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1.
Bioengineering (Basel) ; 11(6)2024 Jun 10.
Article in English | MEDLINE | ID: mdl-38927828

ABSTRACT

Bone drilling is a common procedure used to create pilot holes for inserting screws to secure implants for fracture fixation. However, this process can increase bone temperature and the excessive heat can lead to cell death and thermal osteonecrosis, potentially causing early fixation failure or complications. We applied a three-dimensional dynamic elastoplastic finite element model to evaluate the propagation and distribution of heat during bone drilling and assess the thermally affected zone (TAZ) that may lead to thermal necrosis. This model investigates the parameters influencing bone temperature during bone drilling, including drill diameter, rotational speed, feed force, and predrilled hole. The results indicate that our FE model is sufficiently accurate in predicting the temperature rise effect during bone drilling. The maximum temperature decreases exponentially with radial distance. When the feed forces are 40 and 60 N, the maximum temperature does not exceed 45 °C. However, with feed forces of 10 and 20 N, both the maximum temperatures exceed 45 °C within a radial distance of 0.2 mm, indicating a high-risk zone for potential thermal osteonecrosis. With the two-stage drilling procedure, where a 2.5 mm pilot hole is predrilled, the maximum temperature can be reduced by 14 °C. This suggests that higher feed force and rotational speed and/or using a two-stage drilling process could mitigate bone temperature elevation and reduce the risk of thermal osteonecrosis during bone drilling.

2.
Clin Cosmet Investig Dermatol ; 17: 1033-1036, 2024.
Article in English | MEDLINE | ID: mdl-38737947

ABSTRACT

Sporotrichosis is a subacute or chronic infectious disease caused by sporothrix. It is mainly caused by Sporothrix inoculation after accidental skin injury during human labor. The clinical manifestations of sporotrichosis are variable, ranging from nodules, plaques, ulcers, verrucous lesions, and subcutaneous masses. Some reports indicate that sporotrichosis can mimic psoriasis-like lesions. We herein report a case of sporotrichosis mimicking rosacea lesions. In addition, the patient had a history of nasal trauma, and we believe that the patient was inoculated with Sporothrix after the nasal skin was damaged during labor activities. The patient was given itraconazole 200 mg orally daily for 3 months, which effectively resolved the rash.

3.
Diagnostics (Basel) ; 14(10)2024 May 15.
Article in English | MEDLINE | ID: mdl-38786318

ABSTRACT

(1) Background: Non-invasive prenatal testing (NIPT) is a screening test for fetal aneuploidy using cell-free fetal DNA. The fetal fragments (FF) of cell-free DNA (cfDNA) are derived from apoptotic trophoblast of the placenta. The level of fetal cfDNA is known to be influenced by gestational age, multiple pregnancies, maternal weight, and height. (2) Methods: This study is a single-center retrospective observational study which examines the relationship between the fetal fraction (FF) of cell-free DNA in non-invasive prenatal testing (NIPT) and adverse pregnancy outcomes in singleton pregnancies. A total of 1393 samples were collected between 10 weeks and 6 days, and 25 weeks and 3 days of gestation. (3) Results: Hypertensive disease of pregnancy (HDP) occurred more frequently in the low FF group than the normal FF group (5.17% vs. 1.91%, p = 0.001). Although the rates of small for gestational age (SGA) and placental abruption did not significantly differ between groups, the composite outcome was significantly higher in the low FF group (7.76% vs. 3.64%, p = 0.002). Furthermore, women who later experienced complications such as HDP or gestational diabetes mellitus (GDM) had significantly lower plasma FF levels compared to those without complications (p < 0.001). After adjustments, the low FF group exhibited a significantly higher likelihood of placental compromise (adjusted odds ratio: 1.946). (4) Conclusions: Low FF in NIPT during the first and early second trimesters is associated with adverse pregnancy outcomes, particularly HDP, suggesting its potential as a predictive marker for such outcomes.

5.
Sci Rep ; 13(1): 21105, 2023 11 30.
Article in English | MEDLINE | ID: mdl-38036587

ABSTRACT

Preterm birth prediction is essential for improving neonatal outcomes. While many machine learning techniques have been applied to predict preterm birth using health records, inflammatory markers, and vaginal microbiome data, the role of prenatal oral microbiome remains unclear. This study aimed to compare oral microbiome compositions between a preterm and a full-term birth group, identify oral microbiome associated with preterm birth, and develop a preterm birth prediction model using machine learning of oral microbiome compositions. Participants included singleton pregnant women admitted to Jeonbuk National University Hospital between 2019 and 2021. Subjects were divided into a preterm and a full-term birth group based on pregnancy outcomes. Oral microbiome samples were collected using mouthwash within 24 h before delivery and 16S ribosomal RNA sequencing was performed to analyze taxonomy. Differentially abundant taxa were identified using DESeq2. A random forest classifier was applied to predict preterm birth based on the oral microbiome. A total of 59 women participated in this study, with 30 in the preterm birth group and 29 in the full-term birth group. There was no significant difference in maternal clinical characteristics between the preterm and the full-birth group. Twenty-five differentially abundant taxa were identified, including 22 full-term birth-enriched taxa and 3 preterm birth-enriched taxa. The random forest classifier achieved high balanced accuracies (0.765 ± 0.071) using the 9 most important taxa. Our study identified 25 differentially abundant taxa that could differentiate preterm and full-term birth groups. A preterm birth prediction model was developed using machine learning of oral microbiome compositions in mouthwash samples. Findings of this study suggest the potential of using oral microbiome for predicting preterm birth. Further multi-center and larger studies are required to validate our results before clinical applications.


Subject(s)
Microbiota , Premature Birth , Pregnancy , Female , Infant, Newborn , Humans , Mouthwashes , Microbiota/genetics , Pregnancy Outcome , Machine Learning , RNA, Ribosomal, 16S/genetics
6.
Nutrients ; 15(17)2023 Aug 26.
Article in English | MEDLINE | ID: mdl-37686772

ABSTRACT

Chronic liver injury due to various hepatotoxic stimuli commonly leads to fibrosis, which is a crucial factor contributing to liver disease-related mortality. Despite the potential benefits of Suaeda glauca (S. glauca) as a natural product, its biological and therapeutic effects are barely known. This study investigated the effects of S. glauca extract (SGE), obtained from a smart farming system utilizing LED lamps, on the activation of hepatic stellate cells (HSCs) and the development of liver fibrosis. C57BL/6 mice received oral administration of either vehicle or SGE (30 or 100 mg/kg) during CCl4 treatment for 6 weeks. The supplementation of SGE significantly reduced liver fibrosis induced by CCl4 in mice as evidenced by histological changes and a decrease in collagen accumulation. SGE treatment also led to a reduction in markers of HSC activation and inflammation as well as an improvement in blood biochemical parameters. Furthermore, SGE administration diminished fibrotic responses following acute liver injury. Mechanistically, SGE treatment prevented HSC activation and inhibited the phosphorylation and nuclear translocation of Smad2/3, which are induced by transforming growth factor (TGF)-ß1 in HSCs. Our findings indicate that SGE exhibits anti-fibrotic effects by inhibiting TGFß1-Smad2/3 signaling in HSCs.


Subject(s)
Chenopodiaceae , Hepatic Stellate Cells , Animals , Mice , Mice, Inbred C57BL , Liver Cirrhosis/drug therapy
7.
3D Print Addit Manuf ; 10(4): 732-748, 2023 Aug 01.
Article in English | MEDLINE | ID: mdl-37609594

ABSTRACT

Laser powder bed fusion (LPBF) provides a rapid and versatile approach for producing parts with complex geometries. However, many parts with intricate geometries have overhang structures, which are not easily fabricated by using LPBF and are often downgraded by staircase effects, warpage, cracks, and dross formation. Thus, the present study proposes a combined numerical and experimental approach for determining the optimal settings of the laser power and scanning speed that minimize the surface roughness and maximize the density of Inconel 718 LPBF overhang structures. In the proposed approach, the heat transfer simulations are employed to determine the melt pool depth, the melt pool length, and the solid cooling rate within the feasible input space of laser power and scanning speed combinations. Notably, the simulations take account of both the difference in the material properties of the solid and powder materials, respectively, and the variation of the laser absorptivity in the depth direction of the powder layer. The simulation results are then used to train artificial neural networks for predicting the melt pool depth for 3600 combinations of the laser power and scanning speed within the input space. The resulting processing maps are screened in accordance with three quality criteria (namely the melt pool depth, the melt pool length, and the solid cooling rate) to determine the optimal processing region, which improves the surface roughness. The feasibility of the proposed approach is demonstrated by fabricating 10 × 10 and 20 × 20 mm2 horizontal overhang structures using parameter settings chosen from the optimal processing map. It shows that the optimal processing conditions result in a low surface roughness and a maximum density of 99.78%.

8.
BMC Pediatr ; 23(1): 392, 2023 08 08.
Article in English | MEDLINE | ID: mdl-37553623

ABSTRACT

BACKGROUND: As the survival rates of very low birth weight (VLBW) infants have increased, their neurodevelopmental outcomes are of concern. This study aims to determine the demographic and perinatal characteristics of premature infant according to head growth, identify clinical factors affecting growth catch-up, and explore differences in developmental outcomes according to catch-up states. METHODS: This nationwide prospective cohort study of Korean Neonatal Network data analyzed premature infants with very low birth weight (< 1,500 g) between 2014 and 2017. A total of 253 eligible infants who had completed the Bayley Scales of Infant and Toddler Development, Third Edition, were assigned into two groups: a catch-up (CU) group with a head circumference above the 10th percentile and a no catch-up (NCU) group with a head circumference below the 10th percentile at 18-24 months of corrected age (CA). RESULTS: Most (81.4%, 206/253) premature infants exhibited catch-up growth at 18-24 months of CA. Rates of microcephaly, intraventricular hemorrhage (IVH), bronchopulmonary dysplasia (BPD), sepsis, necrotizing enterocolitis (NEC), length of NICU stay, ventilation care, and parenteral nutrition were significantly greater in the NCU group (P < 0.05). On multiple linear regression analysis, BPD status was the most influential clinical factor affecting catch-up head growth after adjusting for gestational age, birth weight, and birth head circumference (adjusted OR 4.586, 95% CI 1.960-10.729). At 18-24 months of CA, the NCU group exhibited lower developmental indices and a higher rate of developmental delay than the CU group. Motor developmental delay was the most significant factor relevant to catch-up head growth, and the motor development difference between the two groups was only statistically significant after adjusting for four major neonatal morbidities: IVH, BPD, sepsis, and NEC status (adjusted OR 10.727, 95% CI 1.922-59.868). CONCLUSION: As association was observed between head growth catch-up status and developmental outcomes in VLBW infants at 18-24 months of CA. Key clinical factors associated with catch-up status included BPD and NEC status, length of parenteral nutrition, and ventilator care. Further study is needed to establish causality and explore additional factors that may influence developmental outcomes in this population.


Subject(s)
Infant, Very Low Birth Weight , Sepsis , Infant , Pregnancy , Female , Infant, Newborn , Humans , Cohort Studies , Prospective Studies , Infant, Premature , Birth Weight
9.
Obstet Gynecol Sci ; 66(5): 385-394, 2023 Sep.
Article in English | MEDLINE | ID: mdl-37495212

ABSTRACT

OBJECTIVE: To report the experiences of triplet pregnancies complicated by twin-to-twin transfusion syndrome (TTTS) treated with fetoscopic laser coagulation at a single center. METHODS: Herein, we conducted a retrospective analysis to investigate the management and perinatal outcomes of triplet pregnancies with TTTS treated at a single institution between 2017 and 2022. RESULTS: Seven of the 98 triplet pregnancies (7.1%) encountered were complicated by TTTS, and all were dichorionic triamniotic triplets. Of the seven triplet pregnancies complicated by TTTS, four were treated with fetoscopic laser coagulation at our center, at a median gestational age of 20 weeks. No procedure-related complications or maternal complications were observed. The survival rate was higher and perinatal outcomes were better in fetoscopic laser coagulation cases than in other management cases. Four donor and four recipient triplets survived, with a median gestational age of 33 weeks at delivery. Although there were no cases of poor neonatal outcomes, one case was diagnosed with white matter injury, suspected to be hypoxic-ischemic encephalopathy on postnatal investigation. CONCLUSION: Fetoscopic laser coagulation is a feasible treatment option for triplet TTTS, provided the attending specialists have extensive experience with this technique.

10.
Imeta ; 2(4): e140, 2023 Nov.
Article in English | MEDLINE | ID: mdl-38868217

ABSTRACT

Airborne microorganisms, including pathogens, would change with surrounding environments and become issues of global concern due to their threats to human health. Microbial communities typically contain a few abundant but many rare species. However, how the airborne abundant and rare microbial communities respond to environmental changes is still unclear, especially at hour scale. Here, we used a sequencing approach based on bacterial 16S rRNA genes and fungal ITS2 regions to investigate the high time-resolved dynamics of airborne bacteria and fungi and to explore the responses of abundant and rare microbes to the atmospheric changes. Our results showed that air pollutants and microbial communities were significantly affected by human activities related to the Chinese New Year (CNY). Before CNY, significant hour-scale changes in both abundant and rare subcommunities were observed, while only abundant bacterial subcommunity changed with hour time series during CNY. Air pollutants and meteorological parameters explained 61.5%-74.2% variations of abundant community but only 13.3%-21.6% variations of rare communities. These results suggested that abundant species were more sensitive to environmental changes than rare taxa. Stochastic processes predominated in the assembly of abundant communities, but deterministic processes determined the assembly of rare communities. Potential bacterial pathogens during CNY were the highest, suggesting an increased health risk of airborne microbes during CNY. Overall, our findings highlighted the "holiday effect" of CNY on airborne microbes and expanded the current understanding of the ecological mechanisms and health risks of microbes in a changing atmosphere.

11.
Article in English | WPRIM (Western Pacific) | ID: wpr-999981

ABSTRACT

Background/Aims@#Existing hepatocellular carcinoma (HCC) prediction models are derived mainly from pretreatment or early on-treatment parameters. We reassessed the dynamic changes in the performance of 17 HCC models in patients with chronic hepatitis B (CHB) during long-term antiviral therapy (AVT). @*Methods@#Among 987 CHB patients administered long-term entecavir therapy, 660 patients had 8 years of follow-up data. Model scores were calculated using on-treatment values at 2.5, 3, 3.5, 4, 4.5, and 5 years of AVT to predict threeyear HCC occurrence. Model performance was assessed with the area under the receiver operating curve (AUROC). The original model cutoffs to distinguish different levels of HCC risk were evaluated by the log-rank test. @*Results@#The AUROCs of the 17 HCC models varied from 0.51 to 0.78 when using on-treatment scores from years 2.5 to 5. Models with a cirrhosis variable showed numerically higher AUROCs (pooled at 0.65–0.73 for treated, untreated, or mixed treatment models) than models without (treated or mixed models: 0.61–0.68; untreated models: 0.51–0.59). Stratification into low, intermediate, and high-risk levels using the original cutoff values could no longer reflect the true HCC incidence using scores after 3.5 years of AVT for models without cirrhosis and after 4 years of AVT for models with cirrhosis. @*Conclusions@#The performance of existing HCC prediction models, especially models without the cirrhosis variable, decreased in CHB patients on long-term AVT. The optimization of existing models or the development of novel models for better HCC prediction during long-term AVT is warranted.

12.
Chinese Journal of Hepatology ; (12): 705-709, 2023.
Article in Chinese | WPRIM (Western Pacific) | ID: wpr-986198

ABSTRACT

Objective: To investigate the clinical features and long-term prognosis of primary biliary cholangitis (PBC) in patients with past hepatitis B virus (HBV) infection. Methods: 353 cases with PBC who visited the Liver Disease Center of Beijing Friendship Hospital Affiliated to Capital Medical University between January 2000 and January 2018 were retrospectively analyzed and were divided into the past HBV infection group (156 cases) and the no HBV infection group (197 cases). The two groups' baseline clinical features were compared. Ursodeoxycholic acid response rate after one year, GLOBE score, UK-PBC score, and long-term liver transplantation-free survival rate were compared through outpatient and telephone follow-up. Results: PBC with past HBV infection had a significantly reduced female proportion compared to the no HBV infection group (91.9% vs. 79.5%, P = 0.001). However, there were no statistically significant differences in age, biochemical indices, immunological indicators, platelet count, cirrhosis proportion, and others. Ursodeoxycholic acid biochemical response rate was reduced in patients with past HBV infection at the end of one year of treatment, but the difference was not statistically significant (65.8% vs. 78.2%, P = 0.068). In addition, there were no statistically significant differences between the GLOBE score (0.57 vs. 0.59, P = 0.26) and UK-PBC 5-year (2.87% vs. 2.87%, P = 0.38), 10-year (9.29% vs. 8.2%, P = 0.39) and 15-year liver transplantation rates (16.6% vs. 14.73%, P = 0.39). Lastly, the overall 5-year liver transplantation-free survival rate had no statistically significant difference between the two groups of patients (86.4% vs. 87.5%, P = 0.796). Conclusion: Primary biliary cholangitis had no discernible effect in terms of age at onset, biochemical indices, immunological indicators, cirrhosis proportion, ursodeoxycholic acid response rate after one year, GLOBE score, UK-PBC score, or overall liver transplantation-free survival rate in patients with past hepatitis B virus infections.

13.
Chinese Journal of Hepatology ; (12): 698-704, 2023.
Article in Chinese | WPRIM (Western Pacific) | ID: wpr-986197

ABSTRACT

Objective: To understand ten-year changes in clinical characteristics and antiviral treatment patterns of chronic hepatitis B in China. Methods: Patients with chronic HBV infection:demographic, virologic, hematologic, blood biochemistry, and antiviral treatment data were extracted from the China Registry of Hepatitis B (CR-HepB) database between 2012 and 2022 for descriptive statistics and change trend analysis. Multiple group comparisons were conducted using the Kruskal Wallis H test, while counting data was compared between groups using χ (2) test. Results: A total of 180 012 patients with chronic HBV infection were included, with a median age of 40 years old, and a male proportion accounting for 60.2%. The HBeAg positive rate was 43.3%. Over time, the median age of new patients each year increased from 39 to 47 years, while the HBeAg positive rate decreased from 51.3% to 32.8%. The initial diagnosis of patients was mainly CHB (71.4%), followed by hepatitis B cirrhosis (11.8%), inactive HBsAg carrier status (10.6%), and chronic HBV carrier status (6.2%). Among the newly registered patients every year from 2012 to 2022, the proportion of hepatitis B cirrhosis remained stable, but after 2019, the proportion of CHB increased and the proportion of other diagnoses decreased. The proportion of patients with cirrhosis increased with age in different age groups, with 3.5%, 19.3%, and 30.4% in the < 40, 40-69, and≥70 age groups, respectively. The proportion of women in patients with cirrhosis also increased with age, from 16.1% in those < 30 years old to 44.3% in those≥80 years old. From 2012 to 2022, the proportion of patients receiving first-line nucleos(t)ide analog antiviral treatment increased year by year, from 51.0% in 2012-2013 to 99.8% in 2022. Conclusion: The CR-HepB registration data reflect the changes in clinical characteristics and antiviral treatment patterns in patients with chronic HBV infection in China over the past ten years and can thus provide a reference to promote hepatitis B diagnosis and treatment practice, as well as scientific research.


Subject(s)
Humans , Male , Female , Adult , Aged, 80 and over , Antiviral Agents/therapeutic use , Hepatitis B, Chronic/epidemiology , Hepatitis B e Antigens , Hepatitis B/drug therapy , Hepatitis B Surface Antigens , Hepatitis A , Liver Cirrhosis/drug therapy , China/epidemiology , Registries , Hepatitis B virus/genetics , DNA, Viral
14.
Chinese Journal of Hepatology ; (12): 677-680, 2023.
Article in Chinese | WPRIM (Western Pacific) | ID: wpr-986192

ABSTRACT

A normal liver can develop cirrhosis through long-term and repeated stimulation from various etiologies. Histological manifestations like the collapse of hepatic lobular structure (including microvascular structure) and the formation of pseudolobules can lead to portal hypertension and even decompensated cirrhosis. More and more evidence suggests that effective etiological treatment can not only delay but also reverse the progression of cirrhosis. The mechanism of cirrhosis reversal mainly includes the degradation of extracellular matrix, hepatocyte regeneration, and hepatic lobular remodeling. The "gold standard" for the evaluation of cirrhosis reversal at present is still a liver biopsy. Therefore, the histopathological evaluation of cirrhosis reversal is very important for determining the disease's prognosis, efficacy, and mechanism of exploration.


Subject(s)
Humans , Liver Cirrhosis/pathology , Liver/pathology , Hypertension, Portal , Hepatocytes/pathology , Prognosis
15.
Chinese Journal of Hepatology ; (12): 385-388, 2023.
Article in Chinese | WPRIM (Western Pacific) | ID: wpr-986142

ABSTRACT

Chinese Society of Hepatology and Chinese Society of Infectious Diseases, Chinese Medical Association update the guidelines for the prevention and treatment of chronic hepatitis B (version 2022) in 2022. The latest guidelines recommend more extensive screening and more active antiviral treating for hepatitis B virus infection. This article interprets the essential updates in the guidelines to help deepen understanding and better guide the clinical practice.


Subject(s)
Humans , Hepatitis B, Chronic/drug therapy , Hepatitis B/drug therapy , Hepatitis B virus , Antiviral Agents/therapeutic use , Gastroenterology
16.
Journal of Clinical Hepatology ; (12): 1299-1303, 2023.
Article in Chinese | WPRIM (Western Pacific) | ID: wpr-978782

ABSTRACT

In order to reduce the disease burden of chronic hepatitis B (CHB) and improve the treatment rate of CHB, the indications for anti-viral therapy have been gradually expanded and simplified in guidelines for the prevention and treatment of CHB released by Chinese Medical Association from 2005 to 2022. This article elaborates on the evolution in the indications for anti-viral therapy in CHB from the five aspects of converging indications of HBeAg-positive and HBeAg-negative CHB, reduction in the treatment threshold of HBV DNA, reduction in the treatment threshold of serum alanine aminotransferase, emphasis on the risk factors for disease progression, and gradual loosening of the requirements for virological indicators in patients with liver cirrhosis.

17.
Article in Chinese | WPRIM (Western Pacific) | ID: wpr-960700

ABSTRACT

In order to achieve the global goal of eliminating viral hepatitis as a public health threat by 2030 proposed by the World Health Organization, it is of great importance to expand the treatment of chronic hepatitis B patients. Recent studies have shown that alanine aminotransferase (ALT) is associated with liver inflammation, fibrosis, hepatocellular carcinoma, and outcome events of liver disease. Besides, as a strategy for expanding antiviral therapy, reducing the treatment threshold of ALT can reduce the occurrence of liver cirrhosis, hepatocellular carcinoma, and liver-related death. In the Expert opinion on expanding antiviral therapy for chronic hepatitis B published in China in 2022, the treatment indication for chronic hepatitis B patients was updated to positive serum HBV DNA and ALT above the treatment threshold (30 U/L for male and 19 U/L for female), with the exclusion of other causes.

18.
J Cardiothorac Surg ; 17(1): 336, 2022 Dec 23.
Article in English | MEDLINE | ID: mdl-36564804

ABSTRACT

BACKGROUND: Acute aortic regurgitation (AR) is uncommon condition and usually results in an emergent situation because the left ventricle does not adapt quickly due to a sudden increase in end-diastolic volume caused by the regurgitant flow. Thoracic endovascular aortic repair (TEVAR) is a procedure that places a stent-graft on the lesion of thoracic aorta through a minimally invasive approach. CASE PRESENTATION: Here we report that a catheter-induced aortic valve injury associated with TEVAR can cause delayed AR, exemplified by the case of a patient who developed acute AR 42 months after TEVAR. For this, aortic valve replacement was performed and the patient was discharged without complications. CONCLUSION: Our results demonstrate that when a catheter-related procedure is performed around the aortic valve, slight injury of the valve can cause aortic insufficiency even 3 years after surgery. Consequently, when performing a catheter-related procedure around the aortic valve, special attention is always required.


Subject(s)
Aortic Aneurysm, Thoracic , Aortic Diseases , Aortic Valve Insufficiency , Blood Vessel Prosthesis Implantation , Endovascular Procedures , Humans , Blood Vessel Prosthesis , Stents , Aortic Aneurysm, Thoracic/surgery , Aortic Valve Insufficiency/diagnostic imaging , Aortic Valve Insufficiency/etiology , Aortic Valve Insufficiency/surgery , Endovascular Procedures/adverse effects , Aorta, Thoracic/diagnostic imaging , Aorta, Thoracic/surgery , Aorta, Thoracic/injuries , Aortic Diseases/surgery , Treatment Outcome , Retrospective Studies
19.
World J Surg ; 46(12): 2864-2871, 2022 12.
Article in English | MEDLINE | ID: mdl-36207419

ABSTRACT

BACKGROUND: The purpose of our study was to assess the mid-term outcomes of the patients with grade III blunt thoracic aortic injury (BTAI) who were treated non-operatively and to determine the specific conditions for successful NOM. METHODS: We retrospectively reviewed patients with grade III BTAI at a single level 1 trauma center between January 2012 and March 2020, and compared the demographics and outcomes of NOM and thoracic endovascular aortic repair (TEVAR). We also examined the factors contributing to the selection of NOM by calculating the odds ratios for age, sex, initial systolic blood pressure, injury severity score, abbreviated injury scale score, pseudoaneurysm/neck (P/N) ratio, and comorbidity. RESULTS: In total, 46 adults were included. Thirty patients underwent NOM and 19 underwent TEVAR. The time from injury to computed tomography, hospital days, intensive care unit length of stay, and follow-up period showed no difference between the two groups. Aorta-related mortality was not observed in either group. Two patients (7.4%) in the NOM group experienced an increase in pseudoaneurysms: one of them underwent delayed surgical repair without complications, and the other maintained regular follow-up. The odds ratio for selecting NOM was significant when the P/N ratio was < 1.30 (OR = 4.687 [95% CI, 1.229-17.882], p = 0.024). CONCLUSIONS: We suggest that carefully selected patients with BTAI grade III could be observed nonoperatively or treated by delayed intervention on outpatient basis, and a P/N ratio < 1.30 can be used as a cutoff to decide treatment options for BTAI grade III.


Subject(s)
Endovascular Procedures , Thoracic Injuries , Vascular System Injuries , Wounds, Nonpenetrating , Adult , Humans , Retrospective Studies , Vascular System Injuries/surgery , Treatment Outcome , Time Factors , Thoracic Injuries/surgery , Wounds, Nonpenetrating/surgery , Aorta, Thoracic/diagnostic imaging , Aorta, Thoracic/surgery , Aorta, Thoracic/injuries , Aorta
20.
Front Plant Sci ; 13: 985088, 2022.
Article in English | MEDLINE | ID: mdl-36262653

ABSTRACT

Drought stress is one of the major abiotic stress factors that affect plant growth and crop productivity. Tartary buckwheat is a nutritionally balanced and flavonoid-rich pseudocereal crop and also has strong adaptability to different adverse environments including drought. However, little is known about its drought tolerance mechanism. In this study, we performed comparative physiological and transcriptomic analyses of two contrasting drought-resistant Tartary buckwheat genotypes under nature drought treatment in the reproductive stage. Under drought stress, the drought-tolerant genotype XZSN had significantly higher contents of relative water, proline, and soluble sugar, as well as lower relative electrolyte leakage in the leaves than the drought-susceptible LK3. A total of 5,058 (2,165 upregulated and 2,893 downregulated) and 5,182 (2,358 upregulated and 2,824 downregulated) potential drought-responsive genes were identified in XZSN and LK3 by transcriptome sequencing analysis, respectively. Among the potential drought-responsive genes of XZSN, 1,206 and 1,274 genes were identified to be potential positive and negative contributors for XZSN having higher drought resistance ability than LK3. Furthermore, 851 out of 1,206 positive drought-resistant genes were further identified to be the core drought-resistant genes of XZSN based on WGCNA analysis, and most of them were induced earlier and quicker by drought stress than those in LK3. Functional annotation of the 851 core drought-resistant genes found that a large number of stress-responsive genes were involved in TFs, abscisic acid (ABA) biosynthesis, signal transduction and response, non-ABA signal molecule biosynthesis, water holding, oxygen species scavenging, osmotic adjustment, cell damage prevention, and so on. Transcriptional regulatory network analyses identified the potential regulators of these drought-resistant functional genes and found that the HD-ZIP and MYB TFs might be the key downstream TFs of drought resistance in Tartary buckwheat. Taken together, these results indicated that the XZSN genotype was more drought-tolerant than the LK3 genotype as evidenced by triggering the rapid and dramatic transcriptional reprogramming of drought-resistant genes to reduce water loss, prevent cell damage, and so on. This research expands our current understanding of the drought tolerance mechanisms of Tartary buckwheat and provides important information for its further drought resistance research and variety breeding.

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