P2 was separated from centipede venom with the molecular weight of 6122.8,and its primary sequence consists of 53 amino acid residues NH2-ELTWDFVRTCCKLFPDKSECTKACATEFTGGDESRLKDVWPRKLRSG DSRLKD-OH.Peptide SsTx-P2 potently inhibited the current of Kv4.1 channel transiently transfected in HEK293 cell,with 1.0 μmol/L SsTx-P2 suppressing 95%current of Kv4.1 channel.Its structure showed that SsTx-P2 shared a conserved helical structure.Conclusion:The study has isolated a novel peptide SsTx-P2 from centipede venom,which can potently inhibit the potassium ion channel Kv4.1 and displays structural conservation.

Objective: To investigate the relationship between total homocysteine (tHcy) levels and sarcopenia among the elderly, so as to provide insights into the prevention and treatment of sarcopenia. Methods: The elderly aged 65 years and older who participated in the physical examination of Shibantan Township Health Center in Xindu District, Chengdu City from April to June 2021 was selected as the study subjects. The elderly with sarcopenia (diagnosed according to the diagnostic criteria of the Asian Sarcopenia Working Group in 2019) and non-sarcopenia were matched 1︰1 by gender and age (±2 years). Demographic information, skeletal muscle mass, skeletal muscle strength and tHcy were collected through questionnaire surveys, physical examination and laboratory testing. Multivariable conditional logistic regression model was used to explore the relationship between tHcy and sarcopenia. Results: A total of 320 individuals, including 160 sarcopenia patients and 160 non-sarcopenia individuals, were investigated. There were 138 males (43.13%) and 182 females (56.87%), with a median age of 71.00 (interquartile range, 6.00) years. There were 57 drinkers (17.81%), 78 smokers (24.37%), 173 cases of hypertension (54.06%) and 124 cases of hyperhomocysteinemia (38.80%). Multivariable conditional logistic regression analysis showed that elevated tHcy was associated with an increased risk of sarcopenia (OR=1.107, 95%CI: 1.024-1.197), after adjusting for smoking, alcohol consumption, hypertension, waist circumference, neck circumference, body mass index, platelet count and high density lipoprotein cholesterol. Conclusion Elevated tHcy is associated with sarcopenia, and intervention should be carried out for the elderly with higher tHcy.

Objective:To isolate a potassium ion channel Kv4.1 inhibitor from centipede venom,and to determine its sequence and structure.Methods:Ion-exchange chromatography and reversed-phase high-performance liquid chromatography were performed to separate and purify peptide components of centipede venom,and their inhibiting effect on Kv4.1 channel was determined by whole-cell patch clamp recording.The molecular weight of isolated peptide Kv4.1 channel inhibitor was identified with matrix assisted laser desorption ionization-time-of-flight mass spectrometry;its primary sequence was determined by Edman degradation sequencing and two-dimensional mass spectrometry;its structure was established based on iterative thread assembly refinement online analysis.Results:A peptide SsTx-P2 was separated from centipede venom with the molecular weight of 6122.8,and its primary sequence consists of 53 amino acid residues NH2-ELTWDFVRTCCKLFPDKSECTKACATEFTGGDESRLKDVWPRKLRSG DSRLKD-OH.Peptide SsTx-P2 potently inhibited the current of Kv4.1 channel transiently transfected in HEK293 cell,with 1.0 μmol/L SsTx-P2 suppressing 95%current of Kv4.1 channel.Its structure showed that SsTx-P2 shared a conserved helical structure.Conclusion:The study has isolated a novel peptide SsTx-P2 from centipede venom,which can potently inhibit the potassium ion channel Kv4.1 and displays structural conservation.

Objective:To isolate a potassium ion channel Kv4.1 inhibitor from centipede venom,and to determine its sequence and structure.Methods:Ion-exchange chromatography and reversed-phase high-performance liquid chromatography were performed to separate and purify peptide components of centipede venom,and their inhibiting effect on Kv4.1 channel was determined by whole-cell patch clamp recording.The molecular weight of isolated peptide Kv4.1 channel inhibitor was identified with matrix assisted laser desorption ionization-time-of-flight mass spectrometry;its primary sequence was determined by Edman degradation sequencing and two-dimensional mass spectrometry;its structure was established based on iterative thread assembly refinement online analysis.Results:A peptide SsTx-P2 was separated from centipede venom with the molecular weight of 6122.8,and its primary sequence consists of 53 amino acid residues NH2-ELTWDFVRTCCKLFPDKSECTKACATEFTGGDESRLKDVWPRKLRSG DSRLKD-OH.Peptide SsTx-P2 potently inhibited the current of Kv4.1 channel transiently transfected in HEK293 cell,with 1.0 μmol/L SsTx-P2 suppressing 95%current of Kv4.1 channel.Its structure showed that SsTx-P2 shared a conserved helical structure.Conclusion:The study has isolated a novel peptide SsTx-P2 from centipede venom,which can potently inhibit the potassium ion channel Kv4.1 and displays structural conservation.