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Objective:To investigate the risk factors of postoperative acute kidney injury (AKI) in the elderly patients with intertrochanteric fractures.Methods:The clinical data of elderly patients who underwent surgery for intertrochanteric fractures in Second Affiliated Hospital of Chongqing Medical University from July 2018 to December 2022 were retrospectively analyzed, which was divided into AKI group and non-AKI group according to whether AKI occurred after surgery, with 33 cases in the AKI group and 274 cases in the non-AKI group. The data from two groups of patients including age, gender, body mass index, underlying diseases, Charlson comorbidity index(CCI), pre- and postoperative related laboratory indicators, American Society of Anesthesiologists classification, anesthesia and surgical methods, operation time, intraoperative hypotension, blood transfusion, perioperative medication and other electronic case data were compared. Measurement data with normal distribution were represented as the mean±standard deviation ( ± s), and comparison between groups was conducted using t-test. The measurement data of non-normal distribution were expressed by median (interquartile range) [ M( Q1, Q3)], and the Mann-Whitney U test was used for comparison between groups. Comparison between groups of count data was conducted using the Chi-square test or Fisher exact test. Univariate analysis was conducted on the pertinent indicators of the two groups, and the indicators with statistically significant were chosen for incorporation into the multivariate Logistic regression analysis to investigate the independent risk factors for postoperative AKI. Results:The incidence of postoperative AKI was 10.75% in elderly patients with intertrochanteric fractures. Results of the univariate analysis showed that there were significant differences between the two groups in diabetes mellitus, chronic kidney disease, CCI ≥2, baseline serum creatinine, preoperative blood urea nitrogen, preoperative estimated glomerular filtration rate, preoperative and early postoperative serum albumin levels, intraoperative hypotension, and perioperative blood transfusion( P<0.05). Results of multivariate Logistic regression analysis showed that CCI ≥ 2 ( OR =3.231, 95% CI: 1.150-9.074, P =0.026) and intraoperative hypotension ( OR =4.617, 95% CI: 1.746-12.205, P=0.002) were associated with the occurrence of AKI after intertrochanteric fracture surgery. Conclusion:CCI≥2 and intraoperative hypotension are independent risk factors of postoperative AKI in the elderly patients with intertrochanteric fractures.
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Objective:To automatically synthesize Al 18F-1, 4, 7-triazacyclononane-1, 4, 7-triacetic acid (NOTA)-fibroblast activation protein inhibitor (FAPI)-04, perform PET/CT imaging in vivo, and evaluate its diagnostic efficacy on tumors. Methods:Al 18F-NOTA-FAPI-04 was produced in All-in-one automatic synthesis module and its quality control was conducted by high performance liquid chromatography (HPLC) equipped with a radioactive detector. Al 18F-NOTA-FAPI-04 PET/CT imaging was performed in normal BALB/c mice ( n=3) and 4T1 breast cancer models ( n=3) to determine its biodistribution. Then Al 18F-NOTA-FAPI-04 and 18F-FDG PET/CT imaging were performed in a hepatocellular carcinoma patient (male, 51 years old). Results:The synthesis time of Al 18F-NOTA-FAPI-04 was about 35 min, and the radiochemical yield was (25.2±1.9)% (attenuation correction, n=3). The product was colorless transparent solution with pH value of 7.0-7.5, and the specific activity was (46.11±3.07) GBq/μmol (attenuation correction, n=3). The radiochemical purity was above 99.0% and was still above 98.0% at room temperature after 6 h. PET/CT imaging in mice showed that physiological uptake of Al 18F-NOTA-FAPI-04 was mainly in biliary system and bladder, and Al 18F-NOTA-FAPI-04 highly concentrated in tumor xenografts. PET/CT imaging in the patient showed that Al 18F-NOTA-FAPI-04 obtained high tumor background ratio (TBR) values of 4.1, 8.9, 5.4, 4.8, 2.2 in parasternal lymph nodes, anterior diaphragmatic lymph nodes, hilar lymph nodes, pancreaticoduodenal ligament lymph nodes, abdominal aortic lymph nodes, respectively, while TBR values were 1.0, 2.8, 5.0, 2.1, 1.1 by 18F-FDG. Conclusions:Al 18F-NOTA-FAPI-04 can be synthesized with short time, high radiochemical yield and good stability using All-in-one module. Al 18F-NOTA-FAPI-04 PET/CT imaging has high contrast and excellent diagnostic efficacy on tumors.
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Objective To synthesize and analyze 18 F-prostate specific membrane antigen ( PSMA)-1007, followed by its imaging in prostate cancer. Methods Based on one-step method, 18 F-PSMA-1007 was produced by the CFN-MPS-200 automatic synthesis module and its quality analysis was conducted. 18 F-PSMA-1007 PET/CT imaging was performed in a prostate cancer patient (66 years old). Results The syn-thesis time of 18F-PSMA-1007 was about 50 min, and the radiochemical yield was (25.0±5.0) % (attenua-tion correction, n=3). The radiochemical purity was above 99.0% and was above 98.0% after 6 h. The product was colorless transparent solution with pH value of 7.0-7.5, and the specific activity was (410.0± 11.0) MBq/ml and the radioactive nuclear purity was above 99.0%. PET/CT imaging in the patient showed that 18 F-PSMA-1007 was highly concentrated in prostate cancer with maximum standardized uptake value ( SUVmax ) of 40.9. Conclusion Based on CFN-MPS-200 multifunction synthesis module, 18 F-PSMA-1007 can be stably synthesized with high radiochemical yield and can be concentrated in prostate cancer.
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Objective@#To synthesize and analyze 18F-prostate specific membrane antigen (PSMA)-1007, followed by its imaging in prostate cancer.@*Methods@#Based on one-step method, 18F-PSMA-1007 was produced by the CFN-MPS-200 automatic synthesis module and its quality analysis was conducted. 18F-PSMA-1007 PET/CT imaging was performed in a prostate cancer patient (66 years old).@*Results@#The synthesis time of 18F-PSMA-1007 was about 50 min, and the radiochemical yield was (25.0±5.0) % (attenuation correction, n=3). The radiochemical purity was above 99.0% and was above 98.0% after 6 h. The product was colorless transparent solution with pH value of 7.0-7.5, and the specific activity was (410.0±11.0) MBq/ml and the radioactive nuclear purity was above 99.0%. PET/CT imaging in the patient showed that 18F-PSMA-1007 was highly concentrated in prostate cancer with maximum standardized uptake value (SUVmax) of 40.9.@*Conclusion@#Based on CFN-MPS-200 multifunction synthesis module, 18F-PSMA-1007 can be stably synthesized with high radiochemical yield and can be concentrated in prostate cancer.
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@#Neuromuscular disease (NMD) is a group of hereditary or acquired myopathy typically manifested as motor dysfunction. There is still no consensus in the standardized tools for evaluation of motor function. Among the tools widely used, Motor Function Measure can be used in all kinds of NMD, while North Star Ambulatory Assessment and Performance of the Upper Limb can be for Duchenne muscular dystrophy, and Hammersmith Functional Motor Scale, the Children's Hospital of Philadelphia Infant Test of Neuromuscular Disorders and Upper Limb Module for spinal muscular atrophy.
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Objective:To observe the correlation among cardiac function ,inflammation factor and plasma testoster‐one level in aged male patients with chronic heart failure (CHF) .Methods :A total of 91 male CHF inpatients were selected from our hospital ,including 31 cases with NYHA cardiac function class Ⅱ ,30 cases with class Ⅲ and 30 ca‐ses with class Ⅳ .Another 40 corresponding male patients without CHF were regarded as non‐CHF control group . Plasma levels of testosterone ,interleukin (IL)‐6 ,tumor necrosis factor (TNF)–α and brain natriuretic peptide (BNP) and cardiac function were compared between two groups .Results:Compared with non‐CHF control group , there were significant reductions in plasma testosterone level , P<0. 05 or 0. 01 ,and they more reduced along with NYHA cardiac function class rose in all CHF subgroups ,P<0.05 or <0.01 .Correlation analysis indicated that tes‐tosterone level was inversely correlated with IL‐6 and TNF‐α levels (r= -0.244 , -0.322 , P<0.05 both) ,and positively correlated with LVEF (r=0.322 ,P=0.01) .Conclusion:In patients with chronic heart failure ,the poo‐rer cardiac function is ,the lower plasma testosterone level is .Testosterone level measurement contributes to judging disease degree and prognosis of patients with chronic heart failure .
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Objective To explore the clavicular hook plate in the treatment of distal clavicle fracture dislocation acromioclavicular joint clinical effects.Methods Twenty-three cases of Neer Ⅱ type distal clavicle fracture and 28 cases of Allman Ⅲ acromioclavicular joint dislocation line with open reduction and clavicular hook plate fixation.Results Fifty-one patients in this group have received 6-24 months of follow-up,an average of 18 months.2-3 weeks after the activities returned to normal off the shoulder,clavicle fractures were 3-12 months after bone healing and no-dislocation of acromioclavicular joint occur.According to Karlsson evaluation criteria:excellent in 40 cases,good in 9 cases and poor in 2 cases,excellent rate of 96.1%.Conclusion The clavicular hook plate fixation strength in the design and in line with the anatomical acromioclavicular joint physiological characteristics,surgical trauma,and has a fixed precise,allows early functional exercise.It is the ideal way to lock joint dislocation.
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BACKGROUND:Usual mechanics experiment approach cannot be applied directly to human body and the inter-comparability of models is low.Therefore finite element numerical simulation to mechanical behavior of human body has become an effective method for better understanding of the human body.OBJECTIVE:To establish a three-dimensional finite element model of femoral osteoporosis.METHODS:According to the average Chinese femur parameters,1 male patient with severe osteoporosis,aged 86 years,with no hip joint diseases,was selected.The data of femoral osteoporosis was obtained by means of spiral CT scanning.The graphical data were processed by the Mimics 11.1 (a graph processing software),and the outline curve data of femoral bone cortex inside and outside surface were obtained.The curve data were imported into the Unigraphic NX4.0 for solid modeling.The femur three-dimensional model composed of the cortical bone,cancellous bone and medullary canal was obtained.The model data were imported into the Ansys 11.0 for operations such as assigning,meshing,and contact interactions to establish three-dimensional finite element model of osteoporotic femur.RESULTS AND CONCLUSION:Three-dimensional finite element model of femur of osteoporosis was successfully established,which provides a reliable method for the construction of finite element model of femoral osteoporosis,and creates conditions for investigating femoral osteoporosis fracture fixation method and joint replacement.
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Forty patients with hip disease who underwent first total hip arthroplasty (THA) in Department of Orthopedics, Second Hospital of Chongqing Medical University from January 1999 to January 2002 were selected. They were treated with cemented (n =16) and cementless THA (n =24). The time to leave bed of cemented-THA group was obviously shortened compared with cementless THA group (P
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BACKGROUND:Alendronate is a new generation of diphosphate,which is the second generation of osteoporosis drugs.It is widely used to treat diseases related to increase of bone absorption in clinic.OBJECTIVE:To observe the effect of alendronate on the proliferation and the mRNA expression of osteoprotegerin(OPG) and receptor activator of nuclear factor kappa B ligand(RANKL) of human osteoblasts.DESIGN,TIME AND SETTING:A single sample observational experiment was performed at the Basic Research Institute of Chongqing Medical University from November 2007 to March 2008.MATERIALS:Osteoblasts were isolated from cancellous bone in a surgical operation.Alendronate was the product of Merck Sharp & Dohme S.p.A.METHODS:Osteoblasts were cultured with various concentrations of alendronate(1?10-9,1?10-8,1?10-7,1?10-6,1?10-5,1?10-4 mol/L).Osteoblasts cultured without alendronate were assigned as controls.MAIN OUTC0ME MEASURES:①The morphology and growth of osteoblasts were observed.②Effect of alendronate on the proliferation of osteoblasts were detected by MMT method.③The effect of various concentrations of alendronate on the mRNA expression of OPG and RANKL were detected by using RT-PCR.RESULTS:1?10-5 and 1?10-4 mol/L alendronate inhibited the proliferation of osteoblasts.1?10-9-1?10-6 mol/L alendronate promoted the proliferation of osteoblasts,and the 1?10-8 mol/L alendronate had the strongest effect.Alendronate inhibited RANKL mRNA expression in a concentration-dependent manner,1?10-5 mol/L alendronate had a strongest effect at 72 hours after culture(P
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From the status quo of doctor—patient relationship and medical students' communication competence and in combination with the need of transformation of modern medicine,the article discussed stressing the training of the clinical medical students' ability to deal with doctor—patient relationship so as to cultivate their communication competence.
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Objective:The patients undergoing operation for the fracture of hip or/and pelvis are at risks for venous thromboembolic complication.We measured the level of tumor necrosis factor-alpha(TNF-?) and intercellular adhesion molecule-1(ICAM-1) to evaluate the relation between cytokine and deep venous thromboses(DVT).Methods:28 patients of fracture of hip or/and pelvis were divided into two groups according to venography.The levels of ICAM-1 were tested with enzyme-linked immunosorbent assay(ELISA),while TNF-? were tested with radioimmunoassay at the first day after injury,and 1st,3rd,7th,12th day of postoperative period.Results:We found a marked increase of TNF-? and ICAM-1 in all the patients,and there was significant difference between the patients and normal controls (P
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Objective To explore the relative factors influencing the recurrence of endometriosis. Methods Three hundred and fifty-six patients of endometriosis were treated with surgery and then followed up for 3 years. Seventy-five recurrent cases among them were analyzed retrospectively. Results The recurrent rate was different in the ≤24 year age group (?~2=11.212, P