Feasibility of using cortical bone trajectory screws in osteoporotic thoracolumbar fixation based on evaluation of bone CT values at bone-screw interface / 中华创伤骨科杂志

Objective:To evaluate the feasibility of using cortical bone trajectory (CBT) screws in the osteoporotic thoracolumbar fixation by comparing the bone CT values at the bone-screw interface between traditional trajectory (TT) screws and CBT screws in patients with different bone densities.Methods:The high-resolution CT imaging data of thoracolumbar segments following thoracic or lumbar spine fractures from April 2020 to October 2022 were collected at The Second Hospital Affiliated to Wenzhou Medical University for retrospective analysis. They were divided into 3 groups: a normal bone mass group, an osteopenia group and an osteoporosis group. From each group 30 cases were chosen (90 cases in total, 36 males and 54 females). All the data were imported into Mimics 18.0 for three-dimensional bone reconstruction in which placement of TT and CBT screws was simulated on the vertebrae from T10 to L2 (non-fractured vertebrae). Regions of interest (ROI) where each simulated screw intersected the bone were segmented to measure their CT bone values. For each vertebra in each group, the relative difference percentage in average CT value of ROI between TT and CBT screws was calculated. The CT values of ROI were compared in the same group between TT and CBT screws from T10 to L2; the CT values of ROI were compared in the same screws among the 3 groups from T10 to L2; the CT values of ROI were compared between the CBT screws in the osteopenia and osteoporosis groups and the TT screws in the normal bone mass group; the relative difference percentages in average CT value of ROI between CBT and TT screws were compared between the 3 groups from T10 to L2.Results:The average CT value of ROI for CBT screws was significantly higher than that for TT screws from T10 to L2 in every group ( P< 0.001); as for the CT values of ROI for CBT and TT screws from T10 to L2, the osteoporosis group<the osteopenia group<the normal bone mass group ( P<0.001); from T10 to L2, the CT value of ROI for CBT screws in the osteopenia group was significantly higher than that for TT screws in the normal bone mass group ( P<0.001); the CT value of ROI for CBT screws in the osteoporosis group was not significantly different from that for TT screws in the normal bone mass group ( P>0.05). At T10, T12, and L1, the relative difference percentage in average CT value of ROI between CBT and TT screws was significantly higher in the osteopenia and osteoporosis groups than that in the normal bone mass group ( P<0.05), but there was no such a difference between the osteopenia and the osteoporosis groups ( P>0.05). At T11 and L2, there was no significant difference between the 3 groups in the relative difference percentage in average CT value of ROI between CBT and TT screws ( P>0.05). Conclusions:As bone mass decreases, both CBT and TT screws lead to a significant decrease in the bone density at the bone-screw interface. In patients with osteoporosis, CBT screws can still lead to a higher bone density at the bone-screw interface than TT screws, thus providing a higher strength at the bone-screw interface.

Interferon-related gene array in predicting the efficacy of interferon therapy in chronic hepatitis B / 生物医学工程学杂志

This study aims to clarify host factors of IFN treatment in the treatment of chronic hepatitis B (CHB) patients by screening the differentially expressed genes of IFN pathway CHB patients with different response to interferon (IFN) therapy. Three cases were randomly selected in IFN-responding CHB patients (Rs), non-responding CHB patients (NRs) and healthy participants, respectively. The human type I IFN response RT 2 profiler PCR array was used to detect the expression levels of IFN-related genes in peripheral blood monocytes (PBMCs) from healthy participants and CHB patients before and after Peg-IFN-α 2a treatment. The results showed that more differentially expressed genes appeared in Rs group than NRs group after IFN treatment. Comparing with healthy participants, IFNG, IL7R, IRF1, and IRF8 were downregulated in both Rs and NRs group before IFN treatment; CXCL10, IFIT1, and IFITM1 were upregulated in the Rs; IL13RA1 and IFI35 were upregulated in the NRs, while IFRD2, IL11RA, IL4R, IRF3, IRF4, PYHIN1, and ADAR were downregulated. The expression of IL15, IFI35 and IFI44 was downregulated by 4.09 ( t = 10.58, P < 0.001), 5.59 ( t = 3.37, P = 0.028) and 10.83 ( t = 2.8, P = 0.049) fold in the Rs group compared with the NRs group, respectively. In conclusion, IFN-response-related gene array is able to evaluate IFN treatment response by detecting IFN-related genes levels in PBMC. High expression of CXCL10, IFIT1 and IFITM1 before treatment may suggest satisfied IFN efficacy, while high expression of IL13RA1, IL15, IFI35 and IFI44 molecules and low expression of IFRD2, IL11RA, IL4R, IRF3, IRF4, PYHIN1 and ADAR molecules may be associated with poor IFN efficacy.

Association between anti-tissue transglutaminase antibody titers and duodenal histopathology among adults with celiac disease / 中华内科杂志

To evaluate the association between serum anti-tissue transglutaminase antibody (anti-tTG) titers and the severity of histological damage to the duodenal mucosa and to predict a possible anti-tTG cutoff value for diagnosing celiac disease (CD) and villous atrophy in the domestic population. Clinical and pathological data from 76 adult CD patients with positive anti-tTG titers and duodenal biopsy results who were treated at the People′s Hospital of Xinjiang Uygur Autonomous Region from July 2017 to January 2022 were retrospectively analyzed. The correlation between anti-tTG titers and the severity of duodenal mucosal damage was statistically assessed to predict the optimal anti-tTG titer cut-off value for diagnosing CD and villous atrophy. Of the 76 patients, 10 had underlying CD, and of the 66 patients with duodenal histopathology, four were Marsh Ⅰ, six were Marsh Ⅱ, and 56 were Marsh Ⅲa-c grade. In adults with CD, anti-tTG titers were shown to be associated with the severity of histological damage to the duodenal mucosa. When the anti-tTG level was ≥5 times the upper limit of normal (ULN), the sensitivity and specificity for diagnosing CD were 83.9% and 92.9%, respectively. When the anti-tTG titer was ≥8 times the ULN, the sensitivity and specificity for diagnosing villous atrophy were 67.9% and 90.0%, respectively. Anti-tTG levels had a strong predictive value for diagnosing CD in adults when titers exceeded 10 times the ULN. Thus, the anti-tTG cut-off value can be combined with clinical judgment to diagnose CD, limiting the use of invasive endoscopy.

Influencing factors on the detection rate of colorectal polyps in colonoscopy using repeated examination / 中华消化内镜杂志

Objective@#To study influencing factors on the detection rate of colorectal polyps by repeated examination in colonoscopy.@*Methods@#A total of 900 patients in the digestive endoscopy center of the People′s Hospital of Xinjiang Uygur Autonomous Region received colonoscopy, 300 patients were randomly selected for a second examination and they were selected for three times examination from August 2016 to March 2017. Objective factors for colonoscopy were strictly controlled during the examination, such as endoscopists′ experience, endoscopic operating method, cleansing degree of the intestine and withdrawal time. The characteristics of polyps were recorded, including number, location, shape, size and pathological types of polyps. The characteristics of polyps were compared between the same patient, and between the first-examination group, the second-examination group and the third-examination group. Logistic regression was used to analyze the independent influencing factors of missed diagnosis.@*Results@#A relatively high rate of missed diagnosis could occur in multiple polyps, ascending colon polyps, transverse colon polyps, sigmoid polyps, stepless polyps and small polyps (<5 mm) (All P<0.05), and the pathological type was irrelevant to missed diagnosis (P>0.05). Logistic regression analysis showed that the number, location, shape and size of colorectal polyps were all independent factors influencing the detection rate(all P<0.05). The detection rate of polyps in the two times colonoscopy group was higher than that of the one time colonoscopy group, but there was no statistical difference between the second observation and the third observation (P>0.05).@*Conclusion@#The number, location, shape and size of colorectal polyps are all independent factors influencing the detection rate. The detection rate of polyps may be improved by using the second colonoscopy.

Correlation between neutrophils lymphocytes ratio and disease activity in patients with ulcerative colitis / 中国医师杂志

Objective To investigate the conrelation between neutrophils lymphocytes ratio (NLR) and disease activity of ulcerative colitis (UC).Methods Case-control study was used to compare NLR differences of 82 active UC patients,45 inactive UC patients,and 254 healthy controls.The multivariate analysis was applied to analyze the correlation between the NLR,erythrocyte sedimentation rate (ESR),Creactive protein (CRP),white blood cells (WBCs),and UC activity.The sensitivity and specificity of NLR to identify UC activity was evaluated.Results NLR of active UC group was 2.45 ± 1.22,which was significantly higher than that of inactive UC group and healthy control group,their NLR were 1.92 ± 0.68 and 1.83 ±0.75,respectively (H =9.991,P =0.007).The multivariate analysis showed that only CRP was correlated with UC activity (OR =1.396,95％ CI:1.086 ～ 1.795,P =0.009).Receiver operating characteristic (ROC) curve analysis showed that the optimum NLR cut-off point for UC activity was 2.23,the sensitivity and specificity were 55.82％ and 62.75％,respectively.Conclusions NLR has a certain reference value for the evaluation of UC activity,but it cannot be independent as a clinical index to evaluate the UC activity.

Investigation of disease related knowledge level and needs in Xinjiang Uygur and Han patients with ulcerative colitis / 中国实用护理杂志

Objective To investigate the knowledge level and needs in Xinjiang Uygur and Han patients with ulcerative colitis (UC), compare the differences between the two ethnic groups. Methods A total of 194 Uygur and Han UC patients were investigated with the general information questionnaire, the Crohn′s and Colitis Knowledge Score (CCKNOW) questionnaire, disease related knowledge needs questionnaire, to analyze the investigate results. Results CCKNOW score of Uygur and Han UC were (6.9±3.5) points and (9.2±3.1) points respectively, and Uygur was significantly lower than that of Han (Z=-2.831, P=0.005). Knowledge accuracy of dietary (30% and 63%) and drug (45% and 44%) were higher than general information (24% and 32%) and complications (12% and 30%) . Disease related knowledge needs score of Uygur and Han UC patients were (168.2±15.6) points and (155.4±17.2) points respectively, the score of Uygur patients was significantly higher than that of Han patients (t=4.429, P=0.001).The highest disease related knowledge needs score was (4.7±1.0) points of reproductive knowledge for Uygur UC patients, for Han patients was knowledge of daily life which was (4.8 ± 0.8) points. Conclusions The disease related knowledge level of Xinjiang Uygur and Han UC patients are relatively low, especially lack of general knowledge and diet knowledge, disease related knowledge of Uygur UC patients are lower than Han patients. The needs of the disease knowledge are very high for two ethnic groups, different one has different ethnic, gender, age, education level, living environment, hospitalization times, areas of disease related knowledge needs are also different. It is necessary to choose the targeted education content and suitable education way according to individual differences for nursing staff.

Clinical characteristics of 67 cases of new-onset diffuse type ulcerative colitis / 中华消化杂志

Objective To analyze the clinical characteristics of new onset diffuse type ulcerative colitis.Methods From May 2007 to March 2012,clinical data of hospitalized patients diagnosed in the People's Hospital of Xinjiang Autonomous Region as new onset ulcerative colitis were retrospectively analyzed,and constituent ratios of nationality,gender,age at diagnosis,residential environment,severity of disease,clinical symptoms,results of laboratory examination,results of colonoscopic examination and results of histopathological examination were compared among the diffuse type,the type of proctosigmoiditis and the type of left-sided colitis.Normal distribution data were analyzed by one-way analysis of variance,skew distribution data and ordinal data were analyzed by Kruskal-Wallis H test,and count data were analyzed by chi-square test in the comparison among the three groups.Results A total of 67 patients with new-onset diffuse type ulcerative colitis were enrolled.The constituent ratios of Han nationality,Uygur nationality and Kazak nationality were 32.8％(22/67),58.2％(39/67),and 9.0％(6/67),respectively.The ratio of male to female was 1.48∶ 1.The age at diagnosis was (43.27 ± 16.91) years old.The ratio of city to countryside was 3.19∶ 1.To the severity of the disease,mild was more common,the proportion of mild,moderate and severe were 56.7％(38/67),20.9％(14/67) and 22.4％ (15/67),respectively.Abdominal pain,diarrhea and purulent stools were the predominant symptoms.Some patients might have fever and tenesmus,a few patients accompanied with abdominal distension,nausea,vomiting and peripheral arthritis.The percentage of increasesed erythrocyte sedimentation rate,hypersensitive Creation protein and plasmatic fibrinogen was 37.3％(25/67),44.8％(30/67) and 31.3％ (21/67),respectively.To compare with patients with proctosigmoiditis and left-sided colitis,the patients with new-onset diffuse type colitis had higher Mayo score and were more prone to develop abdominal pain,diarrhea,severe colitis,and were more common in Uygur nationality.There were statistical differences in abdominal pain,diarrhea,severity,ratio of Uygur nationality and Mayo score in pairwise comparison among the three groups (all P＜0.017).Conclusion Abdominal pain,diarrhea and Uygur nationality are more common in new onset diffuse ulcerative colitis in Xinjiang Region,with relatively high Mayo score and mild to moderate degree,while severity significantly increased compared to the type of proctosigmoiditis and the type of left-sided colitis.

Study of recurrence factors of ulcerative colitis in Xinjiang district / 中国综合临床

Objective To investigate clinical characteristics and related factors of ulcerative colitis (UC).Methods One hundred and thirty-seven newly diagnosed patients with UC from 2006 to 2009 in the People's Hospital of Xinjiang Uygur Autonomous Region were selected as our subjects.The clinical data were recorded and the patients were followed up for 3 years.Results Of 137 patients,complete remission rate was 38.69％ (53/137),and partial response rate was 61.31％ (84/137).The overall effective rate was 100％ (137/137).The 1-year cumulative relapse rate was 26.28％ (36/137),and 2-year cumulative relapse rate was 49.64％ (68/137),59.85％ (82/137) for 3-year cumulative relapse rate.The occasion rate (≤ 1 time/year)was 27.01％ (37/137),and frequency (≥2 times/year) was 32.85％ (45/137).Fifty-five patients (40.15％ (55/137)) were no recurrence within 3 years.Relapse rate were not relate to gender (P ＞0.05).The relapse rate of patients less than 50 years was 68.09％ (64/94) substantially higher than that over 50 age group (41.86％ (18/43),x2 =8.444,P ＜ 0.05).The relapse rate of Uygur patients (70.42％,50/71) was substantially higher than the Han (48.48 ％ (32/66),x2 =6.851,P ＜ 0.05).The relapse rate of left colon and extensive colon were 71.64％ (48/67) and 71.88％ (23/32),higher than that of rectum(28.94％,11/38) (P＜ 0.05).The relapse rate of severe group (82.61％,19/23) was higher than that of the mild (52.38％,33/63)and moderate groups (58.82％,30/51) (P ＜ 0.05).In maintenance of mitigation group,52.73％ patients (29/55) were received maintenance treatment and relapse of those patients were significantly higher than recurrence group (31.71％,26/82,P ＜ 0.05).Mental stress may be the top one risk factor,which lead to recurrence of UC (64.63％,53/82),followed by imbalance diet (56.10％,46/82) and overwork (39.02％,32/82).Conclusion Relapse rate of the Uygnr UC patients was higher than that of the Han,and young adults has the higher recurrence rates than the elder.The factors of lesion extent,severity,ability to maintain treatment are related to recurrence of UC.Stress,imbalance diet and overwork are risk factors of recurrence of UC.

The correlation between human leukocyte antigen-DRB1 alleles and anti-neutrophil cytoplasmatic antibodies in Han and Uygur ulcerative colitis patients in Xinjiang region / 中华消化杂志

Objective To study the correlation between human leukocyte antigen (HLA)-DRB1 alleles and anti neutrophil cytoplasmatic antibodies (ANCA) in Han and Uygur ulcerative colitis (UC)patients in Xinjiang region.Methods The serum ANCA was determined by indirect immunofluorescence assay in 62 Uygur UC patients,58 Han UC patients,188 Uygur and 184 Han healthy control individuals.HLA-DRB1 typing was performed by polymerase chain reaction-sequence based typing (PCR-SBT).The allele frequency of HLA-DRB1 was compared in ANCA positive and negative Han and Uygur patients as well as healthy controls.Stratified analysis was performed according to UC clinical type,severity and involvement.SPSS 17.0 software was applied for x2 test.Once P＜0.05,the odds ratio (OR) and 95％ confidence intervals (95％CI) was calculated.Results The positive rate of ANCA in Uygur UC patients (53.2％,33/62) was significantly higher than that of Han patients (34.5％,20/58) and the difference was statistically significant (x2=4.269,P =0.045).In Uygur,the gene frequency of HLA-DRB1 * 13 in ANCA positive UC patients (0.202)was significantly higher than that of ANCA negative patients (0.017) (x2 =10.092,P=0.016,OR=16.000,95％CI:2.892 to 88.524) and healthy controls (0.075) (x2=9.351,P＝0.040,OR=3.407,95％CI:1.666 to 6.971).The gene frequency of HLA-DRB1 * 13 in ANCA positive pancolitis type UC patients (9/15) was significantly higher than that of ANCA negative pancolitis type UC patients (1/14) and the difference was statistically significant (x2=8.955,P =0.040,OR =19.500,95％CI:2.787 to 136.461).However,in Han patients,there were no significant differences of HLA-DRB1 alleles frequencies among ANCA positive patients,ANCA negative patients and healthy controls (all P＞0.05),and the results of stratified analysis were same.Conclusions In Uygur UC patients of Xinjiang region,HLA-DRB1 * 13 may correlated with ANCA and with ANCA of pancolitis type UC patients.There is no such correlation in Han patients of Xinjiang region.