Correlation analysis between tumor burden and biochemical indicators of parathyroid adenoma / 中华内分泌外科杂志

Objective:To determine the correlation of tumor volume and weight with biochemical parameters in patients with parathyroid adenoma (PA) .Methods:A prospective electronic database collected clinical data on 208 patients with PA treated for the first time by surgery at department of general surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College.The relationship between biochemical parameters and tumor volume and weight was analyzed with Spearman’s correlation.Results:Tumor volume and weight were positively correlated with parathyroid hormone (PTH) ( r=0.33, P<0.001; r=0.39, P<0.001), calcium ( r=0.16, P=0.018; r=0.18, P=0.007) and alkaline phosphatase levels ( r=0.24, P<0.001; r=0.27, P<0.001), respectively. Clinical correlates affecting serum PTH were age, serum calcium and tumor weight ( F=30.325, P<0.001) . Conclusions:Tumor burden in patients with PA correlates with some laboratory biochemical parameters. Age and cystic lesions of the tumor may influence the actual serum PTH levels.

Treatment of polyethylene sleeve wear in rotating hinge knee joint with femoral component revision surgery / 中华骨科杂志

Objective:To investigate the clinical efficacy of femoral component revision surgery in addressing polyethylene sleeve wear in rotating hinge knee joints.Methods:A retrospective analysis was conducted on 21 patients who underwent treatment for polyethylene sleeve wear in rotating hinge knee joints at the Department of Orthopaedics, the Fourth Medical Center, PLA General Hospital, spanning from August 2008 to April 2023. There were 8 males and 13 females with a median age of 63(38, 76) years. Among them, 11 cases involved the left side, and 10 cases involved the right side. The average body mass index (BMI) was 25.0(22.5, 31.0) kg/m 2, and all cases underwent unilateral knee joint revision. The time interval from receiving the hinge knee joint prosthesis to revision was 10.5(6.0, 17.0) years, with 18 cases undergoing primary revision and 3 cases undergoing revision for the second time. Revision surgery of the femoral component sleeve was performed in all patients due to polyethylene sleeve wear. Visual analogue scale (VAS), range of motion (ROM) of the knee joint, changes in hip-knee-ankle angle (HKA), and Knee Society score (KSS) were collected and recorded to assess the surgical outcomes. Results:All patients were followed up for a median duration of 12.5(11.7, 13.4) months. Preoperatively, the VAS score was 5(3, 7) points, which significantly decreased to 0(0, 1) points at the last follow-up ( Z=5.721, P<0.001). At the last follow-up, the KSS scores decreased from 41.19±13.65 points preoperatively to 79.81±7.80 points, indicating a statistically significant difference ( t=12.560, P<0.001). HKA increased from 174.65°±5.20° preoperatively to 178.71°±2.79°, with a statistically significant difference ( t=5.533, P<0.001). Knee joint ROM increased from 69.05°±34.37° preoperatively to 110.00°±10.12°, also demonstrating a significant improvement ( t=5.960, P<0.001). Notably, patients exhibited knee joint stability with no passive flexion or extension laxity. Conclusion:Femoral component sleeve revision surgery effectively addresses polyethylene sleeve wear in rotating hinge knee joint prostheses, thereby mitigating the substantial loss of bone and soft tissue associated with overall revision procedures. The early postoperative clinical outcomes are promising and indicative of the efficacy of this surgical intervention.

Research Progress of Deep Learning in Bladder Cancer Pathology / 肿瘤防治研究

The incidence of bladder cancer is increasing annually, and the gold standard for its diagnosis relies on histopathological biopsy. Whole-slide digitization technology can produce thousands of high-resolution captured pathological images and has greatly promoted the development of digital pathology. Deep learning, as a new method of artificial intelligence, has achieved remarkable results in the analysis of pathological images for tumor diagnosis, molecular typing, and prediction of prognosis and recurrence of bladder cancer. Traditional pathology relies heavily on the professional level and experience of pathologists; as such, it is highly subjective and has poor reproducibility. Deep learning can automatically extract image features. It can also improve diagnostic efficiency and repeatability and reduce missed and misdiagnosed rates when used to assist pathologists in making decisions. This technology cannot only alleviate the pressure of the current shortage of skilled workforce and uneven medical resources but also promote the development of precision medicine. This article reviews the latest research progress and prospects of deep learning in pathological image analysis of bladder cancer.

Leg length discrepancy after total hip arthroplasty: a comparison between robotic-assisted and coventional implantation / 中华骨科杂志

Objective:To compare the difference of LLD (leg length discrepancy) between robot-assisted and conventional methods of total hip arthroplasty (THA).Methods:Data of 38 patients who had THA performed by robot-assisted or conventional methods from January 2019 to May 2020 were retrospectively analyzed. There were 38 cases (54 hips) in robot-assisted THA group (robot group) with 18 males and 20 females (age 53.5±13.6 years, BMI 26.2±3.4 kg/m 2), and there were 21 cases (32 hips) with osteonecrosis of the femoral head, 17 cases (22 hips) with Crown typeⅠandⅡdevelopmental dysplasia of the hip. There were 38 cases (54 hips) in conventional THA group (conventional group), with 19 males and 19 females, (age 52.3±14.7 years old, BMI 25.7±2.9 kg/m 2), and there were 19 cases (30 hips) with developmental dysplasia of the hip, and 19 cases (24 hips) with osteonecrosis of the femoral head. The operative time, postoperative LLD, Harris score, forgotten joint score-12 (FJS-12) and the difference between preoperative and postoperative LLD between the two groups were compared, and the correlation between surgical methods and the change of hip length was also evaluated. Results:The operation time of the robot group was 73.3±14.1 min and which was 59.3±12.6 min in conventional THA group ( t=2.732, P=0.003). In the robot group, the postoperative LLD was 2.3±3.4 mm, which was less than that of the conventional group 6.7±5.4 mm ( t=3.521, P < 0.001). When the absolute value of LLD was larger than 5 mm as an abnormal value, it was 2.6% (1/38) in the robot group and 47.3% (18/38) in the conventional group. The difference of hip length (HL) in planning and post-operation in the robot group was 2.8±2.2 mm, which was smaller than that in the conventional THA group 7.9±5.3 mm ( t=2.357, P < 0.001). In addition, there was a correlation between the change of hip length results and the postoperative measurement of hip length in the robot group ( r=0.983, P < 0.001). At the last follow-up, Harris score and FJS-12 were recorded in the robot group and coventional group. The scores were 83.1±5.3 and 32.5±4.9 respectively in the robot group, 82.9±7.2 and 31.9±6.7 in the conventional group, respectively. There was no significant difference between the two groups ( t=0.221, 0.356; P=0.819, 0.731). Postoperative bleeding occurred in 1 case in the robot group with postoperative suture healed well. The fracture of the posterior wall of the acetabulum was found in the conventional group and the patient avoids weight bearing 4 weeks after operation. The postoperative recovery was good and no other related complications were found. Conclusion:Robot-assisted THA can accurately restore the length of both legs and reduce LLD compared with conventional THA. The real-time monitoring of LLD during robot operation can give the operator an accurate reference.

Comparison of patient-specific distal femoral cutting guide and conventional instruments in total knee arthroplasty / 中华骨科杂志

Objective To design a patient-specific distal femoral cutting guide for total knee arthroplasty using rapid prototyping and 3D printing technology and compare with conventional instrumentation.Methods A prospective self-control study was performed in 32 patients who underwent bilateral total knee arthroplasty between March 2015 and November 2015 in our department.The bilateral knee joints were randomly divided into patient-specific guide group and traditional surgery group.The patient-specific guide group obtained CT data of the lower extremities preoperatively.Patient-specific distal femoral cutting guides were designed and manufactured using rapid prototyping and 3D printing techniques.The traditional surgery group were performed using conventional instrumentation.The operation time of the two groups was recorded,and the amount of distal femoral osteotomy was measured.Postoperative alignments were measured including the angle of the lower limb mechanical axis angle (hipknee-ankle Angle,HKA),the mechanical lateral distal femoral angle (mLDFA),and the mechanical proximal tibial angle (mMPTA).In different follow-up points Hospital for Specific Surgery scores of the knee were recorded.Results In the coronal position,the postoperative mLDFA was 90.34°± 1.6° in the patient-specific guide group and 91.37°± 1.8° in the conventional surgery group.The difference between the two groups was statistically significant (t=-2.452,P=0.020).In the patient-specific guide group,the HKA angle was 0.36°±2.35°,and the conventional surgery group was 0.87°±1.85°.The difference between the two groups was statistically significant (t=-2.332,P=0.043).If preoperative mLDFA≤93°,there was no significant difference in postoperative mLDFA between the two groups (t=-1.409,P ＞ 0.05).If preoperative mLDFA ＞ 93°,there was a significant difference in postoperative mLDFA between the two groups (t=-4.145,P=0.004).In addition,the operation time of the patient-specific guide group was significantly shorter (t=-2.425,P ＜ 0.05),but the two groups did not have significant functional differences in the early postoperative period.Conclusion The 3D-printed patient-specific distal femoral cutting guide can significantly shorten the operation time and improve postoperative alignments.It is simple to operate.However,large sample sizes and long-term follow-up studies are still needed to verify their long-term effects.

Determination of Organochlorine Pesticides Residue in Suppositories of Chinese Medicinal Materials(Ⅰ) / 中药新药与临床药理

Objective To develop a suitable extraction and purification method for detecting the residue of 20 kinds of organochlorine pesticides(OCPs) in suppositories of Chinese medicinal materials which are made of fat-soluble bases.Methods Different methods were applied for the extraction, and GPC was used for the purification of the sample Huazhi Shuan, and then the residue contents of OCPs were determined by GC- ECD method.20 kinds of OCPs were added to the samples and the feasibilities of the methods were evaluated by the obtained recovery. The established method were used in the analysis of the residue of OCPs in other Chinese herbal suppositories.Results The recovery and the reproducibility of this method met the requirements for the analysis of pesticides residues. Conclusion This developed method may provide reference for the detection of organochlorine pesticides residue in these kinds of Chinese medicinal preparations.

Determination of Emodin and Chrysophanol Contents in Qingre Anchuang Tablets by HPLC / 中药新药与临床药理

Objective To determine the contents of emodin a nd chrysophanol in Qingre Anchuang tablets(QAT)by HPLC.Method The C 18 column was applied.Methanol -0.1%p hosphoric acid solution(90∶10)served as the mobile phase.The wavelength of detection was at 440nm.Results Emodin and chrysophanol in QAT were c an be isolated com-pletely,and the range of linear correlation was 0.0543～0.3258?g for emodin(r=0.99997)and 0.1048～0.6288?g for chrysophanol(r=0.99999).The average recovery rate of emodin and chrysophanol was 96.87%(RSD =1.98%,n=6)and 96.22%(RSD =1.88%,n=6)respectively.Conclusion The method was accurate,reliable and with good reproducibility.It could be used for quality control of QAT.

Methodological Study of Determining Organochlorine Pesticides Residue in Suppositories of Chinese Medicinal Materials(Ⅱ) / 中药新药与临床药理

Objective To develop a suitable solid-phase extraction(SPE)method for the further purification of the test solu- tion in suppositories of Chinese medicinal materials which are made of lipid soluble bases,and to detect the residues of 20 kinds of organochlorine pesticides(OCPs).Methods Different kinds of SPE columns were selected and several elution solvents were used for the purification of the sample of herbal medicine of Huazhi Shuan,and then the residue contents of OCPs were determined by GC-ECD method.Twenty kinds of OCPs were added into the samples and the efficacy of the methods were eval- uated by the obtained recoveries.Results The recoveries of the 20 kinds of OCPs being detected were basically comply with the requirements for the analysis of pestiside residues.Conclusion After the tested solution is obtained from GPC column and is further purified through florisil SPE column,the impurity can be removed and the high accuracy of the quantitative analysis of the compounds can be achieved.