Relationship between red blood cell distribution width and short-term mortality of hip fractures in the elderly / 中华老年医学杂志

Objective:To study the relationship between red blood cell distribution width(RDW)and short-term mortality in elderly patients with hip fragility fractures.Methods:The clinical data and blood routine test at admission of 205 elderly patients with brittle hip fractures who were admitted to our hospital from 2020 to 2021 and were followed up for one year were retrospectively analyzed.The comorbid conditions, RDW and cumulative mortality at 6 months and 1 year after fractures were counted, and the relationship between RDW and short-term mortality were analyzed.Results:The 6-month(6.7% and 20.8%, χ2=8.591, P=0.003)and 1-year(6.7% and 26.7%, χ2=14.818, P<0.001)mortality of patients with ≤1 comorbidity were significantly lower than those of patients with ≥2 comorbidities.Moreover, the 6-month and 1-year mortality in patients with RDW>13.5% were significantly higher than those of patients with RDW ≤ 13.5%.The proportion of RDW>13.5 % in patients with at least two comorbidities was significantly higher than that in patients with ≤1 comorbidity.Taking RDW=13.6% as the cut-off value of 6-month and 1-year mortality, the sensitivity and specificity for predicting 6-month mortality were 71.4 % and 59.9 %, respectively, and the sensitivity and specificity for predicting 1-year mortality were 64.7 % and 59.6 %, respectively. Conclusions:Red cell distribution width is associated with short-term mortality, and higher RDW is associated with a higher risk of mortality among elderly patients with brittle hip fractures.

Changes of serum ferritin and 25-(OH) vitamin D3 in cranial neuropathy diabetic patients / 中国医师杂志

Objective To observe the changes of serum ferritin and 25-(OH) vitamin D3 in patients with diabetic cranial neuropathy.Methods There were 50 patients without diabetic Cranial neuropathy,46 patients with diabetic cranial neuropathy,and 40 cases of normal control group.The changes of serum ferritin and 25-hydroxy vitamin D3 were observed in each group.The correlation between two indexes and the correlation with diabetic cranial neuropathy were analzyzed.Results The serum ferritin levels in diabetic group and diabetic neuropathy group were significantly higher than those in normal control group (P ＜ 0.01),and its level in patients with diabetic cranial neuropathy [(687.54 ± 65.38)ng/ml] was significantly higher than that of patients without diabetic cranial neuropathy [(497.28 ± 46.39) ng/ml,P ＜0.01].The serum 25-(OH) vitamin D3 levels in the diabetic group and diabetic neuropathy group were lower than those in the control group (P ＜ 0.01),and its level in patients with diabetic cranial neuropathy [(26.45 ± 8.93)nmol/l] was significantly less than that of patients without diabetic cranial neuropathy [(37.19-± 9.74)nmol/L,P ＜ 0.01].Serum ferritin levels were positively correlated with 25-(OH) vitamin D3 (r =-0.59,P ＜ 0.01).Multivariate unconditional Logistic regression analysis showed that diabetic neuropathy was negatively correlated with 25-(OH) vitamin D3 (P ＜ 0.05).Conclusions The increases of serum ferritin and 25-(OH) vitamin D3 are closely related to the occurrence and development of diabetic cranial neuropathy,which provides the theoretical basis for clinical intervention therapy.

Study of the default mode network alteration after subacute pontine infarction using rs-fMRI / 实用放射学杂志

Objective To investigate the alteration and possible compensation mechanism of the default mode network (DMN) in patients with subacute pontine infarction.Methods Rs-fMRI data were collected from 23 patients with subacute pontine infarction and 23 normal controls.The data was analyzed with the functional connectivity (FC) method and compared between subacute pontine infarction patients and controls.All imaging was performed on a Philips Achieva 3.0T MRI scanner.Posterior cingulated cortox (PCC) was used as seed points to analyze the FC changes in the brain regions between the pontine infarction group and the controls.The discrepancies of experiment data between two groups were compared by using two-sample t-test analysis.Results The FC of the DMN showed a significant increase in the right postcentral gyrus, left medial prefrontal cortex and left precuneus compared with normal controls and a significant decrease in bilateral insula,posterior lobe of the left cerebellum,right parahippocampal gyrus and left inferior occipital gyrus.Conclusion The DMN altered in patients with subacute pontine infarction and the changes of the FC suggested the plasticity of cortical or compensation in the relevant brain areas.

Clinical application of a 3D-printed metal drilling template in surgery for complex upper cervical disorders / 中华创伤骨科杂志

Objective To report the clinical effects of a 3D-printed metal drilling template used in surgery for complex upper cervical disorders.Methods Between August 2015 and June 2017,5 patients with upper cervical disorder complicated with complex cranial cervical junction deformity underwent instrumentation and fusion.They were 4 males and one female,aged from 3 to 36 years.All the patients underwent thin slice CT scan before operation.The CT image data were imported into a computer workstation for three dimensional reconstruction of individualized models of the upper cervical spine on which individualized drilling templates were designed.Guided by each of the individualized metal drilling templates manufactured by 3D printing,surgery via the posterior approach was performed in 2 cases and surgery via the combined anterior and posterior approach in 3 cases.After surgery,the screw trajectory was evaluated by CT scan.Results Surgery succeeded in all the 5 patients.A total of 5 pedicle screws and 5 laminar screws were drilled.Postoperative CT scan showed accurate placement of all the 10 screws.The patients recovered with no neurovascular complications.Conclusion Since an individualized 3D-printed metal drilling template can improve the accuracy and safety of screw placement,it can reduce surgical risks and enhance surgical success in the surgery for complex upper cervical disorders.

Study on Medication Rules of Spleen-stomach Deficiency Syndromes inLin Zheng Zhi Nan Yi An Based on Data Mining / 中国中医药信息杂志

Objective To discuss the relation and differences among spleen-deficiency syndromes, stomach-deficiency syndromes and spleen-stomach deficiency syndromes.Methods Terms about spleen-stomach deficiency syndromes in the book ofLin Zheng Zhi Nan Yi Anwere screened. Syndrome names about “spleen deficiency”, “stomach deficiency”, “stomach-yang deficiency”, “tu deficiency”, “spleen-stomach deficiency”, “middle-jiao deficiency”, “yang-ming deficiency”, and “tai-yin deficiency” should be included in this study. And then medication and compatibility of medicines of spleen-deficiency syndromes, stomach-deficiency syndromes and spleen-stomach deficiency syndromes were determined according to the main efficacy of the medication and compatibility of medicines. Relevant data were standardized and then database was built. Apriori algorithm in SPSS Clementine12.0 was used to conduct data mining.Results Totally 421 relevant cases were collected in this study, involving 525 prescriptions (92 spleen-deficiency syndromes, 276 stomach-deficiency syndromes and 157 spleen-stomach deficiency syndromes). 11 medication association rules about spleen-deficiency syndromes, 38 about stomach-deficiency syndromes, and 28 about spleen-stomach deficiency syndromes were found based on data mining. ConclusionMost prescriptions for spleen-stomach deficiency syndromes are “warm dryness, cool and moister, sweet and warm to tonify the midde jiao”, which embody Ye’s medication features that emphasizes treating spleen and stomach separately, the differences of lifting spleen and dropping stomach, and in nourishing yin and tonifying yang.

Comparative study of the volume and fiber of frontal lobe in amnestic mild cognitive impairment / 中华行为医学与脑科学杂志

ObjectiveTo detect the fiber structure and volume differences in frontal lobe between patients with amnestic mild cognitive impairment (aMCI) and normal control.MethodsT1 -weighted magnetic resonance imaging and diffusion tensor imaging were obtained in 28 aMCI patients and 25 normal controls.Volumes,fiber fractional anisotropy (FA),fiber apparent diffusion coefficient (ADC),fiber number,and average fiber length of frontal lobe in the two groups were measured.ResultsVolumes of left frontal lobe ( ( 337.35 ± 20.45 ) cm3 ) in aMCI group were smaller than control ( (358.54 ± 27.26) cm3 ) ( t =- 3.223,P =0.002 ).Numbers of short range fiber in left frontal lobe ( 16985 ± 892) were significantly increased relative to control ( 16387 ±752) ; while numbers of long range fiber (3214 ± 185 ) were reduced compared with control (3425 ± 277 ),and ADC values increased ( t =2.621,P =0.012; t =-3.714,P =0.001 ; t =17.595,P=0.000).In aM CI group,numbers of long range fiber in right frontal lobe were reduced (2895 ± 343 vs.3451 -± 230,t =- 7.011,P =0.000),and ADC values were increased ( t =4.443,P =0.000).In aMCI group,numbers of long range fiber in left frontal lobe were positively correlated with scores of mini-mental state examination ( MMSE ) ( r =0.457,P =0.015 ),while ADC values of long range fiber in left frontal lobe were negatively correlated with scores of MMSE ( r=-0.415,P=0.028).ConclusionThe structure and fiber connectivity are affected in aMCI patients and the lesion of connectivity in left frontal lobe are related to the severity of symptom.

Electroacupuncture for promoting endogenous neural stem cell proliferation and neurological rehabilitation early after cerebral infarction / 中华物理医学与康复杂志

Objective To study the effects of electroacupuncture (EA) on the proliferation and differentiation of neural stem cells (NSCs),and to explore any effect of EA in neurological rehabilitation and its mechanism.Methods Middle cerebral artery occlusion (MCAO) was used to establish a model of cerebral infarction in 120 Wistar rats.They were then randomly divided into a treatment group and a control group,both of which were further subdivided into 1,3,7,14,21 and 28 day sub-groups with 10 in each sub-group.Bromodeoxyuridine (Brdu) was given at the 1st,2nd,6th,13th,20th and 27th day to detect any proliferation and differentiation of NSCs.After 7 days the motor function of the two groups was evaluated using a beam walking test.Rats were sacrificed at the different time points and Brdu labeled cells and nestin-positive cells were determined by immunohistochemistry.The level of basic fibroblast growth factor-2 (FGF-2) mRNA was determined by in-situ hybridization.The results were analyzed using a micro-image analysis system.Results The Brdu-labeled cell counts and nestin-positive cells were significantly different between the treatment and control groups at each time point.Motor function improved significantly in the treatment group with EA stimulation compared with the control group,but there was no significant difference between the 21 day and 28 day sub-groups in the treatment group.The expression levels of bFGF-2 mRNA were significantly different between the treatment and control groups at the early time points (up to the 14th day).Conclusions EA can promote proliferation of NSCs and increase the expression of FGF-2 mRNA,particularly early after cerebral infarction.It may be one of mechanisms of EA's effectiveness in treating ischemic stroke.

The expression and clinical significance of MMP-2 and MMP-7 in colorectal carcinomas / 中国综合临床

Objective To investigate the expression of MMP-2 and MMP-7 and their elinieopathologieal significance in eoloreetal carcinomas. Methods The expression of MMP-2 mRNA, MMP-7 mRNA and MMP-2, MMP-7 in 42 samples of eoloreetal carcinomas and its adjacent normal eoloreetal mueosa were examined using fluo-rescence quantitative RT-PCR (FQ-RT-PCR) and immunohistoehemistry. The relationship of their expression with some elinieopathologieal characteristics was analyzed. Results MMP-2 mRNA, MMP-7 mRNA and MMP-2, MMP-7 were significantly over-expressed in eoloreetal carcinomas compared with its adjacent normal eoloreetal mueosa( P < 0.05 ) , and they were positively associated with bowel wall invasion, the regional lymph node metastasis and Dukes stage. The expression of MMP-2 mRNA and MMP-7 mRNA was positively correlated with MMP-2 and MMP-7 in eoloreetal eareinornas. Conclusions MMP-2 and MMP-7 may play a key role in eoloreetal carcinogenesis,tumor in-vasion and metastasis. Examination of combined MMP-2 and MMP-7 expression may have an important significance to judge the malignant degree and biological behavior of human eoloreetal carcinoma and for evaluating the progno-sis.