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.     

正交偏光镜下人体胆汁液晶光学性质的研究

本文报导了在正交偏光镜下，对人体胆汁液晶的光学性质的研究，结果表明，胆汁液晶是一种非均质体，在正交偏光镜下，呈现出特殊的干涉图样和四次消光现象，光性符号是单轴正性的，干涉色级是一级灰白，双折射率Δｎ＝０．０１１－０．０１７。     

胸水细胞端粒酶活性检测对良恶性胸腔积液的鉴别诊断价值

目的：探讨胸水细胞端粒酶活性对良、恶性胸腔积液的鉴别诊断价值。方法：用改良的PCR-ELISA法检测37例恶性、32例良性胸水细胞端粒酶活性,并与胸水细胞学、癌胚抗原（CEA）诊断结果进行比较。结果：37例恶性胸腔积液中有26例端粒酶活性阳性（26/37）,阳性率为70.27%,高于良性胸腔积液中端粒酶海性表达（2/32,P＜0.01);端粒酶活性检测诊断恶性胸水敏感性为70.27%,特异性为93.75%,与胸水细胞学诊断符合率为54.05%;其敏感性高于胸水CEA诊断结果（敏感性为51.35%)。结论：胸水细胞端粒酶活性检测作为细胞学检查的辅助手段能提高恶性胸水的诊断率,有助于良、恶性胸腔积液的鉴别诊断。     

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。