Manual Therapy for a Chronic Non-Specific Low Back Pain Rat Model.

Chronic low back pain (CLBP) is a highly prevalent condition worldwide and a major cause of disability. The majority of patients with CLBP are diagnosed with chronic non-specific low back pain (CNLBP) due to an unknown pathological cause. Manual therapy (MT) is an integral aspect of traditional Chinese medicine and is recognized as Tuina in China. It involves techniques like bone-setting and muscle relaxation manipulation. Despite its clinical efficacy in treating CNLBP, the underlying mechanisms of MT remain unclear. In animal experiments aimed at investigating these mechanisms, one of the main challenges is achieving normative MT on CNLBP model rats. Improving the stability of finger strength is a key issue in MT. To address this technical limitation, a standardized procedure for MT on CNLBP model rats is presented in this study. This procedure significantly enhances the stability of MT with the hands and alleviates common problems associated with immobilizing rats during MT. The findings of this study are of reference value for future experimental investigations of MT.

Simultaneous Knockouts of the Oxytocin and Vasopressin 1b Receptors in Hippocampal CA2 Impair Social Memory.

Oxytocin (Oxt) and vasopressin (Avp) are two neuropeptides with many central actions related to social cognition. The oxytocin (Oxtr) and vasopressin 1b (Avpr1b) receptors are co-expressed in the pyramidal neurons of the hippocampal subfield CA2 and are known to play a critical role in social memory formation. How the neuropeptides perform this function in this region is not fully understood. Here, we report the behavioral effects of a life-long conditional removal (knockout, KO) of either the Oxtr alone or both Avpr1b and Oxtr from the pyramidal neurons of CA2 as well as the resultant changes in synaptic transmission within the different fields of the hippocampus. Surprisingly, the removal of both receptors results in mice that are unable to habituate to a familiar female presented for short duration over short intervals but are able to recognize and discriminate females when presented for a longer duration over a longer interval. Importantly, these double KO mice were unable to discriminate between a male littermate and a novel male. Synaptic transmission between CA3 and CA2 is enhanced in these mice, suggesting a compensatory mechanism is activated to make up for the loss of the receptors. Overall, our results demonstrate that co-expression of the receptors in CA2 is necessary to allow intact social memory processing.

Imaging evaluation of the efficacy and prognosis of neoadjuvant chemotherapy for osteosarcoma / 中国医师杂志

Osteosarcoma is the most common primary malignant bone tumor in children and adolescents. Neoadjuvant chemotherapy is an important part of the standard treatment mode for osteosarcoma. Preoperative evaluation of the effect of neoadjuvant chemotherapy is of great significance to the selection of surgical plan and the adjustment of subsequent treatment plan. Imaging evaluation method is one of the important ways to evaluate the efficacy of neoadjuvant chemotherapy and the prognosis of patients. It has the advantages of simple, quick and non-invasive, and has become a research hotspot.

Application of mind mapping combined with interactive communication mode in clinical teaching of Neurosurgery / 中华医学教育探索杂志

Objective:To observe the application effect of mind mapping combined with interactive communication mode in clinical teaching of neurosurgery.Methods:A total of 40 students who practiced in the Department of Neurosurgery in the Affiliated Hospital of Guizhou Medical University from September 2019 to September 2020 were included in the control group, and traditional teaching was adopted; another 40 students who practiced from October 2020 to October 2021 were included in the observation group, and mind mapping combined with interactive communication mode was adopted for teaching. The two groups of students were taught for 2 weeks, and after the teaching, the teaching effect was compared between the two groups. SPSS 25.0 software was used to conduct t-test and Chi-square test. Results:After 2 weeks of teaching, the scores of theoretical knowledge (90.38±4.03) and practical operation skills (93.37±3.48) in the two groups were higher than those before teaching [(85.52±5.26) and (87.25±4.48)], with statistically significant differences ( t=4.63, 6.83, P<0.001). The case analysis score of the two groups was higher than that before teaching, and that of the observation group (86.03±6.07) was higher than that of the control group (79.13±5.57), with statistically significant differences ( t=5.30, P<0.001). The scores of interpersonal communication ability and cooperation ability of the two groups were higher than those before teaching. The scores of interpersonal communication ability (82.53±4.74), cooperation ability (169.73±7.55) of the observation group were higher than those of the control group [(77.93±4.45) and (158.42±8.01)], with statistically significant differences ( t=4.48, 6.49, P<0.001). Conclusion:Mind mapping combined with interactive communication mode can effectively improve the clinical basic knowledge and clinical practice ability of interns in the Department of Neurosurgery, and improve their communication and cooperation ability.

Design and clinical application of the distal femur spherical motion axis hinge knee prosthesis / 中华骨科杂志

Objective:To investigate the feasibility and early clinical efficacy of spherical motion axis hinge knee prosthesis to reconstruct distal femoral bone defects.Methods:A retrospective analysis was performed on 16 patients admitted to PLA 960th Hospital and Tianjin Hospital from October 2019 to November 2021, including 8 males and 8 females, with an average age of 43.3±17.8 years (range, 15-71 years). There were 13 patients of primary tumors of the distal femur and 3 patients of postoperative revision of knee joint prostheses. Among the 13 patients with distal femur tumors, there were 6 cases of osteosarcoma, 5 cases of giant cell tumor of bone, 1 case of leiomyosarcoma and 1 case of chondrosarcoma. The reasons for revision after prosthesis replacement in 3 cases were: 2 cases of aseptic loosening after tumor-type prosthesis and 1 case of periphery fracture of surface artificial knee prosthesis. A spherical shaft rotary hinged knee prosthesis was designed and fabricated to reconstruct postoperative femoral defects in 16 patients. Follow up regularly after the operation, recheck the X-ray film to evaluate the lower limb force line, evaluate the quality of life after the operation with the Chinese version of 36-item short-form (SF-36), and evaluate the postoperative limb function with the Musculoskeletal Tumor Society (MSTS) 93 evaluation system.Results:All 16 patients were successfully placed with prostheses, and except for 2 patients undergoing total femoral replacement, the length of bone defects was 18.2±11.7 cm (range, 8.6-47.1 cm) in other 14 patients, and the operation time was 138±19 min (range, 110-170 min), the intraoperative blood loss was 211±118 ml (range, 100-500 ml). The postoperative full length orthostatic X-ray film of the lower limbs showed that the distance between the mechanical axis of the lower limb and the center of the knee joint was 0.1 (0, 0.7) cm in 16 patients, and the hip-knee ankle angle was 179.0°±2.3°(range, 173.3°-182.2°). The patients were followed up for 12-36 months. No prosthesis complications were found in 16 patients. The SF-36 score was 56.7±7.0 (range, 42.7-67.4) for physiological function and 54.1±7.6 (range, 40.5-66.3) for psychological function. The maximum knee flexion angle was 120.0°±15.6° (range, 95°-130°). The MSTS 93 score of 15 patients with tumor was 25.0±1.7 (range, 22-28), including 7 excellent and 8 good. One patient developed liver and lung metastases 10 months after surgery and died 18 months after surgery. The remaining patients, as of the last follow-up, were alive and had no local recurrence or distant metastases. Tumor-free survival time was 25.8±8.4 months (range, 12-36 months).Conclusion:The spherical motion axis hinge knee prosthesis reconstruction for distal femoral bone defects is simple and fast in intraoperative prosthesis installation, and there are no prosthetic related complications during short-term follow-up. The clinical efficacy is satisfactory.

Effects of propiconazole on physiological and biochemical properties of Panax notoginseng and dietary risk assessment / 中国中药杂志

To study the residue and dietary risk of propiconazole in Panax notoginseng and the effects on physiological and bioche-mical properties of P. notoginseng, we conducted foliar spraying of propiconazole on P. notoginseng in pot experiments. The physiolo-gical and biochemical properties studied included leaf damage, osmoregulatory substance content, antioxidant enzyme system, non-enzymatic system, and saponin content in the main root. The results showed that at the same application concentration, the residual amount of propiconazole in each part of P. notoginseng increased with the increase in the times of application and decreased with the extension of harvest interval. After one-time application of propiconazole according to the recommended dose(132 g·hm~(-2)) for P. ginseng, the half-life was 11.37-13.67 days. After 1-2 times of application in P. notoginseng, propiconazole had a low risk of dietary intake and safety threat to the population. The propiconazole treatment at the recommended concentration and above significantly increased the malondialdehyde(MDA) content, relative conductivity, and osmoregulatory substances and caused the accumulation of reactive oxygen species in P. notoginseng leaves. The propiconazole treatment at half(66 g·hm~(-2)) of the recommended dose for P. ginseng significantly increased the activities of superoxide dismutase(SOD), peroxidase(POD), and catalase(CAT) in P. notoginseng leaves. The propiconazole treatment at 132 g·hm~(-2) above inhibited the activities of glutathione reductase(GR) and glutathione S-transferase(GST), thereby reducing glutathione(GSH) content. Proconazole treatment changed the proportion of 5 main saponins in the main root of P. notoginseng. The treatment with 66 g·hm~(-2) propiconazole promoted the accumulation of saponins, while that with 132 g·hm~(-2) and above propiconazole significantly inhibited the accumulation of saponins. In summary, using propiconazole at 132 g·hm~(-2) to prevent and treat P. notoginseng diseases will cause stress on P. notoginseng, while propiconazole treatment at 66 g·hm~(-2) will not cause stress on P. notoginseng but promote the accumulation of saponins. The effect of propiconazole on P. notoginseng diseases remains to be studied.

Oral pathogen aggravates atherosclerosis by inducing smooth muscle cell apoptosis and repressing macrophage efferocytosis / 国际口腔科学杂志·英文版

Periodontitis imparting the increased risk of atherosclerotic cardiovascular diseases is partially due to the immune subversion of the oral pathogen, particularly the Porphyromonas gingivalis (P. gingivalis), by inducing apoptosis. However, it remains obscure whether accumulated apoptotic cells in P. gingivalis-accelerated plaque formation are associated with impaired macrophage clearance. Here, we show that smooth muscle cells (SMCs) have a greater susceptibility to P. gingivalis-induced apoptosis than endothelial cells through TLR2 pathway activation. Meanwhile, large amounts of miR-143/145 in P.gingivalis-infected SMCs are extracellularly released and captured by macrophages. Then, these miR-143/145 are translocated into the nucleus to promote Siglec-G transcription, which represses macrophage efferocytosis. By constructing three genetic mouse models, we further confirm the in vivo roles of TLR2 and miR-143/145 in P. gingivalis-accelerated atherosclerosis. Therapeutically, we develop P.gingivalis-pretreated macrophage membranes to coat metronidazole and anti-Siglec-G antibodies for treating atherosclerosis and periodontitis simultaneously. Our findings extend the knowledge of the mechanism and therapeutic strategy in oral pathogen-associated systemic diseases.

In-situ formed elastin-based hydrogels enhance wound healing via promoting innate immune cells recruitment and angiogenesis.

Harnessing the inflammation and angiogenesis is extremely important in wound healing. In this study, we developed bioactive elastin-based hydrogels which can recruit and modulate the innate immune cells and accelerate angiogenesis in the wound site and subsequently improve wound regeneration. These hydrogels were formed by visible-light cross-linking of acryloyl-(polyethylene glycol)-N-hydroxysuccinimide ester modified elastin with methacrylated gelatin, in order to mimic dermal microenvironment. These hydrogels showed highly tunable mechanical properties, swelling ratios and enzymatic degradation profiles, with moduli within the range of human skin. To mimic the in vivo degradation of the elastin by elastase from neutrophils, in vitro co-culture of the hydrogels and neutrophils was conducted. The derived conditioned medium containing elastin derived peptides (EDP-conditioned medium) promoted the expression of both M1 and M2 markers in M1 macrophages in vitro. Additionally, the EDP-conditioned medium induced superior tube formation of endothelia cells in Matrigel. In mice wound model, these elastin-based hydrogels attracted abundant neutrophils and predominant M2 macrophages to the wound and supported their infiltration into the hydrogels. The outstanding immunomodulatory effect of the elastin-based hydrogels resulted in superior angiogenesis, collagen deposition and dermal regeneration. Hence, these elastin-based hydrogels can be a promising regenerative platform to accelerate wound repair.

Machine Learning-Based Risk Model for Predicting Early Mortality After Surgery for Infective Endocarditis.

Background The early mortality after surgery for infective endocarditis is high. Although risk models help identify patients at high risk, most current scoring systems are inaccurate or inconvenient. The objective of this study was to construct an accurate and easy-to-use prediction model to identify patients at high risk of early mortality after surgery for infective endocarditis. Methods and Results A total of 476 consecutive patients with infective endocarditis who underwent surgery at 2 centers were included. The development cohort consisted of 276 patients. Eight variables were selected from 89 potential predictors as input of the XGBoost model to train the prediction model, including platelet count, serum albumin, current heart failure, urine occult blood ≥(++), diastolic dysfunction, multiple valve involvement, tricuspid valve involvement, and vegetation >10 mm. The completed prediction model was tested in 2 separate cohorts for internal and external validation. The internal test cohort consisted of 125 patients independent of the development cohort, and the external test cohort consisted of 75 patients from another center. In the internal test cohort, the area under the curve was 0.813 (95% CI, 0.670-0.933) and in the external test cohort the area under the curve was 0.812 (95% CI, 0.606-0.956). The area under the curve was significantly higher than that of other ensemble learning models, logistic regression model, and European System for Cardiac Operative Risk Evaluation II (all, P<0.01). This model was used to develop an online, open-access calculator (http://42.240.140.58:1808/). Conclusions We constructed and validated an accurate and robust machine learning-based risk model to predict early mortality after surgery for infective endocarditis, which may help clinical decision-making and improve outcomes.

One case of pancreatic metastases from small cell lung cancer / 中华内分泌外科杂志

Pancreatic metastasis of small cell lung cancer is very rare in clinic. The purpose of this article is to improve the knowledge of clinical and radiologists about this disease by reporting one case.

Preliminary application of navigation-assisted total knee arthroplasty using adjusted restricted kinematic alignment / 中华骨科杂志

Objective:To evaluate the feasibility and clinical outcomes of navigation-assisted total knee arthroplasty (TKA) using adjusted restricted kinematic alignment (arKA).Methods:Data of 14 consecutive cases of OrthoPilot navigation-assisted TKA using arKA from October 2019 to September 2021 were retrospectively analyzed, including 3 males and 9 females. The average age was 67.71±8.96 years with mean body mass index (BMI) 25.94±3.12 kg/m 2. 27 consecutive patients who underwent navigation-assisted TKA using aMA during the same period were assessed as the control group. There were no significant differences in gender, age or BMI between the two groups. Intraoperative parameters including operative duration, tibia resection angle, frontal femoral angle, axial femoral angle, joint line translation, medial and lateral gap in extension and flexion position were recorded. Radiographic parameters including hip-knee-ankle (HKA) angle, coronal femoral component angle (cFCA), coronal tibial component angle (cTCA), sagittal femoral component angle (sFCA) and sagittal tibial component angle (sTCA) were measured. Functional outcomes were assessed by Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Hospital for Special Surgery (HSS) score. Surgery-related complications were recorded. Results:All cases were followed up. The mean follow-up of arKA group was 18.57±6.98 months and follow-up of aMA group was 22.15±4.91 months. The intraoperative tibial resection was 3.07°±1.00° in arKA group versus 0.67°±0.56° in aMA group ( P<0.05). The lateral cutting height of tibia was 9.07±1.82 mm in arKA group versus 6.89±2.94 mm in aMA group ( P<0.05). The lateral gap in flexion was 1.71±0.83 mm in arKA group versus 1.04±0.71 mm in aMA group ( P<0.05). The difference of medial-lateral flexion laxity was 1.14±0.86 mm in arKA group versus 0.41±0.75 mm in aMA group ( P<0.05). The postoperative HKA angle was 174.10°±1.63° in arKA group versus 177.12°±2.07° in aMA group ( P<0.05). The cTCA was 87.58°±0.85° in arKA group versus 89.14°±1.23° in aMA group ( P<0.05). The cFCA was 93.10°±1.75° in arKA group versus 90.41°±3.01° in aMA group ( P<0.05). There was no statistical difference between the two groups in sFCA (1.30°±0.82° vs. 1.56°±1.19°), sTCA (87.16°±0.95° vs. 87.79°±1.04°) and femoral notching (7.1% vs. 11.1%). The preoperative HSS score in arKA group was 46.07±4.68 and HSS score at 1 month postoperatively was 73.86±3.48 ( P<0.05). The preoperative HSS score in aMA group was 47.04±4.52 and HSS score at 1 month postoperatively was 74.04±3.57 ( P<0.05). There was no statistical difference between the two groups in WOMAC score (12.93±2.37 vs. 12.63±2.34) and HSS score (86.86±2.74 vs. 86.11±2.95) at 6 months postoperatively. 2 cases (14.3%) in arKA group and 5 cases (18.5%) in aMA group had deep venous thrombosis (χ 2=0.12, P=0.733). Conclusion:Navigation-assisted TKA using arKA offers the surgeons a new alignment option for severe knee deformity with satisfactory clinical outcomes, the arKA technique has advantages in soft tissue protection and gap balance regulation compared to aMA technique.

Research progress on pesticide residues of Panax notoginseng / 中国中药杂志

Panax notoginseng is a perennial Chinese medicinal plant, which has serious continuous cropping obstacles and is prone to a variety of diseases and insect pests during the growth process. At present, the prevention and control of pests and diseases is mainly carried out through chemical pesticides, and the consequent pesticide residues of P. notoginseng have attracted much attention. This study reviewed the types and detection methods of pesticide residues in P. notoginseng from 1981 to 2021, and compared the limits of pesticide residues in P. notoginseng in China and abroad to provide a reference for rational application of pesticides in P. notoginseng and quality control of medicinal materials, thereby promoting the sustainable development of the P. notoginseng industry in China. Currently, there are only 40 published papers on pesticide residues of P. notoginseng, which is indicative of a serious problem of insufficient research. At present, hundreds of pesticide residues in P. notoginseng can be detected simultaneously by using chromatography-tandem mass spectrometry. The pesticides detected have gradually changed from early prohibited ones, such as dichlorodiphenyl trichloroethane(DDT), benzene hexachloride(BHC), and parathion, to low toxic ones(e.g., dimethomorph, procymidone, propicona-zole, and difenoconazole). The dietary risk from pesticide residues in P. notoginseng is low, which would not cause harm to consu-mers. This study concluded that in the future, the development of the quality standard for pesticide residues of P. notoginseng should be actively carried out. To increase the pesticides used in actual production in the quality standard based on the existing ones and to guide farmers to use pesticides scientifically will be the focus of future work.

Effects of chloropicrin fumigation on soil and growth and development of Panax notoginseng / 中国中药杂志

The continuous cropping obstacle of Panax notoginseng is serious, and effective control measures are lacking. Soil disinfection with chloropicrin(CP) has been proven to be effective in reducing the obstacles to continuous cropping of other crops. In order to ascertain the effect of CP in the continuous cropping of P. notoginseng, this paper explored the influences of CP at different treatment concentrations(0,30,40,50 kg/Mu, 1 Mu≈667 m~2) on soil macro-element nutrients, soil enzyme activity, growth and development of P. notoginseng, and the accumulation of medicinal components. The results showed that CP fumigation significantly increased the content of total nitrogen, alkali-hydrolyzable nitrogen, ammonium nitrogen, nitrate nitrogen, and available phosphorus in the soil, but it had no significant effect on potassium content. The soil protease activity showed a trend of first increasing and then decreasing with the prolonging of the treatment time. Both the soil urease and acid phosphatase activities showed a trend of first decreasing and then increasing with the prolonging of the treatment time. The higher the CP treatment concentration was, the lower the urease and acid phosphatase activities would be in the soil. The protease activity was relatively high after CP40 treatment, which was better than CP30 and CP50 treatments in promoting the nitrogen-phosphorus-potassium accumulation in P. notoginseng. The seedling survival rates after CP0, CP30, CP40, and CP50 tratments in October were 0, 65.56%, 89.44%, and 83.33%, respectively. Compared with the CP30 and CP50 treatments, CP40 treatment significantly facilitated the growth and development of P. notoginseng, the increase in fresh and dry weights, and the accumulation of root saponins. In summary, CP40 treatment accelerates the increase in soil nitrogen and phosphorus nutrients and their accumulation in P. notoginseng, elevates the seedling survival rate of P. notoginseng, enhances the growth and development of P. notoginseng, and promotes the accumulation of medicinal components. CP40 treatment is therefore recommended in production.

Warming acupuncture combined with "three steps and seven methods" of tuina for chronic nonspecific low back pain of yang deficiency and cold-dampness blockage: a randomized controlled trial / 中国针灸

OBJECTIVE@#To compare the clinical efficacy and possible mechanism of warming acupuncture combined with "three steps and seven methods" of tuina and simple "three steps and seven methods" of tuina in treatment of chronic nonspecific low back pain (NLBP) of yang deficiency and cold-dampness blockage.@*METHODS@#A total of 138 patients were randomized into an observation group (69 cases, 5 cases dropped off) and a control group (69 cases, 7 cases dropped off). In the control group, "three steps and seven methods" of tuina was applied. On the basis of the treatment in the control group, warming acupuncture was applied at Shenshu (BL 23), Yaoyangguan (GV 3), Mingmen (GV 4), Weizhong (BL 40) and ashi points. The treatment was given once a day, 6 times a week for 3 weeks in both groups. Before and after treatment, the short form of McGill pain questionnaire (SF-MPQ) score, Oswestry disability index (ODI) score, finger-to-floor distance (FFD), Schober test distance, fear-avoidance beliefs questionnaire (FABQ) score and yang deficiency and cold-dampness blockage score were observed, the serum levels of tumor necrosis factor-α (TNF-α), interleukin (IL)-1β, IL-6 and thromboxane B2 (TXB2) were detected in both groups. The recurrence rate was evaluated in follow-up of 6 months after treatment.@*RESULTS@#After treatment, the scores of PRI, PPI, VAS, ODI, FABQ and FFD, yang deficiency and cold-dampness blockage scores were decreased compared before treatment in both groups (P<0.01), and those in the observation group were lower than the control group (P<0.01); the Schober test distances were increased compared before treatment in both groups (P<0.01), and that in the observation group was larger than the control group (P<0.01). After treatment, the serum levels of TNF-α, IL-1β, IL-6 and TXB2 were decreased compared before treatment in both groups (P<0.01), and those in the observation group were lower than the control group (P<0.01). In follow-up, the recurrence rate was 12.8% (6/47) in the observation group, which was lower than 34.3% (12/35) in the control group (P<0.05).@*CONCLUSION@#Warming acupuncture combined with "three steps and seven methods" of tuina can effectively alleviate pain in patients with chronic NLBP of yang deficiency and cold-dampness blockage, improve activity and dysfunction of waist, the clinical efficacy is superior to simple "three steps and seven methods" of tuina, its mechanism may be relate to the inhibition of inflammatory reaction.

SYSTEMATIC OBSERVATION OF COVID-19 MITIGATION (SOCOM): ASSESSING FACE COVERING AND DISTANCING IN SCHOOLS

IntroductionDuring the COVID-19 pandemic, some K-12 schools resumed in-person classes with varying degrees of mitigation plans in the fall of 2020. Physical distancing and face coverings can minimize SARS-CoV-2 spread, the virus that causes COVID-19. However, no research has focused on mitigation strategy adherence during school days. Thus, we sought to develop a systematic observation protocol to capture COVID-19 mitigation strategy adherence in school environments: The Systematic Observation of COVID-19 Mitigation (SOCOM). MethodsWe extended previously validated and internationally used tools to develop the SOCOM training and implementation protocol to assess physical distancing and face covering behaviors. SOCOM was tested in diverse indoor and outdoor settings (classrooms, lunchrooms, physical education [PE], and recess) among diverse schools (elementary, secondary, and special needs). ResultsFor the unique metrics of physical-distancing and face-covering behaviors, areas with more activity and a maximum of 10-15 students were ideal for accurately capturing data. Overall proportion of agreement was high for physical distancing (90.9%), face covering (88.6%), activity type (89.2%), and physical activity level (87.9%). Agreement was lowest during active recess, PE, and observation areas with [≥]20 students. ConclusionsMillions of children throughout the US are likely to return to school in the months ahead despite the current surge of COVID-19 cases. SOCOM is a relatively inexpensive tool that can be implemented by schools to determine mitigation strategy adherence and assess changes to protocols to help students return to school safely and slow the spread of COVID-19 and can be used for research purposes.

Effects of Quercetin on Acrylamide-Induced Variation of Serum Elements in Rats.

Acrylamide (AA) is an organic chemical widely existing in the public diet, especially in foods with high-temperature fried and baked starchy and may have various adverse health effects on organisms. The purpose of this study was to investigate whether quercetin plays a protective role in AA-induced element variation in rats. Rats were randomly divided into the control group, AA-treated group [5 mg/kg body weight (bw)], two dosages of quercetin-treated groups (10 and 50 mg/kg·bw, respectively), and two dosages of quercetin plus AA-treated groups. After a 16-week treatment, the serum samples of rats were collected. Serum elements were analyzed by using inductively coupled plasma mass spectrometry (ICP-MS) combined with multivariate statistical analysis, and antioxidant indices, lipid peroxidation indicator, as well as inflammatory biomarkers, were also detected. The accuracy and precision of the method were verified, and all the validated data are within the satisfactory range. The results showed that the levels of vanadium (V), copper (Cu), zinc (Zn), selenium (Se), cobalt (Co), and magnesium (Mg) in serum were significantly lower (p < 0.01), while serum calcium (Ca) level was significantly higher (p < 0.01) in AA-treated group compared with the control group. When high-dose quercetin was administered to rats combined with AA, a significant recovered effect for the above elements levels was observed compared with the AA-treated group. This study suggests that quercetin (50 mg/kg·bw) exerts a regulatory and protective role in AA-induced variation of serum elements via reducing oxidative stress and inhibiting inflammation.

The early learning curve of OrthoPilot computer navigation assisted total knee arthroplasty / 中华骨科杂志

Objective:To explore the early learning curve of OrthoPilot navigation assisted total knee arthroplasty (TKA).Methods:Data of 40 consecutive cases of OrthoPilot navigation assisted TKA completed by the same surgical team in our department were retrospectively analyzed. According to the operation order, 40 cases were divided into the original phase group (the first 20 cases) and the subsequent phase group (the second 20 cases). In original phase group, the average age was 69.85±6.86 years with mean body mass index 24.10±2.88 kg/m 2, preoperative HSS score 48.80±5.33, preoperative knee ROM 87.05°±11.02° and preoperative alignment deviation of 7.40°±5.59°. In subsequent phase group, the average age was 66.65±7.92 years with mean body mass index 22.85±3.15 kg/m 2, preoperative HSS score 49.00±5.47, preoperative knee ROM 85.80°±11.65° and preoperative alignment deviation of 8.22°±5.21°. Perioperative data such as operative duration, incision length, hemoglobin drop and postoperative hospital stay, radiographic outcomes including hip-knee-ankle angle (HKAA), mechanical lateral distal femoral angle (mLDFA), mechanical medial proximal tibial angle (mMPTA), sagittal femoral component angle (sFCA), sagittal tibial component angle (sTCA), joint line convergence angle (JLCA), and functional scores were compared between the two groups. Results:All 40 cases were followed up for 24-33 months (mean, 27.38± 2.73 months). No severe postoperative complications such as infection and loosening occurred during the follow-up. The mean operative duration was 112.35±25.49 min in original phase group versus 82.10±10.96 min in subsequent phase group ( P< 0.05). The durations of tibial cutting was 11.95±3.27 min in original phase group versus 7.35±2.23 min in subsequent phase group ( P< 0.05); the femoral planning + cutting time was 20.95±6.91 min in original phase group versus 16.60±4.78 min in subsequent phase group, and trial + prosthesis implantation time was 39.65±7.72 min in original phase group versus 25.10±5.72 min in subsequent phase group,which was significantly higher in original phase group. There was no significant difference in other perioperative data such as incision length, hemoglobin drop and postoperative hospital stay between the two groups. As for radiographic outcomes, there was no statistical difference between the two groups in the postoperative angular deviation of HKAA (0.70°±0.80° vs. 0.80°±1.06°), mLDFA (0.89°±0.91° vs. 1.00°±0.86°), mMPTA (0.77°±0.53° vs. 0.76°±1.03°), sFCA (0.73°±0.48° vs. 0.87°±1.06°), sTCA (0.95°±0.58° vs. 1.16°±1.14°) and JLCA (0.27°±0.25° vs. 0.39°±0.18°). In original phase group, the HSS scores preoperative and 3 days postoperative were 48.80±5.33 and 60.05±5.10 respectively, and those in subsequent phase were 49.00±5.47 and 60.75±4.47 respectively, and both groups showed satisfactory functional recovery. There was no significant difference in HSS scores at all follow-up time points between two phases, as well as ROM (113.20°±9.82° vs. 113.50°±12.44°) and FJS-12 scores (78.00°±10.98° vs. 76.65°±10.29°) at 2 years postoperatively. Conclusion:In this study, we described a time-related early learning curve for OrthoPilot navigation-assisted TKA, in which the operative duration tended to be shorter after the first 20 cases. However, benefiting from good operative accuracy and repeatability, satisfactory radiographic and functional outcomes can be obtained in early stage of the learning curve.

Comparison of prosthesis locations and postoperative hip functions between supercapsular percutaneously-assisted total hip (SuperPATH) and posterolateral approaches in total hip arthroplasty / 中华创伤骨科杂志

Objective:To compare the prosthesis locations and postoperative hip functions between supercapsular percutaneously-assisted total hip (SuperPATH) approach and traditional posterolateral approach (PLA) in total hip arthroplasty.Methods:A retrospective analysis was conducted of the 107 patients who had undergone unilateral total hip arthroplasty at Department of Orthopedic Surgery, The First Affiliated Hospital to Soochow University from August 2016 to February 2019. They were divided into 2 groups according to their surgical approaches. In the SuperPATH group of 54 cases, there were 20 males and 34 females with an age of (64.3±9.1) years; in the PLA group of 53 cases, there were 20 males and 33 females with an age of (62.2±10.6) years. The 2 groups were compared in terms of abduction angle, ratio of abduction angle to safety zone, anteversion angle, ratio of anteversion angle to safety zone, retroversion angle, incidence of retroversion, and differences in eccentricity and lower limb length on the first day after operation, and Harris hip scores at 1 week, 3 months and the last follow-up postoperatively. Their complications were also recorded as well.Results:There were no statistically significant differences in the preoperative general data between the 2 groups, showing comparability ( P>0.05). The postoperative imaging data were complete for the 107 patients who had been followed up satisfactorily for 14 to 36 months (average, 25 months). The SuperPATH group had significantly larger retroversion angle (13.6°±9.6°) and incidence of retroversion (18.5%, 10/54), significantly smaller difference in eccentricity [0.26 (0.13,0.49) cm], and significantly higher Harris hip score [(74.8±7.8) points] at one week after surgery than those in the PLA group [3.0°±1.0°; 5.7%, 3/53; 0.38 (0.13,0.70) cm; (72.0±6.7) points] ( P<0.05). There were no statistically significant differences between the 2 groups in abduction angle, ratio of abduction angle to safety zone, anteversion angle, ratio of anteversion angle to safety zone, difference in lower limb length, or Harris hip scores at 3 months or the last follow-up postoperatively (all P>0.05). Follow-ups in both groups observed no more than one case of dislocation which responded to manual reduction. Conclusion:The minimally invasive SuperPATH approach may obtain better femoral eccentricity and higher early hip function scores than the traditional posterolateral approach, but may lead to a higher incidence of retroversion after prosthesis placement.

The optimal surgical time of laparoscopic appendicectomy after conservative treatment of appendiceal abscess in children / 中华实用儿科临床杂志

Objective:To explore the optimal surgical time of laparoscopic appendectomy after conservative treatment of appendiceal abscess in children.Methods:Clinical data of 86 children with appendiceal abscess diagnosed in the Department of General Surgery, Wuhan Children′s Hospital, Tongji Medical College, Huazhong University of Science and Technology from January 2016 to June 2020 were retrospectively analyzed.According to the delayed laparoscopic appendectomy interval after the appendiceal abscess was cured, 86 children were divided into group A, B and C. Briefly, patients in the 3 groups were treated with laparoscopic appendectomy 4 weeks, 8 weeks and over 12 weeks after the appendiceal abscess was cured, respectively.Children with recurrent appendicitis during delayed operation were not included.The incidence of appendicitis recurrence during delayed operation, the incidences of intraoperative complications, conversion to laparotomy, and postoperative complications, operation time, the time of postoperative intestinal function recovery, and postoperative hospital stay were compared among 3 groups.Results:There were 10, 31 and 45 cases in group A, B and C, respectively.Among them 10, 30 and 39 patients received laparoscopic appendectomy, and 0, 1 and 6 cases had appendicitis recurrence in group A, B and C, respectively.There were no significant differences in the age, gender, diameter of appendiceal abscess, inflammatory indexes at diagnosis of diagnosing appendiceal abscess, cure time of conservative treatment of abscess, and inflammatory indexes at laparoscopic appendectomy among the 3 groups (all P>0.05). The incidence of appendicitis recurrence in group C(13.33%) was significantly higher than that in group A (0) and group B (3.22%)( P<0.05). There was no significant difference in the incidence of appendicitis recurrence between group A and group B( P>0.05). The incidences of intraoperative(group A, B, C was 40.00%, 10.00%, 10.26%, respectively) and postoperative complications (group A, B, C was 40.00%, 6.70%, 5.10%, respectively), and conversion to laparotomy(group A, B, C was 20.00%, 0, 0), operation time [group A, B, C was (106.70±7.42) d, 41.40±10.44) d, (39.60±11.27) d, respectively], postoperative intestinal function recovery time [group A, B, C was(5.80±2.15) d, (0.93±0.17) d, (0.83±0.11) d], and postoperative hospital stay[group A, B, C was(12.40±4.15) d, (1.67±0.31) d, (1.58±0.44) d] in group A were significantly higher than those in group B and group C(all P<0.05), but no significant differences were found between group B and group C(all P>0.05). Conclusions:Eight weeks are the best time for laparoscopic appendectomy after conservative treatment of appendiceal abscess in children.

Compliance and influencing factors of stretch sock pressure therapy with varicose veins of lower extremities / 中华全科医师杂志

A total of 280 patients with varicose veins of lower extremities who were prescribed stretch socks as pressure therapy in the outpatient clinic of Beijing Chaoyang Hospital from September 2019 to November 2019 were included in the study. Among 280 patients 208 were followed up for one year(74.3%), 139 cases (66.8%) gave up wearing stretch socks and 69 cases (33.2%) insisted to wear. The main reasons for giving up wearing were feeling too tight (23.1%), too much troubles (17.7%), symptom improvement (15.1%), poor effect (10.8%) and so on. The compliance of wearing stretch socks as pressure therapy in outpatients with varicose veins of lower extremities is poor with a variety of reasons, the data may provide a reference for improving clinical compliance in the future.