Total Hip Arthroplasty with Robotic Arm Assistance for Precise Cup Positioning: A Case-Control Study.

OBJECTIVE: To determine whether more precise cup positioning can be achieved with robot-assisted total hip arthroplasty (THA) as compared to conventional THA. METHODS: In this study, between July 2019 and May 2021, 93 patients aged 23-75 years with osteonecrosis of the femoral head (ONFH) and adult developmental dysplasia of hip who underwent first hip surgery were included in the study. They were randomly assigned to either the robotic-assisted THA group (n = 45) or the conventional THA group (n = 48). After the operation, all patients were given routine rapid rehabilitation guidance. The duration of operation was recorded to estimate the learning curve through cumulative summation analysis. We compared the demographics, duration of operation, cup positioning, leg length discrepancy, hip offset, and Harris Hip Score between robot-assisted THA and manual THA. Precision in the positioning of the acetabular prosthesis using the MAKO system was also compared between the two groups. RESULTS: The mean duration of operation for the robot-assisted THA group was 91.37 ± 17.34 min (range: 63 to 135 min), which was significantly higher than that for the conventional THA group. When the number of procedures was increased to 13, the duration of operation in the robot-assisted group decreased significantly and gradually became stable. In terms of duration of operation, robot-assisted THA was associated with a learning curve of 13 cases. The mean amount of bleeding in the robot-assisted THA group was not significantly different from that in conventional THA group (328 ± 210 ml vs 315 ± 205 ml) (p = 0.741). There was no significant difference in the proportion of prostheses located within Lewinnek's safe zone between robot-assisted THA group and conventional THA group (69.81% vs 64.41%). The leg length discrepancy (LLD) was significantly smaller in the robot-assisted THA group than in the conventional THA group (p < 0.001), but both were within acceptable limits (10 mm). The inclination and anteversion angles of the acetabular prosthesis planned before operations were correlated with the actual measurement (r = 0.857 p < 0.001, r = 0.830, p < 0.001). After surgery, none of the patients experienced hip dislocation, aseptic loosening, or periprosthetic infection during the 3 months of follow-up. CONCLUSION: The proportion of acetabular prostheses in the Lewinnek's safety zone was higher and the extent of LLD was significantly lower in the robot-assisted THA group, as compared to the same metrics in the conventional THA group. The MAKO robot improved the accuracy of implant placement in THA.

Long non-coding RNA highly up-regulated in liver cancer promotes exosome secretion.

BACKGROUND: Highly upregulated in liver cancer (HULC) is a long non-coding RNA (lncRNA) which has recently been identified as a key regulator in hepatocellular carcinoma (HCC) progression. However, its role in the secretion of exosomes from HCC cells remains unknown. AIM: To explore the mechanism by which HULC promotes the secretion of exosomes from HCC cells. METHODS: Serum and liver tissue samples were collected from 30 patients with HCC who had not received chemotherapy, radiotherapy, or immunotherapy before surgery. HULC expression in serum exosomes and liver cancer tissues of patients was measured, and compared with the data obtained from healthy controls and tumor adjacent tissues. The effect of HULC upregulation in HCC cell lines and the relationship between HULC and other RNAs were studied using qPCR and dual-luciferase reporter assays. Nanoparticle tracking analysis was performed to detect the quantity of exosomes. RESULTS: HULC expression in serum exosomes of patients with HCC was higher than that in serum exosomes of healthy controls, and HULC levels were higher in liver cancer tissues than in tumor adjacent tissues. The expression of HULC in serum exosomes and liver cancer tissues correlated with the tumor-node-metastasis (TNM) classification, and HULC expression in tissues correlated with that in serum exosomes. Upregulation of HULC promoted HCC cell growth and invasion and repressed apoptosis. Notably, it also facilitated the secretion of exosomes from HCC cells. Moreover, qPCR assays showed that HULC repressed microRNA-372-3p (miR-372-3p) expression. We also identified Rab11a as a downstream target of miR-372-3p. Dual-luciferase reporter assays suggested that miR-372-3p could directly bind both HULC and Rab11a. CONCLUSION: Our findings illustrate the importance of the HULC/miR-372-3p/Rab11a axis in HCC and provide new insights into the molecular mechanism regulating the secretion of exosomes from HCC cells.

[Application of self-made fine-tuning device in distal locking process of femoral interlocking intramedullary nail].

OBJECTIVE: To evaluate the curative efficacy of self-made fine-tuning setting in the process of femoral distal implantation of intramedullary nail. METHODS: From October 2015 to October 2017, 66 cases of femoral shaft fracture were treated with anterograde interlocking intramedullary nail including 45 males and 21 females with a mean age of(37.21±11.18) years old. Among them, 36 cases were treated with the manufacture's aiming device and self-made fine-tuning setting (research group), other 30 cases were treated with the manufacture's aiming device(control group). The mean operation time, the times of C-arm scan in surgery, the post-operation complications and the fracture union were observed and compared in two groups. RESULTS: Sixty-two cases acquired 8 to 15 months with a mean time of 12.4 months follow-up visit. The post-operation complications and the fracture union between the two groups had no significant difference(P>0.05), the mean operation time and the times of C-arm scan in surgery had statistically significant difference(P<0.05). CONCLUSIONS: Self-made fine-tuning setting in the process of femoral interblocking intramedullary nail could shorten operation time and reduce the the times of C-arm scan.

Human Babesiosis Caused by a Babesia crassa-Like Pathogen: A Case Series.

Background: Human babesiosis is an emerging health problem in China. Methods: Babesia were identified in ticks, sheep, and humans in northeastern China using polymerase chain reaction (PCR) followed by genetic sequencing. We enrolled residents who experienced a viral-like illness after recent tick bite or were healthy residents. We defined a case using the definition for babesiosis developed by the US Centers for Disease Control and Prevention. Results: A Babesia crassa-like agent was identified in Ixodes persulcatus and Haemaphysalis concinna ticks using PCR followed by sequencing. The agent was characterized through phylogenetic analyses of the 18S rRNA gene, the ß-tubulin gene, and the internal transcribed spacer region. We tested sheep as a possible reservoir and found that 1.1% were infected with the B. crassa-like agent. We screened 1125 human participants following tick bites using B. crassa-specific PCR and identified 31 confirmed and 27 suspected cases. All the patients were previously healthy except for 1 with an ovarian tumor. Headache (74%), nausea or vomiting (52%), and fever (48%) were the most common clinical manifestations of confirmed cases. Six of 10 cases remained PCR positive for B. crassa-like infection 9 months after initial diagnosis. Asymptomatic infections were detected in 7.5% of 160 local residents. Conclusions: We identified B. crassa-like infection in people in northeastern China that caused mild to moderate symptoms. The possibility of more severe disease in immunocompromised patients and of transmission through the blood supply due to asymptomatic infections justifies further investigation of this reported infection.

Ontogeny reversal and phylogenetic analysis of Turritopsis sp.5 (Cnidaria, Hydrozoa, Oceaniidae), a possible new species endemic to Xiamen, China.

Ontogeny reversal, as seen in some cnidarians, is an unprecedented phenomenon in the animal kingdom involving reversal of the ordinary life cycle. Three species of Turritopsis have been shown to be capable of inverted metamorphosis, a process in which the pelagic medusa transforms back into a juvenile benthic polyp stage when faced with adverse conditions. Turritopsis sp.5 is a species of Turritopsis collected from Xiamen, China which presents a similar ability, being able to reverse its life cycle if injured by mechanical stress. Phylogenetic analysis based on both 16S rDNA and cytochrome c oxidase subunit I (COI) genetic barcodes shows that Turritopsis sp.5 is phylogenetically clustered in a clade separate from other species of Turritopsis. The genetic distance between T. sp.5 and the Japanese species T. sp.2 is the shortest, when measured by the Kimura 2-Parameter metric, and the distance to the New Zealand species T. rubra is the largest. An experimental assay on the induction of reverse development in this species was initiated by cutting medusae into upper and lower parts. We show, for the first time, that the two dissected parts have significantly different potentials to transform into polyps. Also, a series of morphological changes of the reversed life cycle can be recognised, including medusa stage, contraction stage I, contraction stage II, cyst, cyst with stolons, and polyp. The discovery of species capable of reverse ontogeny caused by unfavorable conditions adds to the available systems with which to study the cell types that contribute to the developmental reversal and the molecular mechanisms of the directional determination of ontogeny.

A MOUSE MODEL OF MAMMARY HYPERPLASIA INDUCED BY ORAL HORMONE ADMINISTRATION.

BACKGROUND: Mammary hyperplasia is one of the most common benign breast disorders. Although traditional Chinese medicine has a vast experience in the treatment of mammary hyperplasia, it is not accepted widely due to its unclear mechanism. METHODS AND MATERIALS: To address the mechanism, we developed a mouse model of mammary hyperplasia. We gave mice estradiol valerate tablets and progesterone capsules sequentially for one month by intragastric administration. RESULTS: Mice treated by this method had a series of pathological changes which are similar to those detected in women with mammary hyperplasia, including ectopic level of estradiol and progesterone in serum, hyperplasia of mammary glands and increased expression of ERα and PR. CONCLUSION: This model will facilitate the mechanical study of traditional medicine on mammary hyperplasia.

Enhancing immune responses to inactivated porcine parvovirus oil emulsion vaccine by co-inoculating porcine transfer factor in mice.

Inactivated porcine parvovirus (PPV) vaccines are available commercially and widely used in the breeding herds. However, inactivated PPV vaccines have deficiencies in induction of specific cellular immune response. Transfer factor (TF) is a material that obtained from the leukocytes, and is a novel immune-stimulatory reagent that as a modulator of the immune system. In this study, the immunogenicity of PPV oil emulsion vaccine and the immuno-regulatory activities of TF were investigated. The inactivated PPV oil emulsion vaccines with or without TF were inoculated into BALB/c mice by subcutaneous injection. Then humoral and cellular immune responses were evaluated by indirect enzyme-linked immunosorbent assays (ELISA), fluorescence-activated cell sorter analyses (FACS). The results showed that the PPV specific immune responses could be evoked in mice by inoculating with PPV oil emulsion vaccine alone or by co-inoculation with TF. The cellular immune response levels in the co-inoculation groups were higher than those groups receiving the PPV oil emulsion vaccine alone, with the phenomena of higher level of IFN-γ, a little IL-6 and a trace of IL-4 in serum, and a vigorous T-cell response. However, there was no significant difference in antibody titers between TF synergy inactivated vaccine and the inactivated vaccine group (P>0.05). In conclusion, these results suggest that TF possess better cellular immune-enhancing capability and would be exploited into an effective immune-adjuvant for inactivated vaccines.

[Morphological features of the fimbria of the fallopian tube in pelvic serous adenocarcinoma].

OBJECTIVE: To study the serous lesions of the fimbria of the fallopian tube in patients with pelvic serous adenocarcinoma and investigate its significance in the serous carcinogenesis. METHODS: To observe the morphological features of the fimbria of the fallopian tube in 43 cases of pelvic serous adenocarcinoma (31 cases of ovarian carcinoma and 12 cases of peritoneal carcinoma). Immunohistochemical examination of p53 expression was performed on samples of 69 fallopian tubes of 40 cases. RESULTS: Fimbria carcinoma was identified in 44 tubes in 31 of 43 cases. Fourteen of the carcinoma foci were ≤ 5 mm. In 68.3% of the fimbria carcinomas demonstrated involvement of the mucosa. Twenty eight tubes of 20 cases exhibited intraepithelial carcinoma. Twenty three of 44 tubes of the fibria carcinomas showed fimbria adherence and unclear appearance. The early histological changes of the fimbria epithelium included proliferation of local secretory cells, homogeneity, and straightening of the mucous folds. Clusters of tumor epithelial cells or single gland with atypical features floated between mucosal folds were found in 71.4% of the fimbria with intraepithelial carcinoma. The positive expression rate of p53 in the fimbria carcinomas and the fimbria intraepithelial carcinomas were 86.4% and 60.7%, respectively. CONCLUSIONS: Fimbria carcinomas is an important component in pelvic serous adenocarcinomas. The fimbria intraepithelial carcinoma is also very common among the cases of pelvic serous adenocarcinoma. The fimbria may be an important primary site of pelvic serous adenocarcinomas.

[Atypical endometriosis: a clinicopathologic study of 163 cases].

OBJECTIVE: To investigate the clinicopathologic features of atypical endometriosis (AEM) and to discuss the relationship between AEM and tumors. METHODS: A retrospective analysis was performed of 163 cases of AEM, which were retrieved from the Department of Pathology files at the Tianjin Central Obstetrics and Gynecology Hospital between Jan 2004 and Dec 2006. The pathologic changes of AEM including its glandular epithelium, stroma, background and the conditions coexisting with tumor were observed. RESULTS: The AEM accounted for 4.38% (163/3724) of the endometriosis (EM) cases. Of 172 AEM foci of 163 patients, 168 were in the ovary, and the other 4 were in the fallopian tube, cervix and uterine serosa respectively. The rate of ovarian AEM was 6.81% of endometriosis. AEM associated with tumour was found in 26 cases (15.95%) and among 27 of ovarian AEM, 15 were malignant, 9 borderline and 3 benign. The AEM epithelia were mainly arranged in the form of surface epithelium. They present with characteristic features of moderate to marked pleomorphism, epithelial tufting and bud structures by microscopy. The walls of AEM cyst were presented with three layers of epithelium, endometrioid stroma and fibrosis-collagen. The endometrioid stroma were usually thin in contrast to the fibro-collagen tissue, which was often thick with scarred background. The transformation from AEM to tumor was found in most of the malignant tumors (14/15, 93%). CONCLUSIONS: AEM lesions hold some features of both EM and tumor, which may have a relatively higher potential for tumorigenesis and canceration. The process of damage and repair in EM foci during a long course may play a role in the development of EM into AEM and finally into tumor.