Objective To investigate disease constitution of elderly inpatient in the Xuanwu Hospital, Capital Medical University in Beijing in 2011, so as to provide baseline data for further study. Methods Elderly (patients no less than 60 years old) inpatients’ records in the Xuanwu Hospital, Capital Medical University in 2011 were collected. Based on all the diagnosis on hospital discharge records, the diseases were standardized and classified according to the International Classification of Disease, 10th Edition (ICD-10). Data (including general information of the inpatients, all discharge diagnosis, and the distribution of disease type, age and sex) were analyzed through descriptive analysis using Microsoft Excel 2007 software. SPSS 17.0 software was performed for hypothesis test. Results a) The total numbers of elderly inpatients were 13 807 in 2011, accounting for 39.79% of all the inpatients. Males were more than females (male: female=1.26 to 1). The average kind of disease each patient was diagnosed with was 4.41, ranging from 1 to 11. b) The disease spectrum of patients with one disease was nervous system diseases, neoplasms, and digestive system diseases. The primary and secondary diseases of patients with two diseases were mostly circulatory system diseases. c) All the diagnosis included 18 categories, the top 7 were circulatory system diseases, endocrine, nutritional and metabolic diseases, digestive system diseases, respiratory system diseases, and nervous system diseases, accounting for 83.4% of all the diagnosis. The primary diagnosis included 18 categories, the top 5 were circulatory system diseases, neoplasms, digestive system diseases, respiratory system diseases, and nervous system diseases, accounting for 68.6% of all the elderly inpatients. d) In the circulatory system diseases, the top 5 diseases were cerebral infarction, occlusion and stenosis of precerebral arteries, not resulting in cerebral infarction, angina pectoris, acute myocardial infarction, atherosclerosis, chronic ischaemic heart disease, accounting for 69.8% of all the circulatory system diseases patients. Diseases in different age and gender group were cerebral infarction, angina, acute myocardial infarction, and chronic ischemic heart disease (Plt;0.05). Conclusion The disease constitution of the Xuanwu Hospital, Capital Medical University is complex, and the primary diagnosis is mainly circulatory system diseases. It can be concluded that in the following studies attention should be paid to drug utilization of circulatory system diseases, so as to provide evidence for making the China specific potentially inappropriate medicine list and disease prevention for the elderly.
The presence of thrombus on the surface of blood-contacting biomaterials in clinical practice can significantly impact both the longevity of the biomaterials and the overall survival prognosis of patients. The administration of anticoagulant and antiplatelet medications may heighten the risk of systemic bleeding. Developing biomaterials with anti-thrombogenetic properties and enabling localized anti-thrombosis may offer a solution to these challenges. The development strategies for anti-thrombogenetic biomaterials can be categorized into three main approaches based on the mechanisms of thrombus formation on biomaterial surfaces: altering physical and chemical properties, designing coatings containing or releasing active substances, and promoting endothelialization. However, due to the intricate and interconnected nature of these mechanisms, biomaterials constructed using a single approach may not effectively prevent thrombus formation. The collaborative intervention of various mechanisms can facilitate the development of biomaterials with enhanced blood compatibility.
Objective To investigate the efficacy of autologous bone marrow mononuclear cells transplantation in treating lower l imb thromboangiitis obl iterans (TAO). Methods From January 2005 to November 2008, 25 patients (27 l imbs) with lower l imb TAO were treated. There were 24 males (26 l imbs) and 1 female (1 l imb), aging 16-44 years (33 years on average). Fifteen left l imbs and 12 right l imbs were involved. The median duration of disease was 2 years (from 3 months to9 years). Intermittent claudication was observed in 5 cases (5 l imbs), 16 patients (17 l imbs) had symptom of rest pain, 4 patients (5 l imbs) suffered ulcer on the distal l imbs. The results of visual analogue scale (VAS), maximum walking distance (MWD), ankle/brachial index (ABI), and transcutaneous oxygen pressure (TcPO2) before operation were (7.16 ± 1.12) points, (0.098 ± 0.043) km, 0.20 ± 0.09, and (11.78 ± 3.46) mm Hg (1 mm Hg=0.133 kPa), respectively. A total of 300 mL bone-marrow blood was extracted from the il iac bone. And then the mononuclear cells were isolated from the bone-marrow blood. All patients received cell transplantation only one time. The amount of transplantation bone marrow mononuclear cells was (1.82-29.46) × 109 (mean 13.33 × 109). Results All patients were followed up for 1 years. After 4 weeks of implantation, the results of VAS, MWD, ABI, and TcPO2 were (2.39 ± 0.51) points, (0.783 ± 0.176) km, 0.28 ± 0.16, (21.33 ± 6.57) mm Hg, respectively, showing significant difference compared with preoperative results (P lt; 0.05). The VAS, MWD, ABI, and TcPO2 increased to (2.44 ± 0.67) points, (1.199 ± 0.304) km, 0.37 ± 0.09, (27.90 ± 5.23) mm Hg after 1 year of implantation, showing significant differences compared with preoperative results (P lt; 0.05). One ulcer healed well and the improvement was obtained in other 3 cases after 4 weeks of implantation (80%). Four ulcers healed well after 1 year of implantation (80%). After 1 year of implantation, angiography revealed 37.04% affected limbs had a satisfactory neovascularization. The angiographic levels were grade 0 in 5 cases, grade 1 in 12 cases, grade 2 in 4 cases, and grade 3 in 6 cases. Conclusion Autologous bone marrow mononuclear cells transplantation could be a simple, safe, effective method to treat TAO.
Objective To conduct a systematic and comprehensive bibliometric analysis related to medical imaging in coronavirus disease 2019 (COVID-19) published by Chinese authors, and indicate the current status and guidance for coping with the challenges brought by long COVID. Methods Literature records pertaining to COVID-19 imaging were retrieved from the Web of Science (WOS) and Chinese Science Citation Database (CSCD) with a date range of January 1st, 2020 to December 31st, 2022. CiteSpace was used to analyze the popular topics and generate a visual map to further refine research trends. Results The search enrolled 2229 publications (1771 publications from WOS and 458 from CSCD). The monthly volume of publications showed a significant increase followed by a gradual decline, and then maintained a stable level. Clustering analysis of keywords and co-citations revealed that the research hotspots in COVID-19 imaging were clinical features, imaging differential diagnosis, and the application of artificial intelligence. Keyword burst analysis showed that “deep learning” was the most intensive keyword, while “attention mechanism” had the longest burst duration. Conclusions In recent years, the research in the field of COVID-19 imaging has made steady progress. Artificial intelligence has received the most attention. Clinical features, imaging features and artificial intelligence assisted diagnosis are the top of most concerns. The future focus of COVID-19 imaging research may be on improving algorithm models to expand the application of artificial intelligence in disease diagnosis, treatment, and management.
Objective To explore the effectiveness of interlocking intramedullary nail fixation system for Sanders type Ⅱ and Ⅲ calcaneal fractures by comparing with open surgery. Methods Forty patients (40 feet) with Sanders type Ⅱ and Ⅲ calcaneal fractures, who were admitted between May 2020 and December 2022 and met the selection criteria, were included in the study. They were randomly allocated into control group and minimally invasive group using a random number table method, with 20 cases in each group. The patients were treated with the interlocking intramedullary nail fixation system in the minimally invasive group and with steel plate internal fixation via a lateral L-shaped incision in the control group. There was no significant difference between the two groups (P>0.05) in terms of gender, age, fracture classification and side, cause of injury, time from injury to admission, and preoperative width, length, height, Böhler angle, and Gissane angle of the calcaneus. The operation time, intraoperative blood loss, incision length, hospital stay, fracture healing time, incidence of complications, as well as pre- and post-operative imaging indicators (Böhler angle, Gissane angle, width, height, and length of the calcaneus) and American Orthopaedic Foot and Ankle Society (AOFAS) score of foot were recorded and compared between the two groups. Results The incision length, operation time, and hospital stay of the minimally invasive group were significantly shorter than those of the control group, and the intraoperative blood loss significantly reduced (P<0.05). All patients of the two groups were followed up, with the follow-up time of 8-12 months (mean, 10.2 months) in the minimally invasive group and 8-12 months (mean, 10.4 months) in the control group. No complication occurred in the minimally invasive group after operation. One case of incision epidermal necrosis and 1 case of traumatic arthritis occurred in the control group after operation. However, there was no significant difference in the incidence of complications between the two groups (P>0.05). At last follow-up, the AOFAS score was significantly higher in the minimally invasive group than in the control group (P<0.05). Imaging examination showed that the calcaneal fractures of the two groups healed, and there was no significant difference in healing time between the two groups (P>0.05). Compared with preoperative conditions, the Böhler angle and Gissane angle of the calcaneus in the two groups significantly increased, the width narrowed, and the height and length increased at 3 days after operation and the last follow-up, with significant differences (P<0.05). There was no significant difference between 3 days after operation and last follow-up (P>0.05). There was no significant difference between the two groups at each time point (P>0.05). ConclusionThe interlocking intramedullary nail fixation system in treatment of Sanders type Ⅱ and Ⅲ calcaneal fractures has the advantages of minimal trauma, shortened hospital stay, reliable fracture reduction and fixation, and satisfactory foot function recovery.
Objective To observe the adhesion and prol iferation of late endothel ial progenitor cells (EPCs) planted on nanoporous PLLA scaffold in vitro and to provide a new approach that optimizes tissue engineered material. Methods Male and female New Zealand rabbits (weight 2.5-3.0 kg) were used. Isolated late EPCs from rabbit peri pheral blood were cultured. Electrostatic spinning technique was adopted to prepare misal igned nanofibers, al igned nanofibers and super-al igned nanofibers, and low temperature plasma technique was appl ied to prepare misal igned membrane, al igned membrane and super-al igned membrane. After being divided into group A (cells only), B (misal igned membrane), C (normal membrane), D (al igned membrane) and E (super-al igned membrane), the primary late EPCs (1 × 105/mL) werecultured on scaffolds and MTT method was used to detect cell prol iferation abil ity at 3, 5, 7, 9, 11, 13, 15 and 17 days afterculture. After being divided into group A (misal igned membrane), B (normal membrane), C (al igned membrane) and D (superal igned membrane), precipitation method was appl ied to detect cell adhesion rate at 4, 12 and 24 hours after compound culture, and the morphologic changes of cells were observed at 4, 24 and 72 hours after compound culture. Results Fiber diameters in nanofibrous PLLA scaffolds were 300-400 nm, with a porosity rate of above 90%. At 3, 5, 7, 9, 11, 13, 15 and 17 days after culture, A value of each group was increased with time and the cells in each group grew well, showing there was no significant difference between group A and group B at each time point (P gt; 0.05 ); during the period of 7-15 days after culture, the difference between groups C, D and E and groups A and B was significant (P lt; 0.05). At 4 hours after compound culture, the adhesion rate of group A was superior to that of groups B, C and D (P lt; 0.05); at 12 and 24 hours after compound culture, the adhesion rate of groups B, C and D was remarkably higher than that of group A (P lt; 0.05); significant difference was noted in each group between the time point of 4 hours and the time point of 12 and 24 hours after compound culture (P lt; 0.05), but no significant difference between 12 hours and 24 hours was detected (P gt; 0.05). Morphology observation demonstrated that cells grew well on the scaffolds, the cells in groups A and B grew sporadically and disorderly, while the cells in groups C and D attached and al igned along fiber and prol iferated, with an excretion of ECM. Group D was better at maintaining cell morphology. Conclusion Al igned and superal igned nanofibers of PLLA scaffold can promote the adhesion and prol iferation of seed cells on the scaffold and maintain good cell morphology, which is an appropriate candidate scaffold material for blood vessel tissue engineering. Late EPCs is an ideal cell source for blood vessel tissue engineering.
Objective To study the clinical and angiographic features in ST Segment Elevation Myocardial Infarction (STEMI) patients with spontaneous reperfusion. Methods A total of 519 patients with STEMI underwent Primary percutaneous coronary intervention (PCI) from January 2006 to December 2009 in Anzhen Hospital were enrolled. All patients were divided into the spontaneous reperfusion group (TIMI flow gradeⅢ ) and the non-spontaneous reperfusion group (TIMI flow grade 0-Ⅱ ) according to the TIMI flow grade before primary PCI. The incidence rate of spontaneous reperfusion through coronary angiography before primary PCI was observed, and the clinical relevant factors and angiographic lesion features of spontaneous reperfusion were analyzed. Results There were significant differences in age, CTnI peak value, high thrombus burden, and lesion location in distant LAD (P=0.000, 0.000, 0.002, 0.000, and 0.003, respectively) between the two groups. But there were no significant differences in gender, hypertension, diabetes mellitus, smoking history, hyperlipemia, angina pectoris history, culprit vessel distribution, lesion distribution in LCX and RCA, and collateral circulation between the two groups (Pgt;0.05 for all). Conclusion Compared to the patients without spontaneous reperfusion, patients with spontaneous reperfusion are younger in age, lower in CTnI peak value, and heavier in thrombosis burden, with culprit lesions mostly located in the distant LAD.
Objective To investigate the relation between artery location for anastomosis and recipient’s hepatic arterial anatomic variation or pathological abnormity in adult liver transplantation. Methods From March 2004 to July 2006, 80 cases of adult orthotopic liver transplantation (OLT) were performed in this hospital. Preoperative magnetic resonance angiography combined with operative artery dissection were performed to recognize and classify the hepatic arterial variation or pathological abnormity, then the arterial anastomotic location and stoma diameter were recorded. The location and diameter of anastomosis were compared between variation group and non-variation group. Results The recipient’s hepatic arterial variation rate was 11.3%(9/80), 8/9 of variable artery were right hepatic arteries which arose from gastroduodenal artery (GDA), common hepatic artery (CHA), celiac artery or superior mesenteric artery. The locations for anastomosis were the branch patches of CHA (7/9) and GDA (2/9). The pathological abnormities comprised of hepatic arterial intimal dissection (1 case) and hepatic arterial stenosis (1 case), the corresponding anastomotic location was the end of CHA in former case and anterior wall of suprarenal aorta in latter case. The proportion of anastomotic locations differed statistically between variation group and non-variation group (χ2=18.679, P＜0.01). The anastomotic diameter of CHA branch patch in variation group had no statistic difference compared with branch patch of CHA or proper hepatic artery (PHA) in non-variation group (Pgt;0.05). Conclusion The recipient’s hepatic arterial variation influences the selection of locations for anastomosis, the branch patch of CHA is the preferred location. The anastomotic stoma diameter of PHA branch patch in non-variation group obtains a similar size of CHA branch patch in variation group, the PHA branch patch can be used as a common location when arterial variations are absent.
ObjectiveTo study the effectiveness of liver function, hepatic energy metabolism, regeneration, and apoptosis on the obstructive jaundice rat after partial hepatectomy (PH) combined with internal biliary drainage under the condition of conspicuous bilirubinemia. MethodsOne hundred and twenty male SD rats were used in research, six of whom were divided into sham operation (SO) group. Twenty rats underwent bridge operation between common bile duct and duodenum after 70% PH (70%PH group), and 6 rats out of the 94 rats who underwent common bile duct ligation (CBDL) for 5 d were randomly selected as CBDL group, and the residual rats were done the second operations after 5 d and were divided into three groups: bile duct obstruction combined with reperfusion of bile flow group （BDO-RBF group， n=20), 42% PH with BDO-RBF group (n=20), and 70%PH with BDO-RBF group (n=25). Levels of TB, ALT, ALB, and ALP in serum; HGF, bcl-2 mRNA and protein； ATP, ADP, and AMP; hepatocyte proliferation/apoptosis index in hepatic tissues were dynamically observed after operation (24 h, 72 h, and 7 d), respectively. The liver function and hepatocyte energy metabolism were only detected in the SO group. ResultsRats without obstructive jaundice would have an excellent liver regeneration after 70% PH, while the liver function and hepatocyte energy metabolism could recover rapidly. The liver function, hepatocyte energy metabolism, HGF and bcl-2 mRNA and protein of liver tissue and the hepatocyte proliferation/apoptosis index in partial (42% or 70%) hepatectomy combined with internal biliary drainage in obstructive jaundice group were significantly influenced while recovered rapidly (Plt;0.05). ConclusionsUnder the condition of conspicuous bilirubinemia, the influences of hepatectomy combined with internal biliary drainage on hepatocyte energy metabolism, liver function, hepatocyte regeneration and apoptosis are severer than that of normal rats who underwent 70% hepatectomy, while also make the rats recover rapidly in hyperbilirubinemia groups. The database suggest that it is not necessary to do preoperative external biliary drainage before performing liver resection.