Analgesic Effects of Ultrasound‐Guided Iliohypogastric/Ilioinguinal Nerve Block Combined with Lateral Femoral Cutaneous Nerve Block in Total Hip Arthroplasty via Direct Anterior Approach: A Retrospective Cohort Study

ObjectiveThis study aimed to explore the efficacy and safety of the combination of lateral femoral cutaneous nerve blocks (LFCNB) and iliohypogastric/ilioinguinal nerve blocks (IHINB) on postoperative pain and functional outcomes after total hip arthroplasty (THA) via the direct anterior approach (DAA).MethodsIn this retrospective cohort study, patients undergoing THA via the DAA between January 2019 and November 2019 were stratified into two groups based on their date of admission. Sixty‐seven patients received LFCNB and IHINB along with periarticular infiltration analgesia (PIA) (nerve block group), and 75 patients received PIA alone (control group). The outcomes included postoperative morphine consumption, postoperative pain assessed using the visual analogue scale (VAS), the QoR‐15 score, and functional recovery measured as quadriceps strength, time to first straight leg rise, daily ambulation distance, and duration of hospitalization. The Oxford hip score and the UCLA activity level rating were assessed at 1 and 3 months after surgery. In addition, postoperative complications were recorded. Patients were also compared based on the type of incision used during surgery (traditional longitudinal or “bikini” incision).ResultsPatients in the nerve block group showed significantly lower postoperative morphine consumption, lower resting VAS scores within 12 h postoperatively, lower VAS scores during motion within 24 h postoperatively, and better QoR‐15 scores on postoperative day 1. These patients also showed significantly better functional recovery during hospitalization. At 1‐month and 3‐month outpatient follow up, the two groups showed no significant differences in Oxford hip score or UCLA activity level rating. There were no significant differences in the incidence of postoperative complications. Similar results were observed when patients were stratified by type of incision, except that the duration of hospitalization was similar.ConclusionCompared to PIA alone, a combination of LFCNB and IHINB along with PIA can improve early pain relief, reduce morphine consumption, and accelerate functional recovery, without increasing complications after THA via the DAA.     

Novel glucose-lowering drugs for non-alcoholic fatty liver disease

BACKGROUNDThe efficacy of novel glucose-lowering drugs in treating non-alcoholic fatty liver disease (NAFLD) is unknown.AIMTo evaluate the efficacy of glucose-lowering drugs dipeptidyl peptidase-4 (DPP-4) inhibitors, glucagon-like peptide-1 receptor agonists (GLP-1 RAs), and sodium-glucose cotransporter 2 (SGLT2) inhibitors in treating NAFLD and to perform a comparison between these treatments.METHODSElectronic databases were systematically searched. The inclusion criteria were: Randomized controlled trials comparing DPP-4 inhibitors, GLP-1 RAs, or SGLT2 inhibitors against placebo or other active glucose-lowering drugs in NAFLD patients, with outcomes of changes in liver enzyme [alanine aminotransferase (ALT) and/or aspartate aminotransferase (AST)] from baseline.RESULTSNineteen studies were finally included in this meta-analysis. Compared with placebo or other active glucose-lowering drug treatment, treatment with DPP-4 inhibitors, GLP-1 RAs, and SGLT2 inhibitors all led to a significant decrease in ALT change and AST change from baseline. The difference between the DPP-4 inhibitor and SGLT2 inhibitor groups in ALT change was significant in favor of DPP-4 inhibitor treatment (P < 0.05). The trends of reduction in magnetic resonance imaging proton density fat fraction and visceral fat area changes were also observed in all the novel glucose-lowering agent treatment groups.CONCLUSIONTreatment with DPP-4 inhibitors, GLP-1 RAs, and SGLT2 inhibitors resulted in improvements in serum ALT and AST levels and body fat composition, indicating a beneficial effect in improving liver injury and reducing liver fat in NAFLD patients.     

Investigation of urinary components in rat model of ketamine-induced bladder fibrosis based on metabolomics

BackgroundKetamine abuse has been linked to the system''s damage, presenting with lower urinary tract symptoms (LUTS). While the pathogenesis of ketamine-induced urinary damage is not fully understood, fibrosis is believed to be a potential mechanism. A metabolomic investigation of the urinary metabolites in ketamine abuse was conducted to gain insights into its pathogenesis.MethodsA rat model of ketamine induced bladder fibrosis was established through tail vein injection of ketamine hydrochloride and control group was established through tail vein injection of the equivalent normal saline. Hematoxylin and eosin (H&E) staining and Masson trichrome staining were performed to evaluated bladder pathology. Urinary components were detected based on a metabolomic approach using ultra-high performance liquid tandem chromatography quadrupole time of flight mass spectrometry (UHPLC-QTOFMS platform). Orthogonal projections analyzed the data to latent structures discriminant analysis (OPLS-DA) and bioinformatics analysis.ResultsThe rat model of ketamine induced bladder fibrosis was confirmed through H&E and Masson trichrome staining. There were marked differences in the urinary metabolites between the experimental group and the control group. Compared to the control group, 16 kinds of differential metabolites were up-regulated and 102 differential metabolites were down-regulated in the urine samples of the ketamine group. Bioinformatics analysis revealed the related metabolic pathways.ConclusionsUsing a ketamine-induced bladder fibrosis rat model, this study identified the differential urinary metabolites expressed following ketamine treatment. These results provide vital clues for exploring the pathogenesis of ketamine-induced LUTS and may further contribute to the disease''s diagnosis and treatment.     

Association of TERT gene polymorphisms with clinical benign prostatic hyperplasia in a Chinese Han population of the Northwest region

BackgroundTo investigate the association between single nucleotide polymorphisms (rs10078761, rs12696304, rs2853669, rs16847897, rs2736100, rs10069690) of telomerase gene (TERT) and the risk clinical benign prostatic hyperplasia (BPH) in a Chinese Han population of the Northwest region.MethodsA total of 150 BPH patients and 150 healthy older males from the northwest Chinese Han population were included in this study. The sample size for this unmatched case-control study was estimated by the look-up table method. Meanwhile, the general information and disease data of patients were collected. Age was only collected in healthy control subjects for statistical correction. Genotypes were detected using a multiplex PCR + ligase detection reaction (LDR). Typing results and clinical data were statistically analyzed using multiple linear regression and logistic regression. Pearson correlation was used for Hardy-Weinberg equilibrium.ResultsThe included population is in Hardy-Weinberg equilibrium. There was no significant association between SNP and the risk of BPH by correlation analysis. However, 4 haplotypes (TCTGGT, TCTGTC, TGCCTC, and TGTGTC) were identified as risk factors of BPH by haplotype analysis. The SNP rs2853669 is an independent risk factor for smooth muscle type of hyperplasia. Besides, rs2736100, rs10078761, and rs10069690 which are in linkage disequilibrium are associated with the severity of BPH.ConclusionsPolymorphism of the TERT gene determines the different disease development and pathological manifestations of BPH in the Chinese Han population the Northwest region.     

The association between caudal block and urethroplasty complications of distal tubularized incised plate repair: experience from a South China National Children’s Medical Center

BackgroundThe effect of caudal block (CB) on the incidence of urethroplasty complications in hypospadias repair remains controversial. The evidence is conflicting, and some confounding bias issues need to be addressed. We sought to study a more homogenous group of distal hypospadias patients undergoing primary tubularized incised plate (TIP) repair by a senior pediatric urology surgeon in the past 2 years to examine the relationship between urethroplasty complications and the use of CB.MethodsWe reviewed our database to identify consecutive patients who had undergone hypospadias repairs by a senior director surgeon at our Center between January 2018 and November 2020. To be eligible to participate in the study, patients had to meet the following inclusion criteria: (I) have distal hypospadias; (II) have undergone a primary TIP repair; and (III) have attended follow-up appointments for a minimum period of 6 months. The primary outcome was the development of urethroplasty complications during the follow-up period. The principal variable of interest was whether or not CB was used perioperatively. The patients were categorized into a CB group (general anesthesia combined with CB) or a control group (general anesthesia only). Other potential risk factors were analyzed, including patient age at operation, patient weight, glans width, and the length of the urethral plate defect.ResultsThirty (12.2%) of the distal patients developed postoperative surgical complications. The postoperative surgical complication rates were similar between the different anesthesia groups. Weight, the length of the urethral plate length, and glans width did not contribute to the risk. Age was the only independent risk factor for postoperative surgical complications, and the complication rates increased in older patients.ConclusionsOur data from consecutive TIP repairs in distal hypospadias patients indicated no association between the use of CB anesthesia and the postoperative urethroplasty complication rate. Patients who were older in age when they underwent surgery had a higher risk of complications.     

Assessment of Carbendazim Residues and Safety in Celery Under Different Cultivation Conditions

Although the carbendazim is widely used to manage spot blight in celery cultivation, information on residues identified is of interest. In this study, we examined the dissipation and residual amounts of carbendazim in celery and soil under different cultivation methods when using the suggested dose and ten times of that and the bioconcentration factor of carbendazim for celery. The results showed that when celery leaves were sprayed with the suggested dose, the half-lives in a celery field and greenhouse were 2.75 days and 3.29 days, respectively. When the soil matrix was sprayed with the recommended dose before cultivation, the half-lives of carbendazim residues were 16.86 days and 11.97 days. We also conducted a long-term dietary risk assessment using the corresponding criteria. The results showed that, in China, the use of carbendazim at a dose of 0.022 g/m² is safer and more reasonable when the harvest interval is 28 days.

     

中国2001-2016年麻疹发病率时空分布特征

目的 分析我国麻疹病例时空分布和空间聚集性特征。方法 资料来源于中国疾病预防控制信息系统传染病疫情报告监测系统2001-2016年全国麻疹病例数据,人口学数据来源于国家统计局。运用ArcGIS 10.2软件进行全局和局部空间自相关分析,运用SaTScan 9.6软件进行时空扫描分析。结果 2001-2016年全国共报告麻疹1 012 537例,年发病率整体呈下降趋势。2001-2004、2005-2008和2009-2012年的麻疹发病存在全局空间聚集性,其Moran''s I值分别为0.29、0.26和0.31。局部空间自相关分析结果显示,麻疹在各时间阶段均存在高-高聚集区域并主要集中在西部地区,同时2005-2008年广东省是一个单独的高-低离散区域,未检测到低-低聚集区域。时空扫描结果显示,2001-2008年我国麻疹病例在西部地区、华中地区和华北地区、山西省和广西壮族自治区形成一个广泛的聚集区。结论 2001-2016年我国麻疹的发病在空间、时间上均存在一定的聚集性,可根据聚集情况,为麻疹防控策略的制定提供依据。     

中国9个长寿地区65岁及以上人群氧化应激水平与高甘油三酯血症的关联研究

目的探讨我国长寿地区65岁及以上老年人氧化应激水平与高甘油三酯血症的关系。方法研究对象来源于2017-2018年“老年健康生物标志物队列研究”,最终将我国9个长寿地区2393名65岁及以上老年人群纳入研究。通过问卷调查和体格检测,收集调查对象的人口学特征、生活方式及健康状况等信息,同时采集调查对象的静脉血以检测丙二醛(MDA)、超氧化物歧化酶(SOD)及甘油三酯水平。采用限制性立方样条拟合多重线性回归模型分析MDA、SOD与甘油三酯的关联,采用广义线性混合效应模型分析氧化应激与高甘油三酯血症的关联。结果2393例调查对象年龄为(84.6±11.3)岁,最小65岁,最大112岁;男性1145名(47.9%);甘油三酯水平为(1.4±0.8)mmol/L,高甘油三酯血症检出率为9.99%(239名)。限制性立方样条拟合多重线性回归模型分析结果显示,MDA水平与甘油三酯水平呈线性关联;SOD水平与与甘油三酯水平呈非线性关联。广义线性混合效应模型分析结果显示,调整相关混杂因素后,MDA每升高1 nmol/ml,高甘油三酯血症检出风险增加[OR(95%CI)值为1.063(1.046,1.081)];SOD每升高1 U/ml,高甘油三酯血症检出风险降低[OR(95%CI)值分别为0.986(0.983,0.989)]。结论我国9个长寿地区65岁及以上老年人MDA和SOD水平与高甘油三酯血症发生风险有关联。     

上海市松江区成年人高尿酸血症与慢性肾病关系的队列研究

目的 分析社区成年人高尿酸血症（HUA）与慢性肾病（CKD）发病风险的关系。方法 基于华东区域自然人群队列,对7 276例基线时未患CKD的上海市松江区20~74岁常住居民进行基于社区的前瞻性队列研究。CKD的诊断根据美国肾脏基金会慢性肾脏病实践指南的标准,HUA定义为血清尿酸（SUA）>420 μmol/L（男性）或>360 μmol/L（女性）。采用Cox比例风险模型分析HUA与CKD发病风险的关联。结果 经过中位时间2.65年的随访,队列人群新发CKD病例301例,累积发病率为4.14%,发病密度为16.01/1 000人年（95% CI：14.20~17.82）。CKD发病人群HUA的基线患病率显著高于非CKD发病人群。多因素Cox回归分析显示,HUA与CKD发病风险呈显著正关联,HUA患者的CKD发病风险HR值为1.92（95% CI：1.46~2.53）。在对性别、年龄、BMI、2型糖尿病、高血压等因素分层后,HUA与CKD发病风险仍呈显著正关联;在相加模型中,年龄与HUA存在交互作用,交互作用指数为1.78（95% CI：1.18~2.68）。结论 上海市松江区成年人CKD的发病率较高,HUA为CKD发病的独立危险因素。