Unicompartmental knee arthroplasty in treatment of medial compartment osteoarthritis of knee joint:joint function and changes in inflammatory cytokines / 中国组织工程研究

BACKGROUND:Unicompartmental knee arthroplasty has been paid more and more attention because of its advantages of fewer traumas,less blood loss,less complications,faster recovery,excellent knee function and high prosthetic survival rate.Most of the relevant reports focused on its clinical effect,but the changes in the levels of relevant inflammatory cytokines in patients after unicompartmental knee arthroplasty were rarely reported. OBJECTIVE:To investigate the effect of unicompartmental knee arthroplasty in patients with medial compartment osteoarthritis of the knee and the changes of interleukin-1,interleukin-6,and tumor necrosis factor-α levels. METHODS:A total of 30 patients with medial compartment osteoarthritis of the knee who received unicompartmental knee arthroplasty from September 2021 to March 2023 and met the inclusion criteria were selected as the study subjects.Medial angle of proximal tibia,femoral and tibial angle,pain visual analog scale score,hospital for special surgery score,knee joint range of motion,synovial fluid interleukin-1,interleukin-6,and tumor necrosis factor-α levels before and after surgery were compared and statistically analyzed. RESULTS AND CONCLUSION:(1)All 30 patients had grade I wound healing.All patients were followed up for more than 6 months after surgery.There were no complications such as prosthesis loosening and dislocation of prosthesis liner in all patients.(2)The medial proximal tibia angle and the femoral and tibial angles measured after operation were significantly improved(P<0.05).(3)The visual analog scale score,hospital for special surgery score and range of motion measured at 1,3,and 6 months after operation were better than those before operation(P<0.05),and showed a gradual improvement(P<0.05).(4)The levels of interleukin-1,interleukin-6,and tumor necrosis factor-α in synovial fluid at 3 and 6 months after operation were decreased gradually compared with those before operation(P<0.05)and showed a gradual downward trend at each time point after operation.(5)It is indicated that unicompartmental knee arthroplasty can effectively treat medial compartment osteoarthritis of the knee,significantly relieve pain,restore knee joint function,improve knee varus deformity and lower limb strength line,and reduce the levels of inflammatory cytokines interleukin-1,interleukin-6,and tumor necrosis factor-α in joints to a certain extent.

Penile protection with a self-developed flexible sleeve penile protection device after circumcision: a prospective randomized controlled trial / 现代泌尿外科杂志

【Objective】 To investigate the protective effects of aflexible sleeve penile protection device on reducing postoperative pain and wound edema in patients after circumcision. 【Methods】 A total of 54 patients who underwent circumcision at Yan’an Branch of Peking University Third Hospital during Feb.1 and May 31, 2023 were enrolled.The patients were randomly divided into the experimental group and control group, with 27 patients in either groups.Patients in the experimental group were treated with a flexible sleeve penis protection device after surgery, and patients in the control group were treated with traditional gauze bandage after surgery.Postoperative pain, wound edema and complications were compared between the two groups. 【Results】 In terms of pain, the visual analogue scale of the experimental group was significantly lower at 6 hours [(1.7±0.9) vs.(3.3±1.9), P0.05).In terms of edema, the edema score of the experimental group was significantly lower than that of the control group on the 2nd postoperative day [(2.0±1.0) vs.(4.0±0.8), P0.05). 【Conclusion】 The flexible sleeve penile protection device has significant effects of reducing early postoperative pain and reducing edema in patients undergoing circumcision.

Cognitive impairment in patients with lacunar stroke / 国际脑血管病杂志

Lacunar stroke (LS) is one of the subtypes of small cerebral vascular disease. Recent studies have shown that LS has a high risk of cognitive impairment, which imposes a heavy burden on patients, their families and society. However, at present, there is a lack of comprehensive discussion on the related factors, pathogenic mechanism, clinical features, prevention and treatment of cognitive impairment in LS patients. Therefore, this article reviews the relationship between LS and cognitive impairment, in order to provide clinical basis for early prevention and rehabilitation plan, and improve long-term follow-up awareness and comprehensive management ability of cognitive function in LS patients.

DLL3 promotes progression of prostate cancer through MAPK pathway / 中国病理生理杂志

AIM:To explore the impact of Delta-like ligand 3(DLL3)on the progression of prostate cancer(Pca)and to elucidate its potential molecular mechanisms.METHODS:Overexpression and interference plasmids of DLL3 gene were constructed,and the effects of DLL3 on the proliferation,migration and invasion of Pca cells were as-sessed.Tumorigenesis assay was employed to determine whether DLL3 influenced the proliferation of PC-3 cells in vivo.The impact of DLL3 on epithelial-mesenchymal transition(EMT)and mitogen-activated protein kinase(MAPK)signaling was investigated through Western blotting.RESULTS:Overexpression of DLL3 significantly enhanced the proliferation,migration,invasion and EMT processes of Pca cells compared with empty vector group and blank control group(P＜0.05).Conversely,knockdown of DLL3 expression yielded opposite effects(P＜0.05).Moreover,up-regulation of DLL3 promoted tumor growth in the nude mouse xenograft model(P＜0.05).Further investigation demonstrated that DLL3 up-regulation led to increases in the levels of MAPK signaling pathway-related proteins.Interestingly,MAPK inhibitor effec-tively reduced the proliferation,migration and invasion of Pca cells caused by DLL3 overexpression(P＜0.05).CON-CLUSION:DLL3 promotes the proliferation,migration and invasion of Pca through the MAPK pathway.

Effect of Yiqi Liangxue Shengji Formula （益气凉血生肌方） on Recurrence of Angina Pectoris and Quality of Life after Percutaneous Coronary Intervention in Coronary Heart Disease Patients with Qi Deficiency and Blood Stasis Syndrome and Binding of Stasis and Heat Syndrome： A Randomized， Triple-blind， Placebo-controlled Parallel Trial / 中医杂志

ObjectiveTo observe the clinical effect of Yiqi Liangxue Shengji Formula （益气凉血生肌方， YLSF） on recurrence of angina pectoris and quality of life at eight weeks after perecutaneous coronary intervention （PCI）. MethodsEighty-two coronary artery disease （CAD） patients with qi deficiency and blood stasis and binding of stasis and heat syndrome who had underwent PCI were randomly divided into two groups with 41 patients each in the treatment group and the control group. Based on conventional western medicine after PCI， patients in the treatment group orally took YLSF granules while those in the control group were administered with placebo， one dose daily for 8 weeks. The recurrence rate of angina pectoris and readmission rate within eight weeks after PCI were recorded. Before and after treatment， total traditional Chinese medicine （TCM） syndrome score， Seattle Angina Questionnaire （SAQ） scores （physical limitation， angina stability， angina frequency， treatment satisfaction and disease perception）， and the SF-36 scores for quality of life （physical and mental health） were evaluated. The adverse reactions during medication in both groups were recorded. ResultsWithin eight weeks after PCI， the recurrence rate of angina pectoris in the treatment group （4/41， 9.76%） was significantly lower than that in the control group （11/41， 26.83%， P＜0.05）. The readmission rate in the treatment group was 2.44% （1/41）， while that in the control group was 12.20% （5/41）， with no significantly statistical difference （P＞0.05）. After treatment， total TCM syndrome score significantly decreased in both groups， while in terms of quality of life， the SAQ scores on domains of angina stability， angina frequency and disease perception as well as SF-36 total scores， physical health and mental health scores significantly increased （P＜0.05 or P＜0.01）. Compared between the two groups， total TCM syndrome score was significantly lower in the treatment group than the control group （P＜0.01）， while no significant differences were found in SAQ scores and SF-36 total， physical and mental health scores （P＞0.05）. No adverse reactions occurred in both groups during the treatment period. ConclusionYLSF can reduce the recurrence rate of angina pectoris within eight weeks after PCI for coronary artery disease， and can improve the TCM syndrome score， and have sound safety， with comparable effect to that of placebo in improving postoperative short-term quality of life.

The role of sarcopenia in treatment-related outcomes in patients with renal cell carcinoma: A systematic review and meta-analysis.

BACKGROUND: in recent years, more attention has been paid to the fuzzy relationship between skeletal muscle components and renal cell carcinoma (RCC). This study attempts to conduct a meta-analysis using all relevant research evidence to explore the impact of sarcopenia on the final survival and recurrence outcome of RCC patients and the change process of this impact after treatment. METHODS: This systematic review and Meta-analysis study took "sarcopenia", "kidney" and "tumor" and their synonyms as the main search terms, and comprehensively searched all relevant literatures published in PubMed, web of science, SpringerLink, EMBASE, Cochrane Library, Ovid (Lww oup), Wiley, ScienceDirect and Scopus databases since February 2, 2022. Multivariate hazard ratio (HR) and 95% confidence interval (CI) of overall survival (OS), cancer specific survival (CSS), and progression free survival (PFS), as well as rough data of Kaplan-Meier survival curve, were combined as the main analysis results. Subgroup analyses based on cohort characteristics (treatment, ethnicity, and BMI factors) for each study were used as secondary outcomes. The combined effect was estimated by random effect model or fixed effect model, and the heterogeneity was evaluated by I2 value. Because this study belongs to secondary literature, the medical ethics committee of the First Affiliated Hospital of Xinjiang Medical University considers that ethical review is unnecessary. RESULTS: Eighteen retrospective studies involving 3591 patients with RCC were analyzed, of which 71.5% were men and the median age of the cohort was 61.6. The prevalence of sarcopenia was 43% (38-48%). Sarcopenia is an independent predictor of OS (HR: 1.83, 95% CI = [1.41, 2.37]), and this prognostic value can also be reflected in Asian populations (HR: 2.59, 95% CI = [1.90, 3.54]) and drug treated patients (HR: 2.07, 95% CI = [1.07, 4.04]). Sarcopenia can also be used as an independent predictor of CSS (HR: 1.78, 95% CI = [1.34, 2.36]) and PFS (HR: 1.98, 95% CI = [1.34, 2.92]). The effect of low skeletal muscle mass on OS and CSS increased slowly from 1 to 5 years. CONCLUSION: Sarcopenia can be used as a comprehensive prognostic factor in RCC population, but the detailed effects from ethnic characteristics and treatment mechanism need to be further studied.

Prompt value of MRI scanner-detected temporalis muscle thickness in patients with stroke / 中华老年医学杂志

Objective:To investigate the relationship of sarcopenia diagnosed by temporalis muscle thickness(TMT)with physical status and prognosis of stroke patients.Methods:Temporalis muscle thickness was detected by MRI scanner.The median value of TMT was used as the risk classification index of sarcopenia in 265 stroke patients.The relationships of TMT with several indicators of Essen Stroke Risk Score(ESRS), National Institutes of Health Stroke Scale(NIHSS), Barthel index, water swallow test, Venous thromboembolism(VTE)assessment of medical inpatients, as well as the modified Rankin Score(mRS)follow-up results at 3 and 6 months after discharge were retrospectively analyzed.Results:There were 166 men and 99 women in the study cohort, with an average age of(62±13.1)years.The TMT value of men was 0.58 mm, which was significantly higher than that of women( t=2.307, P<0.05).There were significant differences in age( χ2=33.443, P<0.001), albumin( t=-2.467, P<0.05), triglyceride( Z=-2.777, P<0.01)and hemoglobin( t=-3.264, P<0.001)between sarcopenia group and non-sarcopenia group.As compared with non-sarcopenia group, atherosclerosis( χ2=4.715, P<0.05), pulmonary infection( χ2=4.707, P<0.05)and hypertension( χ2=4.046, P<0.05)were easy to be accompanied in sarcopenia group.There was good agreement in TMT measurements among different investigators(ICC=0.980, P<0.001).After adjusting for confounding variables, Logistic regression analysis showed that sarcopenia was significantly correlated with ESRS( OR=1.92, P< 0.05)and Barthel index( OR=1.66, P< 0.05)at admission, and Barthel index after discharge( OR=1.84, P<0.05), mRS at 3 months after discharge( OR=3.09, P<0.001), mRS at 6 months after discharge( OR=3.36, P<0.001). Conclusions:TMT can be used as a comprehensive index to dynamically display the physical state and prognosis of stroke patients, but further research is needed to determine the causal relationship.

Research advances in the value of sarcopenia in the prognosis of patients after liver transplantation / 临床肝胆病杂志

Sarcopenia is often observed in patients with end-stage liver disease such as advanced liver cancer. This complication is associated with mortality rate in the perioperative period of liver transplantation, and limited liver resources require traditional evaluation systems to further improve the survival rate of the transplant cohort. Summarization and evaluation of skeletal muscular pathology and diagnosis and treatment strategies show that as a body composition parameter that can effectively predict the survival of patients, skeletal muscle can help to optimize the sequence of transplantation cohorts and surgical benefits in combination with liver function assessment scale. The specific mechanism of related death remains unclear, the diagnostic indicators are gradually streamlined, and there is no treatment strategy that can reverse the mortality rate. Based on the existing literature, sarcopenia is one of the important parameters for determining candidates for liver transplantation.

The observation and nursing care of a patient with extensive degloving injuries complicated infection after skin grafting / 中国实用护理杂志

Objective:Report the nursing process of a patient with extensive degloving injuries who accept repeatedly replanted in the partial necrosis area after skin grafting merge wound infection.Methods:The main points: after patient admitted to hospital initiate first aid treatment and prepare the surgery; manage the blood volume, prevention and monitoring of wound infection at early postoperative; and positive nutrition support and avoid defecate contaminated wounds, early activity and rehabilitation at late postoperative phases.Results:Under careful treatment and care, after three months, all the skin grafts survived and scar healing.Conclusions:On the basis of life support system and skin grafting, taking positive measures to control the wound infection and promote skin survival, had played an important role in the treatment of this case.

Deep Learning-Based Recognizing COVID-19 and other Common Infectious Diseases of the Lung by Chest CT Scan Images

PurposeCOVID-19 has become global threaten. CT acts as an important method of diagnosis. However, human-based interpretation of CT imaging is time consuming. More than that, substantial inter-observer-variation cannot be ignored. We aim at developing a diagnostic tool for artificial intelligence (AI)-based classification of CT images for recognizing COVID-19 and other common infectious diseases of the lung. Experimental DesignIn this study, images were retrospectively collected and prospectively analyzed using machine learning. CT scan images of the lung that show or do not show COVID-19 were used to train and validate a classification framework based on convolutional neural network. Five conditions including COVID-19 pneumonia, non-COVID-19 viral pneumonia, bacterial pneumonia, pulmonary tuberculosis, and normal lung were evaluated. Training and validation set of images were collected from Wuhan Jin Yin-Tan Hospital whereas test set of images were collected from Zhongshan Hospital Xiamen University and the fifth Hospital of Wuhan. ResultsAccuracy, sensitivity, and specificity of the AI framework were reported. For test dataset, accuracies for recognizing normal lung, COVID-19 pneumonia, non-COVID-19 viral pneumonia, bacterial pneumonia, and pulmonary tuberculosis were 99.4%, 98.8%, 98.5%, 98.3%, and 98.6%, respectively. For the test dataset, accuracy, sensitivity, specificity, PPV, and NPV of recognizing COVID-19 were 98.8%, 98.2%, 98.9%, 94.5%, and 99.7%, respectively. ConclusionsThe performance of the proposed AI framework has excellent performance of recognizing COVID-19 and other common infectious diseases of the lung, which also has balanced sensitivity and specificity.

[Establishment of rat models with altered anterior guidance and observation of histological changes in temporomandibular joint synovium].

OBJECTIVE: This study aims to establish a stable animal model with altered anterior guidance and investigate histological changes on temporomandibular joint (TMJ) synovium in rats. METHODS: Thirty-two rats were divided into four groups, namely, control group, anterior-guidance-deficient group (T1), and anterior guidance inclined up to 15 degree (T2) and 30 degree (T3) groups. Metal crowns that add 15 and 30 degrees to the palatal side were cemented to the incisors of maxilla to increase the inclination of anterior guidance. The low-speed diamond wheel shorts for both upper and lower incisors of rats were applied to avoid contact between anterior teeth in all direction, thus establishing an anterior guidance deletion model. TMJ joints on one side of two animals in each group were harvested after 3, 7, 14, and 28 days. Pathological changes were investigated in the TMJ synovium using hematoxylin-eosin (HE) staining. RESULTS: The weight of T1 decreased briefly at first, and then increased slightly (P<0.05). The weight of T3 obviously reduced and then slowly increased, but remained below the initial weight (P<0.05). T3 manifested obvious synovial lining proliferation and vascular dilation (P<0.05). CONCLUSIONS: The rat model of anterior guidance inclined up to 30 degree could imitate the pathological features of TMJ synovium with excessive increase in anterior guidance. A higher inclination of anterior guidance might cause more damage of TMJ synovium. The effect of anterior guidance deletion on TMJ synovium is yet to be determined.
.

Establishment of rat models with altered anterior guidance and observation of histological changes in temporomandibular joint synovium / 华西口腔医学杂志

<p><b>OBJECTIVE</b>This study aims to establish a stable animal model with altered anterior guidance and investigate histological changes on temporomandibular joint (TMJ) synovium in rats.</p><p><b>METHODS</b>Thirty-two rats were divided into four groups, namely, control group, anterior-guidance-deficient group (T1), and anterior guidance inclined up to 15 degree (T2) and 30 degree (T3) groups. Metal crowns that add 15 and 30 degrees to the palatal side were cemented to the incisors of maxilla to increase the inclination of anterior guidance. The low-speed diamond wheel shorts for both upper and lower incisors of rats were applied to avoid contact between anterior teeth in all direction, thus establishing an anterior guidance deletion model. TMJ joints on one side of two animals in each group were harvested after 3, 7, 14, and 28 days. Pathological changes were investigated in the TMJ synovium using hematoxylin-eosin (HE) staining.</p><p><b>RESULTS</b>The weight of T1 decreased briefly at first, and then increased slightly (P<0.05). The weight of T3 obviously reduced and then slowly increased, but remained below the initial weight (P<0.05). T3 manifested obvious synovial lining proliferation and vascular dilation (P<0.05).</p><p><b>CONCLUSIONS</b>The rat model of anterior guidance inclined up to 30 degree could imitate the pathological features of TMJ synovium with excessive increase in anterior guidance. A higher inclination of anterior guidance might cause more damage of TMJ synovium. The effect of anterior guidance deletion on TMJ synovium is yet to be determined.
.</p>

An improved method of blood collection from jugular vein in rats / 局解手术学杂志

Objective To improve the method of blood collection from external jugular vein in rats,so as to repeatedly obtain blood samples of high quality and to meet the special requirements of the experiment.Methods The experimental rats were anesthetized by intraperitoneal anesthesia,and the jugular vein was fully exposed with special fixed method.Whereafter,the blood samples were collected by disposable vacuum blood vessels.Results This method had little traumatic effect.The blood samples were collected from 60 rats at an interval of 14 days with 1.8 to 2.5 mL each time.The success rate was above 95％,and the normal activities of the rats were not apparently affected.This vacuum blood collection method guaranteed the quality of serum,and the veracity of blood detection and analysis were also significantly improved.Conclusion On the basis of the principle of animal welfare,the improved rat jugular vein blood collection method has the advantages of simple operation,less trauma,large blood collection,high blood sample quality aod so on,which can ensure the effect of the special experiment.

Sacroiliac joint injury treated with oblique insertion at anatomical points: a randomized controlled trial / 中国针灸

<p><b>OBJECTIVE</b>To compare the effects of oblique insertion at anatomical points and conventional acupuncture for sacroiliac joint injury.</p><p><b>METHODS</b>Eighty patients were randomly divided into an observation group and a control group, 40 cases in each one. In the observation group, oblique insertion therapy at anatomical points was used, and the 9 points of equal division (anatomical points) marked by palpating the anatomical symbol were treated as the insertion acupoints. In the control group, conventional acupuncture was applied, and perpendicular insertion was adopted at Huantiao (GB 30), Zhibian (BL 54) and Weizhong (BL 40), etc. In the two groups, the! treatment was given once a day and 5 times per week. Ten treatments were made into one course and two courses were required. The clinical effects, the changes of visual analogue scale (VAS) and Oswestry dysfunctional index. (ODI) before and after treatment were observed in the two groups.</p><p><b>RESULTS</b>The total effective rate of the observation group was 90.0% (36/40), which was better than 72.5% (29/40) of the control group (P < 0.05). After treatment, the results of the VAS and ODI of the two groups were apparently declined (both P < 0.01), and those in the observation group were decreased more obviously (both P < 0.01).</p><p><b>CONCLUSION</b>The effect of oblique inser-tion at anatomical points for sacroiliac joint injury is superior to that of conventional acupuncture, which can effectively relieve pain and improve the disfunction.</p>

Nursing care of patient with odontogenic deep neck space infections and secondary mediastinal abscess / 中国现代医生

A report of one case of severe dental deep neck space abscess complicated with extensive mediastinal ab-scess,after operation and nursing discharge. Early tracheotomy,ensure the ventilation function, paying attention to o-ral care and twice airway management; assessment and preparation to the floor of the mouth, neck and chest incision drainage of pus preoperative,monitoring signs of postoperative infection, wound and drainage management; reasonable arrangements for antibiotic input, ensure the stable blood drug level; strengthen psychological counseling for patients and family members.