Fuzhou Second Hospital

ObjectiveTo systematically evaluate the differential long-term outcomes—including mortality, severe disability, and specific neurodevelopmental domains (language, learning, memory)—associated with various therapeutic hypothermia strategies for moderate-to-severe neonatal hypoxic-ischemic encephalopathy (HIE) through a comprehensive review and meta-analysis.MethodsA systematic search was conducted across PubMed, Embase, and the Cochrane Library up to December 2023, supplemented by gray literature and reference tracking. Randomized controlled trials (RCTs) and prospective cohort studies involving neonates ≥36 weeks' gestation with moderate-to-severe HIE treated with therapeutic hypothermia were included. Data extraction covered study characteristics, outcome data, and risk of bias indicators. The subgroup analysis, sensitivity analysis, and assessment of publication bias were carried out.ResultsA total of 11 studies involving 1,466 neonates were included. The pooled composite endpoint rate (mortality + severe disability) after therapeutic hypothermia was 39.2% (95% CI: 32.7%–46.1%). Subgroup analysis revealed that whole-body cooling demonstrated superior efficacy compared to selective head cooling (RR = 0.71, P = 0.03), and lower target temperatures (≤34 °C) further improved outcomes (P = 0.04). Limited domain-specific data showed receptive language delays (18%), expressive language delays (22%), and working memory impairments (15%) in survivors without severe disability. Studies with >18-month follow-up showed a non-significant trend toward higher disability detection. The overall quality of evidence was medium, with most studies having a moderate risk of bias and low applicability concerns. No significant publication bias was detected (P = 0.08).ConclusionTherapeutic hypothermia reduces the combined risk of mortality and severe disability in moderate-to-severe neonatal HIE. Whole-body cooling and target temperatures of 33–34 °C may optimize outcomes, but extreme hypothermia (≤32 °C) is associated with increased mortality, necessitating careful monitoring of adverse events. Further research is needed to optimize protocols and characterize neurodevelopmental outcomes in specific domains (e.g., language, memory).

Non-obese non-alcoholic fatty liver disease (NAFLD), or “lean NAFLD”, challenges the assumption that fatty liver predominantly affects obese individuals. In elderly populations, age-related changes in body composition further limit the utility of body mass index (BMI) for metabolic risk stratification. We aimed to characterise the metabolic profile of lean NAFLD and quantify dose–response relationships between key biochemical markers and NAFLD risk in elderly Chinese adults. We analysed health-examination data from community-dwelling adults aged $$\ge$$65 years attending a primary care centre in Xiamen, China (2022–2024). After excluding individuals with excessive alcohol intake, viral hepatitis markers, or missing ultrasound records, 10,586 participants were included. NAFLD was diagnosed ultrasonographically. Participants were classified as lean (BMI <24 kg/m$$^2$$) or overweight/obese (BMI $$\ge$$24 kg/m$$^2$$) per Chinese criteria. We compared metabolic profiles across four BMI–NAFLD phenotypes and performed stratified analyses by triglyceride-to-HDL cholesterol (TG/HDL-C) ratio and serum uric acid categories. NAFLD prevalence was 30.8% (3,258/10,586), with 35.8% (1,167/3,258) occurring in lean individuals. Lean NAFLD participants exhibited higher TG/HDL-C ratios, fasting glucose, glycated haemoglobin, and uric acid levels than Lean Healthy participants, alongside greater prevalence of hypertension (40.3% vs. 25.0%) and diabetes (23.1% vs. 8.9%). NAFLD prevalence increased from 14.2% (TG/HDL-C <1.0) to 59.4% (TG/HDL-C $$\ge$$2.0) among lean participants, and from 15.6% (normal uric acid) to 47.4% (hyperuricaemia). In multivariable models, the highest TG/HDL-C stratum (TG/HDL-C $$\ge$$2.0) conferred 2.26-fold increased odds of NAFLD (95% CI 1.98–2.57) versus the lowest stratum. A composite model combining TG/HDL-C, uric acid, waist circumference, and fasting glucose achieved an AUC of 0.706 (95% CI 0.688–0.724), substantially exceeding TG/HDL-C alone (AUC 0.615). Over one-third of NAFLD cases in this elderly cohort occurred in lean individuals with substantial metabolic disturbances, and 91.4% simultaneously met MASLD cardiometabolic criteria. TG/HDL-C $$\ge$$2.0 functions primarily as a high-specificity rule-in marker (specificity 97.9%, PPV 59.4%) rather than a screening tool; a composite model incorporating TG/HDL-C ratio, uric acid, waist circumference, and fasting glucose provides improved discrimination (AUC 0.706) for identifying lean individuals with hepatic steatosis in primary care settings where BMI-based screening alone is insufficient.

<title>Abstract</title> <bold>Objective:</bold> Differentiating septic arthritis from transient synovitis in children is challenging. This study aimed to determine the diagnostic value for distinguishing these two conditions and to develop an effective clinical prediction model based on multi-center clinical data to identify and differentiate between the two diseases more comprehensively and accurately. <bold>Methods:</bold> We retrospectively analyzed data of children aged under 18 years who were hospitalized in eight specialized children's hospitals in China from 2013 to 2021. The data included age, sex, initial hospital admission temperature, history of prodromal respiratory infection, prodromal history of strenuous exercise, etc. Laboratory test results, including that of erythrocyte sedimentation rate (ESR), serum white blood cell count (WBC), C-reactive protein (CRP), platelet count (PC), pathogenic bacterial count and other information. The common sites of bone and joint infection in children are the hip and knee joints. Therefore, to ensure the prediction model's reliability, we established three clinical prediction models: one for septic hip arthritis and transient hip synovitis, one for septic knee arthritis and transient knee synovitis, and one for septic arthritis and transient synovitis in either joint which we merged all the data of the hip and knee joints into one data set to build a clinical prediction model. In addition, we conducted single-factor and multi-factor analyses on the data classified by these models. <bold>Results:</bold> This study collected data of 819 children from 8 tertiary children's hospitals, including 265 patients with septic arthritis (mean age 5.55±7.16 years) and 554 patients with transient synovitis (mean age 4.8±3.2 years). In 265 blood and joint aspirate cultures of septic arthritis, the most common causative organism was Staphylococcus aureus (59%). To ensure the quality and reliability of the prediction models, we established three clinical prediction models. For septic hip arthritis, a retrospective study based on six clinical predictors was a history of prodromal respiratory tract infection (HRTI), temperature&gt;37.5 ºC, ESR&gt;20 mm/h, CRP&gt;10 mg/L, red blood cell distribution width (RDW)&gt;50%, and WBC&gt;11×109 /L. When these six factors were present, the probability of septic hip arthritis was 99.99%. For septic knee arthritis, a retrospective study based on three clinical predictors, the predictors were ESR&gt;20 mm/h, CRP&gt;10 mg/L, and absolute monocyte count (AMONO)&gt;0.74×109/L. When these three factors were present, the probability of having septic knee arthritis was 94.68%. For septic arthritis (septic hip arthritis or septic knee arthritis), a retrospective study based on six clinical predictors, the predictors were male children, history of HRTI), temperature&gt;37.5 ºC, ESR&gt;20 mm/hr, PC &gt; 407×10 ⁹ /L and CRP&gt;10 mg/L. When these six factors were present, the probability of septic arthritis was 99.65%. <bold>Conclusion:</bold> This study used multi-center clinical data to construct a new clinical prediction model for children with septic arthritis. The clinical prediction model algorithm developed here outperformed that of previous studies in the probability of diagnosing septic arthritis. In addition to considering body temperature, WBC, ESR, and CRP, we identified new clinical predictors such as sex, history of HRTI, RDW, PC and AMONO.

The title compound, [Zn(HPO4)(C5H5N)] n or pyZn(HPO4) (1), was prepared from the solvothermal reaction of [Mo3O2(O2CCH3)6(H2O)3]ZnCl4 and H3PO4 in a mixture of pyridine and water. It displays an infinite ladder structure built of alternately arranged ZnO3N and PO3(OH) tetra-hedra, linked O-H⋯O hydrogen bonds into supra-molecular sheets. C-H⋯O inter-actions between CH groups of the pyridine rings and phosphate groups connect the sheets into a three-dimensional framework structure.

BackgroundIdiopathic scoliosis (IS), a three-dimensional spinal deformity common in adolescents, can be treated with numerous approaches, including Schroth, Spiral stabilization (SPS), and core exercises, to improve spinal alignment and health. However, few studies have shown the superiority of one treatment over another.ObjectiveThis retrospective cohort study was designed to evaluate the efficacy of three distinct physical therapy protocols in managing IS among adolescents aged 6–18 years with Cobb angles ≤40°.MethodsA total of 61 patients were allocated to one of three therapeutic groups. Each group received interventions twice weekly for 10 sessions. Primary outcomes were assessed by measuring changes in the Cobb angle, whereas secondary outcomes included evaluations of pain (visual analog scale, VAS), the angle of trunk rotation (ATR), trunk aesthetic clinical evaluation (TRACE), radiographic parameters (Alignment of the C7 plumbline (C7PL), clavicle angle, and pelvic obliquity), and quality of life (the Scoliosis Research Society-22 questionnaire,SRS-22).ResultsThe findings revealed significant within-group improvements in the Cobb angle, pain, and trunk rotation for all interventions (p < 0.05). Notably, between-group comparisons indicated that both the Schroth and SPS modalities resulted in greater reductions in the Cobb angle and trunk rotation than core stabilization exercises did (p < 0.05). Moreover, SPS resulted in superior enhancements in the clavicle angle and dynamic postural control, whereas Schroth yielded significant improvements in C7PL alignment.ConclusionThis short-term study underscores the relative effectiveness of the Schroth and SPS interventions in managing three-dimensional spinal deformities and enhancing dynamic postural control while recognizing the limitations of core stabilization exercises for scoliosis.Clinical trial registrationThis retrospective analysis of a clinical trial has been registered in the Chinese Clinical Trial Registry (ChiCTR2500096077) https://www.google.com/search?client=firefox-b-d&q=ChiCTR2500096077.

Orthopedic implants provide structural support, loading-bearing, or motion preservation to ensure surgical success. Zinc (Zn)-based alloys have emerged as promising candidates for next-generation orthopedic implants due to their suitable degradation rate, excellent mechanical properties, antibacterial activity, and complete degradability. However, the clinical application of Zn-based alloys is hindered by significant limitations, including mechanical instability, threshold-dependent bioactivity, an inadequate balance between antimicrobial and osteogenic effects, and variability in stress-induced degradation. This comprehensive review summarizes the feasibility of Zn-based alloys for orthopedic implants, focusing on the biocompatibility, biodegradation behavior, mechanical properties, and interactions with the resident cells. The engineering methods to modify properties of Zn-based materials are also discussed, and their translational applications are highlighted, while addressing the remaining challenges for future investigation. Collectively, advancing research in Zn-based alloys would pave the way for innovative orthopedic solutions that enhance patient outcomes.

ObjectiveAcute liver injury (ALI) caused by sepsis is a fatal disease with a high mortality rate and poor prognosis. Sulforaphane (SFN) is a natural isothiocyanate that has robust antioxidant and anti-inflammatory properties. The aim of this study was to identify the pharmacological effects and therapeutic mechanisms of SFN in lipopolysaccharide (LPS)-induced ALI.MethodsThe role of SFN in ALI was investigated using a mouse model of LPS-induced ALI. Briefly, eighteen mice were divided into three groups: control, LPS, and LPS + SFN, which were intraperitoneally injected for 2 days before LPS treatment. 24 h after the LPS injection, blood and liver tissues were collected for further analysis.ResultsThe hematoxylin and eosin (HE) staining showed a lot of visible necrosis areas, inflammatory cell infiltration, and congestion in liver. Meanwhile, Ly6G and F4/80 staining showed increased infiltration of neutrophils and macrophages in liver, these results indicated that LPS induced sever ALI. As inflammatory response plays a vital role in the pathogenesis of LPS-induced ALI, we detected the occurrence of pyroptosis in liver by ribonucleic acid (RNA) sequencing. The results showed that pyroptosis was significantly promoted by LPS, as indicated by gene ontology (GO) and kyoto encyclopedia of genes and genomes (KEGG) pathway enrichment analyses, revealing the activation of pyroptosis, interleukin (IL)-1 production, IL-18 production, and inflammatory signaling pathways. Then, we explored the effect of SFN on LPS-induced ALI. The results showed that SFN obviously reduced LPS-induced plasma alanine aminotransferase and aspartate aminotransferase level, pathological injuries and TdT-mediated dUTP nick-end labeling (TUNEL) positive cells, indicating protective effect of SFN on ALI. Furthermore, SFN also showed robust effect on LPS-induced inflammatory response in liver, as reflected by suppressing the infiltration of neutrophils and macrophages, and downregulating mRNA levels of C-X-C motif chemokine ligand 9, IL-6, monocyte chemoattractant protein-1, and tumor necrosis factor-α in liver of LPS treated mice. Furthermore, SFN blocked hepatocyte pyroptosis, and suppressed plasma IL-1β and IL-18 levels of LPS treated mice. Mechanistically, SFN selectively activated nuclear factor erythroid 2-related factor 2 (Nrf2)/heme oxygenase-1 (HO-1) signaling to mediate pyroptotic cell death. SFN also reversed the inhibited superoxide dismutase activity and induced malondialdehyde content in liver of LPS exposed mice.ConclusionSFN ameliorated liver injury and inflammation during LPS-induced ALI by suppressing hepatocyte pyroptosis via the activation of Nrf2/HO-1 signaling. This study provides new evidence for the potential treatment of ALI with SFN.

Abstract Objective To investigate the clinical-epidemiological characteristics of trauma-related orthopedic Aeromonas infections and develop a risk prediction model to guide early diagnosis and clinical management. Methods The data were derived from traumatic Aeromonas infection in Fuzhou Second General Hospital from May 2018 to May 2024. The culture results and drug sensitivity data of inpatients were collected, and a retrospective analysis was performed on the distribution and drug resistance of Aeromonas. Statistical analysis of the data was conducted using single factors and logistic regression. Results A total of 111 patients with trauma-related Aeromonas infection were collected with an average age of 49.9 ± 14.3 years. The average length of hospital stay was 36.2 ± 21.1 days, and the average number of surgeries was 2.7 ± 1.6. The outcomes included debridement in 51(45.95%) cases, skin grafting in 17(15.32%) cases, flaps in 27(24.32%) cases, amputation in 14(12.61%) cases, and death in 2(1.80%) cases. The drug sensitivity test results showed that Aeromonas extracted from the wound secretions were resistant to ampicillin and amoxicillin and were sensitive to amikacin, levofloxacin and cefepime. Our research has listed 14 predictive indicators significantly associated with unfavourable prognosis mainly including body mass index (BMI), visible fracture, defect of skin, postoperative alanine aminotransferase (ALT), perioperative blood transfusion, etc. Conclusion The Aeromonas infection predominantly affected middle-aged individuals, with prolonged hospital stays and multiple surgical interventions. Highly adverse outcomes included amputation (12.61%) and even death (1.80%). Antimicrobial susceptibility testing revealed high resistance rates to common antibiotics such as ampicillin but maintained sensitivity to amikacin and levofloxacin. Our predictive model incorporating 14 prognostic indicators enables risk-stratified management. These findings provide critical insights for the early identification of severe infections and optimisation of clinical decision-making in diagnosis and treatment.

ObjectiveThis study aims to assess the incidence of postoperative delirium in elderly patients with hip fractures under the Unaccompanied- Care model and to explore its risk factors.MethodsThis retrospective observational study prospectively included elderly patients with hip fractures who were admitted to the Trauma Department of our hospital from November 2024 to May 2025, managed under the Unaccompanied-Care nursing model, and underwent surgical treatment. We retrospectively analyzed the patients’ baseline data, blood indicators, and surgery-related data for data analysis. Univariate and multivariate logistic regression analyses were used to identify risk factors associated with delirium in the perioperative period.ResultsA total of 138 patients were included, of whom 35 (25.36%) developed delirium. The incidence of delirium was 2.17% (3 cases) preoperatively, 6.52% (9 cases) within 6 h postoperatively, 10.14% (14 cases) within 1 day postoperatively, 4.35% (6 cases) on postoperative day 2, and 2.17% (3 cases) on postoperative day 3. Multivariate analysis showed that mild visual impairment (OR = 15.74, 95% CI: 2.53–97.29, p = 0.003), severe visual impairment (OR = 9.68, 95% CI: 5.20–18.30, p = 0.002); mild hearing impairment (OR = 7.09, 95% CI: 1.23–40.74, p = 0.028), moderate hearing impairment (OR = 6.43, 95% CI: 1.80–51.41, p = 0.031), severe hearing impairment (OR = 16.59, 95% CI: 1.76–156.61, p = 0.014), and hemoglobin (OR = 1.95, 95% CI: 1.91–5.99, p = 0.037) were independent risk factors for delirium.ConclusionAlthough the Unaccompanied-Care model shows specific effects in the nursing of elderly patients with hip fractures, the incidence of delirium remains high. Sensory dysfunction and low hemoglobin levels are important risk factors for delirium.