Real-World Evidence for the Association Between Pneumonia-Related Intensive Care Unit Stay and Dementia

Objective@#There is limited clarity concerning the risk of dementia after pneumonia with intensive care unit (ICU) stay. We conducted a nationwide cohort study, which aimed to investigate the impact of dementia after pneumonia with and without intensive care unit admission. @*Methods@#Data was obtained from Taiwan’s National Health Insurance Research Database between 2000 and 2015. A total of 7,473 patients were identified as having pneumonia required ICU stay, along with 22,419 controls matched by sex and age. After adjusting for confounding factors, multivariate Cox regression model analysis was used to compare the risk of developing dementia during the 15-years follow-up period. @*Results@#The enrolled pneumonia patients with ICU admission had a dementia rate of 9.89%. Pneumonia patients without ICU admission had a dementia rate of 9.21%. The multivariate Cox regression model analysis revealed that the patients with ICU stay had the higher risk of dementia, with a crude hazard ratio of 3.371 (95% confidence interval, 3.093–3.675; p<0.001). @*Conclusion@#This study indicated that pneumonia with ICU stay is associated with an increased risk of dementia. A 3-fold risk of dementia was observed in patients admitted to the ICU compared to the control group.

MiR-103a-3p and miR-107: potential biomarkers for the progression of osteoarthritis / 中华风湿病学杂志

Objective:To explore the potential Hub genes, key miRNAs, biological processes and related signaling pathways in the pathogenesis of osteoarthritis (OA), and provide bioinformatics basis for the pathogenesis and treatment of OA.Methods:The expression profiling chip of OA synovial tissue sample from Gene Expression Omnibus (GEO) were downloaded, differentially expressed genes (DEGs) were identified, and functional enrichment analysis was performed. A protein-protein interaction network (PPI) was constructed. STRING and Cytoscape was used for module analysis, and the Hub gene was further identified, and further miRNAs mining of the Hub gene was carried out.Results:Finally, 9 Hub genes (SOCS3, BTRC, FBXO32, KLHL22, UBE3A, HUWE1, UBR4, ANAPC5, TRIM50) and 2 key miRNAs (hsa-miR-103a-3P, hsa-miR-107) related to the progression of OA were identified .They might be potential biomarkers for the pathogenesis of OA. We also found that signal transduction, the transcriptional positive regulation of RNA polymerase Ⅱ promoter, and protein serine/threoninase activity had a certain correlation with the pathogenesis of OA. In addition, our analysis results showed that cAMP signaling pathway and Rap1 signaling pathway were also involved in the progression of OA.Conclusion:The potential biological molecules, biological processes and related pathways identified in this study may guide us for the further research on the etiology and treatment of OA.

Clinical observation of 15° face-changing acetabular cup in total hip replacement for the treatment of developmental dysplasia of hip / 中国骨伤

<p><b>OBJECTIVE</b>To explore early clinical effect of acetabular cup in total hip replacement for the treatment of Crowe II developmental dysplasia of hip.</p><p><b>METHODS</b>Eighteen patients (18 hips) with Crowe type II developmental dysplasia of hip were treated with total hip replacement from September 2001 to July 2013. Among them,including 13 males and 5 females aged from 42 to 60 years old with an average of 47.6 years old; the courses of diseases ranged from 9 to 22 years with an average of 13.5 years. All the patients had hip joint pain, limb shortening and limited hip function before operation. Harris score of hip joint were used to evaluate recovery of function at 1 day and 12 months after operation. Prosthetic coverage of acetabular cup at 1 week after operation was observed by using radiography.</p><p><b>RESULTS</b>Eighteen patients (18 hips) were followed up from 12 to 24 months with an average 17 months. All incisions were healed at stage I. No deep vein thrombosis, hip dislocation, periprosthetic joint infection and prosthesis loosening were occurred. No revision surgery during follow-up period. Prosthetic coverage of acetabular cup was more than 80% at 1 week after operation. Harris score were increased from 42.67 ± 5.06 before operation to 94.79 ± 3.27 at 12 months after operation (t = -45.269, P < 0.001).</p><p><b>CONCLUSION</b>For type Crowe II developmental dysplasia of hip patients, 15° face-changing acetabular cups in THR could obtain higher actebular component coverage rate and satisfactory early clinical effects.</p>

Positive end-expiratory pressure attenuates positional effect after thoracotomy

Thoracotomy is a common procedure. However, thoracotomy leads to lung atelectasis and deteriorates pulmonary gas exchange in operated side. Therefore, different positions with operated side lowermost or uppermost may lead to different gas exchange after thoracotomy. Besides, PEEP [positive end-expiratory pressure] influence lung atelectasis and should influence gas exchange. The purpose of this study was to determine the physiological changes in different positions after thoracotomy. In addition, we also studied the influence of PEEP to positional effects after thoracotomy. There were eight pigs in each group. Group I received left thoracotomy with zero end-expiratory pressure [ZEEP], and group II with PEEP; group III received right thoracotomy with ZEEP and group IV with PEEP. We changed positions to supine, LLD [left lateral decubitus] and RLD [right lateral decubitus] in random order after thoracotomy. PaO[2] was decreased after thoracotomy and higher in RLD after left thoracotomy and in LLD after right thoracotomy. PaO[2] in groups II and IV was higher than in groups I and III if with the same position. In group I and III, PaCO[2] was increased after thoracotomy and was higher in LLD after left thoracotomy and in RLD after right thoracotomy. In groups II and IV, there were no PaCO[2] changes in different positions after thoracotomy. Lung compliance [Crs] was decreased after thoracotomy in groups I and III and highest in RLD after left thoracotomy and in LLD after right thoracotomy. In groups II and IV, there were no changes in Crs regardless of the different positions. There were significant changes with regards to pulmonary gas exchange, hemodynamics and Crs after thoracotomy. The best position was non-operated lung lowermost Applying PEEP attenuates the positional effects