The objective of this study was to investigate the prevalence of preoperative deep venous thrombosis (DVT) in the pelvic cavity and lower extremities following pelvic and acetabular fractures and to identify the risk factors of the occurrence of DVT. Duplex ultrasound (DUS) screening and blood tests were conducted in patients admitted from June 2012 to December 2020 for surgical treatment of pelvic and acetabular fractures. Univariate analyses were performed on data of demographics, comorbidities, time from injury to surgery, injury mechanism, accompanied injury, and laboratory results. The optimal cutoff values of continuous variables with statistical significance were obtained by using the receiver operating characteristic (ROC) curve. A multivariate logistic regression analysis was then employed to examine the independent values in terms of predicting preoperative DVT. A total of 607 patients with pelvic and acetabular fractures were included, among whom 82 (13.5%) patients sustained preoperative DVTs. Specifically, 31.7% (26/82) were diagnosed with proximal DVTs. Fifty-two (63.4%) patients had DVT within 7 days after injury, and 67 (81.7%) patients within 10 days. The multivariate logistic regression analysis identified 6 factors independently associated with the presence of preoperative DVT, including age > 46 years (odds ratio [OR] = 2.94), BMI > 26.73 kg/m2 (OR = 3.91), time from injury to surgery > 9 days (OR = 5.39), associated injury (OR = 7.85), ALB < 32.8 g/L (OR = 2.71) and FIB > 3.095 g/L (OR = 3.34). Despite the modern prophylactic regimen, the preoperative DVT in patients with pelvic and acetabular fractures still draws the attention of orthopaedic surgeons. Better understanding these risk factors can help surgeons refine the risk stratification profile and perform early interdisciplinary management for patients at high risk of DVT.
The genesis of dolostone has long been puzzling for more than two centuries. Although much work has been done on investigating the process of dolomitization, little emphasis has been put on examining the diagenetic water redox condition with the wealthy geochemical information preserved in primary dolomite, which is believed to archive the aqueous environment as well as biotic and/or abiotic effects during formation. In situ interpretation with high resolution is a prerequisite in refined research of dolomite. Here, we reported the multielement imaging results of a lacustrine dolomite nodule with the host black shale from the Songliao Basin, northeast of China. Micro X-ray fluorescence (μ-XRF) with a spatial resolution down to 10 μm was used for in situ scanning. Two key parameter settings of the μ-XRF, including single-point exposure time and spatial resolution, were optimized to achieve a better result in a reasonable scanning time scale. The final imaging data graphically revealed dynamic variation of elemental distributions, including elements enriched in dolomite (e.g., Ca, Mg, Fe, and Mn), clastic quartz (Si), and clay minerals (e.g., Al and K) and redox-sensitive trace elements (e.g., Cr, Mo, V, and U). The well-preserved laminated structures inside the nodule and the features with a magnesium-rich core wrapped with an iron-concentric outer layer and a manganese-concentric shell together indicated its primary form as dolomite and a gradual transformation into ankerite as well as manganese-ankerite. The elemental variation indicates a varied bottom water redox condition, which involved from sulfidic to ferruginous and manganous zones. Here, we propose that the intermittent supplies of sulfate and Fe-/Mn-oxidized minerals interrupting the black shale deposition while favoring dolomitization might be brought by the oxidized and salted seawater. And this lacustrine dolomite is expected to be a potential fingerprint mineral in tracking the seawater intrusions to the Songliao Basin which happened 91 million years ago.
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