Study on the correlation between early three-dimensional gait analysis and clinical efficacy after robot-assisted total knee arthroplasty / 中华创伤杂志(英文版)

PURPOSE@#Robot-assisted technology is a forefront of surgical innovation that improves the accuracy of total knee arthroplasty (TKA). But whether the accuracy of surgery can improve the clinical efficacy still needs further research. The purpose of this study is to perform three-dimensional (3D) analysis in the early postoperative period of patients who received robot-assisted total knee arthroplasty (RATKA), and to study the trend of changes in gait parameters after RATKA and the correlation with the early clinical efficacy.@*METHODS@#Patients who received RATKA in the Center of Joint Surgery, the First Hospital Affiliated to Army Military Medical University from October 2020 to January 2021 were included. The imaging parameters, i.e., hip-knee-ankle angle, lateral distal femoral angle, medial proximal tibial angle, posterior condylar angle were measured 3 months post-TKA. The 3D gait analysis and clinical efficacy by Western Ontario Mac Master University Index (WOMAC) score were performed pre-TKA, 3 and 6 months post-TKA. The differences in spatiotemporal parameters of gait, kinetic parameters, and kinematic parameters of the operated limb and the contralateral limb were compared. The correlation between gait parameters and WOMAC scores was analyzed. Paired sample t-test and Wilcoxon rank-sum test were used to analyze the difference between groups, and Spearman correlation coefficient was used to analyze the correlation.@*RESULTS@#There were 31 patients included in this study, and the imaging indexes showed that all of them returned to normal post-TKA. The WOMAC score at 3 months post-TKA was significantly lower than that pre-TKA, and there was no significant difference between at 3 and 6 months. The 3D gait analysis results showed that the double support time of the operated limb reduced at 3 and 6 months (all p < 0.05), the maximum extension and maximum external rotation of the knee joint increased at stance phase, and the maximum flexion angle, the range of motion and the maximum external rotation increased at swing phase. Compared with the preoperative data, there were significant improvements (all p < 0.05). Compared with the contralateral knee joint, the maximum external rotation of the knee joint at swing phase was smaller than that of the contralateral side, and the maximum flexion and extension moment was greater than that of the contralateral knee. The maximum external rotation moment of the joint was greater than that of the contralateral knee joint (p < 0.05). There was a negative correlation between the single support time pre-TKA and the WOMAC score at 3 months (p = 0.017), and the single support time at 3 months was negatively correlated with the WOMAC score at 6 months (p = 0.043). The cadence at 6 months was negatively correlated with the WOMAC score at 6 months (p = 0.031). The maximum knee extension at stance phase at 6 months was negatively correlated with the WOMAC score at 6 month (p = 0.048). The maximum external rotation at stance phase at 6 months was negatively correlated with the WOMAC score at 6 months (p = 0.024).@*CONCLUSION@#The 3D gait analysis of RATKA patients is more sensitive than WOMAC score in evaluating the clinical efficacy. Trend of changes in gait parameters shows that the knee joint support, flexion and extension function, range of motion, external rotation and varus deformity moment of the patient were significantly improved at 3 months after surgery, and continued to 6 months after surgery. Compared with the contralateral knee, the gait parameters of the operated limb still has significant gaps in functionality, such as the external rotation and flexion and extension. The single support time, cadence, knee extension, and knee external rotation of the operated limb have a greater correlation with the postoperative WOMAC score. Postoperative rehabilitation exercises should be emphasized, which is of great value for improving the early efficacy of RATKA.

The renal metabolic mechanism of salt sensitive hypertension in Dahl-SS rats / 生理学报

The kidney is one of the main target organs involved in hypertension, and it regulates water and salt metabolism, blood volume and vascular resistance. High salt intake induces salt and water retention, persistent endothelial dysfunction and elevation of blood pressure in salt sensitive individuals. Dahl salt sensitive (Dahl-SS) rats, as a classic animal model for salt sensitive hypertension, have many similar stably inherited physiological characteristics to human with salt sensitive hypertension, such as salt sensitivity, hyperlipidemia, insulin resistance, renal failure, increased urinary protein secretion and low plasma renin activity. Based on renal physiology and biochemistry researches and multi-omics analyses in Dahl-SS rats, this review will summarize the relationship between salt sensitive hypertension and renal redox, NO, amino acids, glucose and lipid metabolism.

Advance in Neuromuscular Training for Rehabilitation after Anterior Cruciate Ligament Reconstruction (review) / 中国康复理论与实践

Neuromuscular training includes muscle strength training, balance training, sensitivity training, proximal control training and proprioceptive training, which is an important rehabilitation training method after anterior cruciate ligament reconstruction. Neuromuscular training can improve the neuromuscular control and stability of knee after anterior cruciate ligament reconstruction, and promote the recovery of motor ability. The effect of neuromuscular training is related with gender, age and training content, and needed more studies.

Hotspot of Sports Injury of Anterior Cruciate Ligament Last Decade: A Visualization Analysis Using CiteSpace / 中国康复理论与实践

Results and Conclusion Totally, 1844 articles were included. The number of scientific research was increasing year by year; the United States had the highest number of papers. Research institutions were mainly composed of universities and medical institutions. There was a close cooperative relationship between high-yielding authors. The researchers mainly focused on the mechanism, prevention, rehabilitation treatment and so on. The research hotspot mainly included anterior cruciate ligament reconstruction, neuromuscular training and return to sports. The injury rate of female was much higher than that of male. Safety education, neuromuscular training, warm-up activities such as FIFA 11+ contributed to the prevention of anterior cruciate ligament injury. Anterior cruciate ligament reconstruction was a common treatment in athletes, which could effectively reduce secondary injury. Limb symmetry index was an effective basis for judging return to sports after operation. Objective:To explore the research hotspot and contents of sports injury of anterior cruciate ligament. Methods:The literatures about anterior cruciate ligament injury in Web of Science from 2009 to 2018 were searched. CiteSpace was used to map the network of country/area, institution, authors and key words. The hotspot of cruciate ligament injury in recent ten years was also reviewed.

Clinical significance of beta-catenin and matrix metalloproteinase-13 in synovial tissue of osteoarthritis / 中国组织工程研究

BACKGROUND: Role of Wnt/β-catenin signaling pathway in the pathogenesis of osteoarthritis has been proved by numerous animal experiments and human specimen trials. Wnt/β-catenin signaling pathway and matrix metalloproteinase 13 (MMP-13) play important roles in pathological process of osteoarthritis, and they may be related with each other. OBJECTIVE: To detect the expression levels of β-catenin and MMP-13 in the synovial tissue of osteoarthritis, and to investigate the relationship between β-catenin and MMP-1 in the pathogenesis of osteoarthritis. METHODS: Synovial tissues were obtained from the 54 patients undergoing total knee arthroplasty or knee arthroscopic diagnosis and treatment surgery and 12 healthy patients suffering from amputation caused by trauma. The samples were divided into non-, mild-, medium-and severe-osteoarthritis groups based on advanced Mankin scores. The expression levels of β-catenin and MMP-13 in the synovial tissues were detected by immunohistochemistry, and correlation analysis was conducted. RESULTS AND CONCLUSION: Immunohistochemistry results showed that MMP-13 was negative in the non-osteoarthritis group, positive in 5 (50%) samples in the mild-osteoarthritis group, positive in 11 (65%) samples in the medium-osteoarthritis group and positive in 23 (85%) samples in the severe-osteoarthritis group. β-Catenin was positive in 1 (8%) sample in the non-osteoarthritis group, positive in 7 (70%) samples in the mild-osteoarthritis group, positive in 14 (82%) samples in the medium-osteoarthritis group and positive in 25 (93%) samples in the severe-osteoarthritis group. The expression levels of β-catenin and MMP-13 in the synovial tissues presented a positive correlation (r=0.806, P ＜ 0.001), and the levels increased with joint degeneration becoming severe. These results imply that there is a significant increase in the expression levels of β-catenin and MMP-13 in the synovial tissues of osteoarthritis compared with the non-osteoarthritis group, and β-catenin and MMP-13 exert effects in development of osteoarthritis. Beta-catenin and MMP-13 are closely associated with pathological changes such as cartilage degeneration and synovial inflammation, thus providing new theoretical direction and experimental basis for targeted gene therapy of osteoarthritis.

Hemi-arthroplasty performed in a 109-year-old patient with intertrochanteric fracture: A case report / 中华创伤杂志(英文版)

The mortality of conservative treatment and the risk resulting from operation for elderly patients with femoral intertrochanteric fractures are high. Safety in the perioperative period and quicker recovery should be placed at the top priority for elderly patients with hip fractures. We reported a case of 109-year-old female patient with intertrochanteric fracture who has undergone the hemiarthroplasty in our center recently. With sciatic nerve and lateral cutaneous nerve block anesthesia, she was offered the artificial femoral head replacement in the lumbar plexus block after sufficient preoperative preparation. The surgery went well with minimally invasive cut, and the patient's recovery was satisfactory.

Advances in pharmacological studies of Panax notoginseng saponins on brain ischemia-reperfusion injury / 药学学报

Sanqi in Chinese herbal medicine is the root and rhizoma of Panax notoginseng (Burk.) F.H.Chen, which belongs to genus Panax in the Araliaceae family and is widely used as a tonic medicine in the traditional Chinese medicine. The main active constituents of sanqi are Panax notoginseng saponins, including ginsenoside Rg1, Rb1 and notoginsenoside R1. A wide variety of pharmaceutical applications of Panax notoginseng saponins have been reported in the regulation of blood circulation system, cardiovascular system and nervous system. Ischemic stroke, the most common form of stroke, leads to a high risk of morbidity and disability, which evolves serious medical, social and economic problems. Ischemia-reperfusion injury is the most important part in the progress of ischemic stroke. Abnormal energy metabolism, disturbance of the ion metabolism, free radical injury, inflammatory reactions all participate in the complex pathological mechanisms of ischemiareperfusion injury. Over the past few decades, substantial studies demonstrated that Panax notoginseng saponins possessed a significant protective effect on ischemia-reperfusion injury. However, little is known about the underlying mechanisms of the protective effects. In order to develop a new medicine from Panax notoginseng, we provide a review of the major literatures on the pharmaceutical actions and molecular mechanisms of Panax notoginseng and Panax notoginseng saponins in the protection of ischemia-reperfusion injury.

Determination of four triterpenoid acids from Guizhi Fuling Capsules by HPLC / 中草药

Objective: To establish an HPLC method for the determination of four triterpene constituents (dehydrotumulosic acid, polyporenic acid C, 3-epi-dehydropachymic acid, and dehydropachymic acid) in Guizhi Fuling Capsules (GFC). Methods: Chromatography conditions were Diamonsic C18 column (250 mm × 4.6 mm, 5 μm), system mobile phase was composed of acetonitrile (A)-0.2% HCOOH aqueous solution (C) in a linear gradient elution mode (0-70 min: 50%-85% A; 70-80 min: 85%-100% A; 80-90 min: 100% A), detective wavelength was set at 242 nm, and column temperature was 40℃. Results: The calibration curve was linear within 0.408-2.04 μg/mL (r = 0.999 9), 0.192-0.96 μg/mL (r = 0.999 5), 0.078-0.39 μg/mL (r = 0.999 5), and 0.075 6-0.378 μg/mL (r = 0.999 5) for dehydrotumulosic acid, polyporenic acid C, 3-epi-dehydropachymic acid, and dehydropachymic acid, respectively. The average recoveries were 97.5% (RSD = 1.4%, n = 5), 98.5% (RSD = 1.6%, n = 5), 97.2% (RSD = 1.2%, n = 5), and 102.3% (RSD = 1.8%, n = 5). Six batches of GFC sample were determined, The average contents of dehydrotumulosic acid, polyporenic acid C, 3-epi-dehydropachymic acid, and dehydropachymic acid were 0.070, 0.015, 0.030, and 0.061 mg/capsule, separately. Conclusion: The method is simple, accurate, and can be used as a quality control method for GFC.

Characterization of Avian Influenza A (H7N9) Virus Prevalence in Humans and Poultry in Huai'an, China: Molecular Epidemiology, Phylogenetic, and Dynamics Analyses / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To trace the source of human H7N9 cases in Huai'an and elucidate the genetic characterization of Huai'an strains associated with both humans and birds in live poultry market.</p><p><b>METHODS</b>An enhanced surveillance was implemented when the first human H7N9 case was confirmed in Huai'an. Clinical specimens, cloacal swabs, and fecal samples were collected and screened by real-time reverse transcription-polymerase chain reaction (RT-PCR) for H7N9 virus. The positive samples were subjected to further RT-PCR and genome sequencing. The phylodynamic patterns of H7N9 virus within and separated from Huai'an and evolutionary dynamics of the virus were analyzed.</p><p><b>RESULTS</b>Six patients with H7N9 infection were previously exposed to live poultry market and presented symptoms such as fever (>38.0 °C) and headaches. Results of this study support the hypothesis that live poultry markets were the source of human H7N9 exposure. Phylogenetic analysis revealed that all novel H7N9 viruses, including Huai'an strains, could be classified into two distinct clades, A and B. Additionally, the diversified H7N9 virus circulated in live poultry markets in Huai'an. Interestingly, the common ancestors of the Huai'an H7N9 virus existed in January 2012. The mean nucleotide substitution rates for each gene segment of the H7N9 virus were (3.09-7.26)×10-3 substitutions/site per year (95% HPD: 1.72×10-3 to 1.16×10-2).</p><p><b>CONCLUSION</b>Overall, the source of exposure of human H7N9 cases in Huai'an was live poultry market, and our study highlights the presence of divergent genetic lineage of H7N9 virus in both humans and poultry specimens in Huai'an.</p>

Chemical constituents of Poria cocos / 中国中药杂志

The chemical constituents of Poria cocos were studied by means of silica gel, ODS column chromatography, Sephadex LH-20 and preparative HPLC. Thirteen compounds were isolated from this plant. By analysis of the ESI-MS and NMR data, the structures of these compounds were determined as tumulosic acid (1), dehydrotumulosic acid (2), 3beta, 5alpha-dihydroxy-ergosta-7, 22-dien-6-one (3), 3beta, 5alpha, 9alpha-trihydroxy-ergosta-7, 22-diene -6-one (4), ergosta-7, 22-diene-3-one (5), 6, 9-epoxy-ergosta-7,22-diene-3-ol (6), ergosta-4,22-diene-3-one (7), 3beta, 5alpha, 6beta-trihydroxyl-ergosta-7,22-diene (8), ergosta-5, 6-epoxy-7,22-dien-3-ol (9), beta-sitosterol (10), ribitol (11), mannitol (12), and oleanic acid 3-O-acetate (13), respectively. Compounds 3-13 were isolated from the P. cocos for the first time.

Research progress of nanoemulsions' applications in improving the bioavailability of poor water-soluble drugs / 中国药学杂志

OBJECTIVE: Learning about the progress of the nanoemulsion drug carrier in the application of the insoluble medicament. METHODS: According to the recent literature and our groups work in this area, the nanoemulsion in improving the bioavailability of poorly soluble drugs has been discussed in many aspects, including its formulation mechanism, preparation methods, Pharmacokinetic, pharmacodynamics and modern application of the traditional Chinese medicine preparation in the recent research. RESULTS: Nanoemulsion carrier insoluble drugs could significantly improve oral absorption rate and bioavailability, enhance targeting effect and reduce the drugs toxicity. CONCLUSION: The select of the optimal scale of production based on the medicinal properties process allowed the nanoemulsion insoluble drugs to achieve a good therapeutic effect after oral administration.

Safety and efficacy of stent placement for treatment of intracranial aneurysms: a systematic review / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To evaluate the safety and efficacy of stent placement for the treatment of complex intracranial aneurysms.</p><p><b>DATA SOURCES</b>We searched six databases, including Pubmed, Embase, SCI-expanded, the Cochrane Library, ISI Proceedings and ProQuest Dissertations & Theses for the relevant studies using multiple key words from December, 1997 to February, 2009.</p><p><b>STUDY SELECTION</b>Thirty-three studies about stent placement for intracranial aneurysms were identified, which reported data from a total of 1069 patients with 1121 intracranial aneurysms.</p><p><b>DATA EXTRACTION</b>We prepared a standardized data extraction form (DEF), which was used by two independent researchers to extract data from the included 33 studies.</p><p><b>RESULTS</b>The overall initial complete occlusion rate was 52.5% (456/869, 95%CI: 49.2% - 55.8%). The overall complication rate was 14.3% (162/1130, 95%CI: 12.3% - 16.4%), of which 3.6% (38/1044, 95%CI: 2.5% - 4.8%) were permanent. Clinical follow-up showed a dependence rate of 8.4% (39/465, 95%CI: 5.9% - 10.9%). Angiographic follow-up showed an improvement rate of 24.3% (117/481, 95%CI: 20.5% - 28.2%) and a recurrence rate of 12.9% (62/481, 95%CI: 9.9% - 15.9%). Chi-squared tests were performed to compare the following subgroups: self-expandable vs. balloon-expandable stents, unruptured vs. acutely ruptured aneurysms, and with vs. without pre-medication. Statistical significance was reached in eight tests.</p><p><b>CONCLUSIONS</b>Intracranial stent is a safe and effective tool for embolizing complex intracranial aneurysms. Self-expandable stents are significantly easier and safer than balloon-expandable stents with respect to navigation and deployment through the tortuous cerebral vasculature. Patients with acutely ruptured aneurysms are more likely to be dependent, but not more likely to suffer more procedure-related complications.</p>

Expression, purification and identification of St. Louis encephalitis virus-like particles in eukaryotic cells / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To express St. Louis encephalitis virus-like particles in mammalian cells, it will provide a prerequisite for further immunological diagnostic studies.</p><p><b>METHODS</b>293T-cell were transiently transfected with recombinant PreM-E plasmid. Expression and antigenicity of the purified protein were determined by transmission electron microscope (TEM), Western-Blot, immunofluorescence assay and ELISA.</p><p><b>RESULTS</b>Recombinant subviral particles, about 50 nm in diameter, were observed by TEM in the supernatant of transfected cells. The results of Western-Blot, IFA and ELISA showed the recombinant proteins retained immunoreactivity similar to those of native virus proteins.</p><p><b>CONCLUSION</b>St. Louis encephalitis virus-like particles has good antigenicity and physical appearance. It will provide a prerequisite for further immune diagnostic reagent.</p>

Transmission electron microscopy investigation of the denudation of the envelope of influenza virus treated with Nonidet P-40 and the binding influence of antibody / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>Through observing the morphological changes of the prepared influenza viruses (H1N1) treated with the different concentration of Nonidet P-40 solutions and added with antibody against the influenza virus using transmission electron microscopy (TEM), to explore the principle of application of the internal antibody for immunoassay of influenza virus.</p><p><b>METHODS</b>Through treating the virus samples with serial diluted Nonidet P-40 solutions from 0.01% to 0.2% and/or not adding antibody against the influenza virus, then investigating the samples by TEM to obtain the morphological changes of the virions.</p><p><b>RESULTS</b>The serial images show that the denudation degree of the virions is proportional with the rise of NP-40 concentration, and partly denuded virion image appeared at 0.1% NP-40 treatment, also under this condition no influence was observed on antibody binding to the virus.</p><p><b>CONCLUSION</b>This work demonstrated the interaction between influenza virion and its antibody under nonionic surfactants existing, which supports the advantages of sample preparation for immunoassay enveloped virus using internal antibody theoretically.</p>

Detection and analysis of antibiotic resistance of Salmonella from retail meats in some districts of Shaanxi province / 中华预防医学杂志

<p><b>OBJECTIVE</b>Salmonella isolates recovered from retail meats that were collected in supermarkets and free markets in Xi'an and Yangling areas of Shaanxi province were studied to determine antibiotic susceptibility.</p><p><b>METHOD</b>Antimicrobial susceptibility to 14 antibiotics of 193 salmonella isolates were determined by using agar dilution method, which was recommended by National Committee of Clinical Laboratory Standard (NCCLS), and E.coli ATCC25922 and E.faecalis ATCC29212 as standard control strains.</p><p><b>RESULTS</b>The 44.6% of the salmonella isolates were resistant to sulfamethoxazole, followed by resistance to kanamycin (40.9%), tetracycline (37.8%), amoxicillin (26.9%), ampicillin (25.4%), gentamicin (23.3%) and chloramphenicol (21.8%). Some isolates also showed resistance to fluoroquinolones, the rates for ciprofloxacin, enrofloxacin, levofloxacin and gatifloxacin were 22.3%, 21.8%, 20.8% and 21.2%, respectively. 55 isolates (28.5%) were multidrug resistant (MDR) strains, 28 of 193 isolates (14.5%) could resist at least 13 antibiotics, 24 isolates (12.4%) were resistant to from 4 to 12 antibiotics.</p><p><b>CONCLUSION</b>Salmonella isolates recovered from retail meats in Xi'an district of Shaanxi province were seriously resistant to antimicrobials commonly used as human and veterinary medicine.</p>

The molecular epidemiologic investigation of hantavirus carried by rodent hosts in Wenzhou, Zhejiang province / 中华流行病学杂志

Objective To study the epidemiological features of hantavirus in rodents in Wenzhou,Zhejiang province.Methods Rodents were captured in Wenzhou,where hemorrhagic fever with renal syndrome (HFRS) had been endemic. Hantavirus antigens in the rat lungs were detected by immunofluorescence assay (IFA).Partial S segment (nt 620-999) and partial M segment (nt 2001-2301)sequences were amplified by RT-PCR,and then sequenced.Neighbor-joining method was used to construct for phylogenetic analysis.Results A total of 96 rodents were trapped in the epidemic areas,and 6 hantavirus antigens were identified from these lung samples (6.3%).Partial S and partial M segment sequences were successfully recovered from 5 samples and determined. Phylogenetic analysis of these sequences indicated that all viruses belonged to Seoul virus (SEOV),regardless of the sources (Rattus norvegicus,Rattus tanezumi and Rattus rattoide) that they were derived. However,the clustering pattern in the partial S-tree was different from that in the partial M-tree,suggesting that the re-assortment between SEOVs had occurred.Conclusion All Rattus rats carried SEOV in Wenzhou and the genetic reassortment with SEOV had occurred naturally.