ObjectiveTo analyze the distribution, prognostic differences, and characteristics of patients with colorectal cancer (CRC) from 2007 to 2022 based on the current version of the Database from Colorectal Cancer (DACCA), so as to provide a basis for clinical decision-making. MethodsThe eligible CRC patients based on the established screening criteria from the updated DACCA were collected. The distribution and survival status of CRC patients in different residence places were analyzed. The residence places included 21 cities (prefectures) within Sichuan Province. ResultsA total of 5 416 cases that met the screening criteria from 2007 to 2022 were collected. Among these, CRC patients were predominantly concentrated in Chengdu (44.77%), Meishan (5.78%), and Nanchong (4.56%) cities. A heatmap depicting the superimposed trend of CRC patients origins revealed the distribution of patients was basically divided into eastern and western regions along the axis of “Mianyang–Chengdu–Yaan cities”. The majority of patients (5 359 cases, 98.95%) was distributed in the eastern region, while a few in the western region (57 cases, 1.05%). The patients in the eastern region were more high clustered (especially Chengdu city), while those in the western region was sporadically dispersed, and the patients in the western region increased slowly without aggregation. The 1, 3, and 5-year cumulative overall survival rates of the CRC patients in the DACCA were 96.2%, 89.7%, and 85.1%, respectively. The multivariate Cox proportional hazards regression model showed that the male, age ≥35-year old, adenocarcinoma (mucinous adenocarcinoma as a reference), poorly differentiated degree, pTNM stages Ⅲ and Ⅳ, obstruction, and perforation were the risk factors for median overall survival shortening in the CRC patients (all P<0.05). The survival curve of patients with CRC drawn by Kaplan-Meier method showed that the overall survival of CRC patients in different cities (prefectures) had no statistical differences as compared with the integral CRC patients (P>0.05), except for Neijiang city (was worse than that of the integral CRC patients, P<0.05). ConclusionsBased on data analysis for the DACCA from 2007 to 2022, the majority of CRC patients clusters in the eastern region. Chengdu city exhibits a high clustering, while the western region shows a sporadic distribution without aggregation phenomena. It is found that the cumulative overall survival of CRC patients in Neijiang city is worse than that of the integral CRC patients, while which in the other cities (prefectures) was relatively close to that of the integral CRC patients in Sichuan Province.
ObjectiveTo retrospectively analyze antibiotic resistance and clinical characteristics of Klebsiella pneumoniae strains for guiding the rational use of antibiotics in the area of the Bai nationality.MethodsThe antibiotic resistance and clinical characteristics of Klebsiella pneumoniae strains were retrospective analyzed, which were isolated from specimens of inpatients in First People’s Hospital of Dali between May 2016 and May 2017.ResultsAmong the 1 342 samples of various kinds of samples, 262 strains of Klebsiella pneumoniae were isolated, with the detection rate of 19.52% (262/1342). Clinical isolated strains were mainly from the new pediatric, intensive care unit, respiratory medicine, pediatrics, and mostly from sputum specimens (78.24%, 205/262). By screening of 22 kinds of antimicrobial agents, all strains had ampicillin resistance (100.00%), while none of these strains had ertapenem resistance. Extended-spectrum β-lactamases (ESBLs) positive strains’ resistance rate was higher than ESBLs negative strains (χ2=261.992, P<0.01). There were 76 drug resistant profiles, most of which were multidrug-resistant bacteria except 116 (44.27%) strains were resistant to ampicillin antibiotics only. And the number of strains in other resistant types ranged from 1 to 16. Only one of 262 strains had amikacin resistance, two of them were resistant to imipenem and meroenan.ConclusionsThere are many multidrug-resistant bacteria in Klebsiella pneumoniae in the population of Bai nationality, and there are no extensively drug resistant bacteria and pandrug-resistant bacteria strains. The strains of carbapene-resistant antibiotics should be worthy of clinical attention.
Objective To investigate the effects of different puncture levels on bone cement distribution and effectiveness in bilateral percutaneous vertebroplasty for osteoporotic thoracolumbar compression fractures. Methods A clinical data of 274 patients with osteoporotic thoracolumbar compression fractures who met the selection criteria between December 2017 and December 2020 was retrospectively analyzed. All patients underwent bilateral percutaneous vertebroplasty. During operation, the final position of the puncture needle tip reached was observed by C-arm X-ray machine. And 118 cases of bilateral puncture needle tips were at the same level (group A); 156 cases of bilateral puncture needle tips were at different levels (group B), of which 87 cases were at the upper 1/3 layer and the lower 1/3 layer respectively (group B1), and 69 cases were at the adjacent levels (group B2). There was no significant difference in gender, age, fracture segment, degree of osteoporosis, disease duration, and preoperative visual analogue scale (VAS) score, and Oswestry disability index (ODI) between groups A and B and among groups A, B1, and B2 (P>0.05). The operation time, bone cement injection volume, postoperative VAS score, ODI, and bone cement distribution were compared among the groups. Results All operations were successfully completed without pulmonary embolism, needle tract infection, or nerve compression caused by bone cement leakage. There was no significant difference in operation time and bone cement injection volume between groups A and B or among groups A, B1, and B2 (P>0.05). All patients were followed up 3-32 months, with an average of 7.8 months. There was no significant difference in follow-up time between groups A and B and among groups A, B1, and B2 (P>0.05). At 3 days after operation and last follow-up, VAS score and ODI were significantly lower in group B than in group A (P<0.05), in groups B1 and B2 than in group A (P<0.05), and in group B1 than in group B2 (P<0.05). Imaging review showed that the distribution of bone cement in the coronal midline of injured vertebrae was significantly better in group B than in group A (P<0.05), in groups B1 and B2 than in group A (P<0.05), and in group B1 than in group B2 (P<0.05). In group A, 7 cases had postoperative vertebral collapse and 8 cases had other vertebral fractures. In group B, only 1 case had postoperative vertebral collapse during follow-up. ConclusionBilateral percutaneous vertebroplasty in the treatment of osteoporotic thoracolumbar compression fractures can obtain good bone cement distribution and effectiveness when the puncture needle tips locate at different levels during operation. When the puncture needle tips locate at the upper 1/3 layer and the lower 1/3 layer of the vertebral body, respectively, the puncture sites are closer to the upper and lower endplates, and the injected bone cement is easier to connect with the upper and lower endplates.
Objective To analyze the differences in microbial communities in bronchoalveolar lavage fluid (BALF) from patients with simple pneumonia versus those with chronic obstructive pulmonary disease (COPD) combined with lower respiratory tract infection using metagenomic next-generation sequencing (mNGS). Methods Patients hospitalized for pulmonary infections at the First Affiliated Hospital of Xinjiang Medical University between December 2021 and March 2023 were included. Based on the presence of COPD, the patients were divided into two groups: those with simple pneumonia and those with COPD combined with lower respiratory tract infection. mNGS was employed to detect microbes in BALF, and the microbial community distribution characteristics of the two groups were analyzed. Results A total of 97 patients were included, of whom 80 (81.82%) had positive microbial detection results. The smoking index in COPD group with lower respiratory tract infection was significantly higher than that in the group with simple pneumonia (t= −3.62, P=0.001). Differences in microbial community distributions were observed between the groups. At the genus level, 19 species of microorganisms were detected in the simple pneumoniapulmonary infection group, including 8 bacteria (42.11%), 2 fungi (10.53%), 3 viruses (15.79%), and 6 other types of microorganisms (31.58%). In contrast, 22 types of microbes were detected in COPD group with lower respiratory tract infection, including 10 bacteria (47.62%), 3 fungi (14.29%), 4 viruses (19.05%), and 4 other types of microorganisms (19.05%). Differences were also noted in reads per million (RPM) values; bacterial RPM values at the genus level were significantly higher in the COPD group during non-severe pneumonia compared to the simple pneumonia group (Z=–2.706, P=0.007). In the patients with severe pneumonia, RPM values at the genus and species levels were significantly higher than those in non-severe pneumonia (Z=−2.202, P=0.028; Z=−2.141, P=0.032). In COPD combined with severe pneumonia, bacterial RPM values were significantly higher at the species level compared to non-severe pneumonia (Z=−2.367, P=0.017). ConclusionsThere are differences in the distribution of microbial communities at the genus and species levels in BALF from patients with COPD combined with lower respiratory tract infection compared to those with simple pulmonary pneumonia. Bacteria are the predominant microbial type in both groups, but the dominant bacterial species differ between them. Simple pneumonia are primarily associated with bacterial, viral, and other types of microbial infections, while COPD combined with lower respiratory tract infection is predominantly associated with fungal and bacterial infections. RPM values may serve as an indicator of the severity of pneumonia.
ObjectiveTo evaluate the safety of photoelectric guided navigation unilateral puncture of the percutaneous kyphoplasty (PKP) in the treatment of thoracolumbar osteoporotic vertebral compression fracture (OVCF).MethodsA randomized controlled clinical research was performed between June 2015 and January 2017. Eighty-five cases of OVCF were treated with photoelectric guided navigation unilateral puncture of the PKP (trial group, 43 cases) or C arm fluoroscopy unilateral puncture of the PKP (control group, 42 cases) respectively. There was no significant difference in gender, age, disease duration, segmental fracture, AO classification, bone mineral density, and preoperative visual analogue scale (VAS) score between 2 groups (P>0.05). The concordance rate of puncture path and design path, the incidence of pedicle wall breaking, the incidence of bone cement leakage, and the rate of bone cement distribution center were observed and calculated on postoperative CT images; the intraoperative X-ray exposure frequency, frequency of puncture, operation time, VAS scores before operation and at 2 days after operation, and postoperative blood vessel or nerve injury were recorded and compared.ResultsThe intraoperative X-ray exposure frequency and puncture frequency in trial group were significantly less than those in control group (P<0.05), but there was no significant difference in operation time between 2 groups (t=0.440, P=0.661). The VAS scores of 2 groups at 2 days after operation were significantly improved when compared with preoperative ones (P<0.05), but there was no significant difference in VAS score at 2 days after operation between 2 groups (t=0.406, P=0.685). All the patients were followed up 6-18 months (mean, 10 months). No blood vessel or nerve injury occurred in 2 groups. The incidence of pedicle wall breaking, the incidence of bone cement leakage, the concordance rate of puncture path and design path, and the rate of bone cement distribution center in trial group were 2.33% (1/43), 2.33% (1/43), 86.05% (37/43), and 88.37% (38/43) respectively, all showing significant differences when compared with those of control group [19.05% (8/42), 21.43% (9/42), 45.24% (19/42), and 50.00% (21/42) respectively] (P<0.05).ConclusionIntraoperative photoelectric guided navigation unilateral puncture of the PKP can improve the success rate of target puncture and reduce the incidence of pedicle wall breaking effectively, and achieve better bone cement distribution and better security.
Objective To investigate the procedure and clinical effect of revascularization for arterial occlusion in lower extremity. Methods From July 1998 to March 2005, 29 cases of arterial occlusion were treated by microsurgery. Of 29 cases, there 22 males and 7 females, aging 22-86 years, including 9 cases of thromboangiitis obliterans(TAO), 17 cases of arterial sclerosis obstruction(ASO) and 3 cases of diabetic foot(DF). The location was the left in 17 cases, the right in 11 cases and both sides in 1 case. All cases were inspected by color-Doppler ultrasonic scanning before operation. The cases of ASO and DF were checked with MRA. The results of examinations showed that the locations of arteriostenosis and obstruction were: in 9 cases of TAO, the distal superficial femoral artery in 3 cases, popliteal artery in 5 cases, bilateral dorsal metatarsal artery in 1 case; in 17 cases of ASO, common iliac artery in 2 cases, external iliac artery in 4 cases, femoral artery in 10 cases and popliteal artery in 1 case; and were all superficial femoral artery in 3 cases of DF. DSA examination confirmed that there was appropriate outflow in 15 cases. Basing on the location and extent of the arterial occlusion, 11 cases were treated by the primary deep vein arterializing, 16 cases by arterial bypass distribution and 2 cases of extensive common iliac arterial occlusion were amputated in the level of 1/3 distal thigh. Results The postoperative duration of follow-up for all cases was 3 months to 7 years. In 9 cases of TAO, 2 healed by first intention after deterioration, 4 healed after changing dressing and 3 had fresh soft tissue growth after debrided superficial secondary necrosis. In 17 cases of ASO, 13 healed by first intention, 2 healed after changing dressing and 2 were amputated. In 3 cases of DF, 2 healed after changed dressing and debrided, 1 was aggravated with the second toe necrosis. Conclusion Performing primary deep veinarteriolization and arterial bypassdistribution is effective for treatment of arterial occlusion of lower extremity. The arterial reconstructive patency rate can be improved by microsurgical treatment.
Objective To explore the method of radiolabeling anti-Aspergillus monoclonal antibody (WF-AF-1)with 99mTc,and evaluate the in vitro and in vivo characteristics of 99mTc labeled WF-AF-1 (99mTc-WF-AF-1). Methods 99mTc-WF-AF-1 was prepared with indirect-labeling method.The labeled product was identified using thin layer chromatography.Suspensions of Aspergillus fumigatus,Staphylococcus aureus and Candida albicans were incubated with 99mTc-WF-AF-1 to evaluate the specificity of the labeled antibody.Mice were injected with 3.7MBq of labeled product.The biodistribution was measured at 40min,2h,4h and 7h after injection. Results The labeling efficiency of 99mTc-WF-AF-1 was over 95%,and the labeled product was stable in serum and phosphate buffer solution.In vitro binding of 99mTc-WF-AF-1 revealed that the labeled Mab-WF-AF-1 preferentially binds to Aspergillus fumigatus. Biodistrbution data showed that the labeled antibody was deposited mainly in liver,kidneys and spleen.The radioactivity uptake in blood at 40min and 7h was (2.51±0.23)%ID/g and (0.53±0.13)%ID/g,respectively. Conclusions The labeling efficiency and stability of 99mTc-WF-AF-1 are high.The labeled antibody is excreted mainly through the liver and kidneys with fast clearance in blood in normal mice.
It has been found that in biological studies, the simple linear superposition mathematical model cannot be used to express the feature mapping relationship from multiple activated grid cells' grid fields to a single place cell's place field output in the hippocampus of the cerebral cortex of rodents. To solve this problem, people introduced the Gauss distribution activation function into the area. We in this paper use the localization properties of the function to deal with the linear superposition output of grid cells' input and the connection weights between grid cells and place cells, which filters out the low activation rate place fields. We then obtained a single place cell field which is consistent with biological studies. Compared to the existing competitive learning algorithm place cell model, independent component analysis method place cell model, Bayesian positon reconstruction method place cell model, our experimental results showed that the model on the neurophysiological basis can not only express the feature mapping relationship between multiple activated grid cells grid fields and a single place cell's place field output in the hippocampus of the cerebral cortex of rodents, but also make the algorithm simpler, the required grid cells input less and the accuracy rate of the output of a single place field higher.
Objective To investigate the load distribution on the more painful and less painful limbs in patients with mild-to-moderate and severe bilateral knee osteoarthritis (KOA) and explore the compensatory mechanisms in both limbs among bilateral KOA patients with different severity levels. Methods A total of 113 participants were enrolled between July 2022 and September 2023. This cohort comprised 43 patients with mild-to-moderate bilateral KOA (Kellgren-Lawrence grade 2-3), 43 patients with severe bilateral KOA (Kellgren-Lawrence grade 4), and 27 healthy volunteers (healthy control group). The visual analogue scale (VAS) score for pain, the Hospital for Special Surgery (HSS) score, passive knee range of motion (ROM), and hip-knee-ankle angle (HKA) were used to assess walking pain intensity, joint function, and lower limb alignment in KOA patients, respectively. Motion trajectories of reflective markers and ground reaction force data during walking were captured using a gait analysis system. Musculoskeletal modeling was then employed to calculate biomechanical parameters, including the peak knee adduction moment (KAM), KAM impulse, peak joint contact force (JCF), and peak medial/lateral contact forces (MCF/LCF). Statistical analyses were performed to compare differences in clinical and gait parameters between bilateral limbs. Additionally, one-dimensional statistical parametric mapping was utilized to analyze temporal gait data. Results Mild-to-moderate KOA patients showed the significantly higher HSS score (67.7±7.9) than severe KOA patients (51.9±8.9; t=8.747, P<0.001). The more painful limb in all KOA patients exhibited significantly greater HKA and higher VAS scores compared to the less painful limb (P<0.05). While bilateral knee ROM did not differ significantly in mild-to-moderate KOA patients (P>0.05), the severe KOA patients had significantly reduced ROM in the more painful limb versus the less painful limb (P<0.05). Healthy controls showed no significant bilateral difference in any biomechanical parameters (P>0.05). All KOA patients demonstrated longer stance time on the less painful limb (P<0.05). Critically, severe KOA patients exhibited significantly higher peak KAM, KAM impulse, and peak MCF in the more painful limb (P<0.05), while mild-to-moderate KOA patients showed the opposite pattern with lower peak KAM and KAM impulse in the more painful limb (P<0.05) and a similar trend for peak MCF. Conclusion Patients with mild-to-moderate KOA effectively reduce load on the more painful limb through compensatory mechanisms in the less painful limb. Conversely, severe bilateral varus deformities in advanced KOA patients nullify compensatory capacity in the less painful limb, paradoxically increasing load on the more painful limb. This dichotomy necessitates personalized management strategies tailored to disease severity.
Sichuan provincial health emergency team has completed a number of domestic emergencies, as well as the emergency medical rescue of the Nepal earthquake, since constructured. It established a great industry image, moreover, the people’s health and safety of life were ensured. This paper summarized the experience of Sichuan provincial health emergency team construction, to provide scientific evidence of optimizing health emergency team construction in China.