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Objective:To investigate the effects of placenta previa on the surgical and pregnancy outcomes in patients with total/subtotal or segmental hysterectomy attributed to placenta accreta spectrum disorders (PAS).Methods:This study retrospectively enrolled 510 patients who gave birth and underwent total/subtotal hysterectomy or segmental hysterectomy (local implantation site) due to PAS at the third Affiliated Hospital of Guangzhou Medical University from January 1, 2017, to December 31, 2022. These subjects were divided into the placenta previa group (427 cases) and non-placenta previa group (83 cases). According to the type of hysterectomy, they were further divided into the total/subtotal hysterectomy and placenta previa subgroup (221 cases), total/subtotal hysterectomy and non-placenta previa subgroup (23 cases), segmental hysterectomy and placenta previa subgroup (206 cases), and segmental hysterectomy and non-placenta previa subgroup (60 cases). Nonparametric test or Chi-square test were used to compare the differences in the clinical features, surgical and pregnancy outcomes between different groups. Binary logistic regression was used to analyze the effects of placenta previa on the risk of additional surgical procedures and adverse maternal outcomes. Results:(1) Compared with the non-placenta previa group, the hemorrhage volume within 24 h postpartum [1 541 ml (1 036-2 368 ml) vs 1 111 ml (695-2 000 ml), Z=－3.91] and the proportion of women requiring additional surgical procedures [84.8% (362/427) vs 69.9% (58/83), χ2=10.61], with total/subtotal hysterectomy [51.8% (221/427) vs 27.7% (23/83), χ2=16.10], cystoscopy and/or ureteral stenting [60.7% (259/427) vs 31.3% (26/83), χ2=24.25], total adverse pregnancy outcomes [86.9% (371/427) vs 65.1% (54/83), χ2=17.75], hemorrhage volume>1 500 ml within 24 h postpartum [54.1% (231/427) vs 33.7% (28/83), χ2=29.94], transfusion of blood products [75.9% (324/427) vs 47.0% (39/83), χ2=28.27] were all higher in the placenta previa group (all P<0.05). Binary logistic regression analysis found that for PAS patients with hysterectomy, regardless of the hysterectomy type (total/subtotal/segmental), placenta previa was risk factor for requiring additional surgical procedures ( aOR=3.26, 95% CI: 1.85-5.72) and adverse pregnancy outcomes ( aOR=5.59, 95% CI: 2.01-6.42), even if adjusting for the confounding factors such as maternal age, number of previous cesarean sections, parity, gestational weight gain, twin pregnancy, and the use of assisted reproductive technology. (2) In patients with total/subtotal hysterectomy, the proportion of women requiring additional surgical procedures was higher in those with placenta previa [82.8% (183/221) vs 56.5% (13/23), χ2=9.11] than those without placenta previa, especially the proportion of cystoscopy and/or ureteral stenting [67.9% (150/221) vs 34.8% (8/23), χ2=9.99] (both P<0.05). However, no significant difference was found in adverse pregnancy outcomes [89.6% (198/221) vs 87.0% (20/23), χ2<0.01, P=0.972] between the two groups. In patients with segmental hysterectomy, higher proportions of women requiring additional surgery [86.9% (179/206) vs 75.0% (45/60), χ2=4.94], with adverse pregnancy outcomes [84.0% (173/206) vs 56.7% (34/60), χ2=25.31], cystoscopy and/or ureteral stenting [52.9% (109/206) vs 30.0% (18/60), χ2=9.78], vascular occlusion [94.2% (194/206) vs 71.7% (43/60), χ2=24.23], hemorrhage volume>1 500 ml within 24 h postpartum [46.6% (96/206) vs 23.3% (14/60), χ2=10.37], and transfusion of blood products [68.9% (142/206) vs 33.3% (20/60), χ2=24.73] were found in the placenta previa group (all P<0.05). Furthermore, patients with placenta previa had more hemorrhage volume within 24 h postpartum [1 368 ml (970-2 026 ml) vs 995 ml (654-1 352 ml), Z=－3.66, P<0.001] in the segmental hysterectomy subgroup. After adjusting for the confounding factors such as age, number of previous cesarean sections, parity, gestational weight gain, twin pregnancy, and the use of assisted reproductive technology, binary logistic regression analysis found that placenta previa did not increase the risk of additional surgical operations ( aOR=2.71, 95% CI: 0.99-7.42) and adverse pregnancy outcomes ( aOR=2.14, 95% CI: 0.54-8.42) in patients with total/subtotal hysterectomy but were risk factors of the two outcomes for those with segmental hysterectomy ( aOR=4.67, 95% CI: 2.15-10.10; aOR=3.80, 95% CI: 1.86-7.77). Conclusions:Placenta previa increases the risk of additional surgical procedures and adverse pregnancy outcomes in patients with total/subtotal or segmental hysterectomy caused by PAS. Appropriate preparation is required after the clinical diagnosis of PAS with placenta previa.
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Objective To explore the influencing factors of coal workers''''cognitive function. Meth-ods There was a physical examination on 3205 workers in the coal mine enterprise.The physical examina-tion included height,weight,blood pressure,blood routine examination and routine urine test,and Mini Men-tal State Examination (MMSE) was used to evaluate the cognitive function.The coal workers were divided in-to cognitive dysfunction group (84 cases) and cognitive function normal group (3121 cases) according to MMSE scores.Logistic regression analysis was used to explore the influencing factors of cognitive function. Results The prevalence of cognitive dysfunction was 2. 62％ in coal workers. The age of the cognitive dys-function group(47.27±8.24) was significantly higher than that in the cognitive function normal group (41.39 ±8.65)(P<0.05),and the degree of culture in cognitive dysfunction group was significantly lower than those in the cognitive function normal group (χ2= 46. 610, P<0. 01 ) . The low density lipoprotein cholesterol ((2.72±0.65)mmol/L),urine pH(5.54±1.51) in the cognitive dysfunction group were significantly lower than those in the cognitive function normal group((2.89±0.73)mmol/L,(5.92±1.28))(P<0.05). The lo-gistic regression analysis showed that age, culture level, BMI, low density lipoprotein cholesterol, urine pH were the impacting factors of cognitive dysfunction. Conclusion Cognitive dysfunction is influenced by age, culture level,BMI and low density lipoprotein cholesterol. The higher of the age and the lower of the culture level,BMI,low density lipoprotein cholesterol,urine pH,the more vulnerable to cognitive dysfunction.
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Objective To explore the clinical effect of computer assisted Taylor three-dimensional external fixator in the treatment of bone fracture of lower extremity.Methods From December 2015 to December 2016,12 patients with bone fracture of lower extremity who took computer assisted Taylor three-dimensional external fixator in Jiaxing Hospital of Zhejiang Provincial Armed Police Force were selected.The clinical data were analyzed,and the fracture recovery was compared.Results After treatment,all patients had successful fracture reduction,and with X-ray detection,the fracture healed completely,l 1 cases showed excellent,1 case showed good,the excellent and good rate was 100％.All patients had no symptoms of osteomyelitis.Conclusion Computer aided 3D Taylor external fixator in the treatment of tibial shaft fracture can effectively improve the treatment effect,enhance the recovery of patients with fracture,and with less trauma,simple operation,and has important significance to improve the quality of life of patients after operation.It is worthy of promotion.
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DNA methylation is an important epigenetic mark that plays a vital role in gene expression and cell differentiation. The average DNA methylation level among a group of cells has been extensively documented. However, the cell-to-cell heterogeneity in DNA methylation, which reflects the differentiation of epigenetic status among cells, remains less investigated. Here we established a gold standard of the cell-to-cell heterogeneity in DNA methylation based on single-cell bisulfite sequencing (BS-seq) data. With that, we optimized a computational pipeline for estimating the heterogeneity in DNA methylation from bulk BS-seq data. We further built HeteroMeth, a database for searching, browsing, visualizing, and downloading the data for heterogeneity in DNA methylation for a total of 141 samples in humans, mice, Arabidopsis, and rice. Three genes are used as examples to illustrate the power of HeteroMeth in the identification of unique features in DNA methylation. The optimization of the computational strategy and the construction of the database in this study complement the recent experimental attempts on single-cell DNA methylomes and will facilitate the understanding of epigenetic mechanisms underlying cell differentiation and embryonic development. HeteroMeth is publicly available at http://qianlab.genetics.ac.cn/HeteroMeth.
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Animals , Humans , Mice , Arabidopsis , Genetics , Cell Line , Computer Simulation , DNA Methylation , Genetics , Databases, Genetic , Entropy , Genetic Heterogeneity , Genome , High-Throughput Nucleotide Sequencing , Oryza , Genetics , Reference Standards , Reproducibility of Results , Sequence Analysis, DNA , Single-Cell Analysis , User-Computer InterfaceABSTRACT
Objective To explore the influence of high flux hemodialysis (HFHD) and hemodialysis filtration (HDF) on the dialysis effect and patients mortality in the patients with end-stage renal disease(ESRD).Methods One hundred and twenty-two patients with ESRD in our hospitals were selected and respectively adopted HFHD (HFHD group,62 cases) and HDF (HDF group,60 cases) for conducting the dialysis therapy.The serum indexes before and after treatment were detected and compared between the two groups.Results Compared with before treatment,the level of blood urea nitrogen (BUN),blood uric acid (BUA),serum creatinine (Scr),blood phosphorus (P),parathyroid hormone (PTH),β2 microglobulin (β2-MG) and cysteine protease inhibitors (Cys-C) after treatment in the two groups were significantly decreased(P＜0.05).The clearance rates of P,PTH and Cys-C in the HFHD group were significantly higher than those in the HDF group(t=2.479,t=1.834,t=1.512,P＜0.05).The mortality after an average follow-up of (12.2 ± 3.7) months had statistical difference between the two groups,the mortality rate in the HDF group was significantly higher than that in the HFHD group (P＜ 0.05).The multivariate Cox regression analysis results showed that the HFHD was an important factor affecting death in ESRD patient (HR =0.50,95 ％ CI:0.33-0.84,P =0.009).Conclusion HFHD has more significant effect for clearing P,PTH,β2-MG and Cys-C than HDF in ESRD patients,moreover can reduces their mortality.
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Objective To compare the effects of surgical versus non-surgical treatment for femoral neck fractures in elderly patients,in order to provide guidance on treatment options.Methods The clinical effects and complications of different approaches from 42 patients with femoral neck fractures who had received treatment at our department from February 2006 to August 2011 were retrospectively analyzed.Results Of the 42 cases,13 cases were treated with artificial hip replacement,18 cases with hollow lag screw fixation,and 11 cases with tibial traction.No death occurred in patients treated with surgery,and 4 patients who had received non-surgical treatment died within 6 months of the followed-up.Conclusions Very elderly patients with femoral neck fractures generally perform well under appropriate perioperative care.Surgical treatment can produce good therapeutic effects,shorten the time for bed rest,improve the quality of life and reduce the mortality rate.
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Objective To evaluate the early effects of bone cement prostheses versus cementless prostheses in very elderly patients undergoing total hip arthroplasty.Methods A total of 110 patients aged 70 years and over who had undergone hip replacement because of hip disease from March 2011 to March 2013 were selected.104 cases were followed up for 3 years,with 46 cases treated with the bone cement prostheses(Group A) and 58 cases with cementless prostheses(Group B).The conditions before and after surgery were recorded.Postoperative Harris scores were collected to evaluate the function of the hip joint,and the loosening of hip prostheses was detected by x-ray.Results Intraoperative blood loss and postoperative drainage volume were lower in Group A than in Group B [(236.0±26.3) ml vs.(296.0±34.5) m1,(123.0±20.3) ml vs.(156.0±26.4) ml,both P ＜0.05].Harris scores before,6 months,1,2 and 3 years after surgery were(40.2±7.2),(80.3±5.2),(90.2±4.5),(90.6±4.2),and(90.8±3.5) in Group A,and(39.8±6.3),(76.5±8.7),(86.5±5.1),(89.3± 4.8),and(91.0± 4.1) in Group B,respectively.Harris scores 6 months and 1 year after surgery were higher in Group A than in Group B,and there was no significant difference in Harris scores between the two groups 2 and 3 years after surgery(P＞0.05).Pain scores before,6 months,1,2 and 3 years after surgery were(13.5± 5.3),(37.5± 6.2),(38.4±5.3),(39.1 ±2.5) and(39.0±2.1) in Group A and(12.9±6.2),(30.2±8.7),(35.9±6.5),(38.6±4.8) and(39.2±2.6) in Group B,respectively.Pain scores 1 year after surgery was better in Group A than in Group B,and there was no significant difference in pain scores between the two groups 2 and 3 years after surgery(P＞0.05).Bone cement implantation syndrome occurred in 6 cases in Group A,of which 1 case had respiratory and cardiac arrest and was successfully rescued after cardiopulmonary resuscitation.In addition,in Group A,1 case had osteolytic disease 2 years after surgery,and,in Group B,4 cases had proximal femoral fractures and 1 case had osteolytic disease 3 years after surgery.Conclusions For very elderly patients undergoing total hip replacement,satisfactory early therapeutic effects can be achieved by using bone cement or cementless prostheses.Intraoperative blood loss,postoperative drainage volume and Harris scores 1 year after surgery are better with bone cement prostheses than with cementless prostheses.Close attention should be paid to possible development of bone cement implantation syndrome during operation.
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Objective To study the curative effect of anterior cervical discectomy with fusion (ACDF)and anterior cervical corpectomy with fusion (ACCF)for multi segment cervical spondylosis;and to provide effective anterior surgery for the disease.Methods According to digital table,106 cases with multi segment cervical spondylosis were randomly divided into ACCF group of 54 cases and ACDF group of 52 cases.The ACDF group was treated with ACDF,and the ACCF group was treated with ACCF.The operation time,bleeding volume and excellent rate of cervical functional improvement of the two groups were observed,and the bone graft fusion,cervical vertebra height change and the change of cervical curvature of the two groups were evaluated.Results The operation time of the ACDF group was higher than that of the ACCF group,the amount of bleeding of the ACCF group was lower than that of the ACDF group,and the differences werestatistically significant (t =2.857,9.097,all P 0.05).Conclusion For multi segment cervical spondylosis,there are no significant differences in efficacy and stability between ACDF and ACCF;ACCF surgery field is more clear and easy to operate,the operation time is short, and there is the phenomenon of titanium mesh sinking.In the maintenance of cervical curvature,ACCF is better than ACDF.
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BACKGROUND:Integrated Traditional Chinese and Western Medicine minimaly invasive treatment for halux valgus based on wrapped curtain method with “8”-shaped bandage and sub toe pad external fixation has been used for a long time in the clinic. This method abandons the internal implant fixationandexternal plaster fixation. After surgery, patients could take care of themselves. However, theactivity of the broken end may cause fracture nonunion, which once aroused scholars’ question. Recently, with the continuous improvement of foot biomechanics research, foot finite element model and applications become a reality. OBJECTIVE:To evaluate thestability of osteotomy after the operation of wrapped curtain method with“8”-shaped bandage and sub toe pad external fixation on the basis of static finite element method. METHODS:A young female volunteer with halux valgus was selected, whose body weight was 58 kg, and right foot halux abductor valgus angle was 24°; intermetatarsal angle was 13°; proximal articulator set angle was 7°; distal articulator set angle was 7°. CT was used to scan the right foot. ABAQUS software was applied to establish a finite element model of right foot halux valgus bone, and model of the first metatarsal neck minimaly invasive osteotomy was simulated based on wrapped curtain method with external fixation. Von Mises stress and displacement at the osteotomy endwere calculated. RESULTS AND CONCLUSION:(1) The maximum stress was 0.067 MPa without external fixation, and the maximum stress was 1.258 MPa with the external fixation. Stress was mainly distributed in the outer edge of the osteotomy. (2) The maximum absolute displacement was 0.363 mm without external fixation, and the maximum absolute displacement was 0.716 mm with external fixation. The two largest displacements were both in the Z-axis direction. Statistical analysis confirmed that the four nodes absolute displacement and stress were significantly different (P 0.05). The four nodes relative displacements were statisticaly significant in Z-axis (P< 0.05). (5) These findings suggest that the external fixation based on wrapped curtain method after halux valgus surgery could effectively reduce osteotomy displacement. The moderate stress and elastic fixation are conducive to fracture healing.
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Objective To investigate the effect of fish oil parenteral supplementation on monocyte function in gastrointestinal cancer patients.Methods Sixty-four gastrointestinal cancer volunteers were equally randomized into study group and control group.Both groups received conventional lipid emulsion,and the study group was added with fish oil parenteral supplementation for 5 days.Blood samples were collected on the 1st,3rd,and 6th post-operative days to detect the interleukin (IL)-1β,IL-10,IL-6,tumor necrosis factor-α,and human leukocyte antigen-DR.Results After 5 days of continuous management,the IL-1β,IL-6,and tumor necrosis factor-o levels in the study group became significantly lower than those in the control group [(1 818 ± 213)pg/Lvs (2292 ±289)pg/L,P=0.027; (415 ±71)pg/Lvs (791±163)pg/L,P=0.001; (2 194± 350) pg/L vs (2 509 ± 507)pg/L,P =0.036,respectively),whereas the level of IL-10 by mononuclear leukocytes in two groups showed no significant difference.The expression of human leukocyte antigen-DR was significantly increased in both groups,but was significantly higher in the study group than in the control group [(76.6±15.2)％ vs (62.3±16.8)％,P=0.029].Conclusion Fish oil helps improve postoperative monocyte function in patients with gastrointestinal tumor.
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Glucokinase (GK) is a new target for the treatment of type II diabetes mellitus (T2DM). In order to find a structure-simplified small molecule GK activator, 19 salicylic acid derivatives were designed and synthesized based on new lead compound (1). Experimental results showed that the potency of compound 8h is superior to control RO-28-0450 in GK activation.
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Objective To estimate the effect of pedicle screw fixation of thoracolumbar fractures via paraspinal approach and compare it with the conventional posterior midline approach.Methods Forty-two cases of thoracolumbar monosegmental fractures subjected to single posterior pedicle screw fixation and reduction from December 2008 to May 2010 were included in the study.Among the patients,19 cases were operated through paraspinal muscular-sparing approach (paraspinal approach group) and 23 cases through posterior midline surgical approach (conventional approach group).Surgical incision length,operation time,intraoperative blood loss,postoperative drainage volume,postoperative hospital stay,pre-and post-operative VAS and other perioperative indices as well as fracture reduction outcome were compared between the two groups.Oswestry disability index (ODI) was assessed after operation.Results There were no statistical differences between the two groups in aspects of surgical incision length,operation time,postoperative hospital stay,height restoration of fractured vertebra (P ＞ 0.05),but intraoperative blood loss (148.5 ± 26.5) ml,postoperative draining loss (72.9 ± 17.3) ml,postoperative VAS (1.1 ± 0.3) points and ODI (13.4 ± 2.7) points in paraspinal approach group showed statistical differences from those in conventional approach group (P ＜ 0.05).Conclusion Paraspinal muscle-sparing approach is characterized by minor trauma,less bleeding,slight pain and quick recovery as compared with conventional posterior midline approach and hence may be the preferred choice for the treatment of thoracolumbar fracture without spinal canal decompression.
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Objective To explore the effect of ω-3 fish oil on nutrition improvement and inflammatory reaction of patients with gastrointestinal tumor after operation.Methods 60 cases with gastrointestinal tumor were divided into control group(30 cases) and study group (30 cases),both groups were provided with parenteral nutrition treatment[ 104.6 kJ · kg-1 · d-1 ].Fish-oil fatty emulsion was given to the study group.The postoperative for the first day received half of the total energy and the total energy The remaining four days.Blood samples were gained on the morning of day 1,on the morning of day 3 and day 6 after operation respectively to measure albumin ( ALB),prealbumin (PA),total protein(TP),transferrin(TRF),the neutrophilic granulocyte count,lymphocyte count (TLC),serum C-reactive protein(CRP).Results Both groups of patients was comparable(all P ＜ 0.05 ).Both groups of patients was treated after five days of postoperative and ALB,TP,TRF were not significantly different.PA in both groups on day 6 was significantly increased,and the study group was higher than control group.there were statistical differences between them ( all P ＜ 0.05 ).The neutrophilic granulocyte count and CRP of both groups were significant reduced,and the study group was lower than control group.There were statistical differences between them( all P ＜0.05 ).Conclusion ω-3 fish oil on nutrition could improve nutritional quality and modulate inflammatory reaction of patients with gastrointestinal tumor after operation.
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Banana bunchy top virus (BBTV),family Nanaviridae,genus Babuvirus,is a single stranded DNA virus (ssDNA) that causes banana bunchy top disease (BBTD) in banana plants.It is the most common and most destructive of all viruses in these plants and is widespread throughout the Asia-Pacific region.In this study we isolated,cloned and sequenced a BBTV sample from Hainan Island,China.The results from sequencing and bioinformatics analysis indicate this isolate represents a satellite DNA component with 12 DNA sequences motifs.We also predicted the physical and chemical properties,structure,signal peptide,phosphorylation,secondary structure,tertiary structure and functional domains of its encoding protein,and compare them with the corresponding quantities in the replication initiation protein of BBTV DNA1.
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A new mutant human papiUomavirus type 16 E7 gene, termed HPV16 HBE7, was isolated from cervical carcinoma biopsy samples from patients in an area with high incidence of cervical cancer (Hubei province, China). A previous study showed that the HPVI6 HBE7 protein was primarily cytoplasmic while wild-type HPV16 E7 protein, termed HPV16 WET, was concentrated in the nucleus. With the aim of studying the biological functions of HPV16 HBE7, the transforming potential of HPV16 HBE7 in NIH/3T3 cells was detected through observation of cell morphology, cell proliferation assay and anchorage-independent growth assay. The effect of HPVI6 HBE7 on cell cycle was examined by flow cytometry. Dual-luciferase reporter assay and RT-PCR were used to investigate the influence of HPVI6 HBE7 protein on the expression of regulation factors associated with GI/S checkpoint. The results showed that HPV16 HBE7 protein, as well as HPV16 WE7 protein, held transformation activity. NIH/3T3 cells expressing HPV16 HBE7 could easily transition from G1 phase into S phase and expressed high level of cyclin A and cdc25A. These results indicated HPV16 mutant E7 protein, located in the cytoplasm, induces oncogenic transformation of NIH/3T3 cells via up-regulation of cyclin A and cdc25A.
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Objective To observe the effect of Shutongan Decoction (STA) on abirritation and generative function of morphine dependence rats and explore its mechanism. Method The model of morphine dependent rat was established. The change of ?-endorphin in hypothalamus and plasma,substance P in ganglion nodosum and nucleus tractus solitarii and incretion hormones in serum of morphine dependence rats were detected by radio-immuno-assay. Result The level of ?-endorphin in hypothalamus of addicted rats was reduced obviously than that in normal rats (P