Nomogram to predict postoperative complications in elderly with total hip replacement

BACKGROUND By analyzing the risk factors of postoperative complications in elderly patients with hip replacement,We aimed to develop a nomogram model based on preoperative and intraoperative variables and verified the sensitivity and specificity for risk stratification of postoperative complications in elderly with total hip replacement patients.AIM To develop a nomogram model for risk stratification of postoperative complications in elderly with total hip replacement patients.METHODS A total of 414 elderly patients who underwent surgical treatment for total hip replacement hospitalized at the Affiliated Hospital of Guangdong Medical University from March 1,2017 to August 31,2019 were included into this study.Univariate and multivariate logistic regression were conducted to identify independent risk factors of postoperative complication in the 414 patients.A nomogram was developed by R software and validated to predict the risk of postoperative complications.RESULTS Multivariate logistic regression analysis revealed that age(OR=1.05,95%CI:1.00-1.09),renal failure(OR=0.90,95%CI:0.83-0.97),Type 2 diabetes(OR=1.05,95%CI:1.00-1.09),albumin(ALB)(OR=0.91,95%CI:0.83-0.99)were independent risk factors of postoperative complication in elderly patients with hip replacement(P<0.05).For validation of the nomogram,receive operating characteristic curve revealed that the model predicting postoperative complication in elderly patients with hipreplacement was the area under the curve of 0.8254 (95%CI: 0.78-0.87), the slope of the calibrationplot was close to 1 and the model passed Hosmer-Lemeshow goodness of fit test (χ^(2) = 10.16, P =0.4264), calibration in R E_(max) = 0.176, E_(avg) = 0.027, which all demonstrated that the model was ofgood accuracy.CONCLUSIONThe nomogram predicting postoperative complications in patients with total hip replacementconstructed based on age, type 2 diabetes, renal failure and ALB is of good discrimination andaccuracy, which was of clinical significance.

An epidemiology study of fecal incontinence in adult Chinese women living in urban areas

Background:Fecal incontinence(FI)has been shown to be a common symptom in Western countries;however,there is few researches focusing on its epidemic condition in Chinese women.We conducted this national population-based epidemiology study to estimate the prevalence and risk factors of FI among adult Chinese women living in urban regions.Methods:This is a subgroup analysis of a national population-based epidemiology study of FI.Total 28,196 adult women from urban regions of six provinces and municipalities participated in this research from 2014 to 2015.They finished the questionnaire under the direction of trained interviewers.FI was defined as accidental leakage of flatus and/or liquid or solid stool at least once in the past.The FI prevalence trend and risk factors were identified by the Cochran-Armitage test,Chi-square test,and multivariable logistic regression.Results:The prevalence of FI in adult females in urban China was 0.43%(95%confidence interval:0.35%-0.51%).Among women with FI,42.96%,82.96%,and 42.22%reported having leakage of solid,liquid stool,and gas,respectively.The overall FI prevalence and the incidence rate of solid stool/liquid stool/gas leakage increased with age.The mean Wexner score was 4.0%and 12.0%FI patients reported Wexner score≥9.Body mass index≥24 kg/m2,pelvic organ prolapses,chronic constipation,chronic cough,alcohol consumption,physical diseases including chronic bronchitis and cancer,gynecological diseases like gynecological inflammation are risk factors for FI.Vaginal delivery was the risk factor for FI in females with labor history.Conclusions:FI was not a common symptom in adult Chinese women living in urban areas and there were some potential modifiable risk factors.

Relationship between Intrauterine Bacterial Infection and Early Embryonic Developmental Arrest

Background： Early embryonic developmental arrest is the most commonly understudied adverse outcome of pregnancy. The relevance of intrauterine infection to spontaneous embryonic death is rarely studied and remains unclear. This study aimed to investigate the relationship between intrauterine bacterial infection and early embryonic developmental arrest. Methods： Embryonic chorion tissue and uterine swabs for bacterial detection were obtained from 33 patients who underwent artificial abortion （control group） and from 45 patients who displayed early embryonic developmental arrest （trial group）. Results： Intrauterine bacterial infection was discovered in both groups. The infection rate was 24.44% （11/45） in the early embryonic developmental arrest group and 9.09% （3/33） in the artificial abortion group. Classification analysis revealed that the highest detection rate for Micrococcus luteus in the early embryonic developmental arrest group was 13.33% （6/45）, and none was detected in the artificial abortion group. M. luteus infection was significantly different between the groups （P 〈 0.05 as shown by Fisher＇s exact test）. In addition, no correlation was found between intrauterine bacterial infection and history of early embryonic developmental arrest. Conelusions： IV/. luteus infection is related to early embryonic developmental arrest and might be one of its causative factors.

Effects of elevated CO2 on the interspecific competition between two sympatric species of Aphis gossypii and Bemisia tabaci fed on transgenic Bt cotton

Effects of elevated CO2 （twice ambient vs. ambient） and Bt CrylAc transgene （Bt cotton cv. 33B vs. its nontransgenic parental line cv. DP5415） on the interspecific competition between two ecologically similar species of cotton aphid Aphis gossypii and whitefly biotype-Q Bemisia tabaci were studied in open-top chambers. The results indicated that elevated CO2 and Bt cotton both affected the population abundances of A. gossypii and biotype-Q B. tabaci when introduced solely （i.e., without interspecific competition） or two species coexisted （i.e., with interspecific competition）. Compared with ambient CO2, elevated COe increased the population abundances ofA. gossypii and biotype-Q B. tabaci as fed on Bt and nontransgenic cotton on 45 （i.e., seedling stage） and 60 （i.e., flowering stage） days after planting （DAP）, but only significantly enhanced aphid abundance without interspecific competition on the 45-DAP nontransgenic cotton and 60-DAP Bt cotton, and significantly increased whitefly abundance with interspecific competition on the 45-DAP Bt cotton and 60-DAP nontransgenic cotton. In addition, compared with nontransgenic cotton at elevated CO2, Bt cotton significantly reduced biotype-Q B. tabaci abundances without and with interspecific competition during seedling and flowering stage, while only significantly decreasing A. gossypii abundances without interspecific competition during the seedling stage. When the two insect species coexisted, the proportions ofbiotype-Q B. tabaci were significantly higher than those ofA. gossypii on Bt and nontransgenic cotton at the same CO2 levels, and elevated CO2 only significantly increased the percentages of biotype-Q B. tabaci and significantly reduced the proportions of A. gossypii on seedling and flowering nontransgenic cotton. Therefore, the effects of elevated CO2 were favorable for biotype-Q B. tabaci to out-compete A. gossypii under the predicted global climate change.