Percutaneous vertebroplasty for the treatment of osteoporotic vertebral compression fractures with spinal origin abdominal pain as the main symptom / 中国骨伤

OBJECTIVE@#To analyze the efficacy of percutaneous vertebroplasty for osteoporotic vertebral compression fractures with spinal origin abdominal pain as the main symptom.@*METHODS@#A retrospective analysis was performed on 37 patients with osteoporotic vertebral compression fractures treated from January 2015 to January 2021, all of whom had spin-derived abdominal pain as the main symptom, and were divided into surgery group(21 cases) and conservative group (16 cases) according to different treatment methods. Patients in the surgery group were treated with percutaneous vertebroplasty, including 7 males and 14 females, with an average age of (75.95±6.84) years old and an average course of disease of (5.26±3.79) days. The conservative group received non-surgical treatment, including 5 males and 11 females, with an average age of (75.50±8.07) years old and an average course of disease of (4.28±3.42) days. Two groups of patients with preoperative mainly characterized by abdominal pain, abdominal distension and constipation, have no obvious chest waist back pain symptoms, the thoracolumbar MRI diagnosed as fresh osteoporotic vertebral compression fractures, record its postoperative abdominal pain visual analogue scale (VAS), medical outcomes study short form-36 (SF-36) score, defecation interval after treatment, etc.@*RESULTS@#Thirty-seven patients were followed up for (14.90±14.11) months in surgery group and( 21.42±17.53) months in conservative group. Compared with before treatment, the VAS of surgery group at each time period after treatment, VAS of conservative group at 1 month after treatment and SF-36 score between two groups at 3 months after treatment were all improved(P<0.05), while VAS of conservative group at 3 days after treatment showed no statistically significant difference(P>0.05). Compared between two groups, there were no significant differences in VAS and SF-36 scores at 1 day before treatment(P>0.05), but VAS at 3 days after treatment in surgery group, life vitality and social function score at 3 months after treatment, and defecation time after treatment in surgery group were better than those in conservative group(P<0.05). There were no significant differences in other indexes(P>0.05). The incision healing of patients in surgery group was good, and no serious complications occurred in both groups.@*CONCLUSION@#Percutaneous vertebroplasty is an effective method for the treatment of osteoporotic vertebral compression fractures with spinal origin abdominal pain as the main symptom. Compared with conservative treatment, percutaneous vertebroplasty has more advantages in early relief of abdominal pain and constipation, recovery of vitality and social function.

Distribution and drug resistance of pathogens causing periprosthetic infections after hip and knee arthroplasty / 中国骨伤

OBJECTIVE@#To study the distribution and drug resistance of pathogens causing periprosthetic infections after hip and knee arthroplasty, and to formulate prevention and treatment strategies for drug-resistant bacteria.@*METHODS@#The data of 146 cases of periprosthetic infection after primary hip and knee arthroplasty from 2010 to 2015 were collected, including 111 cases of periprosthetic infection after hip arthroplasty and 35 cases of periprosthetic infection after knee arthroplasty. The culture positive rate, pathogenic bacteria composition and drug resistance rate were counted over the years, and the change trend of pathogen distribution and drug resistance was analyzed.@*RESULTS@#One hundredand eight strains of pathogenic bacteria were detected in 146 cases, and the positive rate of culture was 73.97%. Gram positive bacteria accounted for 55.48%, Staphylococcus epidermidis and Staphylococcus aureus accounted for 25.34% and 15.07% respectively. Gram negative bacteria accounted for 13.01%, including Enterobacter cloacae, Pseudomonas aeruginosa and Escherichia coli. There were 4 cases of Mycobacterium tuberculosis infection and mixed infection. The results of culture over the years showed that the constituent ratio of Gram positive bacteria had an increasing trend, fluctuating from 39.13% to 76.47%. The results of drug sensitivity showed that the pathogens were highly resistant to β-lactams, quinolones, clindamycin and gentamicin, and the drug resistance rate was increasing, but it was still sensitive to rifampicin, nitrofurantoin, tigecycline, linezolid and vancomycin.@*CONCLUSION@#Gram positive bacteria are the main pathogens of periprosthetic infection, and the proportion is increasing gradually.The pathogens have high resistance to many kinds of antibiotics, and the resistance rate is still increasing. To strengthen the monitoring of the distribution and drug resistance of pathogenic bacteria is helpful to grasp its change trend and formulate targeted prevention and control strategies.

Uremic Toxins in Cognitive Impairment / 中国医学科学院学报

Patients with uremia can suffer from decreased renal function and endocrine and metabolism disorders,which can lead to the accumulation of toxins in the body.Accumulation of uremic toxins is a major cause of cognitive dysfunction in uremic patients.This article summarizes some of the cognitive dysfunction-related uremic toxins and their possible mechanisms.

Epidemiology characteristics of crawfish related rhabdomyolysis in Nanjing, 2016: a multicenter retrospective investigation / 中华危重病急救医学

Objective To investigate the epidemiology characteristics of crawfish related rhabdomyolysis (RM) in Nanjing, 2016.Methods Outpatient and inpatient electronic medical system of 21 hospitals in Nanjing during 2016 were retrospectively searched, and all the patients diagnosed with RM were selected. The patients with none crayfish-related RM was excluded. The epidemiology characteristics were depicted. The geographic information system (GIS) was used to collect, manage and analyze the spatial data, to visualize it, to analyze the spatial distribution features of the disease, and to explore the cause of disease prediction. GeoDa 1.8 software was used to analyze the global and local spatial auto-correlation.Results A total of 1183 patients with crawfish related RM were initially screened, excluding 59 patients with RM caused by trauma, severe exercise, heat stroke, myositis, poisoning, drugs, and genetic diseases, and 1124 patients were enrolled. The proportion of men was 36.48% (410/1124) with an incidence of 12.54/100 thousands; while of women was 63.52% (714/1124) with an incidence of 21.86/100 thousands. The median age at onset was 34 (28, 43) years. From July to August, the incidence of crawfish related RM was the highest, accounting for 96.53% of the total number of cases. The top four incidence areas were Pukou (41.54/100 thousands), Jianye (25.94/100 thousands), Qixia (25.73/100 thousands), Gulou (25.04/100 thousands), all of which were adjacent to the Yangtze River. Global spatial autocorrelation analysis showed: MoranI = 0.427,Z = 2.646,P = 0.003, suggesting that the crawfish related RM had positive spatial autocorrelation. The results showed that the spatial structure of crawfish related RM existed in Nanjing in 2016. Local spatial autocorrelation analysis showed that the high-high concentration areas were Pukou, Jianye and Liuhe. The incidences of above three areas which were the Nanjing section of the lower reaches of the Yangtze River flowed through the region and surrounding areas were higher than the overall incidence of Nanjing.Conclusion The prevalence of crawfish related RM in Nanjing during 2016 had an obvious region-concentrated character and global spatial autocorrelation with the high prevalent regions mainly concentrated in the urban areas adjacent to the Yangtze River.

Anti-oxidant effect of pirfenidone on acute lung injury induced by paraquat poisoning in mice / 中华危重病急救医学

Objective To investigate the anti-oxidant effect of pirfenidone (PD) at different dosage on acute lung injury (ALI) induced by paraquat (PQ) poisoning in mice. Methods 144 ICR mice were randomly divided into four groups: control group (n = 24), PQ poisoned group (n = 24), high and low doses PD treatment groups (n = 48). ALI induced by PQ poisoning model was reproduced by intraperitoneal injection of 25 mg/kg 20% PQ solution in mice, and the mice in control group was given equal volume of normal saline. Intragastric administration with 30 mg/kg and 70 mg/kg PD suspension [PD was dissolved in 0.4% sodium carboxymethyl cellulose sodium (CMC) solution] after PQ poisoning immediately for 3 days in high and low doses PD treatment groups respectively, while the same volume of 0.4% CMC solution was administrated in control group and PQ poisoned group. Then mice in each group were respectively sacrificed at 2, 6, 12, 24, 48 and 72 hours after PD exposure to harvest the lung tissue, nuclear factor-κB (NF-κB) was determined by enzyme linked immunosorbent assay (ELISA), superoxide dismutase (SOD) and malonaldehyde (MDA) were determined by colorimetry, and pulmonary pathological changes were observed with microscope after hematoxylin-ensin (HE) staining. Results Compared with the control group, NF-κB from 2 hours in PQ poisoned group was significantly increased (pg/mg: 106.65±5.96 vs. 79.04±2.40, P 0.05), but no significant difference in NF-κB activity at all time points was found. Under light microscope, a wide range of red blood cells and serous effusion, alveolar septum fracture and pulmonary interstitial inflammatory cell infiltration were shown by pathologic examination in PQ poisoned group. The pathologic changes in high and low doses PD treatment groups were obviously less than those of PQ poisoned group, and no significant difference was found between the two doses groups. Conclusions The early therapeutic effect of PD may relate to the inhibition of NF-κB and reactive oxygen species, then reduce the inflammation of PQ poisoning. The treatment effectiveness of low dose PD seems better than high dose PD.

Clinical features in 65 patients with acute myocardial infarction underwent successful thrombolytic therapy post cardiopulmonary resuscitation / 中华心血管病杂志

<p><b>OBJECTIVE</b>To analyze the clinical features of patients with acute myocardial infarction underwent successful thrombolytic therapy post cardiopulmonary resuscitation.</p><p><b>METHODS</b>This retrospective analysis included 65 patients with acute myocardial infarction underwent successful intravenous thrombolysis post cardiopulmonary resuscitation. The cases were collected from Chinese Journal Full-text Database from 1996 to 2006, only patients met the recanalization criteria of coronary artery were included.</p><p><b>RESULTS</b>Most of the patients were male (93.8%, 61/65) and aged less than 65 years (81.5%, 53/65). Cardiopulmonary resuscitation was performed within 5 min after cardiac arrest in 63 patients (96.9%). Defibrillation was performed 3.2 times per patient, chest compression in 52 patients (80.0%) and tracheal intubation in 21 patients (32.3%). The restoration time of spontaneous circulation were achieved within 10 min in 36 cases (55.4%), between 11 - 30 min in 19 cases (29.2%)and between 31 - 107 min in 10 cases (15.4%). Thrombolysis agents (urokinase, recombinant streptokinase or recombinant tissue-type plasminogen activator) were given intravenously at 172 +/- 92 min after acute myocardial infarction. Mild hemorrhage was seen in 12 cases (18.5%) and there was no report on severe hemorrhage event. The hemorrhage incidence tended to be higher than that of reported large Chinese thrombolysis trials (11.1% - 15.1%, P > 0.05).</p><p><b>CONCLUSION</b>Thrombolytic therapy was relatively safe and effective for those middle-aged male AMI patients received rapid cardiopulmonary resuscitation (< 5 min after cardiac arrest) and with shorter spontaneous circulation restoration time (<30 min).</p>

Meta-analysis of mesenteric arterial embolism or mesenteric arterial thrombosis / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To summarize the clinical characteristics of mesenteric arterial embolism (MAE) and mesenteric arterial thrombosis (MAT), and to clarify the diagnosis and treatment status of MAE and MAT in China.</p><p><b>METHODS</b>A retrospective analysis of 111 cases suffering from MAE or MAT was performed. Data of these cases were collected from Chinese Journal Full-text Database from 1994 to 2006.</p><p><b>RESULTS</b>There were 61 cases (54.9%) with MAE and 50 cases (45.1%) with MAT. Fifty-two patients (46.8%) had arterial fibrillation. Ninety-seven cases (87.4%) were diagnosed by exploratory laparotomy or autopsy, and 14 cases (12.6%) by imageology. Embolism or thrombosis in superior mesenteric artery (SMA) accounted for 92.8%, 4.5% in SMA plus inferior mesenteric artery. 15.2%(14/92) necrosis were located in jejunum or ileum, 39.1%(36/92) in jejunum and ileum, 38.0%(35/92) in jejunum, ileum and colon. Thrombolysis or anticoagulation in artery were operated in 7 cases(6.3%). Extraction of embolism or thrombosis in operation were implemented in 18 cases(16.2%). Intestinal resection were finished in 76 cases(68.5%). Sixty-eight patients (61.3%) were misdiagnosed. Sixty-three cases (60.6%) died.</p><p><b>CONCLUSION</b>The manifestation of MAE or MAT is quite complicated and changeable, so that many cases are misdiagnosed. The clinic and image characteristics of MAE and MAT have not been well known by doctors.</p>