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Objective:To investigate the influencing factors of blood glucose fluctuation after surgery for type A aortic dissection in non-diabetic patients.Methods:A total of 109 patients with non-diabetic type A aortic dissection who underwent surgical treatment in Ningbo Medical Center Li Huili Hospital from Dec. 2016 to Mar. 2022 were selected as the research subjects. Logistic regression analysis was used to explore the influencing factors of blood glucose fluctuation in non-diabetic patients with type A aortic dissection surgery, and a nomogram model of blood glucose fluctuation in non-diabetic patients with type A aortic dissection surgery was constructed.Results:Logistic regression analysis showed that BMI≥24 kg/m 2, poor sleep quality, depression, cardiopulmonary bypass time>5 h and intraoperative bleeding were the risk factors for postoperative blood glucose fluctuation in non-diabetic type A aortic dissection patients ( P<0.05). The C-index of the nomogram model was 0.746 (95% CI: 0.711-0.781) ; the calibration curve was in good agreement with the ideal curve; the AUC of the nomogram model was 0.804. Conclusion:BMI≥24 kg/m 2, poor sleep quality, depression, cardiopulmonary bypass time>5 h and intraoperative bleeding are risk factors for postoperative blood glucose fluctuation in non-diabetic type A aortic dissection patients.
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Objective To explore the possibility of three-dimensional orbit replications for clinic and teaching of orbital blowout fracture surgical operation.Methods The orbital CT DICOM format data from 10 patients with orbital floor fractures were selected between November 2016 and January 2017 from Wendeng Osteopath Hospital.Thresholding technique,region growing technique,edit mask technique and multiple slice edit technique were used in sequence by Mimics software.And 3D replications were printed by Object 500 3D printer.The sizes of the replications were measured.The model of orbital blowout fracture and surgical implant model were simulated by senior orbital surgeon.Results In the 10 cases,male was 5 cases,and female was 5 eyes.The 3 D replications of the orbits were successfully designed and printed.The sizes of the 3D replications were basically consistent with those of patients' orbits,and there was no statistical difference (all P ＞ O.05).Under operation room surgery simulation environment,the orbital fracture surgical repair operation was demonstrated to the resident by the senior surgeon,3D printing orbital blowout fracture model can be successfully used to simulate the operation and teaching demonstration.Conclusion 3D printing orbital blowout fracture model can restore the true orbital injury and orbital anatomic details,provides the design operation of stereoscopic model for the physician,which has positive significance to understand the scope and surgery teaching simulation of orbital blowout fracture.
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Background Accurate measurement of corneal refractive parameters plays an important role in the diagnosis of eye diseases,design of refractive surgery and calculation of intraocular lens (IOL) power.Ophtha TOP is a new IOL calculator,so it is necessary to evaluate the repeatability and accuracy of Ophtha TOP in measuring corneal refractive parameters.Objective This study was to evaluate the repeatability of Ophtha TOP in measuring corneal refractive status in normal eyes and determine the agreement of the measuring outcomes between Ophtha TOP and Pentacam in pre-surgery cataract eyes.Methods A reliability evaluation method of diagnosis test was performed from September 2013 to October 2014.Sixty eyes of healthy volunteers aged (30.83 ±8.66) years old were examined in Tianjin Eye Hospital with Ophtha TOP for more than 5 times to evaluate the stability in measuring corneal refractive parameters.Corneal refractive parameters were measured by both Ophtha TOP and Pentacam for more than twice in 30 pre-surgery cataract eyes to assess the agreement with Pentacam.Keratometry and astigmatism parameters were recorded,including the flattest meridian (Kf),steepest meridian (Ks),mean keratometry (Km) and the astigmatism at J0 and J45.Intra-class correlation coefficients (ICC),repeatability (2.77Sw) and coefficient of variation (CoVs) were used to assess the stability of Ophtha TOP,and Bland-Altman graphs were adopted to value the consistency of measuring outcomes between Ophtha TOP and Pentacam.This study complied with Helsinki declaration,and written informed consent was obtained from each patient prior to any medical examination.Results The ICC of Ks,Kf,Km,J0 and J45 by Ophtha TOP were all ≥0.90,and 2.77Sw were all ≤0.36,The CoVs of Kf,Ks,Km by Ophtha TOP were all ≤0.30.The measuring values of Kf,Ks and Km were significantly higher in the Ophtha TOP than those in the Pentacam,with the mean differences (0.18±0.28) D,(0.24±0.29) D and (0.21± 0.26) D,respectively(t =3.48,4.50,4.49,all at P=0.00).The mean difference of the J0 was (0.07±0.21) D and that of the J45 was (-0.02±0.18)D between Ophtha TOP and Pentacam,showing insignificant differences between them (both at P＞0.05).Bland-Altman graphs revealed that the 95％ limit of agreement (LoA) of Kf,Ks and Km between the two methods was-0.37 D to 0.73 D,-0.33 D to 0.81 D and-0.30 D to 0.72 D,respectively,and that of J0 and J45 was-0.34 D to 0.48 D and-0.37 D to 0.33 D,respectively.Conclusions Ophtha TOP shows an excellent repeatability.Compared with Pentacam,Ophtha TOP presents a good consistence for measurement of the corneal astigmatism and moderate consistence for corneal curvature.
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Objective To explore the relationship between periodontal disease and preeclampsia and the effects of periodontal treatment on preeclampsia.Methods China National Knowledge Infrastructure,Chinese Biomedical Literature Database,WANGFANG DATA,China Dissertation Full-Text Database,China Proceedings of Conference Full-Text Database,Cochrane Library,PubMed,EMbase,Elsevier,Springer,and Science Direct OnSite were extracted from inception till September 30,2014.The case-control,cohort and randomized controlled trials about the association of matemal periodontal disease and preeclampsia were searched according to the inclusion and exclusion criteria.RevMan5.1 and Stata12.0 were used to test the heterogeneity of the results among the different studies and amalgamate the effect size using fixed or random effect models.Results Twenty studies (15 case-control and 5 cohort) involving 8 775 women assessed the association between periodontal disease and preeclampsia.A positive association was found (OR=2.48,95％CI:1.76-3.48,P ＜ 0.01).Meta-analysis of the case-control studies showed more than twice in the odds of preeclampsia with the presence of periodontal disease (OR=2.75,95％CI:1.93-3.92,P ＜ 0.01).Meta-analysis of cohort studies did not reveal any significant differences (OR=1.84,95％CI:0.91-3.74,P ＞ 0.05).Four randomized controlled trials with 3 712 women evaluated the effect of periodontal treatment on preeclampsia,and meta-analysis showed no relative risk reduction in preeclampsia with periodontal treatment (RR=1.04,95％CI:0.84-1.30,P ＞ 0.05).Conclusions Periodontal disease appears to be a possible risk factor for preeclampsia,but treatment during pregnancy does not prevent preeclampsia.High-quality prospective studies are needed to confirm the relationship between periodontal disease and preeclampsia.
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Objective To explore the risk factors of pregnancy complications in patients with gestationaldiabetesmellitus(GDM).Methods 134patientswithGDMweredividedintocontrolgroup without complication (n= 38) and complication group(n= 96).Serum fasting levels of glucose (FPG) , insulin ,lipid and C‐reactive protein (C‐RP) were measured. Both maternal and fetal complications of pregnancy were recorded. Results The levels of C‐RP ,FPG ,progestation BMI and lategestation BMI were significantly increased in complication group than in control group [(5.46 ± 4.20) vs (2.60 ± 2.76) mg/L ,(5.68 ± 1.36) vs (5.25 ± 0.77)mmol/L ,(24.79 ± 3.92) vs (23.03 ± 2.51)kg/m2 ,(29.05 ± 3.79) vs (27.25 ± 2.58)kg/m2 respectively ,P< 0.05].The C‐RP level is significantly associated with FPG.Logistic analysis showed that maternal complications were significantly related to lategestation BMI ,C‐RP , TC and HDL‐C.Infant complications were significantly related to C‐RP. Conclusion C‐RP ,lipid and late gestation BMI play important roles in the development of maternal‐neonatal complications during pregnancy. Keeping rational levels of glucose ,lipid and weight gain are helpful for improving pregnancy outcomes.
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Objective To study the clinical features and the clustering of risk factors in gestational diabetes mellitus (GDM),and analyze the risk factors.Methods Two hundred and three gravida were selected.According to the result of 75 g oral glucose tolerance test,they were divided into 2 groups:GDM group(134 cases) and normal glucose tolerance (NGT) group (69 cases).Blood sugar,blood fat and insulin were measured,and the homeostasis model of assessment for insulin resistance index (HOMA-IR),pancreatic islet beta cell function index (HOMA-β) and insulin sensitivity index (ISI) were calculated.The relation was analyzed between the risk factors and GDM.Results The age,progestation body mass index (BMI),fasting blood glucose,fasting insulin,total cholesterol,triglyeride,low density lipoprotein-eholesterol (LDL-C),HOMA-IR and the positive rate of diabetes mellitus family history in GDM group were significantly higher than those in NGT group [(30.8 ±4.1) years vs.(28.7 ±3.9) years,(24.29 ±3.65) kg/m2 vs.(21.35 ±2.39) kg/m2,(5.22 ±1.26) mmol/L vs.(4.33 ±0.53) mmol/L,(9.27 ±3.55) mU/L vs.(4.75 ±2.73) mU/L,(5.54 ± 1.26) mmol/L vs.(3.74 ± 1.07) mmol/L,(2.63 ± 1.43) mmol/L vs.(1.73 ± 0.76) mmol/L,(3.02 ± 0.97) mmol/L vs.(2.10 ± 0.75) mtmol/L,0.67 ± 0.47 vs.0.43 ± 0.34,40.3％ (54/134) vs.26.1％(18/69)],there were statistical differences (P＜ 0.01 or ＜ 0.05).The HOMA-β and ISI in GDM group were significantly lower than those in NGT group (4.62 ± 0.72 vs.5.57 ± 1.30 and-3.79 ± 0.47 vs.-2.91 ± 0.48),there were statistical differences (P ＜ 0.01).Logistic regression analysis result showed that fasting blood glucose (OR =6.016,95％ CI:1.603-22.585,P =0.008),total cholesterol (OR =2.823,95％ CI:1.568-5.083,P=0.001),diabetes mellitus family history (OR =2.780,95％ CI:1.168-6.617,P=0.021),fasting insulin(OR =1.954,95％ CI:1.371-2.785,P=0.001),progestation BMI(OR =1.787,95％ CI:1.124-2.839,P =0.014),age (OR =1.374,95％ CI:1.087-1.737,P =0.008) and diastolic pressure (OR =1.184,95％ CI:1.045-1.342,P =0.008) were the risk factors of GDM.Conclusions GDM has the clinical features of the clustering of risk factors and genetic susceptibility.The disorder of lipid metabolism and glycometabolism,genetic susceptibility and age are the main risk factors in the development of GDM.