Influencing factors of surgical site infection after abdominal surgery / 中华消化外科杂志

Objective:To investigate the influencing factors of surgical site infection (SSI) after abdominal surgery.Methods:The retrospective cross-sectional study was conducted. The clinical data of 567 patients undergoing abdominal surgery in 6 medical centers, including 445 cases in the Zhengzhou Central Hospital Affiliated to Zhengzhou University, 54 cases in the the First Affiliated Hospital of Zhengzhou University, 49 cases in the Shangqiu First People's Hospital, 10 cases in the Luoyang Central Hospital, 5 cases in the First Affiliated Hospital of Henan University of Science and Technology and 4 cases in the Henan Provincial People's Hospital, from June 1 to June 30, 2020 were collected. There were 284 males and 283 females, aged (51±18)years. Observation indicators: (1) incidence of SSI after surgery; (2) influencing factors of SSI. Follow-up was conducted using outpatient examination and telephone interview to detect the incidence of SSI. Patients without implant were followed up within postoperative 30 days, and patients with implant were followed up within postoperative 1 year. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the independent sample t test. Measure-ment data with skewed distribution were represented as M(range), and comparison between groups was conducted using the Mann-Whitney U test. Count data were described as absolute numbers or percentages, and comparison between groups was performed using the chi-square test or Fisher exact probability. Univariate analysis was performed using the corresponding statistical methods. Multivariate analysis was performed using the Logistic stepwise regression model advance method. Results:(1) Incidence of SSI after surgery. All the 567 patients were followed up after surgery as planned. There were 27 cases with SSI after surgery including 9 cases with superficial incision infection, 9 cases with deep incision infection, 9 cases with organ/gap infection. Of the 27 cases with SSI after surgery, 18 cases with positive results of incisional microbial culture including 8 cases with positive results of Escherichia coli, 6 cases with positive results of Klebsiella pneumonia, 3 cases with positive results of Enterococcus faecium and 1 case with positive result of Pseudomonas aeruginosa. (2) Influencing factors of SSI. Results of univariate analysis showed that age, preoperative hemoglo-bin, preoperative albumin, preoperative fasting blood glucose, preoperative intestinal preparation, surgical type, surgical site, surgical incision type, duration of intensive cure unite, duration of post-operative hospital stay, duration of total hospital stay, operation time, hospital expense were related factors affecting the incidence of SSI of patients undergoing abdominal surgery ( χ2=40.12, Z=?4.22, ?2.21, ?4.75, χ2=7.07, 16.43, 38.06, 17.50, Z=?4.43, ?4.42, ?7.14, ?7.15, ?5.90, P<0.05) and the American Association of Anesthesiologists Classification, preoperative oral antibiotics, surgical methods and postoperative intensive care unit stay were related factors affecting the incidence of SSI of patients undergoing abdominal surgery ( P<0.05). Results of multivariate analysis showed that age, preopera-tive fasting blood glucose, preoperative intestinal preparation, surgical type, surgical site as appendix and rectum, surgical methods, surgical incision type as infective incision and polluted incision, operation time were independent factors affecting the incidence of SSI of patients undergoing abdo-minal surgery ( odds ratio=7.69, 1.21, 0.27, 5.82, 5.19, 19.08, 0.23, 27.76, 4.97, 1.01, 95% confidence intervals as 2.04?28.95, 1.04?1.41, 0.08?0.94, 1.36?24.85, 1.10?24.43, 4.48?81.25, 0.06?0.87, 2.54?303.53, 1.12?22.14, 1.01?1.02, P<0.05). Conclusion:Age, preoperative fasting blood glucose, preoperative intestinal preparation, surgical type, surgical site as appendix and rectum, surgical methods, surgical incision type as infective incision and polluted incision, operation time are independent factors affecting the incidence of SSI of patients undergoing abdominal surgery.

Panax notoginseng Saponins Alleviate TGF-β1-induced Renal Tubular Epithelial Cell Injury by Inhibiting Autophagy / 中国实验方剂学杂志

ObjectiveTo investigate the role and mechanism of Panax notoginseng saponins （PNS） in inhibiting transforming growth factor-β1 （TGF-β1）-induced renal tubular epithelial cell injury. MethodNRK-52E renal tubular epithelial cells were cultured and divided into control group， TGF-β1 group，TGF-β1+12.5 mg·L-1 PNS group，TGF-β1+25 mg·L-1 PNS group and TGF-β1+50 mg·L-1 PNS group. After 48 hours of PNS intervention， the cells and the supernatant were collected， and cell morphology was observed by inverted microscope. Western blot was used to detect the expression of epithelial-mesenchymal transition （EMT）-related proteins and autophagy-related proteins. Flow liquid chromatography for multiple protein quantification and flow cytometry were employed to determine the content of inflammatory factors and apoptosis rate， respectively. ResultCompared with the conditions in the control group， after TGF-β1 induction， the cells showed a spindle-shaped change and the expression of E-cadherin was down-regulated （P<0.05）， while the expression of α-smooth muscle actin （α-SMA） was up-regulated （P<0.05）. After PNS treatment， most of the cells tended to be normal and reversed the occurrence of EMT. In addition， compared with the conditions in the control group， the level of TNF-α was increased while that of IL-10 was decreased， with elevated apoptosis rate （P<0.05） in the TGF-β1 group. After PNS treatment， the level of TNF-α was lowered while that of IL-10 was boosted with the increase of the dose， with reduced apoptosis rate （P<0.05）. Moreover， after TGF-β1 induction， the expression of autophagy-related proteins Beclin 1 and LC3Ⅱ/Ⅰ in renal tubular epithelial cells were up-regulated， while PNS inhibited their expression（P<0.05，P<0.01）. ConclusionPNS had a protective effect on TGF-β1-induced renal tubular epithelial cells， and the mechanism might be that it reduced inflammation and apoptosis by inhibiting autophagy， thus alleviating TGF-β1-induced injury.

Expression and clinical significance of SMYD3 in rectal cancer / 国际生物医学工程杂志

Objective:To study the expression level and clinical significance of SET and MYND domain-containingprotein 3(SMYD3) in rectal cancer tissues.Methods:Immunohistochemistry and Western blot were used to detect the expression of SMYD3 in 64 cases of rectal cancer tissues and corresponding adjacent tissues. The relationship between SMYD3 expression and clinicopathological characteristics and prognosis of rectal cancer were analyzed.Results:The expression rate of SMYD3 in rectal cancer tissue was 60.94%, which was higher than that in adjacent tissues by 14.06%, and the difference was statistically significant (χ 2=30.00, P<0.05). The expression of SMYD3 in rectal cancer tissue has no correlation with the patient's age, gender, and degree of tissue differentiation (all P>0.05), but has correlation with TNM staging, depth of invasion and lymph node metastasis (all P<0.05). The prognosis of the rectal cancer patients with positive expression of SMYD3 was worse than that with negative expression ( P<0.05). The expression of SMYD3 protein in rectal cancer tissues (1.26±0.31) was significantly higher than that in the corresponding adjacent tissues (0.55±0.22) ( t=11.95, P<0.05). Conclusions:The increased expression of SMYD3 is related to the occurrence and development of rectal cancer, and its expression level can be used as an index for judging the malignancy of rectal cancer and evaluating its prognosis. The results of this study show that SMYD3 is involved in the occurrence and development of rectal cancer. The results of this study can provide a basis for SMYD3 as a new target for rectal cancer targeted therapy and a prognostic criterion.

Application of artificial intelligence in various liver and pancreas diseases / 临床肝胆病杂志

A large amount of information, such as clinical hematological data and imaging images, can be extracted by artificial intelligence to form various quantifiable features, analyze the association between different features and problems concerned (such as diagnosis), and thus solve complex medical problems. This article elaborates on the efficiency of various artificial intelligence algorithms in the diagnosis of pancreatic cancer, hepatic fibrosis, and esophageal varices, so as to help clinicians with clearer understanding and better decision-making.

Clinical features and pathogenesis of liver injury caused by SARS, MERS and COVID-19 / 临床肝胆病杂志

Coronavirus disease 2019 caused by severe acute respiratory syndrome coronavirus 2 has become a serious threat to global public health security. Besides lung diseases, severe cases are also accompanied by varying degrees of liver injury. Previous studies have shown that patients infected with severe acute respiratory syndrome coronavirus and Middle East respiratory syndrome coronavirus may also suffer from liver injury, which is closely associated with disease severity. This article elaborates on the clinical features and pathogenesis of liver injury caused by these three types of highly pathogenic human coronavirus, in order to help clinicians better understand this disease and make accurate decisions.

Discussion on academic viewsof the theory of epidemic heat syndrome / 国际中医中药杂志

Our study was based on the book Theory of Epidemic Heat Syndrome. This book was written by Mr. Shao Dengying of Qing dynasty, who was famous in Qing Dynasty on curing virus infection. We described his unique insights in diagnosis and treatment of epidemic heat syndrome in six aspects: the origin, position of epidemic heat invasion, difference between epidemic heat syndrome and typhus, paying attention to the symptoms of epidemic heat, differentiation and treatment from qi, bloods and stomach, and attaching importance to the stomach Qi and kidney essence etc.

Effect of bifidobacterial adhesin on nuclear factor-κB and cytokines in intestinal mucosa of stressed rats / 中华临床营养杂志

Objective To investigate the effect of bifidobacterial adhesin (BA) on nuclear factor of κB (NF-κB) and cytokines of intestinal mucosa of stressed rats.Methods Forty-eight rats were divided into stress group (n =24) and BA group (n =24) using the stochastic indicator method.After the stressed rat models were established withfettering as the stress condition,the experiment lasted 8 days.Both groups were given enteral nutrition (EN) with heat 125.4 kJ/(kg · d) and nitrogen 0.2 g/(kg · d).The BA group was fed with EN plus 5 mg/ (kg · d) bifidobacterial adhesin,and the stress group was fed with EN plus equivalent volume of normal saline [5 mg/ (kg · d)].The levels of NF-κB,interleukin-10 (IL-10),tumor necrosis factor (TNF-α),and interferon-γ (IFN-γ) were measured in both groups before modeling,after modeling,on the 3rd intervention day,and on the 8th intervention day.The changes in the morphology of intestinal mucosal were observed by transmission electron microscopy.Results (1) Expression of NF-κB:The positive expression rate of NF-κB in the intestinal mucosa was 0,79.2％,63.5％,and 66.7％ in the control group and 0,68.4％,55.7％,and 45.8％ in the BA group before modeling,after modeling,on the 3rd intervention day,and on the 8th intervention day.The expressions of NF-κB in both groups significantly increased after the modeling (both P =0.000).Even on the 3rd and 8th intervention days,the positive expression rates of NF-κB in the intestinal mucosa were still significantly higher than the pre-modeling level (both P =0.000).Compared with the levels after modeling and in the control group,the expression of NF-κB in the intestinal mucosa in the BA group on the 8th intervention day was significantly down-regulated (P =0.015,P =0.021).(2) Quantitative expressions of TNF-α and IFN-γ:Compared with the pre-modeling levels,the intestinal mncosa levels of TNF-α [stressed group:(154.63 ± 17.52) pg/g,(198.72 ±26.59) pg/g; BA group:(154.63 ±17.52) pg/g,(201.45 ±28.16) pg/g],IFN-γ [stressed group:(39.47 ±5.76) pg/g,(55.32 ±5.93) pg/g; BA group:(39.47 ± 5.76),(60.75 ± 7.68) pg/g] and the plasma levels of TNF-α [stressed group:(17.35±2.62) pg/g,(30.56±4.85) ng/L; BA group:(83.31 ±9.78) pg/g,(114.82±13.78) ng/L] and IFN-γ [stressed group:(17.35 ±2.62) pg/g,(28.73 ±4.17) ng/L; BA group:(17.35 ± 2.62) pg/g,(30.56 ± 4.85) ng/L] significantl increased (all P ＜ 0.05).On the 3rd and 8th intervention day,the intestinal mucosa levels of IFN-γ [(58.16 ± 7.38) pg/g,(56.37 ± 7.29) pg/g] and TNF-α [(215.76 ±31.54) pg/g and (211.83 ±33.61) pg/g] and plasma levels of IFN-γ [(29.35 ±4.76) ng/L,(30.25±3.67) ng/L] andTNF-α [(125.71 ±17.38) ng/L,(141.26±19.65) ng/L] in the stressed group were significantly higher than the pre-modeling levels (all P ＜ 0.05).On the 3rd and 8th intervention day,the intestinal mucosa levels of IFN-γ [(165.43 ± 24.58) pg/g,(171.57 ± 26.87) pg/g]and IFN-γ [(42.35 ±4.92) pg/g,(40.58 ±4.65) pg/g] and the plasma levels of TNF-α [(103.96 ±13.68) ng/L,(94.53±12.66) ng/L] and IFN-γ [(20.78±2.84) ng/L,(19.65±2.45) ng/L] in the BA group were significantly lower than the post-modeling levels (all P ＜ 0.05),whereas those of IL (intestinal mucosa:(62.82 ±8.34) pg/g,(75.16 ±9.65) pg/g; plasma:(43.32 ±5.28) ng/L,(55.64 ±6.87) ng/L] were significantly higher than the post-modeling levels (all P ＜ 0.05).Compared with the stressed group,the intestinal mucosa levels of TNF-α and IFN-γand plasma levels of IFN-γ and TNF-α significantly decreased while the IL-10 level significantly increased (all P ＜0.05) in the BA group.(3) Histomorphology showed that,compared that the ileal mucosal villi and crypt structure were recovered in the BA group on the 8th intervention day.Compared with the post-modeling conditions,the ileal mucosal villi and crypt structure were damaged in the stressed group,showing edema of the lamina propria,in which inflammatory cell infiltration was observed.Conclusions BA is helpful for the repair of the intestinal mucosa injury after stress by regulating the release of inflammatory mediators and cytokines of intestinal mucosa.

A follow-up investigation on the surgical operations of 84 cases of femoral condylar fracture / 中华创伤骨科杂志

Objective To investigate the effects of surgical operations on different femoral condylar fractures. Methods A retrospective study was carried out on surgical operations of 84 patients with different femoral condylar fractures. The healing of fracture, functional recovery of knee joint and complications were analyzed. Results All the fractures healed in 6 to 12 months. According to Karlstrom's knee function score system, 48 knees were rated as excellent, 20 good, 13 fair, and 3 poor. The total good and excellent rate was 80.9%. Conclusions Anatomical reduction, secure fixation, timely treatment of complicated damage, and early rehabilitation exercise are important in treatment of femoral condylar fracture. The sustain blade plate is recommendable, because its design suits the anatomical structure of femoral condylar, and it not only provides convenient and stable fixation but also allows early postoperative functional training.