Repetitive transcranial magnetic stimulation for lower limb dysfunction post stroke: a scoping review / 中国康复理论与实践

ObjectiveTo summarize and analyze the protocols of repetitive transcranial magnetic stimulation (rTMS) in the treatment of post-stroke lower limb dysfunction. MethodsLiterature about rTMS for lower limb dysfunction of patients post stroke were retrieved from Web of Science, PubMed, CNKI, and Wanfang Data from inception to August 17, 2022. The quality of the literature was evaluated with Physiotherapy Evidence Database (PEDro) scale. Literature quality, data extraction and scoping review were performed by two researchers. ResultsA total of 21 studies were included, in which 20 studies suggested that rTMS treatment could promote the recovery of lower limb motor function after stroke. One study showed negative result. rTMS interventions were reported safe, with no serious adverse reactions. There were great heterogeneity in the demographic and clinical information, study protocols, stimulation parameters, coil types, targets of stimulation, and motor-evoked potential measurement in the included studies. ConclusionThe future protocols of rTMS need to be combined with stroke stage and severity of injury. There is a demand for more real vs. sham rTMS studies, reporting similar designs with sufficient information, to achieve a significant level of evidence regarding the use of rTMS in post-stroke patients.

Improvement of China's legal system for public health emergency management from the perspective of lifecycle management / 中华流行病学杂志

A crucial lesson gained through the pandemic preparedness and response to COVID-19 is that all measures for epidemic control must be law-based. The legal system is related not only to public health emergency management per se but also to all aspects of the institutional supporting system throughout the lifecycle. Based on the lifecycle emergency management model, this article analyses the problems of the current legal system and the potential solutions. It is suggested that the lifecycle emergency management model shall be followed to establish a more comprehensive public health legal system and to gather the intelligence and consensus of experts with different expertise, including epidemiologists, sociologists, economists, jurist and others, which will collaboratively promote the science-based legislation in the field of epidemic preparedness and response for the establishment of a comprehensive legal system for public health emergency management and with Chinese characteristics.

Early clinical application of Mako robot-assisted total knee arthroplasty in knee osteoarthritis / 中国骨伤

OBJECTIVE@#To investigate the early efficacy of Mako robot-assisted total knee arthroplasty (TKA) in the treatment of knee osteoarthritis (KOA) and summarize the initial application experience.@*METHODS@#Retrospective analysis of 73 patients with KOA treated with Mako robot-assisted TKA from June 2021 to December 2021. There were 16 males and 57 females, aged from 54 to 81 years old with an average of (67.8±6.6) years old. The hip knee and ankle angle (HKA), lateral distal femoral angle (LDFA), medial proximal tibial angle (MPTA), lateral femoral component angle (LFCA) and lateral tibial component angle (LTCA) were recorded and analyzed. WOMAC score and KSS were used to compare the functional recovery of patients preoperatively, 3 and 6 months postoperatively.@*RESULTS@#All the 73 patients were successfully treated without serious complications such as vascular and nerve injury, and all the incisions healed well at stageⅠwithout infection. The patients were followed up from 4 to 11 months with an average of (7.0±2.7) months, and the satisfaction rate of the last follow-up was 90.41% (66/73). WOMAC scores were (23.1±5.4) at 3 months and (14.8±4.1) at 6 months postoperatively. KSS clinical scores were ( 76.1±4.0) at 3 months and (82.1±3.7) at 6 months postoperatively;KSS functional scores were (74.3±3.1) at 3 months and (78.6±2.1) at 6 months after operation. Postoperative imaging showed good position of the prosthesis, HKA angle was (178.5±2.1)°, LDFA was (91.2±1.8)°, MPTA was(89.9±1.5) °, LFCA was (7.6±3.1)°, LTCA was (88.2±1.1)°. The mechanical axis within ±3° in sixty cases(82.2%), and the mechanical axis within ±6° in all the patients.@*CONCLUSION@#Mako robot-assisted TKA is a safe and effective surgery in the treatment of knee osteoarthritis, which exhibited good efficacy in the correction of lower limb alignment, soft tissue balance and improvement of knee function. The long-term efficacy needs further follow-up observation.

Functional magnetic resonance imaging study about repetitive transcranial magnetic stimulation for dysfunction after stroke: a scoping review / 中国康复理论与实践

ObjectiveTo explore the brain mechanism of repetitive transcranial magnetic stimulation (rTMS) on dysfunction after stroke using functional magnetic resonance imaging (fMRI). MethodsLiteratures about the functional magnetic resonance imaging study about repetitive transcranial magnetic stimulation for dysfunction after stroke were retrieved in PubMed, Web of Science, CNKI and Wanfang data from establishment to June 1st, 2021. The quality of the literature was evaluated with Physiotherapy Evidence Database (PEDro) scale. Literature screening, and data extraction were performed by two researchers. ResultsA total of 14 randomized controlled trials were finally enrolled. They were of high or very high quality. They mainly involved the therapeutic effect and imaging mechanisms of rTMS on dysfunction after stroke. ConclusionrTMS could change the excitability of the cerebral cortex and the effective connections between brain regions after stroke, promote the reorganization of brain function, and achieve the recovery of post-stroke dysfunction.

Successful Treatment of Severe Heparin-induced Thrombocytopenia with Intravenous Immunoglobulin, Platelet Transfusion and Rivaroxaban: A Case Report / 中国医学科学杂志(英文版)

Heparin-induced thrombocytopenia (HIT) is a relatively infrequent complication of heparin administration. HIT can cause devastating thrombosis, making it one of the most serious adverse drug reactions encountered in clinical practice. We successfully treated a case of severe HIT presenting with thrombosis and life-threatening bleeding complications with intravenous immunoglobulin (IVIG), platelet transfusion and oral anticoagulant Rivaroxaban. In this case, we considered that IVIG played the most important role by preventing further thrombosis, increasing the platelet count, and ensuring the efficacy of Rivaroxaban. We therefore suggest that IVIG might be the optimal treatment for patients with this urgent condition.

Clinicopathological characterization of non-Hodgkin lymphoma of the prostate / 中华男科学杂志

Objective@#To study the clinicopathological characteristics of non-Hodgkin lymphoma (NHL) of the prostate.@*METHODS@#We collected the clinical data on 6 cases of NHL of the prostate pathologically confirmed between 2001 and 2017. The patients were aged 49－76 (median 62) years old, with the main clinical manifestations of painless swelling of the prostate and lower urinary tract obstruction. We analyzed the clinical features and the results of histological detection, immunohistochemical staining and B-cell gene rearrangement assay, and explored the clinicopathological characteristics and differential diagnosis of the disease based on the relevant literature.@*RESULTS@#Histological detection revealed diffuse large B-cell lymphoma (DLBCL) in 4 cases (66.7%), B-lymphoblastic lymphoma (B-LBL) in 1 (16.7%), and Burkitt lymphoma (BL) in another (16.7%). DLBCL was histologically characterized by diffuse oval or round medium-to-large-sized lyphoid cells with an infiltrative growth pattern, B-LBL by monotonous small-to-medium-sized lymphoid cells with prominet mitosis and apoptosis, and BL by diffuse and monotonous medium-sized neoplastic cells with round or oval nuclei, an infiltrative growth pattern, scanty cytoplasm and visible mitosis. One of the DLBCL patients received 5 doses of R-CHOP chemotherapy and has been followed up to the present time, while the other 3 were lost to follow-up; the B-LBL patient died at 1 month after diagnosis; and the BL patient gave up treatment.@*CONCLUSIONS@#Non-Hodgkin's lymphoma of the prostate mostly presents as diffuse large B-cell lymphoma, and its diagnosis depends on immunohistochemistry and related molecular detection as well as its clinical and histopathological manifestations.

Effects and mechanism of hypoxia exposure on related genes in brown fat tissue of obese mice based on mRNA expression profile microarray / 中国应用生理学杂志

OBJECTIVE@#This study intended to screen differentially expressed genes and pathways in Brown Adipose Tissue (BAT) of obese mice after the intervention of hypoxia by mRNA expression profile microarray, exploring the mechanism of hypoxia activated BAT.@*METHODS@#Thirty C57BL/6J male mice were divided into the normal diet control group (N, =8), high-fat diet control group (OB, =8) and high-fat diet hypoxia group (H, =8). Group H was intervened by hypoxia exposure in the oxygen concentration of 11.2% of the normal oxygen and hypoxia for 8 h/d, 6 d/w of 4 weeks. Blood lipid and blood glucose were detected after intervention; RNA microarray scan and bioinformation analysis were done of BAT from scapula. Genes significantly ( ≤ 0.05) regulated more than 1.5 fold were chosen to do Gene Ontology and enrichment analysis by KOBAS 2.0, and confirmation of genes participating in key biological process (BP) and pathway was done by real time qPCR.@*RESULTS@#After intervention, the body weight and blood lipid and glucose levels in group H were significantly lower than those of group OB. Comparing with group N, 802 genes were significantly up-regulated and 1 175genes were down-regulated. The BP of these genes mainly concerned with glucose and lipid metabolic process and inflammatory reaction. Comparing with group OB, 297 genes were significantly up-regulated and 228 genes were down-regulated. These genes participated in glucose and lipid metabolic process, lipid transport, muscle system process and cardiovascular system development. The pathways of regulating BAT by hypoxia exposure mainly concentrated on the HIF-1, PI3K-AKT, FoxO and ErbB signaling pathways.@*CONCLUSIONS@#A series of genes and pathways in BAT could be adjusted by hypoxia exposure, so that hypoxia could improve the activity of BAT, promoting obese organism to lose weight.

Analysis on Scientific Projects about TCM Constitutions Funded by National Natural Science Foundation of China / 中国中医药信息杂志

Objective To analyze scientific projects about TCM constitutions funded by National Natural Science Foundation (NSFC); To understand its development trend and current situation.Methods The scientific projects about TCM constitutions in the fields of H27 and H29 were retrieved in NSFC Network Information System during 1996-2016 and "Dingxiangtong" during 1985-2015. Project year, branch discipline, project category, relying-on units were analyzed. PICO model of evidence-based medicine to build clinical problems was applied to analyze project research objects, clinical or scientific issues, interventions, methods, effects indicators, and the role of links. Results There were totally 61 scientific projects and 26.38 millions yuan funded by NSFC in TCM constitutions during 1988-2016. Project and the amount of fund to overall were on the rise, especially since 2010. There were 48 projects about TCM science, 21.77 million yuan (82.5％), 13 projects about integrated traditional Chinese and Western medicine, 4.61 million yuan (17.5％), including 27 surface projects, 11.32 million yuan (42.9％), 17 youth science fund, 3.32 million yuan (12.6％), 15 regional science fund projects, 6.34 million yuan (24.0％), and 2 key projects, 5.4 million yuan (20.5％). The units with the most foundation were Beijing University of Chinese Medicine (15), Xinjiang Medical University (6), Shanghai University of Traditional Chinese Medicine (5). TCM constitution of zang-fu, qi and blood, and body fluid, clinical basis of integrated traditional Chinese and Western medicine, and basic principles of integrated traditional Chinese and Western medicine were the branches with the most foundation. Conclusion s Supported by NSFC, marked improvement and progress have been achieved in research on TCM constitutions.

Clinical value of hearing screening combined with gene screening on newborns / 预防医学

Objective To understand the carrying condition of the mutation gene of neonatal deafness in Huzhou City and explore the significance of the combination screening of hearing and deafness genes. Methods 2258 newborns who were born in Huzhou maternal and child health care hospital were screened for hearing and deafness and were followed up to the age of 3. Two kinds of complementarity and relativity of screening were analyzed. Early hearing screening was used by transient evoked otoacoustic emission (TEOAE) screening, hearing rescreening was used by TEOAE and autoauditory brainstem response (AABR) . Collected the neonatal umbilical cord blood and detected GJB2, SLC26A4, GJB3, mitochondrial 12SrRNA 4 genes 20 deafness mutations. Results Early hearing screening failed in 550 cases, with a failure rate of 24.36％. Detected in 118 cases of deafness gene carriers, total carrying rate was 5.23％. GJB2, SLC26A4, GJB3 and mitochondrial 12SrRNA gene mutation rate were 3.10％, 1.46％, 0.58％ and 0.09％ respectively. Initial failure rate of mother and child hearing screening was 16.30 ％ (300/1840) . The rate of gene transfer for deafness mutation was 5.65 ％ (104/1840) . Initial failure rate of NICU hearing screening was 59.81 ％ (250/418) . The rate of gene transfer for deafness mutation was 3.35％ (14/418) . The failure rate of initial hearing screening of NICU newborns was higher than that of mother and child (P<0.01) . There was no statistically significant difference in carrying rate between the two groups (P>0.05) . There was no statistical correlation between initial hearing screening andwhether or not to carry deaf mutation gene (P>0.05) . 52 infants were missed in this study. 12 patients were diagnosed with hearing impairment, and the hearing impairment rate was 0.54％. Among them, 9 cases were normal and 3 cases were abnormal. Conclusion Newborns hearing screening by whether or not had nothing to do with deafness gene.Hearing screening with deafness gene screening at the same time can reduce the delay in diagnosis of deafness and drug deafness can also be prevented early.

Correlation among serum high sensitive C reactive protein , homocysteine and ischemic stroke / 心血管康复医学杂志

Objective :To explore correlation among serum levels of high sensitive C reactive protein (hsCRP) ,homocys-teine (Hcy) and severity of ischemic stroke in patients with ischemic stroke .Methods :A total of 131 patients with ischemic stroke were enrolled as stroke group .According to neurologic impairment score ,they were divided into mild group (n＝59) ,medium group (n＝41) and severe group (n＝31) ;according to infarct size ,they were divided into lacunar infarction group (n＝55) ,small infarction group (n＝46) and large infarction group (n＝30).Another 98 healthy subjects undergoing physical examination during the same period were selected as healthy control group .Serum levels of hsCRP and Hcy were measured in all groups ,and their correlation with clinic neurologic impairment degree and infarct size in patients with ische-mic stroke were analyzed .Results :Compared with healthy control group ,there were significant rise in serum levels of hsCRP and Hcy in stroke group ,P＝0.001 both .Compared with mild group ,there were significant rise in serum levels of hsCRP [ (4.43 ± 0.42) mg/L vs.(6.78 ± 1.48) mg/L vs.(9.52 ± 1.73) mg/L] and Hcy [ (17.49 ± 1.32) μmol/L vs. (22.18 ± 1.83) μmol/L vs.(26.01 ± 2.37) μmol/L] in medium group and severe group ,and those of severe group were significantly higher than those of medium group , P＝0.001 all ;compared with lacunar infarction group ,there were signif-icant rise in serum levels of hsCRP [ (4.13 ± 0.53) mg/L vs.(7.61 ± 1.47) mg/L vs.(9.49 ± 2.18 ) mg/L] and Hcy [ (18.49 ± 3.27) μmol/L vs.(22.53 ± 4.28) μmol/L vs.(27.38 ± 5.12) μmol/L] in small infarction group and large in-farction group ,and those of large infarction group were significantly higher than those of small infarction group (P＝0.001 all).Pearson correlation analysis indicated that serum serum levels of hsCRP and Hcy were significant positively correlated with clinic neurologic impairment score and infarct size in patients with ischemic stroke (r＝0.253～0.641 ,P＜0.01 all). Conclusion :Serum levels of hsCRP and Hcy are important indexes assessing severity of ischemic stroke .

Preparation and bioIogicaI properties of TiN/Ag composite coating on pure titanium surface / 中国组织工程研究

BACKGROUND: It is of vital importance to fabricate an interface on the titanium implant surface which can promote early cell adhesion, proliferation, and differentiation, and exert better antibacterial effects with no cytotoxicity. OBJECTIVE: To prepare a TiN/Ag composite coating on the surface of pure titanium implant, and to explore its antibacterial properties and effects on MC3T3-E1 biobehaviors. METHODS: Acid etching blasting and multi-arc ion plating were adopted to prepare TiN/Ag composite coating on the smooth surface of pure titanium. Then, MC3T3-E1 cells that grew well were inoculated onto pure titanium plate, sandblasted and acid-etched titanium plate, and TiN/Ag-coated titanium plate. Twenty-four hours later, cell adhesion and viability were observed under confocal laser scanning microscope, and cell morphology was observed under scanning electron microscope. Cell counting kit-8 was used to detect cell proliferation and cytotoxicity at 24,48,72 hours after inoculation.In addition,Staphylococus aureus solution was dropped onto the smooth titanium plated, acid-etched and sandblasted titanium and TiN/Ag-coated titanium plate, and the growth of bacteria was observed by the laser confocal scanning microscope at 16 hours. RESULTS AND CONCLUSION: Under the confocal laser scanning microscope, spindle cells with bipolar or three poles were observed on the smooth titanium surface, and there was less F-actin and filopodia expression; cells on the TiN/Ag-coated titanium surface and sandblasted and acid-etched titanium surface were scattered with a large amount of interconnected filopodia that were fully stretched and adhered to the titanium surface, highly expressed F-actin was detected, and actin fibers were thickened. Under the scanning electron microscope, the cells on the smooth titanium surface were not fully adhered and stretched, and those on the TiN/Ag-coated titanium surface or the sandblasted and acid-etched titanium surface exhibited better adhesion and extension. Findings from the cell counting kit-8 showed that after 72 hours of inoculation,the cells on the smooth titanium surface grew well,with cytotoxicity level 1.In addition,Staphylococus aureus grew well on the smooth titanium surface under the confocal laser scanning microscope,while a large amount of Staphylococus aureus died on the TiN/Ag-coated titanium surface or on the sandblasted and acid-etched titanium surface. These findings indicated that TiN/Ag coating has good biocompatibility and antibacterial properties.

Therapeautic Mechanism of Electroacupuncture with Unblocking and Regulating Needling Therapy for Liver-stagnation Mammary Gland Hyperplasia Rats and Its Relationship with Vagus Nerve Regulation / 广州中医药大学学报

Objective To explore the actions of vagus nerve in electroacupuncture (EA) with unblocking and regulating needling therapy for the treatment of mammary gland hyperplasia(MGH)with liver stagnation type, and to provide experimental evidences for clinical usage of EA with unblocking and regulating needling therapy. Methods Sixty healthy SD rats were randomly divided into 5 groups,namely blank control group,model control group,EA group,EA with disconnection of vagus nerve group,and sham-operation EA group,12 rats in each group. Except for the blank control group, the rats in the remaining groups were modeled. After successful establishment of the model of mammary gland hyperplasia (MGH) with liver stagnation type, the rats in EA group with disconnection of vagus nerve were given disconnection of unilateral vagotomy operation, the rats in sham-operation EA group were given sham operation, and EA group had no treatment, and then all of the 3 treatment groups were given EA with unblocking and regulating needling therapy. At the end of the experiment, the diameter and height of rat nipple were measured,the serum contents of estradiol (E2)and progestin (P)in the rats were detected by enzyme-linked immunoassay(ELISA),and the contents of anti-estrogen receptor alpha (ERα)and anti-progesterone receptor(PR)in the rat breast tissue were detected by immunofluorescence double staining and Western blotting method. Results (1)EA treatment can obviously improve the diameter and height of MGH rat nipple, but the therapeutic effect of EA group with disconnection of vagus nerve was not obvious. (2)Compared with the model control group,the levels of serum E2 and mammary ERαwere markedly reduced(P<0.01),and serum P level and mammary PR content were obviously increased in EA group and sham-operation EA group (P < 0.01). However,the above indexes had no obvious changes in EA group with disconnection of vagus nerve (P>0.05). Conclusion The therapeutic mechanism of EA with unblocking and regulating needling therapy for liver-stagnation MGH may be closely related with the regulation of vagus nerve.

Clinicopathological features of congential intestinal solitary fibromatosis: 2 cases report and literature review / 临床与实验病理学杂志

Purpose To study the clinicopathological features of congenital solitary intestinal fibromatosis (SIF).Methods Clinical,radiological and pathological features of 2 cases of SIF were analyzed along with a literature review.Results Two cases of SIF with one girl and one boy.Both presented with vomiting and abdominal distention at the birth day.A plain abdominal radiograph revealed small bowl obstruction and pneumoperitoneum.Jejunum atresia and perforation were detected at surgery.Microscopically,spindle tumor cells diffusely infiltrated in the whole intestinal wall,tumor cells were monomorphic with bland looking and rare mitosis was reviewed.Immunohistochemically,vimentin was positive while muscular markers as SMA,desmin and Myogenin were all negative.And S-100,CD117,CD34,ALK and β-catenin were not expressed.ETV6 split gene was not detected in one of the patients by FISH.Two patients of SIF had no tumor recurrence with follow-up till now.Conclusion Congenital SIF is a rare and unique intestinal tumor in neonate,and it should be differentiated from congenital fibrosarcoma and myofibroma.SIF appears a very good prognosis after segmental resection.

Development of Multiplex Immunoassay Based on Inductively Coupled Plasma Mass Spectrometry / 分析化学

Immunoassay is of great importance in the field of clinical detection. Our group proposes the inductively coupled plasma mass spectrometry ( ICP-MS) based immunoassay. Multiplex immunoassay can be realized by stable isotope tagging strategy combined with ICP-MS detection. Since then, large amount of researches in this field have been made at home and abroad, and the method has been proved applicable to the analysis of biological small molecules, proteins, nucleic acids and cells. In this article, the history and development of immunoassay, the characters of ICP-MS based immunoassay, single component and multiplex immunoassay, and the magnetic immunoassay that is recently fast developed are reviewed. The prospect of the developing tendency is also anticipated, hoping to provide references for the research in this field.

Associations of SLCO1B1 polymorphisms with tacrolimus concentrations in Chinese renal transplant recipients / 药学学报

The study aims to investigate the associations of SLCO1B1 polymorphisms with tacrolimus concentrations in Chinese renal transplant recipients. Blood samples and clinical data were collected from 89 renal transplant recipients with tacrolimus treatment. CYP3A5*3 genotypes were detected by PCR-RFLP method and SLCO1B1 (rs2306283, rs4149032) genotypes were detected by Agena Bioscience Mass ARRAY ® system. Trough concentrations of tacrolimus on day 7 after renal transplantation were collected from clinical data. Correlations between genetic polymorphisms and tacrolimus concentrations were analyzed by SPSS. In CYP3A5 nonexpressers, the dose-adjusted concentration of tacrolimus in SLCO1B1 rs2306283 CC carriers was considerably higher than that in CT and TT carriers. The results illustrated that SLCO1B1 rs2306283 polymorphisms were associated with tacrolimus concentrations, and genotyping for this SNP may be usefulfo r individualized medicine of tacrolimus.

Analysis on effects of the neonatal hearing screening combined with deafness genes screening in Huzhou / 中国耳鼻咽喉头颈外科

OBJECTIVETo explore the clinical value of the neonatal hearing combined with deafness gene screening.METHODSFrom February 2014 to August 2015, 1933 newborns were included in the study. We analyzed the effects of combined screening of hearing and deafness gene.RESULTSAmong all the 1933 neonates, 71.34% (1379/1933) passed and 28.66% (554/1933) failed the initial hearing screening.The hearing impairment rate was 4.14‰ (8/1933). Genetic screening mutation rate was counted. GJB2 mutation rate was 28.97‰ (56/1933). SLC26A4 mutation rate was 13.97‰ (27/1933). GJB3 mutation rate was 6.21‰ (12/1933). Mitochondrial 12 S rRNA gene mutation rate was 1.03‰ (2/1933). 1 case of 235 delc homozygous mutation did not pass the initial hearing screening and lost to follow-up rescreening. 2 cases of 12 S rRNA 1555A>G homogeneous mutations passed early hearing screening. 8 cases of auditory handicaps were all normal.CONCLUSIONDeafness gene screening can make up for the deficiencies of the universal newborn hearing screening. Joint use of both of them should complement each other and play the biggest role.

Results of a Second-generation Constrained Condylar Prosthesis in Complex Primary and Revision Total Knee Arthroplasty: A Mean 5.5-Year Follow-up / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The application of second-generation constrained condylar knee (CCK) prostheses has not been widely studied. This retrospective study was carried out to evaluate the clinical and radiographic outcomes of a second-generation CCK prosthesis for complex primary or revision total knee arthroplasty (TKA).</p><p><b>METHODS</b>In total, 51 consecutive TKAs (47 patients) were performed between June 2003 and June 2013 using second-generation modular CCK prostheses. The follow-up was conducted at 3rd day, 1st, 6th, and 12th months postoperatively and later annually. Anteroposterior (AP), lateral, skyline, and long-standing AP radiographs of the affected knees were taken. The Hospital for Special Surgery (HSS) Knee Score, the Knee Society Knee Score (KSKS), the Knee Society Function Score (KSFS), and range of motion (ROM) were also recorded. Heteroscedastic two-tailed Student's t-tests were used to compare the HSS score and the Knee Society score between primary and revision TKAs. A value of P < 0.05 was considered statistically significant.</p><p><b>RESULTS</b>Four knees (two patients) were lost to follow-up, and 47 knees (31 primary TKAs and 16 revision TKAs) had a mean follow-up time of 5.5 years. The mean HSS score improved from 51.1 ± 15.0 preoperatively to 85.3 ± 8.4 points at the final follow-up (P < 0.05). Similar results were observed in terms of the KSKS and KSFS, which improved from 26.0 ± 13.0 to 80.0 ± 12.2 and from 40.0 ± 15.0 to 85.0 ± 9.3 points, respectively (P < 0.05). No significant difference in the HSS, KSKS, KSFS, or ROM was found between primary and revision TKAs (P > 0.05). Two complications were observed in the revision TKA group (one intraoperative distal femur fracture and one recurrence of infection) while one complication (infection) was observed in the primary TKA group. No prosthesis loosening, joint dislocation, patella problems, tibial fracture, or nerve injury were observed. Radiolucent lines were observed in 4% of the knees without progressive osteolysis.</p><p><b>CONCLUSIONS</b>Second-generation modular CCK prostheses are a safe and practical treatment for both primary and revision knees that cannot be balanced. However, further studies focusing on different types of constrained prostheses are required to validate these results.</p>

Arthroplasty versus Internal Fixation for Displaced Intracapsular Femoral Neck Fracture in the Elderly: Systematic Review and Meta-analysis of Short- and Long-term Effectiveness / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>There is conflicting evidence as to whether the femoral head should be preserved or replaced in elderly patients with displaced intracapsular femoral neck fractures. In this article, we performed a systematic review and meta-analysis to compare the short- and long-term effectiveness of arthroplasty (AR) and internal fixation (IF).</p><p><b>METHODS</b>PubMed, Embase, and the Cochrane Library were searched systematically up to January 2016. All randomized controlled trials directly comparing the effectiveness of AR and IF for displaced intracapsular fracture were retrieved with no limitation on language or publication year.</p><p><b>RESULTS</b>In total, eight prospective randomized studies involving 2206 patients were included. The results of our study showed that patients in the AR group reported significantly lower complication (risk ratio: 0.56, 95% confidence interval [CI] = 0.38-0.80), re-operation (risk ratio: 0.17, 95% CI = 0.13-0.22), revision rates (risk ratio: 0.11, 95% CI: 0.08-0.16), and better function compared with their IF counterparts, and they were less likely to suffer postoperative pain. No statistically significant differences for the rates of mortality, infection, and/or deep vein thrombosis between AR and IF were found.</p><p><b>CONCLUSIONS</b>Based on our analysis, we recommend that AR should be used as the primary treatment for displaced intracapsular femoral neck fractures in the elderly. However, IF may be appropriate for those who are very frail.</p>

Vascular Endothelial Growth Factor and Cluster of Differentiation 34 for Assessment of Perioperative Bleeding Risk in Gastric Cancer Patients / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Angiogenesis is the formation of new blood vessels to supply nutrients to tumors. Vascular endothelial growth factor (VEGF) and cluster of differentiation 34 (CD34) are important signaling proteins involved in angiogenesis. Many studies have demonstrated that VEGF and CD34 are related to tumor progression. This study focused on the relationship between VEGF, CD34, and perioperative hemorrhage in patients with gastric cancer.</p><p><b>METHODS</b>To observe the relationship between VEGF and CD34, we tracked 112 patients with advanced gastric cancer for 5 years to assess factors related to hemorrhage, using immunohistochemistry. The results were subjected to statistical analysis using a 2 × 2 contingency table, logistic regression, and receiver operating characteristic (ROC) test.</p><p><b>RESULTS</b>The concentrations of VEGF and CD34 were critically correlated with perioperative hemorrhage and neural invasion in patients with gastric cancer (P < 0.05). Expression of VEGF and CD34 was related (P < 0.05, χ2 = 6.834). VEGF and CD34 co-expression strongly increased the risk of preoperative bleeding (area under the ROC curve >0.7, P < 0.05).</p><p><b>CONCLUSIONS</b>Expression of VEGF and CD34 was critically correlated with perioperative hemorrhage in gastric cancer patients. Co-expression of VEGF and CD34 could be an effective indicator for evaluating the risk of perioperative bleeding in gastric cancer patients.</p>

Medium-Chain Triglyceride Activated Brown Adipose Tissue and Induced Reduction of Fat Mass in C57BL/6J Mice Fed High-fat Diet / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To investigate activation of brown adipose tissue (BAT) stimulated by medium-chain triglyceride (MCT).</p><p><b>METHODS</b>30 Male C57BL/6J obese mice induced by fed high fat diet (HFD) were divided into 2 groups, and fed another HFD with 2% MCT or long-chain triglyceride (LCT) respectively for 12 weeks. Body weight, blood biochemical variables, interscapular brown fat tissue (IBAT) mass, expressions of mRNA and protein of beta 3-adrenergic receptors (β3-AR), uncoupling protein-1 (UCP1), hormone sensitive lipase (HSL), protein kinase A (PKA), and adipose triglyceride lipase (ATGL) in IBAT were measured.</p><p><b>RESULTS</b>Significant decrease in body weight and body fat mass was observed in MCT group as compared with LCT group (P<0.05) after 12 weeks. Greater increases in IBAT mass was observed in MCT group than in LCT group (P<0.05). Blood TG, TC, LDL-C in MCT group were decreased significantly, meanwhile blood HDL-C, ratio of HDL-C/LDL-C and norepinephrine were increased markedly. Expressions of mRNA and protein of β3-AR, UCP1, PKA, HSL, ATGL in BAT were greater in MCT group than in LCT group (P<0.05).</p><p><b>CONCLUSION</b>Our results suggest that MCT stimulated the activation of BAT, possible via norepinephrine pathway, which might partially contribute to reduction of the body fat mass in obese mice fed high fat diet.</p>