Shanghai Sixth Peoples Hospital
Shanghai Sixth Peoples Hospital
Zhou Q.,University of Pittsburgh |
Zhou Q.,Shanghai Sixth Peoples Hospital |
Rosengart M.R.,University of Pittsburgh |
Billiar T.R.,University of Pittsburgh |
And 3 more authors.
JAMA Surgery | Year: 2017
IMPORTANCE Secondary triage from nontertiary centers is vital to trauma system success. It remains unclear what factors are associated with nontransfer among patients who should be considered for transfer to facilities providing higher-level care. OBJECTIVE To identify factors associated with nontransfer among patients meeting American College of Surgeons (ACS) guideline criteria for transfer from nontertiary centers. DESIGN, SETTING, AND PARTICIPANTS A retrospective cohort studywas performed using multilevel logistic regression to ascertain factors associated with nontransfer from nontertiary centers, including demographics, injury characteristics, and center resources. With information obtained from the National Trauma Data Bank (January 1, 2007, to December 31, 2012), relative proportion of variance in outcome across centers was determined for patient-level and center-level attributes. In all, 96 528 patients taken to nontertiary centers (levels III, IV, V, and nontrauma centers) that met ACS guideline transfer criteria were eligible for inclusion. Data analysis was performed from March 17, 2016, to May 20, 2016. MAIN OUTCOMES AND MEASURES The primary outcomewas nontransfer from a nontertiary center. RESULTS Among 96 528 patients meeting ACS guideline criteria for transfer taken initially to nontertiary centers, 55 611 (57.6%) were male and the median age was 52 years (interquartile range, 28-77 years). Only 19 396 patients (20.1%) underwent transfer. Patient-level factors associated with nontransfer included age older than 65 years (adjusted odds ratio [AOR], 1.70; 95%CI, 1.46-1.98; P < .001), severe chest injury (AOR, 1.63; 95%CI, 1.42-1.89; P < .001), and commercial insurance (vs self-pay: AOR, 1.39; 95%CI, 1.15-1.67; P < .001). Center-level factors associated with nontransfer included larger bed size (>600 vs <200 beds: AOR, 9.22; 95%CI, 7.70-11.05; P < .001), nontrauma center (vs level III centers: AOR, 2.71; 95%CI, 2.44-3.01; P < .001), university affiliation (vs community: AOR, 9.68; 95%CI, 8.03-11.66; P < .001), more trauma surgeons (per surgeon: AOR, 1.08; 95%CI, 1.06-1.09; P < .001), and more neurosurgeons (per surgeon: AOR, 1.25; 95%CI, 1.23-1.28; P < .001). For-profit status was associated with nontransfer at nontrauma centers (AOR, 1.55; 95%CI, 1.39-1.74; P < .001), but not at level III, IV, and V trauma centers. Overall, patient-level factors accounted for 36%and center-level factors accounted for 58%of the variation in transfer practices. Patient-level factors accounted for more variation at level III, IV, and V trauma centers (44%), but less variation at nontrauma centers (13%). CONCLUSIONS AND RELEVANCE Only 1 in 5 patients meeting ACS transfer criteria underwent transfer. Factors associated with nontransfer may be useful for trauma system stakeholders to target education and outreach to guide development of more inclusive trauma systems. Further study is necessary to critically evaluate whether these ACS criteria identify patients who require transfer. © 2017 American Medical Association.
CapitalBio eHealth Science & Technology Beijing Co., CapitalBio Corporation, Tsinghua University and Shanghai Sixth Peoples Hospital | Date: 2016-07-06
In one aspect, provided herein are set of primers and use of the same for the detection of SNPs associated with diabetes. In certain embodiments, the primers used to detect SNP sites associated with diabetes comprise Primer Set 1 to Primer Set 47. The experiments show: the genotyping results of the SNP sites associated with diabetes can be accurately detected by the primers disclosed herein, and the risk of individuals can be comprehensively evaluated and the result is more accurate than the single site analysis. In addition, SNPs disclosed herein are verified as associated with type 2 diabetes and its complications, which are especially suitable for the prevention and individualized treatment for type 2 diabetes in East Asian, for example, in China.
Yi C.,Shanghai First Peoples Hospital |
Ma C.,Shanghai First Peoples Hospital |
Xie Z.,Shanghai Sixth Peoples Hospital |
Zhang G.,Shanghai First Peoples Hospital |
And 3 more authors.
International Orthopaedics | Year: 2013
Purpose: The aim of this study was to investigate the expression of insulin-like growth factor (IGF)-1 and programmed cell death 5 (PDCD5) in osteoarthritis chondrocytes, and to explore the potential correlation between them in the apoptosis process of osteoarthritis chondrocytes. Methods: Patients with knee osteoarthritis were placed into four categories according to radiological staging. The mRNA and protein levels of IGF-1 and PDCD5 in osteoarthritis chondrocytes were respectively detected by quantitative reverse transcriptase polymerase chain reaction (qPCR) and western blotting. In addition, IGF-1 and PDCD5 protein expression in chondrocytes were also measured by immunohistochemistry. Apoptotic cells were measured by TUNEL staining. Results: Both the mRNA and protein levels of IGF-1 were down-regulated, while the levels of PDCD5 were up-regulated, and the mRNA and protein levels of IGF-1 were negatively correlated with those of PDCD5, respectively. The apoptotic cell was significantly increased in osteoarthritis chondrocytes compared with control. Importantly, the apoptosis rate was positively correlated with PDCD5 protein expression and negatively correlated with IGF-1 protein expression Conclusions: We concluded that IGF-1 may down-regulate the expression of PDCD5 and thus inhibit the apoptosis of osteoarthritis chondrocytes. © 2013 Springer-Verlag Berlin Heidelberg.
Shi S.-F.,Shanghai Sixth Peoples Hospital |
Jia J.-F.,Shanghai JiaoTong University |
Guo X.-K.,Shanghai JiaoTong University |
Zhao Y.-P.,Shanghai JiaoTong University |
And 4 more authors.
International Journal of Nanomedicine | Year: 2012
Background: Bone disorders (including osteoporosis, loosening of a prosthesis, and bone infections) are of great concern to the medical community and are difficult to cure. Therapies are available to treat such diseases, but all have drawbacks and are not specifically targeted to the site of disease. Chitosan is widely used in the biomedical community, including for orthopedic applications. The aim of the present study was to coat chitosan onto iron oxide nanoparticles and to determine its effect on the proliferation and differentiation of osteoblasts. Methods: Nanoparticles were characterized using transmission electron microscopy, dynamic light scattering, x-ray diffraction, zeta potential, and vibrating sample magnetometry. Uptake of nanoparticles by osteoblasts was studied by transmission electron microscopy and Prussian blue staining. Viability and proliferation of osteoblasts were measured in the presence of uncoated iron oxide magnetic nanoparticles or those coated with chitosan. Lactate dehydrogenase, alkaline phosphatase, total protein synthesis, and extracellular calcium deposition was studied in the presence of the nanoparticles. Results: Chitosan-coated iron oxide nanoparticles enhanced osteoblast proliferation, decreased cell membrane damage, and promoted cell differentiation, as indicated by an increase in alkaline phosphatase and extracellular calcium deposition. Chitosan-coated iron oxide nanoparticles showed good compatibility with osteoblasts. Conclusion: Further research is necessary to optimize magnetic nanoparticles for the treatment of bone disease. © 2012 Cárdenas et al, publisher and licensee Dove Medical Press Ltd.
Min J.Z.,University of Shizuoka |
Yamamoto M.,University of Shizuoka |
Yu H.-F.,Shanghai Sixth Peoples Hospital |
Higashi T.,Tokyo University of Science |
Toyo'Oka T.,University of Shizuoka
Analytical Biochemistry | Year: 2012
The resolution of the intermediate advanced glycation end products (AGEs) in the human nail was carried out by the combination of 4,5-dimethyl-1,2- phenylenediamine (DMPD) derivatives and ultra-performance liquid chromatography with electrospray ionization time-of-flight mass spectrometry (UPLC-ESI-TOF-MS). The reaction of the reagent with 3-deoxyglucosone (3-DG), methylglyoxal (MG), and glyoxal (GO) effectively proceeds at 60 °C for 2 h. The resulting derivatives were efficiently separated by a gradient program (a mixture of water and acetonitrile containing 0.1% formic acid) using a reversed-phase ACQUITY UPLC BEH C 18 column (1.7 μm, 50 × 2.1 mm i.d.) and sensitively detected by TOF-MS. The detection limits (signal-to-noise ratio = 5) of the TOF-MS were 10 to 50 fmol. A good linearity was achieved from the calibration curve, which was obtained by plotting the peak area ratios of the analytes relative to the internal standard (IS) (i.e., 2,3-hexanedione) versus the injected amounts of 3-DG, MG, and GO (r 2 > 0.999), and the intra- and interday assay precisions were less than 6.89%. The derivatives of the compounds in the human nail were successfully identified by the proposed procedure. As we know, these three kinds of dicarbonyl intermediates in the formation of AGEs - 3-DG, MG, and GO - were first found in human nail samples. Using these methods, the amounts of compound in the nails of healthy volunteers and diabetic patients were determined. When comparing the index from the diabetic patients with that from healthy volunteers, there is no significant difference in the content of the MG and GO in the nails. However, a statistically significant (P < 0.001) correlation was observed between the 3-DG concentrations. Because the proposed method provides a good mass accuracy and the trace detection of the dicarbonyl intermediates of AGEs in the human nail, this analytical technique could be a noninvasive technique to assist in the diagnosis and assessment of disease activity in diabetic patients. Here we present a novel, sensitive, and simple method for the simultaneous determination of dicarbonyl compounds in the human nail. © 2011 Elsevier Inc. All rights reserved.
Chen J.,ZheJiang Hospital |
Chen Y.,Shanghai Sixth Peoples Hospital |
Luo Y.,ZheJiang Hospital |
Gui D.,Shanghai Sixth Peoples Hospital |
And 2 more authors.
European Journal of Pharmacology | Year: 2014
Podocyte loss and dysfunction play key role during the development of diabetic nephropathy (DN). The aim of this study was to observe the protective effects of astragaloside IV on podocyte in diabetic rats and explore its mechanisms preliminary. Healthy male Sprague-Dawley (SD) rats were randomized into normal control group, diabetic nephropathy group and diabetic nephropathy with AS-IV treatment group. DN was induced by intraperitoneal injection of streptozotocin (STZ). AS-IV treatment started 2 weeks before STZ injection and lasted 14 weeks. 24 h Urinary proteins were measured 4, 8 and 12 weeks after STZ injection. Body weight, blood glucose, blood urea nitrogen (BUN), creatinine (Cr), alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were measured 12 weeks after STZ injection. Renal pathology, podocyte morphological changes, podocyte density, protein and mRNA expression of integrin α3, integrin β1 and integrin-linked kinase (ILK) were detected by histopathology, electron microscopy, immunohistochemistry, western blot and real-time PCR, respectively. Hyperglycemia, proteinuria, mesangial expansion and podocyte loss, increased protein expression of ILK and decreased protein expression of integrin α3 and integrin β1 were detected in diabetic rats. AS-IV treatment ameliorated podocyte loss, renal histopathology and podocyte foot process effacement, decreased proteinuria, partially restored protein expression of integrin α3, integrin β1 and ILK. These findings suggested that AS-IV may protect podocyte and ameliorate diabetic nephropathy by inhibiting the expression of ILK and restoring the expression of integrin α3β1 in diabetic rats. © 2014 Elsevier B.V.
Xu J.,Soochow University of China |
Xu J.,Shanghai Sixth Peoples Hospital |
Park K.-W.,Korea University |
Kang Q.-L.,Shanghai Sixth Peoples Hospital |
And 2 more authors.
Clinical Orthopaedics and Related Research | Year: 2013
Background: Radiographic measurements are typically used in achondroplasia (ACH) during correction of lower limb alignment. However, reliabilities for the measurements on weightbearing radiographs of the foot and ankle in patients with ACH have not been described, and the differences between the ACH population and subjects without ACH likewise have not been well characterized; these issues limit the use of studies on this subject. Questions/purposes: We proposed (1) to measure the inter- and intraobserver reliability of a number of radiographic measures of ankle and foot alignment in an achondroplastic cohort of patients; and (2) to compare our radiographic measurement values with age-matched literature-based normative values. Methods: Ten radiographic measurements were applied to foot and ankle radiographs of 20 children (40 feet) with ACH (mean age, 10 years; range, 8-16 years). Interobserver and intraobserver reliabilities of these radiographic measurement methods were obtained and expressed by intraclass correlation coefficients (ICCs). The mean values were calculated and compared with the literature-based values. Results: The interobserver reliability was excellent for eight measurements with ICCs ranging from 0.801 to 0.962, except for lateral talo-first metatarsal angle and mediolateral column ratio, which were much lower. The intraobserver reliability was excellent for all 10 radiographic measurements with ICCs ranging from 0.812 to 0.998. Compared with existing literature-based values, all 10 measurements had a significant difference (p < 0.01). Conclusions: We suggest tibiotalar angle, calcaneal pitch angle, tibiocalcaneal angle, talocalcaneal angle, naviculocuboid overlap, talonavicular coverage angle, metatarsal stacking angle, and AP talo-first metatarsal angle with excellent interobserver and intraobserver reliabilities should be considered preferentially in analysis of foot and ankle alignment in children with ACH. Level of Evidence: Level II, diagnostic study. See Guidelines for Authors for a complete description of levels of evidence. © 2013 The Association of Bone and Joint Surgeons®.
Fu Q.,Shanghai Sixth Peoples Hospital |
Zhang J.,Shanghai Sixth Peoples Hospital |
Sa Y.-L.,Shanghai Sixth Peoples Hospital |
Jin S.-B.,Shanghai Sixth Peoples Hospital |
Xu Y.-M.,Shanghai Sixth Peoples Hospital
BJU International | Year: 2013
Objective To describe the complications of transperineal end-to-end anastomotic urethroplasty in patients with posterior urethral strictures resulting from pelvic fracture. Materials and Methods A total of 573 patients, who underwent bulboprostatic anastomosis for posterior urethral strictures, were enrolled in this study. Distraction defects were measured using retrograde urethrography combined with voiding cysto-urethrography. All patients underwent perineal excision and primary anastomotic urethroplasty. The urethroplasty was considered successful if the patient was free of stricture-related obstruction and did not require any further intervention. The degree of stress incontinence was assessed daily by pad testing. The prevalence of pre- and postoperative sexual disorders was investigated using the International Index of Erectile Function-5 questionnaire. Results Of 573 bulboprostatic anastomosis procedures performed, 504 (88%) were successful and 69 (12%) were not successful. The mean (sd) maximum urinary flow rate, assessed by uroflowmetry 4 weeks after surgery, was 20.52 (5.1) mL/s. Intraoperative rectal injury was repaired primarily in 28 cases. Recurrence of urethral strictures was observed in 10 (1.7%) patients during the first 6 months after surgery, and in 45 patients from 6 months to 1 year. All of these patients underwent re-operation. Twenty-four (4.2%) patients had mild urge incontinence and 28 (4.9%) had mild stress incontinence. Erectile dysfunction (ED) was present in two (<0.1%) patients before trauma and in 487 (85%) patients after trauma. There was no statistical difference between the incidences of preoperative and postoperative ED (85 vs 86%, P > 0.05). Nine (1%) patients were found to have false passage between the posterior urethra and bladder neck. Conclusion The majority of complications associated with transperineal bulboprostatic anastomosis can be avoided as long as meticulous preoperative evaluation to define the anatomy and careful intra-operative manipulation are ensured. © 2013 BJU International.
Liu W.,Shanghai Sixth Peoples Hospital |
Zhou D.,Shandong University |
Liu F.,Massachusetts General Hospital |
Weaver M.J.,Brigham and Women's Hospital
Journal of Trauma and Acute Care Surgery | Year: 2013
BACKGROUND: The Trochanteric Fixation Nail System (TFN) was designed with a helical blade to improve resistance to cutout. We evaluated the incidence, modes, and predictors of failure for intertrochanteric hip fractures treated with this device. METHODS: A retrospective review of 341 intertrochanteric hip fractures treated with the TFN was conducted. Fractures were classified from the injury films using the Arbeitsgemeinschaft für Osteosynthesefragen/ Orthopedic Trauma Association (AO/OTA) classification, and quality of reduction and hardware placement was evaluated on the initial postoperative films. RESULTS: Two hundred twenty-three patients met inclusion criteria. The overall rate of mechanical complications was 20.5%. Twenty-one patients (9.4%) had excessive lateral migration of the helical blade (≥10 mm). Fifteen patients (6.7%) had blade migration in the head, including 7 patients (3.1%) with typical cutout and 8 patients (3.6%) with medial perforation without loss of reduction. Three patients (1.3%) sustained a femoral shaft fracture at the tip of the nail. The quality of calcar reduction was significantly predictive of all modes of failure (p < 0.05), except femoral shaft fracture at the nail tip. CONCLUSION: The most common mechanical complication was lateral migration of the helical blade; however, this rarely led to a clinical problem. Medial migration of the blade in the head without loss of reduction was the second most frequent complication. We have identified a new complication associated with the TFN, that is, medial perforation without loss of reduction. Blade migration in the head was less frequent when blades were placed inferiorly with a tip-apex distance of at least 15 mm. LEVEL OF EVIDENCE: Therapeutic study, level IV. Copyright © 2013 Lippincott Williams & Wilkins.
Zou J.,Shanghai Sixth Peoples Hospital |
Zhang W.,Shanghai Sixth Peoples Hospital |
Zhang C.-Q.,Shanghai Sixth Peoples Hospital
Injury | Year: 2013
Introduction: Minimally invasive percutaneous plate osteosynthesis (MIPPO) has become a widely accepted technique to treat distal tibia fractures. However, it remains unclear whether this strategy of biological osteosynthesis with a bridge plate is superior to that of absolute stability with traditional open reduction and internal fixation (ORIF). Methods: In this pilot study, patients with distal tibia fractures, aged from 18 years to 60 years, were included from October 2005 to June 2007. Patients were randomly assigned to a closed group (the patients were treated by MIPPO) or an open group (the patients were treated by traditional ORIF) before they were categorised by AO fracture type. Wound healing was assessed at 2 weeks, 4 weeks, and 3 months postoperatively. Follow-up was performed once a month until the fractures achieved clinical union based on the standard criterion (pain-free full weight-bearing). Evaluation was performed for ankle range of motion, limb rotation, fracture healing, and radiographic alignment. Results: Forty-two patients were randomised to the open group and 52 to the closed group. According to AO/OTA classification, fractures were classified as Types A (55.3%), B (25.5%), and C (9.1%). The median follow-up time was 14.0 months for the open group and 15.0 months for the closed group. There was no significant difference between the groups in healing time for Type A and Type B fractures; however, for Type C fractures, there was a trend towards shorter healing time in the closed group compared with the open group. Conclusions: Our findings suggest that the strategy of biological osteosynthesis with a bridge plate might be superior to that of absolute stability for treating Type C tibia fractures. Further studies are needed to confirm our findings. © 2013 Elsevier Ltd.