Medicine
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The coronavirus disease 2019 (COVID-19) pandemic was disruptive to non-COVID-19-related healthcare. This study aimed to compare patient inflows and patient population characteristics at the Hand Surgery Department of JiShuiTan (JST) Hospital in Beijing, a top referral center, in 2020 during the pandemic relative to the same period in 2019. This cross-sectional study was conducted to analyze the impact of the COVID-19 pandemic on patients admitted to the hand surgery ward. ⋯ The top 5 diagnosis types for admitted patients were consistent throughout J-A19 and in January 2020. The rank of the diagnostic type "open injuries of the hand and wrist" increased significantly in February, March, and April of 2020 compared with 2019. The COVID-19 pandemic decreased patient admissions, especially for nonemergency patients, during J-A20.
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Observational Study
The effect of close and intensive therapeutic monitoring of patients with poorly controlled type 2 diabetes with different glycemic background.
Patients with type 2 diabetes who have HbA1c values ≥ 10% have different previous glycemic trends, including new diagnosis of diabetes. We aimed to assess the efficacy of 3 months of intensive and facilitated antihyperglycemic treatment in patients with different glycemic backgrounds. In this observational study, patients with type 2 diabetes and poor glycemic control (indicated by an HbA1c level of > = 10%) were divided into groups based on their previous HbA1c levels (group 1; newly diagnosed type 2 diabetics, group 2; patients with previously controlled but now deteriorated HbA1c levels, group 3; patients whose HbA1c was not previously in the target range but was now above 10%, and group 4; patients whose HbA1c was above 10% from the start). ⋯ The percentage of patients who achieved an HbA1c level of 7% or less was 60.6%, 38.1%, 16.4%, and 6.2% in the groups, respectively. The rate of those who achieved an HbA1c of 7% or less was nearly 50% of patients with type 2 diabetes mellitus who had previously had good metabolic control, whereas successful control was achieved in only 1 in 10 patients with persistently high HbA1c levels. Patients' glycemic history played an important role in determining their HbA1c levels at 3 months, suggesting that previous glycemic management patterns may indicate future success in diabetes control.
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The anterolateral thigh flap (ALT) is versatile for soft-tissue reconstruction of various body defects because of its thick and vascularized fascia component. We present our clinical experience with the functional one-stage reconstruction of complicated soft-tissue defects using ALTs with vascularized fascia lata (FL). Between April 2018 and February 2022, we transferred ALTs with FL components for various soft-tissue defects in 15 patients. ⋯ Partial flap necrosis occurred in 2 patients and were treated successfully with minimal surgical debridement and dressing. The vascularized fascia could replace a tendon and fascial component and all the patients achieved satisfactory results without major postoperative complications. Anterolateral thigh flaps with vascularized FL provide reliable fascial and tendon components for single-stage reconstruction of complex soft tissue defects.
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This study aimed to identify the key genes involved in the development of endometriosis and construct an accurate predictive model to provide new directions for the diagnosis and treatment of endometriosis. Using bioinformatics analysis, we employed the single-cell cell communication method to identify the key cell subtypes. By combining chip data and integrating differential analysis, WGCNA analysis, and the least absolute shrinkage and selection operator (LASSO) model, key genes were identified for immune infiltration and functional enrichment analyses. ⋯ The predictive model demonstrated good diagnostic performance. Through scRNA-seq, WGCNA, and LASSO methodologies, DES, GREM1, MBNL1, and AEBP1 emerged as crucial core genes linked to tissue stem cell markers in endometriosis. These genes have promising applications as diagnostic markers and therapeutic targets for endometriosis.
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Renal cell carcinoma (RCC) is a common malignant tumor of the urinary system. The von Hippel-Lindau (VHL) tumor suppressor gene play an essential role in the tumorigenic pathway of clear cell RCC (ccRCC). This study was aimed to clarify the influence of VHL polymorphisms on ccRCC susceptibility and survival in Central European population. ⋯ A significant associations were found between allele G and genotypes AG and GG of rs779805 in the VHL tumor suppressor gene and increased tumor size, as well as high nuclear grade. Furthermore, a statistically significant association was observed between rs1642742 of VHL gene and low pathological tumor stage and between rs779805 of VHL gene and high pathological tumor stage. Both investigated SNPs can be important prognostic indicators of RCC in the Central European population, because statistically significant associations were observed between evaluated VHL polymorphisms and the best known factors with proven prognostic significance in kidney cancer.