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In recent years, more and more studies have shown that intestinal flora is critical to the development and progression of metabolic-related fatty liver disease (MAFLD). This article summarizes MAFLD-related intestinal flora and metabolites and their possible mechanisms of action in disease process. Although related intestinal flora and metabolites are expected to become new noninvasive diagnostic markers and therapeutic targets for MAFLD, their clinical application still requires more in-depth research. The development of modern high-throughput sequencing technology provides new ideas for research. The integrated analysis of multi-omics, such as genes, proteins, transcription, and metabolism, allows us to establish a comprehensive understanding of the microbial factors affecting MAFLD under the precision medicine system, so as to lay a foundation for targeted transplantation of intestinal flora and drug development for liver metabolic homeostasis.
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Objective To understand the epidemiological characteristics of the newly diagnosed pulmonary tuberculosis patients in Meishan City from 2014 to 2019, and to carry out trend prediction and analysis, so as to provide theoretical basis for the formulation of prevention and control strategies. Methods Raw data of newly diagnosed tuberculosis patients in Meishan City from 2014 to 2019 were collected from Meishan Statistical Yearbook. And Excel was used to manage the raw data. The epidemiological characteristics of newly diagnosed pulmonary tuberculosis patients in Meishan City from 2014 to 2019 were analyzed, and the epidemic trend of pulmonary tuberculosis in Meishan City in the next two years was predicted by grey GM(1,1) model. Results From 2014 to 2019, a total of 1 832 smear positive pulmonary tuberculosis cases were reported in Meishan City. The annual average reported incidence rate of smear positive pulmonary tuberculosis was 26.95/100 000. The overall incidence rate of smear positive pulmonary tuberculosis showed a downward trend. Among the 1 832 newly diagnosed tuberculosis cases, the majority were male, aged 31~40 years old, spring onset, township residence and rural residence, farmers and students. The predicted incidence of pulmonary tuberculosis in Meishan City from 2014 to 2019 based on grey GM(1,1) model is basically consistent with the actual incidence, and the predicted incidence of pulmonary tuberculosis in 2020 and 2021 are 27.68/100 000 and 30.25/100 000 respectively. Conclusion The incidence of newly diagnosed pulmonary tuberculosis in Meishan City from 2014 to 2019 has a downward trend in general, while it may increase in the next two years, so the prevention and control measures for high-risk groups, regions and seasons should be strengthened.
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Objective To systematically evaluate the postoperative complications following open reduction and internal fixation combined with vascularized bone flap graft versus only reduction and internal fixation for femoral neck fractures.Methods CNKI,Wan Fang Chinese database,Pubmed,EMBASE and Google Scholar English database were searched for the randomized controlled trials from January 1,2000 through October 31,2017 which compared open reduction and internal fixation combined with vascularized bone flap graft (combined surgery group) with only reduction and internal fixation (simple surgery group) for femoral neck fractures.The data concerning postoperative nonunion and avascular necrosis of the femoral head were extracted.The 2 surgical treatments of the patients with femoral neck fracture were compared in terms of the 2 complications.Statistical analyses were conducted using software Stata 12 by relative risk (RR) and corresponding 95％ confidence intervals (95％ CI).Results According to our inclusion and exclusion criteria,a total of 23 studies were included,involving 2,162 cases (1,048 cases receiving combined surgery and 1,114 cases simple surgery).The Meta analyses showed that the fracture nonunion rate for the combined surgery group was significantly lower than that for the simple surgery group [RR =0.27,95％ CI(0.19,0.38),P ＜ 0.001] and the rate of avascular necrosis was also significantly lower for the former than for the latter [RR =0.31,95 ％ CI(0.24,0.42),P ＜ 0.001].Conclusion In the treatment of femoral neck fractures,open reduction and internal fixation combined with vascularied bone graft may lead to lower rates of nonunion and avascular necrosis of the femoral head than simple open reduction and internal fixation.
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Objective To investigate the efficacy of calf self weight traction reduction combined with locking plate fixation for the treatment of intertrochanteric fractures in the elderly.Methods A retrospective case series study was conducted on the clinical records of 174 elderly patients with the modified Evans Ⅰ-Ⅲ types of fresh intertrochanteric fractures treated with locking plate from January 2012 to December 2015.According to treatment method,the patients were assigned to traction bed reduction with locking plate fixation (Group A,62 patients) and calf self weight traction reduction with locking plate fixation (Group B,112 patients).Group A comprised 32 males and 30 females,with age range of 65-91 years [(72.47 ± 6.35) years].Group B comprised 68 males and 44 females,with age range of 65-95 years [(73.23 ± 6.05) years].The time of reduction,operation time,incision length,intraoperative blood loss,frequency of fluoroscopy,postoperative drainage volume,hospital stay,postoperative weightbearing standing time or walking time (ambulation time),surgical complications,and fracture healing were recorded.Harris and modified Barthel index score in Chinese (MBI-C) were used to evaluate the functional recovery of hip joint.Results All patients were followed up for 5-61 months (mean,15 months),and noted with fracture healing.The time of reduction in Group A was (13.27 ± 3.03) minutes,longer than that in Group B (0 minute) (P ＜0.05).The operation time in Group A was (63.63 ± 13.90)minutes,longer than that in Group B [(59.62 ± 8.38) minutes] (P ＜ 0.05).Fluoroscopy in Group A was (5.35 ± 2.36) times,more than (4.28 ± 3.11) times in Group B (P ＜ 0.05).There were no significant differences in the incision length,intraoperative blood loss,postoperative drainage volume,ambulation time,fracture healing time,Harris score,and MBI-C index between the two groups (P ＞0.05).There were no significant differences in the postoperative complications such as deep venous thrombosis,pulmonary infection,incisional infection,urinary tract infection,delirium,bed sores,cardiac insufficiency,electrolyte disturbance,and postoperative plate rupture between the two groups (P＞0.05).The incidence of deep vein thrombosis was 9.7％ (6/62) in Group A,and 4.5％ (5/112) in Group B (P ＞0.05).No screw fracture,nail and plate combination failure,bone nonunion,or screw cut out of the femoral head were observed in both groups.Conclusions For the modified Evans Ⅰ-Ⅲ types of intertrochanteric fractures,both traction bed reduction and calf weight reduction with locking plate have equivalent efficacy.However,the latter method has advantages of shorter reduction and operation time and less intraoperative X-ray exposure,and hence is worthy of clinical application.