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1.
Clin Respir J ; 13(7): 438-445, 2019 Jul.
Article in English | MEDLINE | ID: mdl-30955228

ABSTRACT

INTRODUCTION: The DECAF score is a simple and effective tool for predicting mortality in patients hospitalized with acute exacerbations of chronic obstructive pulmonary disease (AECOPD); however, the DECAF score has not been validated in AECOPD patients requiring invasive mechanical ventilation (IMV). We devised the ventilator (v)-DECAF score, in which "anemia" replaces "acidaemia," for use in AECOPD patients requiring IMV. The objective of this study was to compare the predictive efficacy of the v-DECAF score and the DECAF score. METHODS: This study prospectively recruited 112 consecutive AECOPD patients requiring IMV from a single center. The clinical endpoint was 90-day all-cause mortality. Demographic and clinical data were recorded, as well as APACHE II, GCS, CURB-65, BAP-65 and DECAF scores, and the newly devised v-DECAF score. The discriminatory value of the scoring systems in predicting 90-day all-cause mortality was determined using the area under the receiver operating characteristic (AUROC) curve. RESULTS: In multivariate logistic regression analysis, the v-DECAF score was an independent predictor of 90-day all-cause mortality (odds ratio 3.004, 95% CI 1.658-5.445, P < 0.001). The AUROC of the v-DECAF and DECAF scores were 0.852 (95% CI 0.766-0.938) and 0.777 (95%CI: 0.676-0.878), respectively. The v-DECAF score had a better predictive value for 90-day all-cause mortality compared to the DECAF score (Z = 2.338, P = 0.019). CONCLUSION: The v-DECAF score had good discriminatory power in predicting 90-day all-cause mortality in AECOPD patients requiring IMV.


Subject(s)
Cause of Death , Hospital Mortality/trends , Pulmonary Disease, Chronic Obstructive/mortality , Pulmonary Disease, Chronic Obstructive/therapy , Respiration, Artificial/methods , Aged , China , Cohort Studies , Disease Progression , Female , Hospitalization , Humans , Logistic Models , Male , Middle Aged , Multivariate Analysis , Predictive Value of Tests , Prospective Studies , Pulmonary Disease, Chronic Obstructive/diagnosis , Respiration, Artificial/mortality , Risk Assessment , Severity of Illness Index , Survival Analysis , Treatment Outcome
2.
J Spinal Disord Tech ; 28(2): E74-7, 2015 Mar.
Article in English | MEDLINE | ID: mdl-25089678

ABSTRACT

BACKGROUND: Thoracic transverse process is an important anatomic structure of the spine. Several anatomic studies have investigated the adjacent structures of the thoracic transverse process. But there is still a blank on the morphology of the thoracic transverse processes. The purpose of the cadaveric study is to investigate the morphology of thoracic transverse processes and to provide morphology basis for the pedicle-rib unit (extrapedicular) screw fixation method. METHODS: Forty-five adult dehydrated skeletons (T1-T10) were included in this study. The length, width, thickness, and the tilt angle (upward and backward) of the thoracic transverse process were measured. The data were then analyzed statistically. On the basis of the morphometric study, 5 fresh cadavers were used to place screws from transverse processes to the vertebral body in the thoracic spine, and then observed by the naked eye and on computed tomography scans. RESULTS: The lengths of thoracic transverse processes were between 16.63±1.59 and 18.10±1.95 mm; the longest was at T7, and the shortest was at T10. The widths of thoracic transverse processes were between 11.68±0.80 and 12.87±1.48 mm; the widest was at T3, and the narrowest was at T7. The thicknesses of thoracic transverse processes were between 7.86±1.24 and 10.78±1.35 mm; the thickest was at T1, and the thinnest was at T7. The upward tilt angles of thoracic transverse processes were between 24.9±3.1 and 3.0±1.56 degrees; the maximal upward tilt angle was at T1, and the minimal upward tilt angle was at T7. The upward tilt angles of T1 and T2 were obviously different from the other thoracic transverse processes (P<0.01). The backward tilt angles of thoracic transverse processes gradually increased from 24.5±2.91 degrees at T1 to 64.5±5.12 degrees at T10. The backward tilt angles were significantly different between each other, except between T5 and T6. In the validation study, screws were all placed successfully from transverse processes to the vertebrae of thoracic spine. CONCLUSIONS: The length, width, and thickness of the thoracic transverse processes are suitable for screw placement. And the obvious upward and backward tilt angles provide an excellent screw passage from transverse process to the vertebral body. Screw placement from the transverse processes to the vertebral body is feasible in the thoracic spine. However, there is still some place for improvement of the pedicle-rib unit screw fixation method.


Subject(s)
Fracture Fixation, Internal , Pedicle Screws , Ribs/anatomy & histology , Ribs/surgery , Spine/anatomy & histology , Spine/surgery , Thoracic Vertebrae/anatomy & histology , Thoracic Vertebrae/surgery , Adult , Cadaver , Female , Humans , Male , Middle Aged , Tomography, X-Ray Computed , Young Adult
3.
Mol Med Rep ; 7(2): 577-84, 2013 Feb.
Article in English | MEDLINE | ID: mdl-23242469

ABSTRACT

Cluster of differentiation 133 (CD133) is recognized as a stem cell marker for normal and cancerous tissues. Using cell culture and real­time fluorescent polymerase chain reaction, CD133 expression was analyzed in osteosarcoma tissue and Saos­2 cell lines. In addition, cancer stem cell­related gene expression in the Saos­2 cell line was determined to explore the mechanisms underlying tumorigenesis and high drug resistance in osteosarcoma. CD133+ cells were found to be widely distributed in various types of osteosarcoma tissue. Following cell culture, cells entered the G2/M and S cell cycle stages from G0/G1. Levels of CD133+ cells decreased to normal levels rapidly over the course of cell culture. Colony forming efficiency was higher in the CD133+ compared with the CD133­ subpopulation of Saos­2 cells. Expression levels of stem cell­related genes, including multidrug resistance protein 1 (MDR1) and sex determining region Y­box 2 (Sox2) in the CD133+ subpopulation of cells were found to be significantly higher compared with the CD133­ subpopulation. These observations indicate that CD133+ Saos­2 cells exhibit stem cell characteristics, including low abundance, quiescence and a high potential to undergo differentiation, as well as expression of key stem cell regulatory and drug resistance genes, which may cause osteosarcoma and high drug resistance.


Subject(s)
Antigens, CD/metabolism , Glycoproteins/metabolism , Peptides/metabolism , AC133 Antigen , ATP Binding Cassette Transporter, Subfamily B, Member 1/metabolism , Cell Differentiation , Cell Line, Tumor , Cell Proliferation , Drug Resistance, Neoplasm , Humans , Interphase , Neoplastic Stem Cells/metabolism , Osteosarcoma/metabolism , Osteosarcoma/pathology , SOXB1 Transcription Factors/metabolism
4.
Zhonghua Wai Ke Za Zhi ; 47(15): 1182-4, 2009 Aug 01.
Article in Chinese | MEDLINE | ID: mdl-20021913

ABSTRACT

OBJECTIVES: To study the best entry points, direction and length of screw in acetabular posterior column plate technique, and to prevent the serious complications of screw penetrating the joint surface. METHODS: February to July 2008 20 male cadaveric adult semi-pelvic specimen were taken.Serial cross-sections of the acetabular posterior column were determined and made. The safe angle of screw entry and the length on all entry points of each cross-section were measured. And put all data into software SPSS 10.0 for statistics process. RESULTS: On margin of acetabulum, lateral-middle 1/4 point, midpoint, medial-middle 1/4 point and medial margin of posterior column of each cross-section, safe entry angle of inclination was 39 degrees , 57 degrees , 74 degrees , 90 degrees and 106 degrees respectively, the length of the screw was 39, 57, 74, 90 and 106 mm respectively. CONCLUSION: On lateral 1/4 region, lateral-middle 1/4 region, medial-middle 1/4 region and medial 1/4 region, screw posterior column angle is 40 degrees to 60 degrees , 60 degrees to 75 degrees , 75 degrees to 90 degrees , 90 degrees to parallel to the quadrilateral plate, and the length of the screw is 30 mm.


Subject(s)
Acetabulum/anatomy & histology , Fracture Fixation, Internal/methods , Acetabulum/surgery , Adult , Bone Plates , Bone Screws , Cadaver , Humans , Male
5.
J Foot Ankle Surg ; 48(6): 691.e1-4, 2009.
Article in English | MEDLINE | ID: mdl-19857831

ABSTRACT

UNLABELLED: The authors report an unusual case wherein a fasciocutaneous free flap from an amputated upper limb was used to repair a severe soft tissue injury of the ipsilateral forefoot and ankle. After amputating the nonviable portions of the forefoot, a residual limb flap from the patient's forearm, pedicled with the brachial artery, was used to cover the lower extremity defect. Three years after the injury, the patient was able to maintain balance and ambulate without assistance on the reconstructed lower extremity. LEVEL OF CLINICAL EVIDENCE: 4.


Subject(s)
Ankle Injuries/surgery , Burns, Electric/surgery , Fascia/transplantation , Foot Injuries/surgery , Skin Transplantation/methods , Soft Tissue Injuries/surgery , Surgical Flaps , Ankle Injuries/diagnosis , Burns, Electric/diagnosis , Follow-Up Studies , Foot Injuries/diagnosis , Humans , Male , Middle Aged , Severity of Illness Index , Soft Tissue Injuries/diagnosis
6.
Zhonghua Zheng Xing Wai Ke Za Zhi ; 24(1): 39-41, 2008 Jan.
Article in Chinese | MEDLINE | ID: mdl-18437983

ABSTRACT

OBJECTIVE: To investigate the effect of VEGF (vascular endothelial growth factor) gene therapy and skin flap delay on the survival of rat's abdominal axial skin flap. METHODS: In 48 Wistar rats, the model of a abdominal axial skin flap supplied by right superficial epigastric vessel was created. The rats were divided into six groups. The group was treated with subcutaneous injection of pcDNA4-VEGF165, skin flap delay or VEGF injection combined with skin flap delay. 7 days later, the survival rate of the skin flap was measured; specimens were harvested from the skin flap for histological investigation of the microvessels and for immunohistochemical staining to observe the expression of VEGF. RESULTS: Every treated group was significantly higher than blank group in the average survival rate of the skin flap and group V (gene injection when delayed) has the highest one. The average number of the microvessels in group II, III, V, VI was significantly higher than group IV and blank group. Group IV > group V, VI > group II, III > blank group in lumen diameter of the microvessels. Immunohistochemical staining documented more deposition of VEGF DNA in group II, III, V, VI than group IV and blank group. CONCLUSIONS: Both administration of pcDNA4-VEGF165 and skin flap delay can improve the survival of rat's abdominal axial skin flap, but the mechanisms of the effect were different. The combination of the two ways has stronger effect.


Subject(s)
Abdominal Wall/surgery , Genetic Therapy , Graft Survival , Vascular Endothelial Growth Factor A/genetics , Animals , Disease Models, Animal , Genetic Vectors , Male , Rats , Rats, Wistar , Surgical Flaps
7.
Article in Chinese | MEDLINE | ID: mdl-14551931

ABSTRACT

OBJECTIVE: To study a new kind of operation for displaced talar neck fractures. METHODS: From April 1996 to March 2001, 9 talar neck fractures were treated by internal fixation of absorbable lag screw with a medial approach and cut of medial malleolus to expose the fractures. A non-weight-bearing below-knee cast was applied for 6 to 12 weeks after operation. Once union of the fracture site is apparent, the patient should remain non-weight bearing in a removable short-leg and keep exercise every day. RESULTS: All the patients received follow-up from 15 to 60 months with an average of 28 months. The fractures healed from 20 to 42 weeks. The excellent and good rate of function was 77.8% (7/9) according to American Orthopedic Foot and Ankle Society Score(AOFAS). One case had the complication of superficial infection of wound and skin edge necrosis after operation, which was Hawkins type III. Late complication included two cases of avascular necrosis(AVN). Among them, one AVN of Hawkins type II was caused by early weight-bearing five weeks after operation and gained the fair score. The other AVN of Hawkins type III was inefficient to conservative therapy and proceeded ankle fusion in the end. The AOFAS of the patient was bad. CONCLUSION: Treatment of talar neck fractures by internal fixation of absorbable lag screw with a medial approach is an ideal method. It can gain a satisfactory result by the operation, strict postoperative care and rehabilitation.


Subject(s)
Bone Screws , Fracture Fixation, Internal/instrumentation , Fractures, Closed/surgery , Talus/injuries , Absorbable Implants , Adult , Ankle Injuries/surgery , Female , Follow-Up Studies , Fracture Healing , Fractures, Closed/complications , Humans , Joint Dislocations/complications , Male , Middle Aged , Tarsal Joints
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