“In the field of gynecological surgery, a study at our hospital has made progress. The research team explored the relationship between the duration of hypothermia and postoperative complications. The results showed that the duration of hypothermia and hypothermia upon admission to PACU or ICU are associated with early postoperative complications, laying a foundation for the construction of a hypothermia management system.”
王素梅, 裴丽坚, 张越伦, 易杰
2024, 39(4): 233-240. DOI: 10.24920/004419
Abstract:目的探究妇科手术患者中低体温持续时间与术后并发症之间的关系。方法连续纳入2020年10月至2022年1月我院择期妇科手术的患者,持续监测术中核心体温变化,追踪术后早期并发症。通过线性回归模型控制潜在的混杂因素,分析术后并发症与术中低体温持续时间、最低体温小于36°C以及进入PACU或ICU时低体温状态的关联。此外,使用累积概率散点图和移动平均序列探索低体温持续时间与术后并发症率之间存在的潜在拐点。结果研究共纳入370例患者,其中193例(52.2%)出现低体温,177例(47.8%)体温正常。在这些患者中,共有92例(24.9%)发生了并发症。低体温持续时间(每增加1分钟调整后OR值:1.003,95% CI: 1.000 - 1.006, P = 0.047)和进入PACU或ICU时的低体温状态(调整后OR值:1.980,95% CI: 1.135 - 3.454, P = 0.016)与术后早期并发症相关。值得注意的是,随着低体温持续时间的增加,术后并发症的累积发生率呈上升趋势,且在120分钟处观察到一个潜在的拐点。结论在妇科手术中,低体温的持续时间以及进入PACU或ICU时的低体温状态与术后并发症有关。尽量缩短低体温的持续时间在临床上可能是有意义的。
“In the field of polytrauma care, a study has identified risk factors for lower extremity deep venous thrombosis (LEDVT) in severely traumatized patients. The research, conducted by experts, established a predictive model combining age, Systemic Inflammation Response Index (SIRI), Aggregate Index of Systemic Inflammation (AISI), and albumin, which has a significant predictive value for LEDVT.”
李鹏飞, 路鑫, 周雨倩, 王可, 杨鹏, 陈雄辉, 徐峰
2024, 39(4): 241-248. DOI: 10.24920/004411
Abstract:目的静脉血栓栓塞症是多发伤后常见的并发症之一,是导致患者预后不良的重要因素。本研究旨在探讨重症创伤患者发生下肢深静脉血栓(lower extremity deep venous thrombosis,LEDVT)的危险因素,并评估这些危险因素对LEDVT的预测价值。方法本研究为回顾性、单中心观察性研究。研究对象为2022年1月至2024年5月被收住于苏州大学附属第一医院创伤ICU的重症创伤患者。根据受伤至伤后30天内的超声检查结果,将发生LEDVT的患者纳入LEDVT组,未发生LEDVT的患者纳入NLEDVT组。入院时收集患者的人口学、临床和实验室检查数据。采用多因素逻辑回归识别LEDVT的危险因素,并利用受试者特征曲线(receiver operating characteristic,ROC)评估模型的整体拟合效果。结果LEDVT组纳入56例患者,NLEDVT组纳入81例患者。年龄、全身炎症综合指数(Aggregate Index of Systemic Inflammation,AISI),系统炎症反应指数(Systemtic Immune Inflammation,SIRI),ICU住院时间及白蛋白是LEDVT的独立危险因素(P < 0.05)。这些指标的ROC曲线下面积分别为0.604,0.657,0.694,0.668和0.405。综合分析年龄、SIRI、AISI及白蛋白对重症创伤患者发生LEDVT的预测效能,结果显示ROC曲线下面积为0.805(95%CI:0.73,0.88,P = 0.037)。结论综合年龄、SIRI、AISI和白蛋白的分析模型对重症创伤患者发生LEDVT具有预测价值。
“In the field of traditional Chinese medicine for insomnia treatment, this study statistically analyzed 104 prescriptions and identified six hub herb pairs. Network pharmacology revealed that the cAMP signaling pathway might play a key role in treating insomnia synergistically with HIF-1 signaling pathway, prolactin signaling pathway, chemical carcinogenesis receptor activation, and PI3K-Akt signaling pathway.”
“In the field of nonalcoholic fatty liver disease, researchers have identified cuproptosis- and ferroptosis-related genes involved in the disease and determined the diagnostic value of hub genes. Expert analysis established a nomogram of NASH diagnostic model, which provides solutions to solve diagnostic problems.”
方柔柔, 杨启帆, 赵晶, 徐守竹
2024, 39(4): 261-272. DOI: 10.24920/004403
Abstract:目的筛选参与非酒精性脂肪肝铜死亡和铁死亡过程的核心基因,并确定其对非酒精性脂肪肝的诊断价值。方法本研究从基因表达综合(Gene Expression Omnibus,GEO)数据库中下载非酒精性脂肪肝转录组数据集GSE89632,运用R软件包的"limma"以及加权基因共表达网络分析(weighted correlation network analysis,WGCNA)方法,筛选非酒精性脂肪性肝炎(non-alcoholic steatohepatitis,NASH)组和健康对照(healthy control,HC)组的差异表达基因(differentially expressed genes,DEGs)。采用基因本体(Gene Ontology,GO)和京都基因与基因组百科全书(Kyoto Encyclopedia of Genes and Genomes,KEGG),对DEGs进行功能富集分析。从FerrDb V2数据库中提取铁死亡相关基因,并通过文献检索获取铜死亡相关基因。利用STRING数据库构建与铜死亡和铁死亡均相关的基因,命名为CRF(cuproptosis - and ferroptosis-related,CRF)基因。DEGs、WGCNA和CRF基因的交集作为核心基因,采用GSE109836和GSE227714数据集和实时定量聚合酶链反应(real-time quantitative polymerase chain reaction,RT-qPCR)验证核心基因核心基因的在NASH患者中的表达情况。利用R软件包的"rms",基于核心基因构建非酒精性脂肪肝诊断模型的诺曼图,采用接受者操作特性曲线(receiver operating characteristic,ROC)分析评估核心基因对非酒精性脂肪肝的诊断价值。此外,采用CIBERSORT算法分型NASH组与HC组的免疫细胞浸润情况。采用Spearman相关性分析探讨各种浸润免疫细胞间的关系。结果GSE89632数据集分析显示,NASH组与HC组之间存在236个DEGs。WGCNA分析揭示了8个显著模块和11,095个模块基因。其中330个为CRF基因。交集分析发现,IL6、IL1B、JUN、NR4A1和PTGS2为核心基因,它们在NASH患者的肝组织中均表达下调,此结果得到了验证数据集和RT-qPCR的验证。ROC曲线分析显示,这些基因对非酒精性脂肪肝具有良好的诊断效能,它们的曲线下面积分别为0.985、0.941、1.000、0.967和0.985。NASH组的γδT细胞、M1巨噬细胞、M2巨噬细胞和静息肥大细胞的浸润比例高于HC组。结论IL6、IL1B、JUN、NR4A1和PTGS2是与非酒精性脂肪肝铜死亡和铁死亡相关的核心基因,此发现为深入理解非酒精性脂肪肝的发病机制提供了新见解,可能为疾病的诊断和治疗靶点提供新方向。
“In the field of gastrointestinal cancer treatment, a prospective study has verified the predictive value of myocardial strain for cardiotoxicity associated with fluorouracil-based chemotherapies. The study found that changes in left atrial ejection fraction and left atrial strain during the reservoir phase after the first cycle of chemotherapy are early predictors of cardiac function deterioration.”
“Reporting on the latest advancements in medical education, researchers have found that scenario-based lectures combined with personalized video feedback significantly enhance anesthesia residents' communication skills during preoperative visits. The study, which involved 24 residents, demonstrated that while both groups showed improvement, the video group experienced a more substantial increase in empathy, as measured by the CARE scale. This approach lays a foundation for the construction of more effective communication training systems in anesthesia.”
“In recent years, China's innovative drug development has surged, with biopharmaceutical companies fiercely competing and leading enterprises emerging. Oncological diseases are the most active domain for new drug R&D in China, followed by infectious diseases and neurological diseases. Expert xx established the xx system/explored the xx topic/verified the xx conjecture, which provides solutions to solve xx problems/open up a new direction for xx research/lay a foundation for the construction of xx system.”
“Reporting on the latest medical advancements, a recent study delves into the palliative care for patients with malignant brain tumors. Expert researchers have established a comprehensive system that addresses symptom management, psychological support, and bereavement care, offering valuable insights for clinical practice.”