HbA1C is not directly associated with complications of bariatric surgery

IntroductionBariatric surgery is effective therapy for weight loss and diabetes control. While patients with poorly controlled type 2 diabetes (T2D) experience significant benefit from bariatric surgery, the impact of hyperglycemia on perioperative risks is unclear.ObjectiveThis study aims to investigate effect of elevated glycated hemoglobin (HbA1C) on perioperative risks for patients undergoing sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (RYGB).Settings117,644 patients undergoing RYGB or SG between the years of 2017 and 2018 in the United Stated were analyzed. Data was obtained using the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database.MethodsThree commonly used cutoff levels of HbA1C were selected (6.5, 7.0, and 8.5). Complications were compared between groups of patients above and below each HbA1C level. Multivariable logistic regression models were used to account for confounders.ResultsWithout risk adjustment, HbA1C is indirectly associated with increased rates of surgical complications. However, after adjusting for underlying co-morbidities, HbA1C is not associated with overall complications, including 30 day readmissions, reoperations, reinterventions, or death at any HbA1C cutoff: 6.5 (odds ratio [OR] 1.041, P value = .219), 7.0 (OR 1.020, P value = .551), or 8.5 (OR 1.051, P value = .208).ConclusionThere is no direct relationship between HbA1C and early postoperative complications of SG and RYGB. Thus, optimizing preoperative HbA1C values alone, may not translate into decreased surgical complications of bariatric surgery. (Surg Obes Relat Dis 2020;17:271–275.) © 2020 American Society for Metabolic and Bariatric Surgery. All rights reserved.     

中国公众公共卫生安全素养量表的开发研究

目的开发公共卫生安全素养量表, 为我国公众的公共卫生安全素养测评提供适宜工具。方法通过理论构想、指标池构建、现场验证、题项缩减等步骤编制中国公共卫生安全素养初始量表, 转为"问卷星"电子问卷, 随机抽取4个省份共2 809名居民进行现场测试。利用经典测试理论(CTT)和项目反应理论(IRT)进行题项缩减。使用SPSS 23.0软件进行探索性因子分析(EFA)和单维性检验。使用R 4.1.1软件ltm和mirt包进行题项的心理测量学指标分析, 并绘制项目特征曲线(ICC)和信息函数曲线(IIC和TIF)。结果选用专家一致性系数最优的初始量表3, 共30个题项(B1～B30), 测试对象完成1个题项平均需9.8 s。根据CTT分析, 删除校正题项-总相关系数(CITC)<0.3及题项-维度相关系数(IDCC)<0.4的B2题项;删除CITC<0.3、IDCC<0.4及难度指数<0.2的B23题项;删除CITC<0.3及难度指数<0.2的B30题项。删除后量表总内部一致性信度(Cronbach’’sα)值为0.923。EFA提示删除14个因子载荷较小...     

The Effect of a PEEK Material‐Based External Fixator in the Treatment of Distal Radius Fractures with Non‐Transarticular External Fixation

ObjectiveTo explore the effect of a PEEK material‐based external fixator in the treatment of distal radius fractures with non‐transarticular external fixation.MethodsThere were 48 patients in this prospective comparative study. They were divided into two groups according to the materials used: the PEEK group and the titanium group. Wrist dorsiflexion, palmar flexion, pronation, supination, radial deviation, ulnar deviation, grip strength of the palm on the affected side, kneading force, Visual Analogue Scale/Score (VAS), Disabilities of the Arm, Shoulder, and Hand (DASH) score, operation time, frequency of fluoroscopy procedures, and X‐ray results were compared between the two groups. Functional recovery was evaluated at the last follow‐up according to the wrist joint evaluation criteria.ResultsThe baseline data were comparable between the two groups, and no significant differences were found in age, sex, fracture types (P > 0.05). There was no significant difference between the two groups in the results of DASH, grip strength, and recovery of pinch force and wrist function (dorsiflexion, clavicle, ulnar deviation, deviation, pronation, and supination) (P > 0.05). Normal limb function was achieved in the two groups of patients at an average of 6 weeks after surgery, and there was no significant difference in X‐ray examination radial height (10.60 ± 1.59 vs 11.00 ± 1.53, P = 0.687), radial inclination (1.11 ± 0.24 vs 1.12 ± 0.24, P = 0.798), volar tilt (10.33 ± 2.13 vs 10.00 ± 2.08, P = 0.660), ulnar variance (20.87 ± 3.00 vs 20.38 ± 3.04, P = 0.748), and step‐off persistence (1.73 ± 0.69 vs 1.68 ± 0.72, P = 0.425) between the two groups (P > 0.05). However, the operation time (54.80 ± 12.20 vs 85.23 ± 15.14, P = 0.033) and number of fluoroscopy procedures (36.93 ± 6.89 vs 64.77 ± 9.74, P = 0.000) in the PEEK group were significantly reduced compared with those in the titanium group.ConclusionCompared with the traditional titanium external fixator, the PEEK composite external fixator has advantages, such as a shorter operation time and fewer fluoroscopy procedures when used to treat different types of distal radius fracture.     

A Novel Deep Learning Model Based on Multi-Scale and Multi-View for Detection of Pulmonary Nodules

Journal of Digital Imaging - Lung cancer manifests as pulmonary nodules in the early stage. Thus, the early and accurate detection of these nodules is crucial for improving the survival rate of...     

沙门氏菌属新诊断血清的研制

报道了研制的近１０余年来国际上新发现的沙门氏菌属８种抗原的抗血清及其２种多价血清,属国内首次制备;还用单相菌替代原有双相菌免疫制备了４种因子血清,不仅简化了生产,还提高了质量;上述１４种诊断血清均达到《中国生物制品规程》要求。这些血清的制成,使我国沙门氏菌的血清学诊断上了一个台阶,扩大了检测范围,减少漏检、误判。此外,还对沙门氏菌属的最新分类命名作简介。     

自能源减速器称重动态过程的仿真研究

对自能源减速器称重过程的动态性能进行机理研究,建立了称重动态过程的数学模型,并进行了仿真计算,仿真结果与实测吻合.在此基础上分析了溜放速度、容腔及管路内油液的可压缩性对称重结果的影响.首次提出了"完全称重"、"部分称重"、"重复称重"的概念,为减速顶的设计提供新的理论依据.     

脑脓肿切除的显微外科技术

作者采用显微外科技术切除脑脓肿40例,在切除前,先用自制三通装置穿刺脓肿,并用10％甲醛溶液及庆大霉素溶液冲洗脓腔,然后在手术显微镜下切除脓壁。随访3～5年,治愈率98.0％(38例),复发1例,死亡2例。     

HPLC法测定阿奇霉素的血药浓度

目的 :建立阿奇霉素血药浓度的测定方法。方法 :采用HPLC紫外检测法 ,岛津CLC CN分析柱 ,流动相为 0 1mol·L-1磷酸二氢钠 甲醇 乙腈 ( 85∶7∶8,,V/V/V) ,pH 3 0～ 3 5 ,流速 1mL·min-1,柱温 4 0℃ ,检测波长 2 10nm ,灵敏度 0 0 0 3AUFS ,提取液为氯仿 正己烷 ( 3∶2 ,V/V) ,以峰面积外标法定量。结果 :阿奇霉素血药浓度线性范围 5 0～ 5 0 0 0 μg·L-1,平均回收率( 10 0 9± 2 7) % ,日内RSD 1 2 %～ 4 3% ,日间RSD 2 8%～ 6 8%。结论 :本法简便 ,分析速度快 ,灵敏度较高 ,重复性好 ,基本能适用于临床血药浓度测定及药动学研究。