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World Journal of Clinical Cases 2024年第10期12卷 1837-1843页

作者： Zi Mao zhi-Hong Xiong Jun-feng Li Department of Pain Management The Affiliated Hospital of Yunnan UniversityKunming 650000Yunnan ProvinceChina Department of Medical Administration The Affiliated Hospital of Yunnan UniversityKunming 650000Yunnan ProvinceChina

BACKGROUND Percutaneous kyphoplasty(PKP)is a pivotal intervention for osteoporotic fractures,pathological vertebral compression fractures,and vertebral bone tumors.Despite its efficacy,the procedure presents challenges,notably complications arising from intradural cement leakage.Timely and accurate diagnosis,coupled with emergent intervention is imperative to improve patient prognosis.This case report illuminates the intricacies and potential complications associated with PKP,emphasizing the critical need for vigilant monitoring,prompt diagnosis,and immediate intervention to mitigate adverse outcomes.CASE SUMMARY A 58-year-old male patient,experiencing a T7 osteoporosis-related pathological compression fracture,underwent PKP at a local hospital.Two weeks postprocedure,the patient developed paraplegic and dysuric symptoms,necessitating emergency decompression surgery.Gradual improvement was achieved,marked by the restoration of muscle strength,sensation,and mobility.CONCLUSION PKP Intradural cement leakage following PKP is unusual and potentially fatal.Prompt imaging examinations,urgent evaluation,and the decompression surgery are essential,which help alleviate symptoms associated with spinal damage,markedly improving the overall prognosis.

关键词： Percutaneous kyphoplasty Intradural cement leakage Complication Decompression surgery Case report

Perforated gastric ulcer causing mediastinal emphysema: A case report

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World Journal of Clinical Cases 2024年第4期12卷 859-864页

作者： zhi-Cheng Dai Xun-Wu Gui feng-He Yang Hao-Yuan Zhang Wen-feng Zhang Department of General Surgery Mengcheng County First People's HospitalMengcheng 233500Anhui ProvinceChina Department of Medical Imaging Mengcheng County First People's HospitalMengcheng 233500Anhui ProvinceChina

BACKGROUND Mediastinal emphysema is a condition in which air enters the mediastinum between the connective tissue spaces within the pleura for a variety of reasons.It can be spontaneous or secondary to chest trauma,esophageal perforation,medi-cally induced factors,etc.Its common symptoms are chest pain,tightness in the chest,and respiratory distress.Most mediastinal emphysema patients have mild symptoms,but severe mediastinal emphysema can cause respiratory and circulatory failure,resulting in serious consequences.CASE SUMMARY A 75-year-old man,living alone,presented with sudden onset of severe epigastric pain with chest tightness after drinking alcohol.Due to the remoteness of his residence and lack of neighbors,the patient was found by his nephew and brought to the hospital the next morning after the disease onset.Computed tomography(CT)showed free gas in the abdominal cavity,mediastinal emph-ysema,and subcutaneous pneumothorax.Upper gastrointestinal angiography showed that the esophageal mucosa was intact and the gastric antrum was perforated.Therefore,we chose to perform open gastric perforation repair on the patient under thoracic epidural anesthesia combined with intravenous anesthesia.An operative incision of the muscle layer of the patient's abdominal wall was made,and a large amount of subperitoneal gas was revealed.And a continued incision of the peritoneum revealed the presence of a perforation of approx-imately 0.5 cm in the gastric antrum,which we repaired after pathological examination.Postoperatively,the patient received high-flow oxygen and cough exercises.Chest CT was performed on the first and sixth postoperative days,and the mediastinal and subcutaneous gas was gradually reduced.CONCLUSION After gastric perforation,a large amount of free gas in the abdominal cavity can reach the mediastinum through the loose connective tissue at the esophageal hiatus of the diaphragm,and upper gastrointestinal angiography can clarify the site of perforation.In patients with mediastinal emphysema,open surgery av

关键词： Gastric ulcer Perforated Mediastinal emphysema Case report

Risk factors for brain injury in patients with exertional heatstroke:A 5-year experience

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Chinese Journal of Traumatology 2024年第2期27卷 91-96页

作者： Li Zhong Ming Wu Zhe-Ying Liu Yan Liu zhi-feng Liu Department of Traditional Chinese Medicine The First Affiliated HospitalGuizhou University of Chinese MedicineGuiyang550001China Department of Infection and Critical Care Medicine The Second People's Hospital of Shenzhen&First Affiliated Hospital of Shenzhen UniversityHealth Science CenterShenzhenGuangdong province518035China Department of Medical Critical Care Medicine General Hospital of Southem Theatre Command of PLA.Guangzhou510010China Guangdong Branch Center National Clinical Research Center for Geriatric Diseases(Chinese PLA General Hospital)Guangzhou510010China

Purpose:Minimal data exist on brain injury in patients with exertional heatstroke(EHS)in developing country.In this study,we explored the risk factors for brain injury induced by EHS 90-day after onset.Methods:A retrospective cohort study of patients with EHS was conducted in the intensive care unit of the General Hospital of Southern Theater Command of PLA in China from April 2014 to June 2019.Patients were divided into non-brain injury(fully recovered)and brain injury groups(comprising deceased patients or those with neurological sequelae).The brain injury group was further subdivided into a death group and a sequela group for detailed analysis.General information,neurological performance and information on important organ injuries in the acute stage were recorded and analysed.Multivariable logistic regression was used to identify risk factors for brain injury after EHS and mortality risk factors for brain injury,and Kaplan-Meier survival curve was used to evaluate the effect of the neurological dysfunction on survival.Results:Out of the 147 EHS patients,117 were enrolled,of which 96(82.1%)recovered,13(11.1%)died,and 8(6.8%)experienced neurological sequelae.Statistically significant differences were found between non-brain injury and brain injury groups in age,hypotension,duration of consciousness disorders,time to drop core body temperature below 38.5℃,lymphocyte counts,platelet counts,procalcitonin,alanine aminotransferase,aspartate aminotransferase,creatinine,cystatin C,coagulation parameters,international normalized ratio,acute physiology and chronic health evaluation II scores,sequential organ failure assessment(SOFA)scores,and Glasgow coma scale scores(all p<0.05).Multivariate logistic regression showed that age(OR=1.090,95%CI:1.02-1.17,p=0.008),time to drop core temperature(OR=8.223,95%CI:2.30-29.40,p=0.001),and SOFA scores(OR=1.676,95%CI:1.29-2.18,p<0.001)are independent risk factors for brain injury induced by EHS.The Kaplan-Meier curves suggest significantly prolonged survival(p<0.001)in patients with

关键词： Exertional heatstroke Brain injury Sequela Risk factors Disorders of consciousness

Molecular Dynamics Simulation Studies on the Micromorphology and Proton Transport of Nafion/Ti_(3)C_(2)T_(x) Composite Membrane

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Chinese Journal of Polymer Science 2024年第3期42卷 373-387,I0009页

作者： zhi-Yue Han Su-Peng Pei Chun-Yang Yu Yong-feng Zhou School of Chemical and Environmental Engineering Shanghai Institute of TechnologyShanghai 201418China School of Chemistry&Chemical Engineering Frontiers Science Center for Transformative MoleculesShanghai Key Laboratory of Electrical Insulation and Thermal AgingShanghai Jiao Tong UniversityShanghai 200240China Key Laboratory of Green and High-end Utilization of Salt Lake Resources Chinese Academy of SciencesXining 810008China

The perfluorosulfonic acid(PFSA) membrane doped with two-dimensional conductive filler Ti_(3)C_(2)T_(x) is a fuel cell proton exchange membrane with high application potential. Experimental studies showed that the proton conductivity of Nafion/Ti_(3)C_(2)T_(x) composite membrane is improved significantly compared with that in pure Nafion. However, the microscopic mechanism of doping on the enhancement of membrane performance is remain unclear now. In this work, molecular dynamics simulation was used to investigate the microscopic morphology and proton transport behaviors of Nafion/Ti_(3)C_(2)T_(x) composite membrane at the molecular level. The results shown that there were significant differences about the diffusion kinetics of water molecules and hydroxium ions in Nafion/Ti_(3)C_(2)T_(x) at low and high hydration levels in the nanoscale region.With the increase of water content, Ti_(3)C_(2)T_(x) in membrane was gradually surrounded by ambient water molecules to form a hydration layer, and forming a relatively continuous proton transport channel between Nafion polymer and Ti_(3)C_(2)T_(x) monomer. The continuous proton transport channel could increase the number of binding sites of proton and thus achieving high proton conductivity and high mobility of water molecules at higher hydration level. The current work can provide a theoretical guidance for designing new type of Nafion composite membranes.

关键词： Nafion/Ti_(3)C_(2)T_(x)composite membrane Proton transport Molecular dynamics simulation

Intermittent disturbance mechanical behavior and fractional deterioration mechanical model of rock under complex true triaxial stress paths

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International Journal of Mining Science and Technology 2024年第1期34卷 117-136页

作者： zhi Zheng Hongyu Xu Kai Zhang Guangliang feng Qiang Zhang Yufei Zhao State Key Laboratory of Featured Metal Materials and Life-cycle Safety for Composite Structures Key Laboratory of Disaster Prevention and Structural Safety of Ministry of EducationCollege of Civil Engineering and ArchitectureGuangxi UniversityNanning 530004China State Key Laboratory of Geomechanics and Geotechnical Engineering Institute of Rock and Soil MechanicsChinese Academy of SciencesWuhan 430071China State Key Laboratory of Simulation and Regulation of Water Cycle in River Basin China Institute of Water Resources and Hydropower ResearchBeijing 100080China State Key Laboratory for Geomechanics and Deep Underground Engineering China University of Mining and TechnologyXuzhou 221116China

Mechanical excavation,blasting,adjacent rockburst and fracture slip that occur during mining excavation impose dynamic loads on the rock mass,leading to further fracture of damaged surrounding rock in three-dimensional high-stress and even causing disasters.Therefore,a novel complex true triaxial static-dynamic combined loading method reflecting underground excavation damage and then frequent intermittent disturbance failure is proposed.True triaxial static compression and intermittent disturbance tests are carried out on monzogabbro.The effects of intermediate principal stress and amplitude on the strength characteristics,deformation characteristics,failure characteristics,and precursors of monzogabbro are analyzed,intermediate principal stress and amplitude increase monzogabbro strength and tensile fracture mechanism.Rapid increases in microseismic parameters during rock loading can be precursors for intermittent rock disturbance.Based on the experimental result,the new damage fractional elements and method with considering crack initiation stress and crack unstable stress as initiation and acceleration condition of intermittent disturbance irreversible deformation are proposed.A novel three-dimensional disturbance fractional deterioration model considering the intermediate principal stress effect and intermittent disturbance damage effect is established,and the model predicted results align well with the experimental results.The sensitivity of stress states and model parameters is further explored,and the intermittent disturbance behaviors at different f are predicted.This study provides valuable theoretical bases for the stability analysis of deep mining engineering under dynamic loads.

关键词： True triaxial static and disturbance test Mechanical properties Failure mechanism and precursor Intermittent disturbance effect Fractional mechanical model

Patterns and drivers of avian taxonomic and phylogenetic beta diversity in China vary across geographical backgrounds and dispersal abilities

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Zoological Research 2024年第1期45卷 125-135页

作者： Jian-Chao Liang zhi-feng Ding Chun-Lin Li Yi-Ming Hu zhi-Xin Zhou Gan-Wen Lie Xiao-Nan Niu Wen-Bin Huang Hui-Jian Hu Xing-feng Si Guangdong Key Laboratory of Animal Conservation and Resource Utilization Guangdong Public Laboratory of Wild Animal Conservation and UtilizationInstitute of ZoologyGuangdong Academy of SciencesGuangzhouGuangdong 510260China School of Resources and Environmental Engineering Anhui UniversityHefeiAnhui 230601China Guangdong Eco-Engineering Polytechnic GuangzhouGuangdong 510520China Huizhou Institute of Forestry(Huizhou Botanical Garden Management Service Center) HuizhouGuangdong 516001China Administration of National Nature Reserve for Marine Ecology of Guangdong Nanpeng Islands ShantouGuangdong 515900China Zhejiang Zhoushan Archipelago Observation and Research Station Institute of Eco-ChongmingZhejiang Tiantong Forest Ecosystem National Observation and Research StationSchool of Ecological and Environmental SciencesEast China Normal UniversityShanghai 200241China

Geographical background and dispersal ability may strongly influence assemblage dissimilarity;however,these aspects have generally been overlooked in previous large-scale beta diversity studies.Here,we examined whether the patterns and drivers of taxonomic beta diversity(TBD)and phylogenetic beta diversity(PBD)of breeding birds in China vary across(1)regions on both sides of the Hu Line,which demarcates China’s topographical,climatic,economic,and social patterns,and(2)species with different dispersal ability.TBD and PBD were calculated and partitioned into turnover and nestedness components using a moving window approach.Variables representing climate,habitat heterogeneity,and habitat quality were employed to evaluate the effects of environmental filtering.Spatial distance was considered to assess the impact of dispersal limitation.Variance partitioning analysis was applied to assess the relative roles of these variables.In general,the values of TBD and PBD were high in mountainous areas and were largely determined by environmental filtering.However,different dominant environmental filters on either side of the Hu Line led to divergent beta diversity patterns.Specifically,climate-driven species turnover and habitat heterogeneity-related species nestedness dominated the regions east and west of the line,respectively.Additionally,bird species with stronger dispersal ability were more susceptible to environmental filtering,resulting in more homogeneous assemblages.Our results indicated that regions with distinctive geographical backgrounds may present different ecological factors that lead to divergent assemblage dissimilarity patterns,and dispersal ability determines the response of assemblages to these ecological factors.Identifying a single universal explanation for the observed pattern without considering these aspects may lead to simplistic or incomplete conclusions.Consequently,a comprehensive understanding of large-scale beta diversity patterns and effective planning of conservation strategies necessitate the

关键词： Beta diversity Environmental filtering Dispersal limitation Hu Line Species dispersal ability Breeding birds

Multimorbidity and mortality among older patients with coronary heart disease in Shenzhen,China

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Journal of Geriatric Cardiology 2024年第1期21卷 81-89页

作者： Fu-Rong LI Shuang WANG Xia LI zhi-Yuan CHENG Cheng JIN Chun-Bao MO Jing ZHENG feng-Chao LIANG Dong-feng GU Shenzhen Key Laboratory of Cardiovascular Health and Precision Medicine Southern University of Science and TechnologyShenzhenGuangdongChina School of Public Health and Emergency Management Southern University of Science and TechnologyShenzhenGuangdongChina Shenzhen Health Development Research and Data Management Center ShenzhenChina School of Medicine Southern University of Science and TechnologyShenzhenGuangdongChina

BACKGROUND The current understanding of the magnitude and consequences of multimorbidity in Chinese older adults with coronary heart disease(CHD)is insufficient.We aimed to assess the association and population-attributable fractions(PAFs)between multimorbidity and mortality among hospitalized older patients who were diagnosed with CHD in Shenzhen,China.METHODS We conducted a retrospective cohort study of older Chinese patients(aged≥65 years)who were diagnosed with CHD.Cox proportional hazards models were used to estimate the associations between multimorbidity and all-cause and cardiovascular disease(CVD)mortality.We also calculated the PAFs.RESULTS The study comprised 76,455 older hospitalized patients who were diagnosed with CHD between January 1,2016,and August 31,2022.Among them,70,217(91.9%)had multimorbidity,defined as the presence of at least one of the predefined 14 chronic conditions.Those with cancer,hemorrhagic stroke and chronic liver disease had the worst overall death risk,with adjusted HRs(95%CIs)of 4.05(3.77,4.38),2.22(1.94,2.53),and 1.85(1.63,2.11),respectively.For CVD mortality,the highest risk was observed for hemorrhagic stroke,ischemic stroke,and chronic kidney disease;the corresponding adjusted HRs(95%CIs)were 3.24(2.77,3.79),1.91(1.79,2.04),and 1.81(1.64,1.99),respectively.All-cause mortality was mostly attributable to cancer,heart failure and ischemic stroke,with PAFs of 11.8,10.2,and 9.1,respectively.As for CVD mortality,the leading PAFs were heart failure,ischemic stroke and diabetes;the corresponding PAFs were 18.0,15.7,and 6.1,respectively.CONCLUSIONS Multimorbidity was common and had a significant impact on mortality among older patients with CHD in Shenzhen,China.Cancer,heart failure,ischemic stroke and diabetes are the primary contributors to PAFs.Therefore,prioritizing improved treatment and management of these comorbidities is essential for the survival prognosis of CHD patients from a holistic public health perspective.

关键词： patients morbidity mortality

Glibenclamide pretreatment attenuates early hematoma expansion of warfarin-associated intracerebral hemorrhage in rats by alleviating perihematomal blood-brain barrier dysfunction

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Chinese Neurosurgical Journal 2024年第1期10卷 8-19页

作者： Zongwei Zeng Liang Liang Zhou feng Peiwen Guo Xiaoke Hao Jishu Xian Hua feng Yujie Chen zhi Chen Department of Neurosurgery and State Key Laboratory of Trauma Burn and Combined InjurySouthwest HospitalThird Military Medical University(Army Medical University)Chongqing 400038China Department of Neurosurgery The 945Th Hospital of PLAYaanSichuan Province 625099China Department of Rehabilitation Southwest HospitalThird Military Medical University(Army Medical University)Chongqing 400038China Chongqing Key Laboratory of Precision Neuromedicine and Neuroregeneration Southwest HospitalThird Military Medical University(Army Medical University)Chongqing 400038China Chongqing Clinical Research Center for Neurosurgery Southwest HospitalThird Military Medical University(Army Medical University)Chongqing 400038China

Background Hematoma expansion is a determinant of poor outcome of intracerebral hemorrhage but occurs frequently,especially in warfarin-associated intracerebral hemorrhage(W-ICH).In the present study,we employ the warfarin-associated intracerebral hemorrhage(W-ICH)rat model,to explore the efficacy and potential mechanism of glibenclamide pretreatment on hematoma expansion after intracerebral hemorrhage,hoping to provide proof of concept that glibenclamide in stroke primary and secondary prevention is also potentially beneficial for intracerebral hemorrhage patients at early stage.Methods In the present study,we tested whether glibenclamide,a common hypoglycemic drug,could attenuate hematoma expansion in a rat model of W-ICH.Hematoma expansion was evaluated using magnetic resonance imaging;brain injury was evaluated by brain edema and neuronal death;and functional outcome was evaluated by neurological scores.Then blood-brain barrier integrity was assessed using Evans blue extravasation and tight junction-related protein.Results The data indicated that glibenclamide pretreatment significantly attenuated hematoma expansion at 24 h after W-ICH,thus mitigating brain edema and neuronal death and promoting neurological function recovery,which may benefit from alleviating blood-brain barrier disruption by suppressing matrix metallopeptidase-9.Conclusions The results indicate that glibenclamide pretreatment in stroke primary and secondary prevention might be a promising therapy for hematoma expansion at the early stage of W-ICH.

关键词： Intracerebral hemorrhage Warfarin Glibenclamide Hematoma expansion Blood-brain barrier Matrix metallopeptidase-9

Internal limiting membrane peeling combined with silicone oil or air tamponade for highly myopic foveoschisis

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International Journal of Ophthalmology(English edition) 2024年第6期17卷 1079-1085页

作者： Jin Deng Wen-Tao Sun Ke Gong Li-Ping Wang feng-zhi Li Xi’an People’s Hospital(Xi’an Fourth Hospital) Shaanxi Eye HospitalAffiliated People’s Hospital of Northwest UniversityXi’an 70004Shaanxi ProvinceChina

AIM:To compare the efficacy of pars plana vitrectomy(PPV)combined with internal limiting membrane(ILM)and silicone oil or sterile air tamponade for the treatment of myopic foveoschisis(MF)in highly myopic eyes.METHODS:This retrospective study included 48 myopic eyes of 40 patients with MF and axial lengths(ALs)ranging from 26-32 mm treated between January 2020 and January 2022.All patients were underwent PPV combined with ILM peeling followed by sterile air or silicone oil tamponade and followed up at least 12mo.Based on the features on spectral-domain optical coherence tomography(SD-OCT),the eyes were divided into the MF-only group(Group A,n=15 eyes),MF with central foveal detachment group(Group B,n=20 eyes),and MF with lamellar macular hole group(Group C,n=13 eyes).According to AL,eyes were further divided into three groups:Group D(26.01-28.00 mm,n=12 eyes),Group E(28.01-30.00 mm,n=26 eyes),and Group F(30.01-32.00 mm,n=10 eyes).The best-corrected visual acuity(BCVA),central foveal thickness(CFT),and complications were recorded.RESULTS:The patients included 16 males and 24 females with the mean age of 56±9.82y.The BCVA and CFT improved in all groups after surgery(P0.05).The intergroup differences of BCVA and CFT postoperatively were statistically significant in Group D,E,and F.Twenty eyes were injected with sterile air,and 28 eyes were injected with silicone oil for tamponade based on the AL.However,there was no statistically significant difference among Groups D,E,and F in terms of the results of sterile air or silicone oil tamponade.The mean recovery time was 5.9mo for MF patients subjected to silicone oil tamponade and 7.7mo for patients subjected to sterile air tamponade,and the difference was not statistically significant.CONCLUSION:PPV and ILM peeling combined with silicone oil or sterile air tamponade can achieve good results for MF in highly myopic eyes with ALs≤32 mm.

关键词： axial length myopic foveoschisis highly myopic internal limiting membrane pars plana vitrectomy

Loss of heterozygosity for chromosomes 16q in Wilms tumors predicts outcomes:A meta-analysis

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World Journal of Gastrointestinal Oncology 2024年第5期16卷 2159-2167页

作者： Yuan-Hua Song Wen-Ling Li Zhen Yang Yan Gao zhi-Ping feng Department of Oncology Kunming Children's HospitalKunming 650103Yunnan ProvinceChina Department of Nuclear Medicine The Third Affiliated Hospital of Kunming Medical University(Yunnan Cancer Hospital)Kunming 650118Yunnan ProvinceChina

BACKGROUND The research findings suggest that the prognosis of children with Wilms tumor(WT)is affected by various factors.Some scholars have indicated that loss of heterozygosity(LOH)on chromosome 16q is associated with a poor prognosis in patients with WT.AIM To further elucidate this relationship,we conducted a meta-analysis.METHODS This meta-analysis was registered in INPLASY(INPLASY2023100060).We systematically searched databases including Embase,PubMed,Web of Science,Cochrane,and Google Scholar up to May 31,2020,for randomized trials reporting any intrapartum fetal surveillance approach.The meta-analysis was performed within a frequentist framework,and the quality and network inconsistency of trials were assessed.Odds ratios and 95%CIs were calculated to report the relationship between event-free survival and 16q LOH in patients with WT.RESULTS Eleven cohort studies were included in this meta-analysis to estimate the relationship between event-free survival and 16q LOH in patients with WT(I^(2)=25%,P<0.001).As expected,16q LOH can serve as an effective predictor of eventfree survival in patients with WT(risk ratio=1.95,95%CI:1.52–2.49,P<0.001).CONCLUSION In pediatric patients with WT,there exists a partial correlation between 16q LOH and an unfavorable treatment prognosis.Clinical detection of 16q chromosome LOH warrants increased attention to the patient’s prognosis.

关键词： Loss of heterozygosity Wilms tumor Survival time Chromosomes 16q