Development and Research Progress of 3D Printing Technology in Orthopedic Medical Devices / 中国医疗器械杂志

With the characteristics of fast prototyping and personalized manufacturing, 3D-printing (three-dimensional printing) is an emerging technology with promising applications for orthopedic medical devices. It can complete the process of medical devices with complex shape which can not be completed by conventional fabrication process. At present, a variety of orthopedic medical devices manufactured by 3D printing technology, has been approved for marketing, and their use has been proved to be beneficial. 3D bioprinting in this area has also made a few breakthroughs. However, many challenges still remain to be addressed as well. In this study, the research status, as well as the development of the 3D-printing technology in the field of orthopedic medical devices is elaborated.

Treatment of tibial plateau fractures using modified double reverse traction technique / 中华创伤骨科杂志

Objective:To study the clinical efficacy of our modified double reverse traction technique in the treatment of tibial plateau fractures.Methods:A retrospective study was conducted of the 66 patients with tibial plateau fracture who had been treated by our modified double reverse traction technique at Articular Department, Zhongshan Hospital of Traditional Chinese Medicine from March 2019 to December 2021. There were 37 males and 29 females, with an age of (44±14) years. The double reverse traction technique was used in all patients for reduction of the tibial plateau fracture, and their collapsed articular surfaces were restored by our self-designed universal high affinity prying technique, or by fibular graft support, or by the hooping technique to restore the transverse diameter of the tibial plateau which had been widened. The outcomes of fracture reduction at 2 days postoperation were recorded and evaluated by Rasmussen imaging assessment. Complications were also recorded. The visual analog scale (VAS) pain scores and Hospital for Special Surgery (HSS) scores were compared between preoperation, 3 and 6 months postoperation and the rates of fracture healing between 3 and 6 months postoperation.Results:This group of 66 patients was followed up for 12.0(8.0, 16.5) months. The Rasmussen imaging assessment at 2 days postoperation: 60 excellent, 4 good, and 2 fair cases, yielding an excellent to good rate of 97.0% (64/66). At 3 and 6 months postoperation, the VAS scores [1 (0, 1) and 0 (0, 1)] and HSS scores [84 (78, 88) and 91 (85, 95)] were significantly improved compared with those before operation [4 (3, 5) and 36 (29, 39)], and the values at 6 months postoperation were significantly improved compared with those at 3 months postoperation ( P<0.05). The rate of clinical fracture healing at 6 months postoperation (100%, 66/66) was significantly higher than that at 3 months postoperation (77.3%, 51/66) ( P<0.05). Perioperatively, no adverse events were observed like incision infection, deep vein thrombosis of lower limbs, or failure or exposure of internal fixation, except for delayed incision healing in only one patient. Conclusion:In the minimally invasive surgery for tibial plateau fractures, our modified double reverse traction technique can result in excellent fracture reduction by imaging assessment, fine functional recovery of the knee joint and relief of pain.

A comparative study of bibliotherapy to improve stigma and social function for patients with schizophrenia in rehabilitation / 中国实用护理杂志

Objective:To explore the efficacy of bibliotherapy to improve stigma and social function for patients with schizophrenia in rehabilitation.Methods:From June, 2018 to June, 2020 at Shandong Mental Health Center, a total of 115 patients with schizophrenia in rehabilitation were randomly divided into study group (58 cases) and control group (57 cases). The study group received bibliotherapy and the control group received general rehabilitation nursing based on original antipsychotic treatment and routine nursing. They were assessed with Link Disgrace Scale (LDS) and Inpatient Psychiatric Rehabilitation Outcome Scale (IPROS) before and after intervention.Results:There was no significant difference in the scores of all factors and total scores of LDs and IPROS before intervention between the two groups ( P>0.05). After intervention, the scores of all factors and total scores of LDS in the study group were 29.08±3.25, 63.69 ± 4.09, 12.54 ± 2.15, 105.31 ± 5.22 respectively, which were lower than those in the control group 37.17 ± 3.41, 74.00 ± 4.63,20.17 ± 2.89, 131.33 ± 8.51, there were significant differences between the two groups ( t values were 5.91-9.30, all P<0.05). After intervention, the scores of all factors and total scores of IPROS in the study group were 3.92 ± 1.32, 5.38 ± 1.56, 5.15 ± 1.63, 4.69 ± 1.44, 4.46 ± 1.66, 23.62 ± 3.31 respectively, which were lower than those in the control group 5.58 ± 2.11, 7.33 ± 2.67, 6.83 ± 1.12, 6.75 ± 2.73, 6.42 ± 2.31, 32.92 ± 5.07, there were significant differences between the two groups ( t values were 2.25-5.48, all P<0.05). Conclusions:Bibliotherapy can effectively improve the stigma and social function of patients with schizophrenia in rehabilitation.

Surgical strategies for anteromedial tibial plateau compression fracture complicated with posterolateral corner injury / 中华创伤骨科杂志

Objective:To discuss the surgical strategies for anteromedial tibial plateau compression fracture complicated with posterolateral corner injury.Methods:From 2015 January to 2020 July, 18 patients with anteromedial tibial plateau compression fracture complicated with posterolateral corner injury were admitted to Department Ⅲ of Orthopaedics, Zhongshan Hospital of Traditional Chinese Medicine. They were 11 males and 7 females, aged from 28 to 57 years (average, 38.6 years). By the CT three-column theory, all their fractures were medial column ones; by the Fanelli classification, there were 5 cases of type B and 13 cases of type C. Seventeen patients with fresh fracture were treated with arthroscopic ligament reconstruction and meniscus repair followed by primary reduction and fixation of tibial plateau fracture. The one patient with obsolete injury was treated with high tibial osteotomy around the knee joint and reconstruction of the anterior cruciate ligament. Recorded were the patients' fracture healing time, knee Lysholm score, joint range of motion and complications.Results:The 17 patients with fresh injuries were followed up for 12 to 24 months (average, 18.4 months). Their fracture healing time ranged from 12 to 24 weeks (average, 17.7 weeks). By one year after surgery, their knee extension reached 0° and their knee flexion from 120° to 135° (average, 131.9°); their knee Lysholm scores ranged from 88 to 95 points (average, 91.2 points). The one patient with old injuries was followed up for 18 months, with fracture healing time of 18 weeks, knee range of motion from 0° to 120° and knee Lysholm score of 86 points by one year after operation. None of the patients reported such complications as neurovascular injury, wound infection, internal fixation failure or nonunion.Conclusion:For anteromedial tibial plateau compression fracture complicated with posterolateral corner injury, primary repair and reconstruction can restore knee joint stability, leading to fine therapeutic outcomes.

Application of Nrf2 activators in the treatment of Alzheimer′s disease / 中国药科大学学报

@#Alzheimer′s disease(AD)is an irreversible neurodegenerative disease. Main features in AD brains are abnormal deposition of amyloid-beta peptide(Aβ)in extracellular senile plaques(SP), intracellular neurofibrillary tangles(NFT)formed by hyperphosphorylated tau. The cause of AD is not clear. Oxidative stress is considered to be an important factor leading to the development of AD. Keap1-Nrf2-ARE signaling pathway is one of the most important defense mechanisms of antioxidant and/or electrophilic stress in the body. The activation of Keap1-Nrf2-ARE signaling pathway induces the transcription of a range of cytoprotective genes and reduces oxidative stress. This article outlines the therapeutic effect of flavonoids, phenols, carboxylic acids, esters and other Nrf2 activators on Alzheimer′s disease.

Role of cell adhesion molecule L1 like in the inhibition of the metastasis of esophageal squamous cell carcinoma / 中华消化杂志

Objective To investigate the role of cell adhesion molecule L1 like (CALL) in the genesis and development of esophageal squamous cell carcinoma (ESCC).Methods From July 2007 to December 2010,a total of 100 patients with ESCC who received radical resection of esophageal cancer were enrolled.The ESCC tissues and corresponding tumor-adjacent normal tissues were obtained.The expression of CALl was determined by tissue microarray technology and immunohistochemical staining.The CALL over-expressed esophageal cancer cell line was established.The effects of CALL on cell migration and invasion were detected by wound-healing assay and Transwell assay,respectively.The effects of CALL on actin microfilament was analyzed by filamentous actin (F-actin) staining.Chi square test,Fisher's exact test,multivariate analysis and t test were performed for statistical analysis.Results The positive expression rate of CALL in ESCC tissues was 56 ％ (56/100),which was lower than that of tumor-adjacent normal tissues (95％,95/100),and the difference was statistically significant (x2=41.114,P＜0.01).There were statistically significant differences in CALL expression at protein level among patients with ESCC of different differentiation degree,different pathological T stage,lymph node metastasis and different TNM stage (x2=13.702,5.317,21.453,Fisher's exact test;all P＜ 0.05).The five year disease related survival rate of ESCC patients with down-regulated expression of CALL was 0(0/49),which was lower than those with normal CALL expression (25.5％,13/51),and the difference was statistically significant (x2 =43.338,P＜0.01).The median survival time of CALL expression down-regulated group was 17 months,and that of normal expressed group was 38 months.CALL expression was an independent risk factor of disease special survival rate (hazard ratio (HR) 0.353,95％ confidence interval (CI) 0.188 to 0.666,P=0.001).The results of wound-healing assay showed that the migration ability of CALL overexpressed CALL-k30 cells was lower than that of Vec-k30 cells in control group on 24 hours after wound.The results of Transwell invasion test showed the number of migrating cells penetrating CALL k30 cells attached to the inferior surface of the membrane was 44.000±13.748,which was less than that of the Vec k30 cells (154.333±25.007),and the difference was statistically significant (t=5.136,P=0.036).The results of F-actin staining demonstrated that actin filaments of CALL-k30 cells was 234.667 ± 65.118,which was lower than that of Vec-k30 cells (597.000± 119.929),and the difference was statistically significant (t=4.707,P=0.042).Conclusions CALL lowers the migration and invasion abilities of esophageal cancer cells by inhibiting F-actin microfilaments.Its abnormal expression may play an important role in the genesis,development and prognosis of ESCC.

Effectiveness Analysis of Collaboration Application of SPD and HIS in Drug Logistics Management / 中国药房

OBJECTIVE:To study the effects of the collaboration application of hospital information system (HIS) andsmart chaininventory automation management system(SPD)in drug distribution enterprises on drug logistics management,and achieve the centralized distribution of drugs. METHODS:Related countermeasures in achieving the informatization and scientiza-tion of drug inventory management after the collaboration application of HIS and SPD were introduced,and effectiveness analysis was conducted for the inventory management by comparing related indicators before and after collaboration application. RESULTS:Through the establishment ofunified receiving platformsystem and barcode technology that combined with HIS and SPD,drug barcode acceptance was achieved;setting drug fixed package and scanning fixed cards in outer packing in theunified receiving platformsystem can achieve automatic out-and into-storehouse and generating purchase plan;the collaboration application of HIS and SPD achieved drug concentration distribution. Compared with before,monthly inventory amount was decreased 27.07%(P<0.05)in the condition that both drug purchases and sales amount were increased,into-warehouse time of pharmacy acceptance was decreased from 6-12 s in each drug to 10-15 s in each order,pharmacy staff dropped from 2.5 to 2 persons. CONCLUSIONS:The collaboration application of HIS and SPD in drug logistics management has improved efficiency of warehouse,reduced drug inven-tory and achieved the informatization and scientization of drug inventory management.

Effect of docosahexenoic acid microalgae oil supplementation during pregnancy and lactation on levels of serum polyunsaturated fatty acid and tolerance to ovalbumin in suckling mice / 中华儿科杂志

Objective@#To study the tolerance to ovalbumin (OVA) in suckling mice whose mothers had different doses of docosahexenoic acid (DHA) microalgae oil (DMO) supplementation during pregnancy and lactation.@*Method@#According to different doses of DMO fed to mother mice during pregnancy and lactation, 66 suckling mice were divided into four groups. Suckling mice whose mothers were fed with 0.7% DMO were designated as low dose group (group L) (n=16), 2.1% DMO as middle dose group (group M) (n=16), 3.5% DMO as high dose group (group H) (n=17) and no DMO as control group (n=17). Before exposing to OVA, 8 suckling mice were killed in each group at 21-day-old. Remaining suckling mice were killed at 59-day-old after repeated OVA exposure. The serum polyunsaturated fatty acid (PUFA) levels of suckling mice were analyzed by high performance liquid chromatography (HPLC) at the age of 21- and 59-day.Histological examinations of jejunum were performed by HE staining and the mast cells in jejunum were observed by toluidine blue staining. OVA-IgE in serum, total IgA and OVA-IgA in the feces and IL-4 and IFN-γ in the supernatants of splenic mononuclear cells (SMC) were measured by ELISA. Real time PCR was performed to identify the gene expression of IL-10, TGF-β1 mRNA in SMC. Differences among groups were compared by one-way AVOVA and that between each group were compared by LSD.@*Result@#In group M and H, the serum levels of n-3DHA (108±29)μg/ml; (102±34)μg/ml vs.(40±19)μg/ml (F=12.052, P=0.000)and n-3 eicosapentaenoic acid (6.7±2.3)μg/ml; (7.7±2.0)μg/ml vs. (3.9±1.1)μg/ml(F=9.573, P=0.000) were significantly higher than that in control group at the age of 21-day. The serum levels of n-3DHA were higher in group H (17.1±2.9)μg/ml than that in control group (5.9±3.3) μg/ml after repeated OVA exposure at the age of 59-day (F=10.339, P<0.000). Compared with control group (53±12) pg/ml, the levels of IL-4 in SMC in group H (42±9)pg/ml were lower (F=2.484, P<0.05).@*Conclusion@#The serum levels of DHA in baby mice, whose mothers was fed with DMO during pregnancy and lactation, were significantly increased till adulthood. However, the effect on tolerance to OVA was limited.

Application of U-shaped transdermal surgical navigator based on three-dimensional reverse design in cannulated screwing for femoral neck fracture / 中华创伤骨科杂志

Objective To explore application of our self-designed U-shaped transdermal surgical navigator based on three-dimensional reverse design in cannulated screwing for femoral neck fracture Methods A retrospective study was done of 5 patients with femoral neck fracture who had been treated from August 2016 to March 2017.They were 3 men and 2 women,aged from 33 to 60 years (average,46.5 years).Thin layer CT scanning was conducted on the patients' affected hip (at the left side in 2 cases and at the right side in 3).Based on their CT data,3D design software and 3D printing technique were used to manufacture the U-shaped transdermal surgical navigator and a real-sized model of the fracture.Operations were simulated using the U-shaped transdermal surgical navigator on the fracture model to determine the angle,depth and location of the screwing.Fixation of the fracture with cannulated screws was conducted after confirmation of satisfactory surgical parameters.The postoperative X-ray films of the patients were reviewed.Evaluations were conducted of the screw position,operating time,volume of operative bleeding,and number of intraoperative X-ray shots.Results The screw positions in the 5 patients were consistent with their preoperative design.Four patients had only one shot of fluoroscopy and one patient 3 shots.Their operating time ranged from 15 to 30 minutes,averaging 22.5 minutes;their bleeding ranged from 5 to 10 mL,averaging 7.5 mL.The 5 patients were followed up for an average of 4.5 months (from 3 to 6 months).By the Harris scoring at their final follow-ups,one was excellent,3 good and one fair.No complications like pain,functional impairment of the joint,or collapse or necrosis of the femoral head occurred during the follow-up.Conclusions Our self-designed U-shaped transdermal surgical navigator based on three-dimensional reverse design can significandy improve the accuracy and safety of the cannulated screwing for femoral neck fractures.The operation is minimally invasive,reducing operating time and intraoperative blood loss.

Arthroscopic treatment of tibial intercondylar eminence avulsion fracture in pediatric patients without epiphyseal interference / 中华创伤骨科杂志

Objective To evaluate the clinical efficacy of arthroscopic treatment of tibial intercondylar eminence avulsion fracture in pediatric patients without epiphyseal interference.Methods From February 2010 to February 2014,18 children patients with avulsion fracture of tibial eminence were admitted.They were 12 boys and 6 girls,from 7 to 14 years of age (average,10.4 years).Four cases were complicated with meniscus injury and 2 with medial collateral ligament injury.The mean time from injury to surgery was 4.5 days (range,from 2 to 7 days).According to Meyers-McKeever classification,13 children were type Ⅱ and 5 type Ⅲ.They were treated with Ultrabraid sutures arthroscopically.After reposition,the bone fragments were fixated to the distal epiphysis of tibial tubercle through the inferior of transverse ligament of knee to avoid epiphyseal injury.Anterior drawer test,Lanchman test,pivot shift test and Lysholm knee scoring were conducted at all clinical follow-up visits to assess functional recovery.Results All children were followed up from 10 to 24 months (average,15 months).The X-ray examination demonstrated bone union in all cases.At the end of follow-up,all children achieved satisfactory recovery of range of motion without complications like joint stiffness,joint relaxation,dysfunction or epiphyseal injury.The anterior drawer test,Lanchman test and pivot shift test were all negative at the last follow-up.The mean Lysholm knee scores improved significantly from preoperative 45.6 ± 7.4 to 92.4 ± 5.8 at the final follow-up (t =-25.403,P ＜ 0.01).Conclusions Bone reposition under arthroscopy with suture fixation is reliable and minimally invasive in the treatment of avulsion fractures of tibial intercondylar eminence in pediatric patients.

Therapeutic Effect of Tianwang Buxin Decoction for Delirium After Hip Joint Replacement in Senile Femoral Neck Fracture / 广州中医药大学学报

Objective To observe the therapeutic effect of Tianwang Buxin Decoction for delirium after hip joint replacement in senile femoral neck fracture patients. Methods A total of 57 senile patients with femoral neck fracture induced by falling were enrolled from the department of arthropathy of Zhongshan Hospital of Traditional Chinese Medicine admitted from September of 2009 to February of 2014. The patents were aged over 65 years, and had delirium after hip joint replacement. Random number method was used to divide the patients into Chinese medicine group ( 29 cases) and western medicine group ( 28 cases) , which were given oral use of Tianwang Buxin Decoction and Olanzapine separetely. Before and after treatment, we observed the scores of Delirium Rating Scale (DRS), time for delirium disappearing, and incidence of indifferent mind and somnolence.Results (1) After treatment, DRS scores were obviously decreased in both groups (P0.05). (2) The difference of time for delirium disappearing was insignificant between the two groups after treatment ( P>0.05). ( 3) After treatment, 7 cases of the control group had indifferent mind or somnolence, accounting for 25%. No case of the treatment group had indifferent mind or somnolence. The difference between the two groups was significant ( P<0.01). Conclusion Oral use of Tianwang Buxin Decoction has the same effect as Olanzapine for the treatment of delirium after hip joint replacement in falling-induced senile femoral neck fracture patients, and has the advantages of having no adverse reaction of indifferent mind or somnolence, and can realize comprehensive treatment by modification of the recipe according to the symptoms.

Establishment the cut-off value of hTSH in dried venous blood spots of neonatal screening for CH in Guilin / 国际检验医学杂志

Objective To investigate the distribution of human thyroid stimulation hormone(hTSH) in dried venous blood spots of neonatal screening for congenital hypothyroidism in Guilin ,and establish the hTSH cut‐off value for neonatal screening .Methods We selected 101 817 cases of neonatals with the local household registration from January 2011 to December 2013 ,and collected their venous blood to be made into dried venous blood spots on filter paper ,then the hTSH levels in dried blood spots were deter‐mined for congenital hypothyroidism ,According to screening results ,using the percentile method to calculate the hTSH P50 ,P99 of all the normal neonatals and neonatals that born in different quarters .Results Among 101 817 neonatals who were screened ,101 746 cases of normal neonatals ,71 cases of patients(including 47 cases of patients with CH ,24 cases of patients with high hTSH hy‐perlipidemia) ,the hTSH levels of normal neonatals showing a skewed distribution ,P50 ,P99 were 2 .45 μU/mL ,9 .86 μU/mL .the hTSH levels of the neonatal who were born in different quarters was changed with the change in the quarter ,P50 ,P99 were 2 .15μU/mL ,9 .20 μU/mL in The Spring ;P50 ,P99 were 1 .97 μU/mL ,8 .38 μU/mL in the summer ;P50 ,P99 were 2 .67 μU/mL ,10 .43μU/mL in the autumn ;P50 ,P99 were 2 .90μU/mL ,11 .15μU/mL in the winter .Through the analysis ,although the hTSH cut‐off of capillary blood spots that was used in the local center could be applied to dried venous blood spots ,but not ideal cut‐off value .Even‐tually ,the hTSH P99 9 .20μU /mL in the spring was identified as cut‐off value of dried venous blood spots for routine screening la‐boratory ,which had a sensitivity of 100 .00% ,a specificity of 36 .80% ,the diagnosis rate of 38 .96% ,and no missed phenomena .For the better service ,the hTSH value in the range of 9 .20-20 .00 μU/mL was defined as the boundary region ,and it was the danger region when the hTSH value was higher than 20 .00 μU/mL .Conclusion It is necessary to establish a reasonable hTSH cut‐off value to provide objective evidence for the use of dried venous blood spots of neonatal screening for congenital hypothyroidism ,ac‐cording to the boundary region and the danger region ,the recall chosen a different way ,the development of neonatal screening can be effectively promoted .

Expression of GAP-43 in Midbrain Ventral Tegmental Area of Morphine With-drawal Rats / 法医学杂志

Objective To observe the protein expression of grow thassociated protein-43 (GAP-43) in mid-brain ventral tegmental area in morphine withdrawal rats at different time, and to evaluate the effect of GAP-43 on morphine withdrawal memory. Methods Rat models of morphine dependent 1 week, 2 weeks and 4 weeks were established by morphine hydrochloride intraperitoneal injection with increasing doses to establish natural withdrawal. The protein expression of GAP-43 in midbrain ventral tegmental area was observed by im munohistochemical staining and the results were analyzed by Im age-Pro Plus 5.1 im-age analysis system . Results With prolongation of dependent time, the expression of GAP-43 was de-creased then increased in midbrain ventral tegmental area . Conclusion GAP-43 could play arole in morphine withdrawal memory in midbrain ventral tegmental area.

Practice of case-based PBL teaching model in clinical immunology and laboratory teaching / 中华医学教育探索杂志

Objective To train medical students' competence of independent thinking and problem solving and to improve the quality of teaching.MethodsThe case-based PBL teaching model was introduced to teaching practice for 25 undergraduates majoring in medical laboratory.The teaching process included pre-class mobilization,question,self-study,discussion and summary.Effectiveness of teaching was evaluated with questionnaire.Results For these medical students,the enthusiasm of learning ( 83.3％ ),ability of self-learning and information seeking ( 79.2％ ),ability of discussing and problem solving ( 79.2％ ),ability of scientific thinking and clinical reasoning ( 79.2％ ) were significantly improved.Teaching satisfaction rate of case-based PBL teaching model was up to 95.8％.ConclusionBetter results of teaching were achieved and the case-based PBL teaching model is worth spreading.

The role of polyunsaturated fatty acids in allergic diseases prevention / 国际儿科学杂志

Studies suggested a link between the declining consumption of n-3 polyunsaturated fatty acids (n-3 PUFA)and the rise in allergic diseases. Although the effect of supplementing n-3 PUFA on the treatment of atopic diseases in adult has been disappointing, the epidemiological evidence suggested n-3 polyunsaturated fatty acids may play a role in against allergy. In recent years, there has been a growing focus on the role of n-3 PUFA in allergy prevention in early life. This review will examine the current evidences about the effects and mechanisms of n-3 polyunsaturated fatty acids in allergy protection.