ObjectiveTo investigate the relation between preoperative peripheral blood neutrophil/albumin (NEU/ALB) and hypersensitive C-reactive protein (hs-CRP)/ALB ratios and seroma after laparoscopic transabdominal preperitoneal (LTAPP) hernia repair. MethodsThe patients diagnosed with inguinal hernia and underwent LTAPP hernia repair surgery admitted to the Heji Hospital Affiliated to Changzhi Medical College from June 2020 to June 2023 were retrospective collected. Multivariate logistic regression analysis was conducted to identify the risk factors affecting the occurrence of seroma after LTAPP repair surgery. The area under receiver operating characteristic curve (AUC) and 95% confidence interval (95% CI) were used to evaluate the discriminatory value of preoperative peripheral blood NEU/ALB ratio and hs-CRP/ALB ratio for seroma after LTAPP repair surgery. Delong test was used to compare the discriminatory value of these indicators. Test level α=0.05. ResultsA total of 357 patients who met the inclusion criteria were included in this study, and the seroma occurred in 42 cases (11.8%). The results of multiple logistic regression analysis showed that the larger the diameter of the hernia sac [OR (95%CI)=3.021 (1.498, 6.094), P=0.002], the more intraoperative bleeding [OR (95%CI)=4.654 (2.829, 7.657), P<0.001], and the higher the NEU/ALB ratio [OR (95%CI)=2.585 (1.618, 4.130), P<0.001] and hs-CRP/ALB ratio [OR (95%CI)=1.874 (1.239, 2.834), P=0.003], the higher the probability of seroma after LTAPP hernia repair. The AUC (95%CI) of NEU/ALB and hs-CRP/ALB indicators for predicting seroma after LTAPP repair surgery were 0.750 (0.702, 0.794) and 0.762 (0.715, 0.806), respectively. The optimal cutoff values were 2.970 and 4.001, with sensitivity of 78.6% and 73.8%, and specificity of 60.3% and 65.7%, respectively. The AUC (95%CI) of the combined prediction of seroma after LTAPP repair surgery was 0.851 (0.810, 0.886), with sensitivity and specificity of 71.4% and 87.0%, respectively. The AUC of the combined prediction of seroma after LTAPP repair surgery was higher than that of ALB (Z=2.864, P=0.004) and hs-CRP/ALB alone (Z=2.956, P=0.003). ConclusionFrom the data analysis results of this study, the incidence rate of seroma after LTAPP hernia repair is not low, and the occurrence of seroma should be paid close attention to patients with large hernia sac diameter, more intraoperative bleeding, and NEU/ALB and hs-CRP/ALB ratios.
Objective To evaluate the quality of diagnostic studies on detecting anti-cyclic citrullonated peptide antibody to diagnose rheumatoid arthritis. Methods We searched PubMed, EMbase, The Cochrane Library, and CBM to collect studies on using anti-cyclic citrullonated peptide antibody to diagnose rheumatoid arthritis. QUADAS items were used to evaluate the quality of included studies. Results A total of 195 studies were included. Sixty-nine were English studies and 126 were Chinese studies. All studies had good descriptions of the spectrum of patients and little potential for partial verification bias, differential verification bias, and incorporation bias. However, most studies were prone to disease progression bias, review bias, and clinical review bias. One study did not explain the intermediate test results, and another did not report part of the test results. The overall quality of English studies was better than that of Chinese studies. Conclusion The potential bias of the included studies mainly resulted from the absence of blinding when interpreting the test results. The reporting quality of the included studies was poor.
【Abstract】 Objective To compare the properties of collagen membranes before and after crossl inked and to establ ish the foundation of appl ication of collagen membranes. Methods Fresh bovine tendons were separated and collagen was extracted by washing, smashing and acetic acid dissolving. The collagen protein was determined by ultraviolet spectrophotometer and its characteristics were analyzed by SDS-polyacrylamide gel electrophoresis (SDS-PAGE), wavelength scanning and amino acids detecting. Collagen membranes were produced by lyophil ization. And then the biocharacteristics of the membranes before and after glutaraldehyde crossl inked were compared. BMSCs separated from volunteer’s bone marrow were seeded on collagen membranes before and after crossl inked by 2×103 in 100 μL medium, seven days after culture, the absorption spectrum of BMSCs was examined, and BMSCs were observed by scanning electron microscope (SEM). Results The contents of collagen protein were 2 mg/mL. The maximum absorption wave length appeared at about 230 nm. SDS-PAGE suggested that molecularweight of main bands was more than 66.2×103, the same as collagen marker from calf skin. There were 21.47% glycine, 12.04% pral ine and 10.18% hydroxyprol ine. No tryptophan was found. Before crossl inked, collagen membranes were in shape of white sponges and with big holes and the range of pH value was from 4.5 to 5.0. SEM showed reticular conformation and pore structure of collagen membranes, but the bore diameter was bigger. Their water-absorbing capacity was 61 times as much as their weight. The mechanical strength was 210 g/cm3. The dissolution time of collagenase was 90 minutes. After crossl inked, collagen membranes became thin, colorless, semi-transparent and compact with better tenacity. Under SEM, compact collagen fiber appeared reticular. There was lower water-absorbing capacity and pH value ranged from 6.5 to 7.0. The mechanical strength was 3 400 g/cm3 and the dissolution time of collagenase became longer. BMSCs could grow better either on before-crossl inked collagen membranes or on after-crossl inked ones. Conclusion As biomaterial scaffolds, after crossl inked collagen membranes were better than before-crossl inked ones.