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Objective:To investigate the relationship between wall shear stress (WSS) and the degree of lumen stenosis and plaque characteristics in patients with atherosclerotic stenosis in the middle brain.Methods:Thirty-four patients with moderate to severe unilateral middle cerebral artery stenosis in Nanjing First Hospital from June 2020 to June 2021 were analyzed retrospectively. All patients underwent routine magnetic resonance imaging and vascular wall imaging to obtain plaque parameters such as plaque area, remodeling mode and remodeling index. Based on magnetic resonance angiography, a computational fluid dynamics model was established to simulate the local hemodynamics near the lesion and quantify WSS. The patients were divided into high WSS group and low WSS group according to the median WSS. The differences of clinical baseline data, degree of lumen stenosis and plaque characteristics between the two groups were compared. Pearson correlation analysis was used to calculate the correlation between WSS and lumen stenosis and plaque characteristics.Results:A total of 34 patients were included in this study, 17 in the high WSS group and 17 in the low WSS group. Compared with the low WSS group, the plasma homocysteine level in the high WSS group was lower [(11.10±4.96) μmol/L vs (16.97±6.98) μmol/L, t=-2.83, P=0.010], the degree of stenosis was lower (0.56±0.05 vs 0.66±0.08, t=-4.54, P<0.001), and the proportion of positive lumen remodeling was higher (12/17 vs 4/17, P=0.015). Pearson correlation analysis showed that the degree of lumen stenosis was negatively correlated with WSS ( r=-0.44, P=0.011), and the plaque area was not correlated with WSS. Conclusions:WSS in middle cerebral artery stenosis is related to the degree of lumen stenosis and the mode of vascular remodeling. Higher WSS has poor stability, but lower WSS is more likely to cause lumen stenosis.
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Objective To identify the risk factors for surgical site infections after operation of laparoscopic cholecystectomy (LC), so as to provide warning signs for preventing such incidents. Methods The data of 4042 LC patients from January 2003 to December 2015 were analyzed retrospectively. The risk factors for surgical site infections were identified among demographic data, preoperative patients′history, and operative data using multivariate Logistic regression analysis. Results Surgical site infections after LC was seen in 7.2% (291/4042) of the patients. Multivariate analysis identified the following parameters as risk factors for surgical site infections: additional surgical procedure ( OR 4.011, 95%CI 2.149-7.486), age over 55 years (OR 2.398, 95%CI 1.777-3.235), conversion to open procedure (OR 2.647, 95%CI 1.935-3.621), postoperative hematoma (OR 1.910, 95%CI 1.192-3.060), duration of operation >60 min (OR 2.493, 95%CI 1.710-3.635), cystic stump insufficiency (OR 12.451, 95%CI 4.169-37.189), gallbladder perforation (OR 6.161, 95%CI 2.365-16.047), gallbladder empyema (OR 1.704, 95%CI 1.080-2.689), and surgical revision (OR 15.725, 95%CI 10.439-23.686). Surgical site infections were associated with a significantly prolonged hospital stay (P60 min, age >55 years, conversion to open procedure, cystic stump insufficiency, postoperative hematoma, gallbladder perforation, gallbladder empyema, or surgical revision were identified as specific risk factors for surgical site infections after LC.
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Objective To verify the reliability and validity of the Youth Quality of Life-Deafness Specific Scale (YQOL-DHH) in Chinese version. Methods In order to local and revise the YQOL-DHH, 193 deafnessadolescents were selected as the research objects by convenient sampling. The Chinese version ofYQOL-DHH and WHOQOL-DIS Scales for PD were applied to carry out the investigation. Results 32 items of the original scale were reserved in the Chinese version of the YQOL-DHH.By exploratory factor analysis, the scale could be divided intoself-acceptance, stigma and social participation, which could explain 76.8％ of variability; there was a significant correlation between the factors and the total score (P<0.01);the total content validity of the scale was 0.95;the score of the scale was significantly correlated with the correlation coefficient of WHO-DIS score (P<0.01). The Cronbachαcoefficient of the scale was 0.911 and the test-retest correlation coefficient was 0.634. Conclusions The Chinese version of YQOL-DHH has good reliability and validity, which can be used to measure the quality of life of deafnessyouth.