Precise Tuning of Bilayer Ultrasmall MoS2 Featuring Inhibition of Carrier Recombination and Fast Surface Chemistry for Green H2 Evolution.

Achieving water splitting to produce green H2 , using the noble-metal-free MoS2 , has attracted huge interest from researchers. However, tuning the number of MoS2 layers precisely while obtaining small lateral sizes to surge the H2 -evolution rate is a tremendous challenge. Here, a bottom-up strategy is designed for the in situ growth of ultrasmall lateral-sized MoS2 with tunable layers on CdS nanorods (CN) by controlling the decomposition temperature and concentration of substrate seed (NH4 )2 MoS4 . Here, the bilayer MoS2 and CN coupling (2L-MoS2 /CN) exhibits the optimum photocatalytic activity. Compared to thicker MoS2 , the 2L-MoS2 has sufficient reduction capacity to drive photocatalytic H2 evolution and the ultrasmall lateral size provides more active sites. Meanwhile, the indirect bandgap, in contrast to the direct bandgap of the monolayer MoS2 , suppresses the carrier recombination transferred to 2L-MoS2 . Under the synergistic effect of both, 2L-MoS2 /CN has fast surface chemical reactions, resulting in the photocatalytic H2 -evolution rate of up to 41.86 mmol g-1 h-1 . A novel strategy is provided here for tuning the MoS2 layers to achieve efficient H2 evolution.

Constructing BiOBr1-xIx-y with Abundant Surface Br Vacancies for Excellent Visible-Light Photodegradation Capability of High-Concentration Refractory Contaminants.

Bismuth oxybromide (BiOBr) is a promising photocatalytic semiconductor material due to its unique hierarchical structure and band structure. However, its photocatalytic applications are restricted due to its narrow visible-light absorption range and poor photooxidation capability. In this study, BiOBr1-xIx-y with rich surface Br vacancies (BrVs-rich BiOBr1-xIx-y) was created via a facile indirect substitution strategy. Benefiting from the broadened visible-light response range and reduced recombination rate of photogenerated carriers, BiOBr1-xIx-y shows excellent visible-light photodegradation ability for high-concentration refractory contaminants, such as phenol, tetracycline, bisphenol A, rhodamine B, methyl orange, and even real wastewater. At the same time, the Br vacancies can regulate the band structure of BiOBr1-xIx-y and serve as trap states to promote charge separation, thus facilitating surface photoredox reactions. An in-depth investigation of the Br vacancy effect and photodegradation mechanism was conducted. This novel study revealed the significance of Br vacancies in enhancing the photocatalytic performance of BiOBr under visible light, providing a promising strategy for improving the utilization efficiency of sunlight in wastewater treatment.

In Situ Construction of BiO(ClBr)(1-x)/2Ix-n Solid Solution with Appropriate Surface Iodine Vacancies for Synergistically Boosting Visible-Light Photo-Oxidation Capability.

A proposed BiO(ClBr)(1-x)/2Ix-n solid solution containing abundant iodine vacancies has been constructed through a facile solvothermal treatment strategy. Fascinatingly, the iodine-vacancy BiO(ClBr)(1-x)/2Ix-n solid solution exhibits an outstanding visible-light photocatalytic degradation property for the environmentally hazardous pollutants of methyl orange, tetracycline, and phenol solutions, which is credited to the synergistic effect of iodine vacancies and the solid solution. By manipulating the molar ratios of Cl, Br, and I, the band structure of the solid solution attained is controlled, enabling the samples to maximize the harvest of visible light and to possess strong oxidation features. More importantly, the construction of iodine vacancies is bound to modulate the local surface atomic structure and promotes the efficiency of the separation of photogenerated carriers. Given these, the microstructure and physicochemical and photoelectrochemical properties of the photocatalysts are fully characterized in a series. In addition, the iodine-vacancy BiO(ClBr)(1-x)/2Ix-n solid solution has a stable crystal structure that permits favorable recyclability even after multiple cycles of degradation. This study sheds light on the significance of the simultaneous existence of vacancy and the solid solution for the enhanced performance of photocatalysts and opens up new insights for sustainable solar-chemical energy conversion.

Indirect Substitution Constructing Halogen-Vacancy BiOCl1-xIn Solid Solution with a Suitable Surface Structure for Enhanced Photoredox Performance.

Photocatalytic technology has made a series of breakthroughs in environmental remediation, but the degradation performance of persistent heavy metal ions and organic pollutants is not particularly excellent. In addition, the layered structure of bismuth oxyhalides (BiOX, X = I, Br, and Cl) has been a popular material for photodegradation and photoelectrochemistry. Accordingly, with a view to construct a suitable band structure and control the surface structure, it is necessary to develop a strategy to synthesize a BiOCl1-xIn solid solution with halogen vacancies. In this study, halogen vacancies are in situ introduced into the BiOCl1-xIn solid solution through constructing chemical bonds between the hydroxyl groups in glycerol and the I ions during the growth process. The band of the halogen-vacancy BiOCl1-xIn solid solution is widened and active sites centered at halogen vacancies are formed in the direction favorable for the photocatalytic reaction, resulting in enhanced performance in the reduction of Cr(VI) and the oxidation of phenol. The results obtained can provide a new idea for the design of efficient photocatalysts by controlling the formation of halogen vacancies.

The incidence of deep venous thrombosis after arthroscopically assisted anterior cruciate ligament reconstruction.

PURPOSE: The purpose of our study was to retrospectively assess and analyze the incidence of deep venous thrombosis (DVT) after arthroscopically assisted anterior cruciate ligament reconstruction (ACLR) at our institution. METHODS: We conducted a retrospective analysis of 249 arthroscopic ACLRs performed in our hospital between February 2009 and February 2012. The surgical procedure was standardized in all the patients and was conducted by the same 2 surgeons. Quadrupled hamstring autograft was used in all the patients. No patient was given nonsteroidal anti-inflammatory drugs for the first 2 weeks after surgery. A unilateral contrast venography examination was performed on the third postoperative day. Patients were confined to bed once DVT was confirmed, followed by therapeutic doses of batroxobin. The proportion of patients with DVT was calculated. The significance of the association between clinical factors and postoperative DVT was determined. RESULTS: This study included 171 patients (123 men and 48 women), with a mean age (±SD) of 30.1 ± 10.0 years. DVT was detected in 24 patients (14.0%; 95% confidence interval, 8.8% to 19.3%). Body mass index (BMI), operative time, operator, and duration of tourniquet application were not significant risk factors for DVT. The risk of DVT was significantly higher in patients aged 35 years or older (P < .01). Higher risk for DVT was also identified in female patients (P < .05). Pulmonary embolism did not develop after thrombolytic therapy in any of the 24 patients with DVT after ACLR. CONCLUSIONS: The incidence of DVT in patients who underwent arthroscopic ACLR was 14% in this study. Female patients and those aged 35 years or older have a significantly higher risk of DVT developing after ACLR; thus thromboprophylaxis is advocated in these patients. LEVEL OF EVIDENCE: Level IV, therapeutic case series.

Interfacial elaborating In2O3-decorated ZnO/reduced graphene oxide/ZnS heterostructure with robust internal electric field for efficient solar-driven hydrogen evolution.

Solar-driven hydrogen evolution over ZnO-ZnS heterostructures is considered as a promising strategy for sustainable-energy issues. However, the industrialization of this strategy is still constrained by suppressed carrier migration, rapid charge recombination, and the inevitable utilization of noble-metal particles. Herein, we envision a novel strategy of successfully introducing In2O3 into the ZnO-ZnS heterostructure. Benefiting from the optimized internal electric field and the charge carrier migration mode based on the direct Z-scheme, the interfacial elaborating In2O3-decorated ZnO/reduced graphene oxide (rGO)/ZnS heterostructure manifests smooth charge migration, suppressed electron-hole pair recombination, and increased surface active sites. More importantly, the in situ introduction of In2O3 optimizes the construction of the internal electric field, favoring directional light-triggered carrier migration. As a result, the light-induced electrons generated from the heterostructure can be efficiently employed for the hydrogen evolution reaction. Hence, this work would shed light on the in situ fabrication of noble-metal-free photocatalysts for solar-driven water splitting.

Effect of Tiaodu Tongmai acupuncture therapy on rheumatoid arthritis at different ages by generalized estimating equation / 中国组织工程研究

BACKGROUND:Rheumatoid arthritis is a chronic autoimmune disease characterized by joint pain,swelling,and dysfunction.Acupuncture,as a traditional medical treatment,has proved its effectiveness and safety in many diseases.However,the efficacy of acupuncture in the treatment of rheumatoid arthritis remains controversial.Therefore,the purpose of this study is to evaluate and explore the effect of Tiaodu Tongmai acupuncture in the treatment of preclinical rheumatoid arthritis of different ages through the generalized estimating equation,and to provide a basis for the application of acupuncture in rheumatoid arthritis. OBJECTIVE:To investigate the effect of Tiaodu Tongmai acupuncture therapy on preclinical rheumatoid arthritis(pre-RA)patients at different ages based on generalized estimating equation. METHODS:A total of 123 patients with preclinical rheumatoid arthritis treated from January to September 2023 were selected as the study objects and divided into study group(n=64)and control group(n=59)according to different treatment methods.The study group was given Tiaodu Tongmai acupuncture treatment,and the control group was given acetaminophen tablets.The baseline balance was adjusted by propensity score matching method.The clinical efficacy and cytokine levels before and after treatment between the two groups were compared.The generalized estimating equation model was established to evaluate the efficacy of Tiaodu Tongmai acupuncture therapy on preclinical rheumatoid arthritis patients at different ages. RESULTS AND CONCLUSION:(1)After 0 days of treatment,there were significant differences in joint pain and C-reactive protein expression between study and control groups(P＜0.05).After 4 weeks of treatment,there were significant differences in visual analogue scale scores,joint pain,C-reactive protein and erythrocyte sedimentation rate between the two groups(P＜0.05).After 8 weeks of treatment,there were significant differences in visual analogue scale scores,C-reactive protein and erythrocyte sedimentation rate between the two groups(P＜0.05).After 12 weeks of treatment,there were significant differences in visual analogue scale scores,C-reactive protein and erythrocyte sedimentation rate between the two groups(P＜0.05).(2)The total effective rate of the study group was 93.75%,while that of the control group was 79.17%.The clinical efficacy of the study group was significantly better than that of the control group(P＜0.05).(3)There were significant differences in interleukin-6,interferon-γ,macrophage migration inhibitory factor,rheumatoid factor IgA,rheumatoid factor IgM,metallomatrix proteinase 3,metallomatrix proteinase 9,and anti-cyclic citrulline antibody in the study group before and after treatment(P＜0.05).The levels of interleukin-6,interferon-γ,rheumatoid factor IgA,rheumatoid factor IgM,metallomatrix proteinase 3,metallomatrix proteinase 9,and anti-cyclic citrulline antibody in the control group after treatment were significantly different from those before treatment(P＜0.05).There were significant differences in interleukin-6,interferon-γ,macrophage migration inhibitory factor,rheumatoid factor IgA,rheumatoid factor IgM,metallomatrix proteinase 3,and anti-cyclic citrulline antibody between the two groups after treatment(P＜0.05).(4)After 12 weeks of treatment,the comprehensive efficacy of patients of all ages in the study group was better than that of the control group(P＜0.05).After 8 weeks of treatment,the comprehensive efficacy of patients aged 23-35,36-50,and 51-60 years old in the study group was better than that of the control group(P＜0.05),and the comprehensive efficacy of patients aged 18-22 years old was comparable between the two groups.After 4 weeks of treatment,the comprehensive efficacy of patients aged 36-50 and 51-60 years old in the study group was better than that of the control group(P＜0.05),and the comprehensive efficacy was comparable between the two groups of patients aged 18-22 and 23-35 years.Overall,Tiaodu Tongmai acupuncture therapy has advantages in treating preclinical rheumatoid arthritis patients aged 36-50 and 51-60 years.

Neutral wedge osteotomy assisted by determination of the center of rotation of angulation at the distal humerus anatomical axis for cubitus varus deformity in children / 中华创伤骨科杂志

Objective:To evaluate the clinical outcomes of neutral wedge osteotomy assisted by determination of the center of rotation of angulation (CORA) at the distal humerus anatomical axis for cubitus varus deformity in children.Methods:From 2016 to December 2019, 20 children with cubitus varus after supracondylar fracture of the humerus were treated at Department of Orthopeadics, Children's Hospital of Wujiang District. They were 8 boys and 12 girls, aged from 4 to 12 years (average, 7.0 years). Standard anteroposterior X-ray films of bilateral humerus were taken preoperatively for measurement of Baumann angle, proximal anatomical axis (PAA) and distal anatomical axis (DAA) of bilateral humerus to determine the CORA and the varus deformity angle. A lateral closed neutral wedge osteotomy was performed around the CORA to correct the varus deformity. All children were immobilized with elbow plaster cast after operation. Elbow flexion and extension function, postoperative scar, and body surface carrying angle were recorded. The carrying angle and Baumann angle were also measured on elbow X-ray films. Elbow function was evaluated according to the modified Flynn elbow score at 24 months after operation.Results:All patients were followed up for 24 to 36 months (mean, 29.3 months). Elbow hyperextension was close to normal in 18 cases, and 5° hyperextension existed in 2 cases. The flexion was greater than 130°, averaging 133.1° (from 130° to 138°), in 15 patients. The flexion ranged from 110° to 130° in 5 patients. The Baumann angle was 99.0°±1.0° preoperatively and 76.0°±1.0° postoperatively; the carrying angle was -14.0°±1.0° preoperatively and 13.6°±1.0° postoperatively. There were significant differences between the above items between preoperation and postoperation ( P<0.05). According to the modified Flynn elbow score at 24 months after operation, the elbow function was excellent in 16 and good in 4 cases. The varus of 40° was corrected during surgery in one child. Fixation failure or correction failure occurred in none of the children before removal of the plaster or the Kirschner wire. Conclusions:In neutral wedge osteotomy assisted by determination of the CORA at the distal humerus anatomical axis, the CORA and angulation of the distal humerus inversion can be accurately determined so that the osteotomy line and the angulation correction axis can pass through the CORA to restore the humerus alignment with no displacement of the broken ends.

The incidence and risk factors of preoperative deep vein thrombosis in non-fracure patients awaiting for total joint arthroplasty / 中华骨科杂志

Objective:To explore the incidence and risk factors of preoperative deep vein thrombosis (DVT) of elective total joint arthroplasty (TJA).Methods:Data of 500 patients before TJA from March 2015 to August 2016 who underwent ultrasound surveillance were retrospectively analyzed. All patients were divided into DVT group and non-DVT group according to results of ultrasound. Parameters including demographic data, basic medical history, and surgical information and laboratory indexes were collected. Risk factors were assessed via univariate, multivariate and logistic regression analysis.Results:Preoperative DVT was detected in 23 cases (4.6%, 23/500), all of which occurred in the intermuscular vein with no symptom, and among them there were 16 cases (5.6%, 16/285) before total knee arthroplasty and 7 cases (3.3%, 7/215) before total hip arthroplasty. Univariate analysis showed that age ( t=2.266, P=0.024), female patients ( χ2=4.028, P=0.045), history of hypertension ( χ2=7.907, P=0.005), D-dimer ≥0.5 μg/ml ( χ2=13.171, P < 0.001) were significantly higher than those in non-DVT group, and the differences were statistically significant. Multivariate analysis showed that D-dimer ≥0.5 μg/ml [ OR=6.655, 95% CI (1.929, 22.960), P=0.003] and history of hypertension [ OR=2.715, 95% CI (1.017, 7.250), P=0.046] were independent risk factors for preoperative DVT. Among them, the thrombus of 14 cases located in the operation side, 6 cases in non-operation side, and 3 cases in bilateral sides. Postoperative ultrasound showed that newly DVT occurred in 9 patients of whom 5 cases located in the contralateral muscular veins and 4 cases in the nearby muscular veins. After discharge, 22 patients (95.7%) with preoperative DVT were further evaluated by ultrasound. The average follow-up time was 3.0 months (range from 6 weeks to 9 months). The results showed that thrombus of 7 cases were completely dissolved, 13 cases were partially dissolved, and 2 cases remained unchanged. Thrombus extensions to proximal veins or symptomatic PE were not found. Conclusion:The incidence of preoperative DVT in patients with elective joint replacement was about 4.6%, among which D-dimer ≥0.5 μg/ml and history of hypertension were the risk factors for preoperative thrombosis.

[Helical dual-phase CT scan in evaluating blood supply of primary heptocellular carcinoma after transcatheter hepatic artery chemoembolization with lipiodol].

OBJECTIVE: To evaluate the blood supply of low density viable area of primary heptocellular carcinoma after transcatheter hepatic artery chemoembolization using lipiodol (LP-TACE), by helical dual-phase CT scanning and three dimensional CT (3DCT). METHODS: Thirty-four patients with primary heptocellular carcinoma after LP-TACE were examined by hepatic helical dual-phase CT. 3DCT model of the maximum intensity projection (MIP), surface shaded display (SSD) reconstruction of the hepatic artery and portal vein were simultaneously done in 5 cases. RESULTS: Viable tumor areas of 34 cases of primary heptocellular carcinoma after LP-TACE were divided into four types: peripheral, lateral, central and diffused types. Enhanced tumor vessel or tissue in viable tumor area was found during hepatic dual-phase in 17 cases, during hepatic artery-phase only in 8 and hepatic portal vein-phase only in 3. The viable tumor areas were found to have blood supply from the hepatic vein in 2 cases. The viable tumor area unenhanced during hepatic dual-phase was found in 6 cases. In 5 cases, the relation between the viable tumor area and branches of hepatic artery and portal vein was showed by MIP and SSD of hepatic artery and portal vein. CONCLUSION: Hepatic helical dual-phase CT scan with 3DCT is effective in evaluating the blood supply of viable tumor areas and the therapeutic effect of primary heptocellular carcinoma after LP-TACE.

[The value of three-phase pulmonary helical CT in diagnosing peripheral pulmonary cancer (diameter

OBJECTIVE: To evaluate the value of three-phase pulmonary helical CT in diagnosing peripheral pulmonary cancer (diameter

Effect of endostatin overexpression on angiotensin II-induced cardiac hypertrophy in rats / 中华医学杂志(英文版)

Background@#Endostatin, a biologically active fragment of collagen XVIII, has been observed in patients with ischemic heart disease. The aim of the present study was to investigate whether endostatin overexpression could attenuate cardiac hypertrophy by inhibiting the cyclic adenosine monophosphate-protein kinase A (cAMP-PKA) signaling pathway.@*Methods@#This study was examined in vivo in rats and in vitro in primary neonatal rat cardiomyocytes treated with angiotensin (Ang) II to model cardiac hypertrophy. Twenty-four male Sprague-Dawley rats were randomized into adenovirus (Ad)-green fluorescent protein, Ang II, Ad-endostatin, and Ang II + Ad-endostatin groups (n = 6 in each group). Four weeks later, all the rats were weighed and sacrificed after transthoracic echocardiography. Cardiac function was evaluated by transthoracic echocardiography, cardiomyocyte size was evaluated by hematoxylin-eosin staining. Levels of atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) were evaluated by quantitative reverse-transcription polymerase chain reaction or Western blotting, PKA level was evaluated by Western blotting, and cAMP level was evaluated by enzyme-linked immunosorbent assay. Statistical significance among multiple groups was evaluated by one-way analysis of variance.@*Results@#Endostatin overexpression reduced the increases in left ventricle (LV) mass (P = 0.0063), LV mass/body weight (BW) (P = 0.0013), interventricular septal thickness (IVS) in diastole (P = 0.0013), IVS in systole (P = 0.0056), left ventricular posterior wall thickness (LVPW) in diastole (P = 0.0291), LVPW in systole (P = 0.0080), heart weight (HW) (P = 0.0138), HW/BW (P = 0.0001), and HW/tibial length (P = 0.0372) in Ang II-treated rats. In addition, endostatin overexpression reduced cardiomyocyte cross-sectional area expansion, and reduced the levels of ANP and BNP in Ang II-treated rats (P = 0.0251 and 0.0477 for messenger RNA [mRNA]), and primary neonatal rat cardiomyocytes (P = 0.0188 and P = 0.0024 for mRNA; P = 0.0023 and 0.0013 for protein, respectively). Additionally, endostatin overexpression reduced the increase of cAMP (P = 0.0054) and PKA (P = 0.0328) levels in cardiomyocytes treated with Ang II. Treatment with cAMP reversed the effects of endostatin overexpression on ANP (P = 0.0263) and BNP (P = 0.0322) levels in cardiomyocytes induced by Ang II.@*Conclusion@#Endostatin overexpression could alleviate cardiac hypertrophy by inhibiting the cAMP-PKA signaling pathway.

Effect of endostatin overexpression on angiotensin II-induced cardiac hypertrophy in rats / 中华医学杂志(英文版)

BACKGROUND@#Endostatin, a biologically active fragment of collagen XVIII, has been observed in patients with ischemic heart disease. The aim of the present study was to investigate whether endostatin overexpression could attenuate cardiac hypertrophy by inhibiting the cyclic adenosine monophosphate-protein kinase A (cAMP-PKA) signaling pathway.@*METHODS@#This study was examined in vivo in rats and in vitro in primary neonatal rat cardiomyocytes treated with angiotensin (Ang) II to model cardiac hypertrophy. Twenty-four male Sprague-Dawley rats were randomized into adenovirus (Ad)-green fluorescent protein, Ang II, Ad-endostatin, and Ang II + Ad-endostatin groups (n = 6 in each group). Four weeks later, all the rats were weighed and sacrificed after transthoracic echocardiography. Cardiac function was evaluated by transthoracic echocardiography, cardiomyocyte size was evaluated by hematoxylin-eosin staining. Levels of atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) were evaluated by quantitative reverse-transcription polymerase chain reaction or Western blotting, PKA level was evaluated by Western blotting, and cAMP level was evaluated by enzyme-linked immunosorbent assay. Statistical significance among multiple groups was evaluated by one-way analysis of variance.@*RESULTS@#Endostatin overexpression reduced the increases in left ventricle (LV) mass (P = 0.0063), LV mass/body weight (BW) (P = 0.0013), interventricular septal thickness (IVS) in diastole (P = 0.0013), IVS in systole (P = 0.0056), left ventricular posterior wall thickness (LVPW) in diastole (P = 0.0291), LVPW in systole (P = 0.0080), heart weight (HW) (P = 0.0138), HW/BW (P = 0.0001), and HW/tibial length (P = 0.0372) in Ang II-treated rats. In addition, endostatin overexpression reduced cardiomyocyte cross-sectional area expansion, and reduced the levels of ANP and BNP in Ang II-treated rats (P = 0.0251 and 0.0477 for messenger RNA [mRNA]), and primary neonatal rat cardiomyocytes (P = 0.0188 and P = 0.0024 for mRNA; P = 0.0023 and 0.0013 for protein, respectively). Additionally, endostatin overexpression reduced the increase of cAMP (P = 0.0054) and PKA (P = 0.0328) levels in cardiomyocytes treated with Ang II. Treatment with cAMP reversed the effects of endostatin overexpression on ANP (P = 0.0263) and BNP (P = 0.0322) levels in cardiomyocytes induced by Ang II.@*CONCLUSION@#Endostatin overexpression could alleviate cardiac hypertrophy by inhibiting the cAMP-PKA signaling pathway.

Research progress in the molecular epidemiology of gastric cancer / 中国肿瘤临床

Gastric cancer is a malignant tumor characterized by high morbidity and mortality. With the development of molecular biol-ogy technology and the emergence of various new omics detection techniques in recent years, molecular epidemiologists of gastric cancer have conducted extensive studies on the genetic and host factors, as well as gene-environment interactions associated with ex-posure to environmental factors in gastric cancer. In addition, epidemiologists have studied the evolution of precancerous gastric le-sions, the development of gastric cancer, and explored relevant biomarkers to provide major evidence for the prevention and control of gastric cancer. This review summarizes the latest advances in the molecular epidemiology of gastric cancer, including existing evi-dence in studies for candidate-approach-based serum/plasma biomarkers, genome-wide association, whole-exome sequencing, tissue microarrays, as well as studies on metabolomics and microbiomes. We expect to provide insights into the future of molecular epidemi-ology studies in gastric cancer, promoting etiologic research, and the precise prevention and control of gastric cancer.

Research Progress of Angiogenesis in Atherosclerotic Plaque in Chinese Medicine and Western Medicine / 中国结合医学杂志

Angiogenesis in atherosclerotic plaque plays a critical role in the mechanism of atherosclerotic physiopathology. Present consensus shows that angiogenesis in atherosclerotic plaque is mainly resulted in hypoxia, inflammation and some pro-angiogenic factors. The homeostasis in plaque, which is hypoxic and infiltrated by inflammatory cells, may lead to angiogenesis, increase the plaque instability and the incidence rate of vascular events. This article reviews the progression of pathogenetic mechanism, physiopathological significance, relevant detecting technique and corresponding therapeutic methods of Chinese and Western medicine of angiogenesis in atherosclerotic plaque, so as to provide more theoretical basis for atherosclerotic clinical treatment.

A Clinical Experience of Laparoscopic Nephrectomy in Primary Hospital / 昆明医科大学学报

Objective To investigate the clinical value and the experience of retroperitoneal laparoscopic nephrectomy in primary hospitals. Methods A retrospective analysis of 20 cases of retroperitoneal nephrectomy performed in the people's hospital of Jianshui from July 2014 to December 2017 and 23 cases of open nephrectomy in the same period as the control group, the two groups of surgery and postoperative recovery were analyzed and compared. Results The two groups of patients were operated successfully. The surgery time of the laparoscopic group was (110.14 ±15.63) min and the control group was (100.33 ±10.58) min. There was no statistical difference between the two groups (P＞0.05). No complications occurred during the follow-up period between the two groups, and the difference was not statistically significant. The intraoperative blood loss in the two groups was (40.63 ±22.21) ml and (80.45 ±38.31) m L respectively, and the difference was statistically significant (P＜ 0.05).The indwelling time of drainage tube in the two groups was (2-3) days and (6-7) days respectively. The difference was statistically significant (P＜ 0.05), and the hospitalization time was (3.2 ±2.2) days and (6.4 ± 3.3) days respectively, the difference was statistically significant (P＜0.05). Conclusions Laparoscopic nephrectomy has the advantages of less trauma, faster recovery and shorter hospital stay. With the improvement of operation technique, it will bring more advantages and be worth popularizing.

The feasibility of management with acute proximal deep vein thrombosis without insertion of inferior vena cava filter before hip arthroplasty / 中华骨科杂志

Objective To evaluate the feasibility of anticoagulant therapy for acute proximal deep vein thrombosis without inferior vena cava filter placement for femoral neck patients before hip arthroplasty.Methods From January 2013 to August 2017,9 femoral neck fractures patients with acute proximal deep vein thrombosis before hip arthroplasty were enrolled into this study.There were 3 men and 6 women.The average age was 76.44±5.39 years old (range,69 to 83 years old).The average injured time before admission was 4.00±4.06 days.All patients received anticoagulant therapy without placement of inferior vena cava filter before hip arthroplasty.Four patients received Rivaroxaban 10mg,two times per day,while two patients received Enoxaparin 0.4 ml,two times per day;3 cases received Batroxobin 0.5 ml,every other day combined with Rivaroxaban 10 mg one time per day or Enoxaparin 0.4 ml,one time per day.The size of thrombus before and after treatment,changes of coagulation markers,the outcome of thrombosis before surgery,during surgery,postoperatively and during follow-up,the related complications were recorded.Results The diagnosis time for proximal DVT was 3.89±3.01 days after admission.8 patients showed proximal DVT combined with distal thrombus and 1 patient showed isolated proximal DVT.The average length of proximal thrombus was 10.78±6.10 cm (range,4.0-20.0 cm).The mean duration of treatment was 14.22±7.03 days.The results showed 5 proximal DVTs have complete disappeared,3 cases significantly improved,and 1 case had no change but showed stable.After treatment,the length of the proximal thrombus was significantly decreased (10.77±6.10 cm vs.4.39±6.50 cm),there were statistically significant between two groups (t=3.429,P=0.009);D-dimer was significantly lower after treatment (10.47±4.87 μg/ml vs.2.59± 1.60 μg/ml) with statistical difference (t=4.970,P=O.O01).However,no statistical significance was found in other coagulation parameters such as plasma prothrombin time,the international normalized ratio,activated partial thromboplastin time,thrombin time,fibrinogen.Incision exudate occurred in one patient and anticoagulant therapy was paused,however,two days later,DVT recurred and then the patient received continuous therapy with drug anticoagulation.The average time for postoperative follow-up was 8.3±7.6 months.At the latest follow-up,4 cases had thoroughly recovered with the thrombi fully resolved;4 cases had significantly improved including three thrombi partly locating in the muscular veins and one partly locating in the infra-popliteal vein.One case became more severe after discharge and received continuous anticoagulant therapy.No death,symptomatic pulmonary embolism,bleeding and other adverse events occurred.Conclusion Inferior vena cava filter placement for femoral neck fracture patients with acute proximal venous thrombosis before hip arthroplasty may not be potent.Anticoagulant therapy which make the proximal thrombus completely dissolved or stabilized before surgery may be effective.

Treatment strategies and therapeutic effects in treatment of floating knee in children / 中华创伤杂志

Objective To investigate the treatment strategies and clinical effects in treatment of floating knee in children.Methods A retrospective case series study was made on 26 cases of floating knee treated from July 2005 to June 2015.There were 22 males and four females, aged from 2-14 years (mean, 7.6 years).According to the Letts classification of the floating knee, ten cases were with type A, four with type B, two with type C, eight with type D, and two with type E.Closed fractures were noted in 16 cases and open fractures in 10 cases.According to the Gustilo classification of open fractures, one was with type ⅢA, six with type ⅢB, and three with type ⅢC.One case was amputated from the distal of the femur, eight cases were treated by traction and plaster caster, and 17 cases were treated by reduction and fixation of both femoral and tibil fractures.Wound healing, fracture union, Karsstrom criteria for functional outcome and complications were detected.Results All patients were followed up for mean 2.8 years (range, 1-6 years).One case of Gustilo type ⅢA and six cases of Gustilo type ⅢB open fractures had wound healing after one-stage debridement.Two cases of Gustilo type ⅢC showed wound healing after second-stage skin grafting.One case of Gustilo type ⅢC had amputation wound infection and was cured after a second debridement and dress change.Two had delayed union and there was no nonunion.According to the Karlstrom criteria, the excellent and good rate of functional outcome was 25% and 83% respectively in nonoperative and operative population (P<0.05).Malunion was found in four cases, genu vagum in three and overgrowth of 10-20 mm in seven.There was no premature closure of epiphysis.Conclusion Femur and tibia immobilization of floating knee in children is effective for bone union and functional recovery.

A Practical Method for Acetabulum Component Assembling in Total Hip Arthroplasty with Lateral Position / 中国运动医学杂志

Objective To get a controllable acetabulum component inclination angle during the total hip arthroplasty(THA) with the lateral position,a new method using a self-made instrument was introduced.Methods Totally 80 consecutive patients undergoing THA at the lateral position were enrolled.Forty acetabular components were assembled using a new method with a self-made instrument referring to the 42 degrees' angle drawn on the wall(group A),while another 40 acetabular cups were implanted free-handedly(group B).The postoperative inclination angle was evaluated on the anterior-posterior pelvic radiographs.Results The average inclination angle was 43.3° ± 3.7°(34.7°～49.1°) in group A and 40.3 ± 4.5o(32.8°～50.7°) in group B.Moreover,40/40 of group A and 38/40 of group B were in the Lewinnek's inclination safe zone(P＞0.05),without significant differences between the two groups.Conclusion It is practical and reliable to decide the acetabular component orientation using the lateral position instrument and reference angle on the wall.

Seasonal variations in the incidence of deep vein thrombosis following total knee or hip arthroplasty / 中华骨科杂志

Objective To explore the difference in the incidence of deep vein thrombosis (DVT) following total knee arthroplasty (TKA) or total hip arthroplasty (THA) between different seasons.Methods The present retrospective study examined 2 363 patients undergoing TKA or THA from August 2008 to February 2016.There were 653 male and 1 710 female with the average age of 64.44±13.03 years old (17-91 years old),including 954 patients in TKA and 1 409 in THA.All of the patients received anticoagulant drugs and were compressed with a pressure pump starting on the first postoperative night.Routine venography of the bilateral lower limbs was performed at 3-5 days after the operation.The incidence of DVT in different seasons and different age groups (≥65 years old and ＜65 years old) were counted.Results The present study suggested that the probabilities of DVT after arthroplasty in spring,summer,fall and winter were 15.85％ (116/732),14.92％ (71/476),17.88％ (108/604),22.50％ (124/551) respectively with significantly difference (P＜0.05).The incidence of DVT in winter was higher than that in spring and summer (P＜ 0.017).The probabilities of DVT after TKA in spring,summer,fall and winter were 19.09％ (59/309),15.67％ (37/236),18.11％ (44/243),27.71％ (46/166) respectively with significantly difference (P＜0.05).The incidence of DVT in winter was higher than that in summer (P＜0.017).The probabilities of DVT after THA in spring,summer,fall and winter were 13.48％ (57/423),14.17％ (34/240),17.73％ (64/361),20.26％ (78/385) respectively with significantly difference (P＜0.05),and that in winter was higher than in spring (P＜0.017).The symptomatic DVT after arthroplasty in spring,summer,fall and winter were 3.55％ (26/732),3.78％ (18/476),4.97％ (30/604),6.90％ (38/551) with significantly difference in different seasons (P＜0.05),and that in winter was higher than in spring (P＜0.017).The symptomatic DVT after TKA in spring,summer,fall and winter were 3.88％ (12/309),4.24％ (10/236),4.94％ (12/243),9.64％ (16/166) with significantly difference in different seasons (P＜0.05).The symptomatic DVT in winter was higher than that in spring (P＜0.017).The symptomatic DVT after THA in spring,summer,fall and winter were 3.31％ (14/423),3.33％ (8/240),4.99％ (18/361),5.71％ (22/385) respectively (P＞0.05).The probability of DVT following arthroplasty in older patients (age≥65 years old) in spring,summer,fall and winter were 18.49％ (76/411),16.61％ (45/271),22.07％ (81/367),28.05％ (99/353) with significantly difference among the groups (P＜0.05),while symptomatic DVT in older patients (≥65 years old) in spring,summer,fall and winter were 4.38％ (18/411),4.43％ (12/271),5.72％ (21/367),8.78％ (31/353) respectively with significantly difference (P＜0.05).The probability of DVT in four seasons were 12.46％ (40/321),12.68％ (26/205),11.39％ (27/237),12.63％ (25/198) in younger patients (＜65 years old).However,the difference was not detected among different seasons (P＞0.05).The probability of symptomatic DVT in four seasons were 2.49％ (8/321),2.93％ (6/205),3.80％ (9/237),3.54％ (7/198) in younger patients (＜65 years old) without significant difference (P＞0.05).Conclusion Seasonal variations could place an important effect on the incidence of DVT following TKA or THA,especially for the old patients with age ≥65 years.