The clinical significance of ischaemia-modified albumin in acute coronary syndrome and hypertension.

BACKGROUND: Early diagnosis of acute coronary syndrome is more and more important because of its mortality and morbidity. Hypertension is one of the pathogenesis of acute coronary syndrome, which often leads to stenosis and ischaemia. Ischaemia-modified albumin is sensitive for the occurrence of ischaemia, which attracted us in the significance of ischaemia-modified albumin in patients with chest pain, especially patients complicated with hypertension. METHODS: In total, 200 patients with acute chest pain were included in the study. According to the diagnostic criteria, patients were divided into acute coronary syndrome group and non-ischaemic chest pain group. Cardiac biomarkers were measured with 30 minutes in emergency department, including cardiac troponin T, creatine kinase MB, and ischaemia-modified albumin. Receiver operating characteristic curve (ROC) analysis was used for the sensitivity and specificity of ischaemia-modified albumin in the early diagnosis of acute coronary syndrome. Comparisons between ischaemia-modified albumin and cardiac Troponin T were done between groups. RESULTS: The demographics in two groups were not significantly different in most aspects. Compared with non-ischaemic chest pain group, serum levels of ischaemia-modified albumin and cardiac Troponin T were significantly higher in acute coronary syndrome group. ROC analysis showed that ischaemia-modified albumin had a good sensitivity and specificity in early diagnosis of acute coronary syndrome. The level of ischaemia-modified albumin in acute coronary syndrome patients with hypertension was higher than that in non-ischaemic chest pain patients. CONCLUSIONS: In patients complained with acute chest pain, the serum measurement of ischaemia-modified albumin is potential valuable for the early diagnosis of acute coronary syndrome, especially combined with ECG. The serum level of ischaemia-modified albumin in acute coronary syndrome patients is significantly associated with hypertension.

Clinical application of the modified neck-shoulder technique based on membrane autopsy to laparoscopic totally extraperitoneal prosthesis for indirect inguinal hernia.

OBJECTIVE: To investigate the anatomical basis and clinical application value of the modified neck-shoulder technique based on membrane autopsy in laparoscopic totally extraperitoneal prosthesis (TEP) for tension-free repairs of indirect inguinal hernia. METHODS: In this retrospective cohort study, we analyzed the clinical data of 136 patients with indirect inguinal hernia who underwent laparoscopic TEP for tension-free repairs at the Department of Gastroenterological Surgery Unit 1, the First Hospital of Putian City, Fujian Province from June 2017 to June 2020. The patients were divided into the modified neck-shoulder technique group (68 cases) and the traditional surgery group (68 cases), according to the different surgical methods. The intraoperative and postoperative conditions of the two groups were compared. RESULTS: Both the modified neck-shoulder technique group and the traditional surgery group completed the herniorrhaphy. Compared with the traditional surgery group, the modified neck-shoulder technique group had a shorter operation time [(37.15 ± 5.320) min vs. (54.04 ± 5.202) min, t = 18.472, p < 0.001], less intraoperative blood loss [(5.53 ± 1.634) ml vs. (16.21 ± 3.375) ml, t = 23.544, p < 0.001], lower incidence of intraoperative peritoneal injury [3 cases (4.41%) vs. 9 cases (13.26%), χ2 = 3.29, p = 0.07], lower intraoperative conversion rate [1 case (1.47%) vs. 8 cases (11.76%), χ2 = 5.83, p = 0.016], and lower incidence of postoperative chronic pain [1 case (1.47%) vs. 12 cases (17.65%), χ2 = 10.291, p = 0.001], all of which were statistically significant (p < 0.05). Both groups were followed up for 12 months after surgery. Relapse was not observed in any case. CONCLUSION: Drawing upon the surgical principles of the open neck-shoulder technique and the understanding of the membrane autopsy in the inguinal region, our center has summarized a set of operation procedures called the "modified neck-shoulder technique" for laparoscopic TEP in the tension-free repairs of indirect inguinal hernias. This new surgical technique could expeditiously and precisely navigate the interlayer gap in the preperitoneal space under the enlarged view of the laparoscope. It facilitated the high ligation, disconnection, or repositioning of the hernia sac, enhancing the reliability of patch placement while minimizing collateral damage, reducing postoperative complications, and shortening operation time.

Anthropogenic impacts on isotopic and geochemical characteristics of urban streams: a case study in Wuhan, China.

Urbanization and human activities have significantly modified the geochemical signatures of urban streams worldwide. However, the geochemical characteristics of urban streams in Wuhan, one of the core cities in the Yangtze River Economic Belt in China, remain largely unstudied. Here, we examined the stable isotopes and geochemistry of urban streams at 73 locations in the central districts in Wuhan during May 2019. Maps of isotopic signatures reflected a non-free-flowing state in part of the urban stream system in Wuhan. A lower DO and a higher EC level were found in urban streams relative to the adjacent Yangtze River. The Na+, K+, and Cl- concentrations in urban streams were > 3.0 times as high as those in the Yangtze River, and there was a slight increasing trend between 1.1 and 1.4 times for other major ions. The mildly elevated Fe concentration (1.3 times) and markedly elevated Mn concentration (> 5.0 times) were observed in urban streams. Spearman's correlation analysis indicated strong positive bivariate correlations among Na+, K+, and Cl- in urban streams, and an urban geochemical principal component was identified by principal component analysis. Plotting Na/(Na + Ca) versus total dissolved solids (TDS) indicated a potential risk of "urban stream syndrome." These findings can enhance the knowledge of anthropogenic impacts on current urban stream water quality and provide reference for the restoration and improvement of water ecology functions of the urban stream system in Wuhan.

[In vitro study of a new lasso device for intra-canal broken instrument removal].

PURPOSE: To collect facial stereo images of different lip protrusion by using three dimensional surface imaging device, and investigate facial aesthetic evaluation and differences between orthodontists, general dentists and laypeople. METHODS: In this study, one college student was recruited to take a three-dimensional image of the natural head and face. The software was simulated with a gradient of 2 mm to make the soft tissue lips move back and forth along the sagittal axis from the VSL line.The movement limit was 6 mm in front of and behind the VSL line. The observers included orthodontists, general dentists and laypeople. The data were analyzed with SAS 9.4 software package,visual analog scoring (VAS) was used for evaluation, and fixed-effect model was used for statistical analysis. RESULTS: The results showed that when the lip was on the VSL line, it got the highest scores amount all three groups and had no significant difference.When the lip became protrusive or retractive, it had negative impact on facial esthetics. There were significant differences in the scores of three groups in every 2mm of lip protrusion and lip retraction(P＜0.05). VAS 5 points or less were used as the unacceptable facial aesthetic score. The results showed that lip protrusion was 4 mm before the VSL line in the orthodontist group and less than 5 in the laypeople group . When the lip protruded 6mm before the VSL line and retracted 4 mm behind the VSL line, the scores of the three groups were lower than 5 points. The results also showed that male evaluation of lip protrusion 2 mm before the VSL line had a lower score than female; On the other hand, female evaluation of lip retraction behind the VSL line above 4mm had a lower score than male. CONCLUSIONS: Lip position has significant effect on facial aesthetics. Different observers had significant differences in the evaluation of lip position on facial aesthetics. It is suggested that orthodontists need more communication with patients in determining the target position of orthodontic treatment to improve treatment satisfaction.

[Comparison of digital model and dental plaster model in evaluation of bilateral cleft lip and palate].

PURPOSE: To compare the reliability of digital model and plaster model on evaluation of bilateral cleft lip and palate. METHODS: Nineteen pairs of digital and plaster model obtained from bilateral cleft lip and palate patients were measured, including nine measurements, such as maxillary alveolar length, width, cleft width, the deviation of maxillary middle line. One-way ANOVA was conducted for statistical analysis with SPSS 24.0 software package. RESULTS: There was no significant difference between the repeated measurements of the two types of models, there was no significant difference in the measurements between two types of models used in clinic. CONCLUSIONS: Both methods are suitable for evaluation of bilateral cleft lip and palate patients. Compared with conventional plaster model, digital model provides a safer and convenient way to obtain useful information both for research and clinical need.

Spatial scale and seasonal dependence of land use impacts on riverine water quality in the Huai River basin, China.

Land use pattern is an effective reflection of anthropic activities, which are primarily responsible for water quality deterioration. A detailed understanding of relationship between water quality and land use is critical for effective land use management to improve water quality. Linear mixed effects and multiple regression models were applied to water quality data collected from 2003 to 2010 from 36 stations in the Huai River basin together with topography and climate data, to characterize the land use impacts on water quality and their spatial scale and seasonal dependence. The results indicated that the influence of land use categories on specific water quality parameter was multiple and varied with spatial scales and seasons. Land use exhibited strongest association with dissolved oxygen (DO) and ammonia nitrogen (NH3-N) concentrations at entire watershed scale and with total phosphorus (TP) and fluoride concentrations at finer scales. However, the spatial scale, at which land use exerted strongest influence on instream chemical oxygen demand (COD) and biochemical oxygen demand (BOD) levels, varied with seasons. In addition, land use composition was responsible for the seasonal pattern observed in contaminant concentrations. COD, NH3-N, and fluoride generally peaked during dry seasons in highly urbanized regions and during rainy seasons in less urbanized regions. High proportion of agricultural and rural areas was associated with high nutrient contamination risk during spring. The results highlight the spatial scale and seasonal dependence of land use impacts on water quality and can provide scientific basis for scale-specific land management and seasonal contamination control.

[Effect of the presurgical nasoalveolar molding using computer-aided design technique].

OBJECTIVE: To develop a new method of presurgical nasoalveolar molding based on computer-aided design technique. METHODS: Twenty patients(16 boys, 4 girls) with complete unilateral cleft lip and palate(UCLP) who received presurgical nasoalveolar molding were recruited as the treatment group. Twenty patients(15 boys, 5 girls) with complete UCLP who did not receive presurgical orthopedic treatment were selected as the control group. All parameters of the digital maxillary model were measured using the Rapidform XOR3 software. The statistical analysis was performed with SPSS 15.0. RESULTS: A'-X and B-Il were reduced significantly after presurgical nasoalveolar molding. However, the mean alveolar height [F- hight (3.7 ± 1.1) mm, F'-height (4.6 ± 0.9) mm] decreased significantly after treatment(P <0.05). There were significant differences between the treatment group and the control group(P<0.05). CONCLUSIONS: Maxillary alveolar morphology could be improved in UCLP infants treated with computer-aided presurgical nasoalveolar molding. The width of the cleft could be reduced and the maxillary midline corrected effectively. However, the alveolar height decreased significantly after the treatment.