A multicenter clinical study of robot-assisted total knee arthroplasty / 中华骨科杂志

Objective:To evaluate the accuracy of the domestic "Skywalker" surgical robot in implementing personalized lower limb alignment reconstruction scheme in total knee arthroplasty (TKA) and the short-term clinical outcome of robotic assisted TKA.Methods:From September 2020 to January 2021, the data of patients who received surgical robot assisted TKA in 5 clinical centers in China (Shanghai Ninth People's Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Southwest Hospital affiliated to Third Military Medical University, The Affiliated Hospital of Qingdao University, The First Affiliated Hospital of Chongqing Medical University and Yantai Yuhuangding Hospital, and Shanghai Ninth People's Hospital affiliated to Shanghai Jiao Tong University School of Medicine was the group leader) were prospectively collected and retrospectively analyzed. There were 24 males and 82 females with an average age of 67.6±7.3 years, (range 45-80 years); Average body mass index 26.42±4.31 kg/m 2, all the operation were performed by "Skywalker" surgical robot system according to preoperative design based on CT. The operation time, intraoperative blood loss, hospitalization days and postoperative complications were recorded, and the imaging indexes including hip-knee-ankle (HKA), lateral distal angle of femur (LDFA) and medial proximal angle of tibia (MPTA) measured before and after the operation, implant model indexes (preoperative planning implant model and postoperative implant model) and short-term clinical efficacy indexes [Western Ontario and McMaster Universities (WOMAC) osteoarthritis index] pain score, stiffness score, joint function score, total score and SF-12 score before and 3 months after the operation) were compared. Results:The average follow-up period was 109.60±9.80 d, (range 95-143 d). The average operation time of 106 patients was 105.30±23.22 min; The average intraoperative blood loss was 141.70±58.33 ml; The average length of hospitalization was 5.82±2.80 d. One patient had ischemic stroke after operation, and one patient had abnormal liver function after operation. According to the judgment of the investigator, all of them were not related to the operation. The actual angle error is the difference between the preoperative planning angle and the postoperative measurement angle. The absolute error of 99.1% (105/106) of the HKA angle was within 3°, 90.8% (69/76) of LDFA, 98.7% (75/76) of the MPTA. In 45 patients in one center where data were available, the actual implant models used in all patients were consistent with the preoperative planning size, and there were only differences in version selection such as Asian condyle. WOMAC pain score, joint function score, total score was improved from 7.34±2.85, 25.10±9.85, 34.75±13.02 to 3.34±2.66, 14.68±9.64, 18.66±13.49 before and after operation, respectively, which were statistically significant ( P<0.001) and SF-12 physiological score and psychological score were improved form 27.24±6.42, 30.68±8.26 to 38.83±5.74, 39.36±7.85 before and after operation, respectively, which were statistically significant ( t=7.33, P<0.001; t=4.53, P=0.043). Conclusion:Domestic surgical robot system "Skywalker" can assist the surgeon to achieve accurate and personalized reconstruction of lower limb alignment and achieve satisfactory short-term clinical outcomes. The long-term clinical outcomes of personalized reconstruction and survival rate of implant still need to be further studied.

Dihydromyricetin mediates epithelial mesenchymal transformation and regulates the proliferation and apoptosis of esophageal squamous cell carcinoma cells / 中华肿瘤杂志

Objective: To study the effects of dihydromyricetin (DMY) on the proliferation, apoptosis and epithelial mesenchymal transition (EMT) of esophageal squamous cell carcinoma (ESCC) cell KYSE150 and KYSE410. Methods: KYSE150 and KYSE410 cells were treated with different concentrations of DMY (0, 25, 50, 100, 150, 200 μmol/L) for 24 hours. The median inhibition concentration (IC50) values of KYSE150 and KYSE410 were detected by cell counting kit-8 (CCK-8) method. Then 0.5‰ dimethyl sulfoxide (DMSO) was used as control group, dihydromyricetin (DMY), dihydromyricetin and transforming growth factor-β1 (DMY+ TGF-β1), transforming growth factor-β1 (TGF-β1) were used as experimental group. Cell proliferation and apoptosis rates were measured by clonal formation and flow cytometry. Transwell invasion and wound healing assay were used to detect cell invasion and migration. The protein expression levels of Caspase-3, Caspase-9, Bcl-2, Bax, Smad2/3, phosphorylation-Smad2/3 (p-Smad2/3) and Vimentin were detected by western blot. Results: The IC50 values of DMY on KYSE410 and KYSE150 cells were 100.51 and 101.27 μmol/L. The clone formation numbers of KYSE150 and KYSE410 in DMY group [(0.53±0.03) and (0.31±0.03)] were lower than those in DMSO group [(1.00±0.10) and (1.00±0.05), P<0.05]. The apoptosis rates of KYSE150 and KYSE410 cells in DMY group [(1.84±0.22)% and (2.80±0.07)%] were higher than those in DMSO group [(1.00±0.18)% and (1.00±0.07)%, P<0.05]. The invasion numbers of KYSE150 and KYSE410 cells in DMY group [(0.42±0.03) and (0.29±0.05)] were lower than those in DMSO group [(1.00±0.08) and (1.00±0.05), P<0.05]. The migration rates of KYSE150 and KYSE410 cells in DMY group [(0.65±0.14)% and (0.40±0.17)%] were lower than those in DMSO group [(1.00±0.10)% and (1.00±0.08)%, P<0.05]. The clone formation numbers of KYSE150 and KYSE410 in TGF-β1 group [(1.01±0.08) and (0.99±0.25)] were higher than those in DMY+ TGF-β1 group [(0.73±0.10) and (0.58±0.05), P<0.05]. The apoptosis rates of KYSE150 and KYSE410 cells in TGF-β1 group [(0.81±0.14)% and (1.18±0.10)%] were lower than those in DMY+ TGF-β1 group [(1.38±0.22)% and (1.85±0.04)%, P<0.05]. The invasion numbers of KYSE150 and KYSE410 cells in TGF-β1 group [(1.19±0.11) and (1.39±0.11)] were higher than those in DMY+ TGF-β1 group [(0.93±0.09) and (0.93±0.05), P<0.05]. The migration rates of KYSE150 and KYSE410 cells in TGF-β1 group [(1.87±0.19)% and (1.32±0.04)%] were higher than those in DMY+ TGF-β1 group [(0.86±0.16)% and (0.77±0.12)%, P<0.05]. The protein expression levels of Bax, Caspase-3 and Caspase-9 in KYSE150 and KYSE410 cells in DMY group were higher than those in DMSO group, while the protein expression level of Bcl-2 was lower than that in DMSO group (P<0.05). The protein expression levels of p-Smad2/3, Smad2/3 and Vimentin in KYSE150 and KYSE410 cells in DMY group were lower than those in DMSO group (P<0.05). The protein expression levels of Bax, Caspase-3 and Caspase-9 in KYSE150 and KYSE410 cells in TGF-β1 group were lower than those in DMY+ TGF-β1 group, and the protein expression level of Bcl-2 was higher than that in DMY+ TGF-β1 group (P<0.05). The protein expression levels of Bax, Caspase-3 and Caspase-9 in KYSE150 and KYSE410 cells in DMY+ TGF-β1 group were lower than those in DMY group, and the protein expression level of Bcl-2 was higher than that in DMY group (P<0.05). The protein expression levels of p-Smad2/3, Smad2/3 and Vimentin in KYSE150 and KYSE410 cells in TGF-β1 group were higher than those in DMY+ TGF-β1 group (P<0.05). Conclusion: DMY can inhibit the proliferation and EMT of ESCC mediated by TGF-β1 and promote cell apoptosis.

Study on the effect of small alcohol on lipid hydration and liposome formation / 生物医学工程学杂志

Liposomes with precisely controlled composition are usually used as membrane model systems to investigate the fundamental interactions of membrane components under well-defined conditions. Hydration method is the most common method for liposome formation which is found to be influenced by composition of the medium. In this paper, the effects of small alcohol (ethanol) on the hydration of lipid molecules and the formation of liposomes were investigated, as well as its coexistence with sodium chloride. It was found that ethanol showed the opposite effect to that of sodium chloride on the hydration of lipid molecules and the formation of liposomes. The presence of ethanol promoted the formation of liposomes within a certain range of ethanol content, but that of sodium chloride suppressed the liposome formation. By investigating the fluorescence intensity and continuity of the swelled membranes as a function of contents of ethanol and sodium chloride, it was found that sodium chloride and ethanol showed the additive effect on the hydration of lipid molecules when they coexisted in the medium. The results may provide some reference for the efficient preparation of liposomes.

Pharmacodynamic material basis and mechanism of Fufang Yuxingcao Mixture for the treatment of heat-clearing and detoxification based on network pharmacology / 药学学报

We explored the pharmacodynamic material basis and network regulatory mechanism of Fufang Yuxingcao Mixture (FYM) for the treatment of fever and inflammation. Targets of the 25 compounds in FYM were predicted according to the reverse pharmacophore method and TCMSP, UniProt database. Gene ontology (GO) function enrichment and pathway analysis of the targets was analyzed by Omicsbean software and the Kyoto Gene and Genome Encyclopedia (KEGG) database. A "compound-target-pathway-pharmacological action-effect" network was established with Cytoscape 3.6.1 software. The lipopolysaccharide (LPS)-induced RAW264.7 cell inflammation model was used to verify the anti-inflammatory effects of FYM and its 10 important components. The network pharmacology experiment showed that 25 compounds affected 97 pathways through 211 targets, of which 15 key targets [including RAC-alpha serine/threonine-protein kinase (AKT1), insulin (INS), vascular endothelial growth factor A (VEGFA), interleukin-6 (IL-6), cellular tumor antigen p53 (TP53), tumor necrosis factor (TNF), transcription factor AP-1 (JUN), caspase-3 (CASP3), matrix metalloproteinase-9 (MMP9), interleukin-8 (IL-8), prostaglandin G/H synthase 2 (PTGS2), proto-oncogene c-Fos (FOS), tyrosine-protein kinase SRC (SRC), c-Jun N-terminal kinase 1 (MAPK8), estrogen receptor 1 (ESR1)] and 46 pathways (including NF-kappa B signaling pathway, Toll-like receptor signaling pathway, MAPK signaling pathway, IL-17 signaling pathway, arachidonic acid metabolism, cAMP signaling pathway, T cell receptor signaling pathway, calcium signaling pathway, inflammatory mediator regulation of TRP channels, chemokine signaling pathway, Th1 and Th2 cell differentiation, natural killer cell mediated cytotoxicity, etc.) were related to anti-inflammatory, antipyretic, immune regulation, and analgesia. In vitro cell experiments showed that FYM and the 10 components (including isoquercitrin, luteoloside, baicalein, wogonin, wogonoside, phillyrin, forsythoside A, chlorogenic acid, isochlorogenic acid A, and sweroside) could significantly reduce the expression of nitric oxide (NO), TNF-α and IL-6 in cell supernatants, indicating that the above 10 components may be the key pharmacodynamic material basis of FYM.

Research progress in molecular coupling mechanism of osteogenic differentiation and angiogenesis in traumatic bone defects / 中华创伤杂志

Management of bone defects caused by fractures，bone tumors or infections is clinically difficult as well as a hot topic in current studies. With further researches over bone defects，the construction of tissue-engineered bone has played a great role in the treatment of bone defects. Blood vessels not only provide the necessary nutritional mineral salts，growth factors，hormones for bone formation，also are able to mediate the interaction among osteoblasts and osteoclasts，osteocytes，bone autonomic nerve and endothelial cells，since bone formation exist spatially and temporally connection with angiogenesis. Therefore，the authors make a systematic literature review on the research progress of the coupling mechanism of angiogenesis and osteogenic differentiation，blood vessels and related signal pathways on osteogenic differentiation and angiogenesis-related molecules in osteogenic differentiation during the process of traumatic bone defects，so as to provide new ideas for the treatment of bone defects.

Self-made calcaneal distraction device and percutaneous screw fixation at the key points for treatment of displaced intra-articular calcaneal fractures / 中华创伤杂志

Objective:To compare the clinical outcomes of percutaneous screw fixation at the key points using a self-made calcaneal distraction device with traditional open reduction plate internal fixation for the treatment of patients with displaced intra-articular calcaneal fractures (DIACFs).Methods:A retrospective case-control study was made on clinical data of 60 patients (69 feet) with DIACFs admitted to First Affiliated Hospital of Chongqing Medical University between January 2015 and January 2019. There were 51 males and 9 females, with an average age of 47.2 years [(47.2±8.7)years]. According to the Sanders classification, there were 42 feet of type II, 15 feet of type III and 12 feet of type IV. According to the Essex-Lopresti classification, there were 43 feet of tongue type fractures and 23 feet of joint depression fractures. Another 3 feet were not applicable to this classification system. In Group A, 30 patients (35 feet) were treated by percutaneous reduction or reduction using tarsal sinus approach with the self-made calcaneal distraction device followed by percutaneous screw fixation. In Group B, 30 patients (34 feet) were treated by open reduction and internal fixation with plates using the traditional extended lateral approach. Waiting time for surgery, operation time, length of hospital stay, efficacy of reduction and fracture healing, American Orthopedic Foot and Ankle Society (AOFAS) score, Maryland score, visual analog scale (VAS), and incidence of surgical site related complications were compared between groups. The efficacy of reduction was evaluated by measuring the height, length and width as well as the B?hler angle of the calcaneus.Results:All patients were followed up for an average of 28.2 months [(28.2±11.3)months]. The waiting time for surgery in Group A was (3.4±1.3)days, significantly shorter than that in Group B [(6.9±1.9)days] ( P<0.05). The operation time was (91.7±10.3)minutes in Group A and (92.8±11.5)minutes in Group B ( P>0.05). The length of hospital stay in Group A was (7.0±1.4)days, significantly shorter than that in Group B [(12.7±1.7)days] ( P<0.05). At the final follow-up, all fractures were healed, with no reduction loss of fixation observed. The height of the calcaneus was (48.9±2.0)mm in Group A and (49.3±2.6)mm in Group B ( P>0.05). The length of the calcaneus was (83.2±2.9)mm in Group A and (83.5±2.7)mm in Group B ( P>0.05). The width of the calcaneus was (35.8±2.3)mm in Group A and (35.1±1.3)mm in Group B ( P>0.05). The B?hler angle of the calcaneus was (24.7±6.4)° in Group A and (25.9±5.8)° in Group B ( P>0.05). At the final follow-up, the AOFAS score was (87.1±8.5)points in Group A and (86.7±7.8)points in Group B, with the good and excellent rate of 89% (31/35) and 88% (30/34) respectively ( P>0.05). The Maryland score was (85.3±9.5)points in Group A and (84.9±9.5)points in Group B, with the good and excellent rate of 86% (30/35) and 85% (29/34), respectively ( P>0.05). The VAS was (2.3±1.5)points in Group A and (2.5±1.5)points in Group B ( P>0.05). No surgical site related complication was observed in Group A. While in Group B, there was one foot of superficial incision infection, three necrosis of the skin at the edge of the incision, and one deep infection ( P<0.05). Conclusions:For the treatment of DIACFs, percutaneous screw fixation at the key point using the self-made calcaneal distraction device can achieve the same clinical outcome as traditional open reduction plate internal fixation, but it has advantages like significant shorter waiting time for surgery, less invasiveness, faster recovery and lower incidence of incision-related complications. This method is especially suitable for patients with contraindications of open reduction and internal fixation.

Comparison of the clinical value of MRI and enhanced CT in the diagnosis of liver cancer / 中国基层医药

Objective:To compare the clinical value of magnetic resonance imaging (MRI) and enhanced CT in the diagnosis of liver cancer.Methods:From January 2017 to December 2017, 72 patients with liver neoplasms who received treatment in Yuyao People's Hospital were selected as the subjects of this study.Enhanced CT scan and liver MRI scan were used in all patients respectively to compare the examination conditions of the two scanning methods for the lesions, the positive rate and accuracy of the detection, as well as the sensitivity and specificity of the two methods.Results:There was no statistically significant difference in the detection of extrahepatic lesions between the two methods(41.67% vs.36.11%, P>0.05). The detective rate of intrahepatic lesions of MRI (94.44%) was higher than that of enhanced CT(77.78%), the difference was statistically significant(χ 2=8.361, P<0.05). The missed diagnosis rate[5.56%(4/72)], misdiagnosis rate[1.39%(1/72)] of MRI were lower than those of enhanced CT[22.22%(16/72), 11.11%( 8/72)], and the accuracy of MRI[93.06%(67/72)] was higher than that of enhanced CT[66.67%(48/72)], the differences were statistically significant(χ 2=8.361, 4.354, 15.587, all P<0.05). The sensitivity[92.86%(52/56)], specificity[93.75%(15/16)] of MRI were higher than those of enhanced CT[71.43%(40/56), 50.00%(8/16)](χ 2=8.675, 7.575, all P<0.05). Conclusion:In the clinical diagnosis of liver cancer, the diagnostic accuracy of liver MRI is relatively high, which is conducive to the establishment and implementation of patients' treatment plan, and is conducive to clinical application and promotion.

Clinical value of Gd-EOB-DTPA magnetic resonance imaging in the differential diagnosis of cirrhotic nodules and small hepatocellular carcinoma / 中国基层医药

Objective:To evaluate and analyze the clinical value of Gd-EOB-DTPA magnetic resonance imaging in the differential diagnosis of cirrhotic nodules and small hepatocellular carcinoma.Methods:A total of 40 patients with cirrhosis admitted to Yuyao People's Hospital from January 2017 to June 2018 were enrolled in this study.MRI scan, Gd-EOB-DTPA dynamic enhanced scan and hepatobiliary specific scan were performed in these patients, and their magnetic resonance images were analyzed.All patients underwent magnetic resonance examination and were given surgery or needle biopsy to detect their pathological results.According to the signal intensity of hepatobiliary specific lesions, the patients were divided into three groups: low signal, mixed signal and other signals, and the results were compared with pathological grades of postoperative specimens.Results:After 40 patients with cirrhosis received MRI and dynamic contrast-enhanced scans, 136 nodules were diagnosed as cirrhotic regenerative nodules or hyperplastic nodules.Thirty-four patients were diagnosed with small hepatocellular carcinoma, and 42 small liver cancers were found after combined with Gb-EOB-DTPA hepatobiliary specific scan, the difference was statistically significant (χ 2=8.962, P<0.05). There was statistically significant difference between the signal intensity and pathological grade of 42 cases with hepatocellular carcinoma.There were no statistically significant differences in tumor size and pathological grade. Conclusion:For patients with clinically suspected hepatocellular carcinoma, Gd-EOB-DTPA magnetic resonance imaging is helpful to early detection of cirrhotic nodules and small liver cancer with malignant tendency, and can improve the accuracy of clinical diagnosis of diseases.

Research progress in risk factors of periprosthetic infections after joint replacement / 中华创伤杂志

Prosthetic joint infection (PJI) is a catastrophic complication after joint replacement.It has become the primary cause of revision surgery after knee arthroplasty and the third cause of revision after hip replacement surgery.The risk factors involve the patient (intrinsic factor) and the environment (extrinsic factor),which can be further divided into uncontrollable factors such as the history of surgical infection and other factors related to age and sex of tumor,as well as the risk factors caused by patients' own characteristics and associated diseases,such as body mass index,smoking,diabetes,rheumatoid arthritis and medicine use.The authors summarize the patients' own characteristics,associated diseases and medication to comprehensively evaluate and understand how to reduce the risk of PJI in the perioperative period,so as to provide some reference for clinical treatment.

Cone-beam computed tomography digital for measuring the inclination angle to the long axis of healthy maxillary anterior teeth and morphologically characterizing their labial bone plates / 华西口腔医学杂志

OBJECTIVE@#We aim to determine the thickness of the labial plate, the distance between the cement-enamel junction (CEJ) and alveolar crest, and the inclination angle of the long axis of healthy maxillary anterior teeth by using cone- beam computed tomography (CBCT).@*METHODS@#A total of 345 CBCT volumes obtained by Newtom VGI® CBCT were analyzed by using the NNT software. The digital measurements of the labial bone plate thickness at level 4 mm below the CEJ, the midpoint of tooth root and the radiological tooth apex, the distance between the CEJ and alveolar crest, and the angle between the long axis of the teeth and the long axis of alveolar process were obtained from the mid-sagittal planes of maxillary incisors and canines. Plate thickness 4 mm below the CEJ was measured, and values below ≥1 mm were recorded.@*RESULTS@#In the central incisor, 1) the angle between the long axis of the teeth and alveolar bone was 15.2°±6.2°, the distance between the CEJ and alveolar crest was (1.5±1.0) mm, labial bone plate thick-ness at 4 mm below the CEJ was (0.8±0.4) mm, the midpoint of tooth root was (0.6±0.4) mm, and the radiological tooth apex was (1.3±0.7) mm; in the lateral incisor, 16.2°±8.8°, (1.6±1.0) mm, (0.7±0.5) mm, (0.4±0.6) mm, and (1.1±0.7) mm, respectively; and in the canine, 19.0°±6.2°, (1.8±1.0) mm, (0.9±0.6) mm, (0.4±0.6) mm, and (1.2±0.7) mm, respectively. 2) The frequencies of plate thickness ≥1 mm were 28.3%, 25.8%, and 42.7% in the central incisor, lateral incisor, and canine, respectively. 3) The distance between the CEJ and alveolar crest was positively correlated with age. The correlation coefficients was 0.42 (P<0.01) in the central incisor, 0.50 (P<0.01) in the lateral incisor, and 0.62 (P<0.01) in the canine.@*CONCLUSIONS@#The thickness of labial bone plate is thin, the distance from CEJ to alveolar crest increases with age, and the long axis of the teeth is more inclined than the long axis of alveolar process. Knowledge of these special morphological characteristics can improve the safety and result for many dental procedures.

Exploration of the Role of Tumor Suppressor Genes Foxo1 and PTEN in the Tumorigenesis of Mouse Natural Killer-Cell Lymphoma / 中国实验血液学杂志

OBJECTIVE@#To explore whether tumor suppressor gene Foxo1 and PTEN play a critical role in the tumorigenesis of mouse natural killer-cell lymphoma.@*METHODS@#NKp46-iCre mice were crossed with mice carrying floxed Foxo1 alleles (Foxo1) as well as floxed PTEN alleles (PTEN) to generate mice in which Foxo1 and PTEN in NK cells were knock-out, referred as Foxo1PTEN. The growth and development of the mice and tumor formation were observed. The flow cytometry was used to detect the percentages of NK cells in main lymphatic organs. B16F10 metanoma model of tumor metastasis was utilized to investigate NK cell-mediated tumor surveillance in vivo after NK cells special deletion of Foxol and PTEN.@*RESULTS@#The mouse model with NK cell-special Foxo1 and PTEN double knockout was established. Compared with control group (Foxo1PTEN mice), Foxo1PTEN mice were born alive and appeared to be healthy over a period of 46 weeks. No spontaneous tumor formation was observed at this stage. There were no significant differences in NK cell percentages of gated lymphocytes from various organs including blood, bone marrow, peripheral lymph node and spleen between Foxo1PTEN mice and Foxo1PTEN mice [PB: 4.76%±0.46% vs 4.17%±0.64% (P＞0.05, n=8); BM: 1.13%±0.23% vs 1.31%±0.10% (P＞0.05, n=8) ; LN: 0.50%±0.10% vs 0.85%±0.20% (P＞0.05, n=8); SP: 4.41%±0.65% vs 3.50%±0.24% (P＞0.05, n=8)]. B16F10 melanoma metastasis model of tumor was established, No differences in median survival time were observed in the 2 types of mice (P＞0.05, n=13).@*CONCLUSION@#The simultaneous deletion of the Foxo1 and PTEN genes may not plays significant role in the tumorigenesis of mouse natural killer-cell lymphoma and NK cell-mediated tumor surveillance in vivo.

Application Value of Immunohistochemistry and Bone Marrow Morphology Detection in the Diagnosis and Clinical Staging of Non-Hodgkin's Lymphoma / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To investigate the application value of immunohistochemistry detection and bone marrow morphology analysis in the diagnosis and clinical staging of non-Hodgkin's lymphoma.</p><p><b>METHODS</b>Sixty-four cases of non-Hodgkin's lymphoma were selected in our hospital and the immunohistochemistry detection of pathologic specimens was perforemed by related monoclonal antibody and the bone marrow morphology was also examined.</p><p><b>RESULTS</b>The positive rate of antibody CD79a on B cell lymphoma was 84.62%, and CD20 was 91.43%; the positive rate of antibody CD45RO on T cell lymphoma was 87.50%, and 88.89% of CD3. The bone marrow involvement was found in 10 cases (15.63%), 8 cases(12.50%) progressed to lymphoma - leukemia period; lymphoma cells were lower than 5% in 20 cases (31.25%).</p><p><b>CONCLUSION</b>Immunohistochemistry detection can help to define the type of T or B cell lymphoma in patients with non-Hodgkin's lymphoma, the bone marrow morphology analysis can clear whether the patients with non-Hodgkin's lymphoma suffered from bone marrow involvement and whether developed to lymphoma- leukemia period. These methods possess more high value in clinical application.</p>

Expression of EVI1 in Bone Marrow of Patients with AML and ALL and Its Correlation with Leukemia Subtyping, Clinical Features and Prognosis of Patients / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To explore the expression of EVI1 gene in AML and the ALL patients' bone marrow cells, and its correlation with the leukemic typing, clinical characteristics and prognosis.</p><p><b>METHODS</b>Three hundred and thirty-three cases of leukemia in our hospital from 2012 to 2016 were enrolled in this study. Among them there were 263 cases of AML, 70 cases of ALL, and 13 volunteers were selected as normal controls. The bone marrow samples of the patients and volunteers were aspirated. Firstly, the blood mononuclear cells(PBMNC) were separated from the samples through the Ficoll-Hypaque density gradient centrifugation. Secondly, the total DNA was extracted, and the expression of EVI1 mRNA were assayed by real-ime quantitative PCR, which help to find out the EVI1 mRNA expression difference between AML and ALL. Finally, the correlation of EVI1 expression with the acute leukemia typing, clinical characteristics and prognosis were analyzed by a series of statistical method.</p><p><b>RESULTS</b>Based on the expression levels of the EVI1 mRNA determined by real-time quantitative PCR, the expression levels in AML and ALL were both higher, but without significant difference. The rates of both EVI1 mRNA overexpression and low expression of the EVI1 mRNA in AML patients were higher than those in AML group, however, the rate of normal expression in ALL group was statistically significantly lower than that in the AML. The level of Plt in patients with AML-M1 and T-ALL positively correlated with the level of EVI1 expression（r=0.393,P<0.05；ρ=0.442，P<0.05）while the level of blasts(%) in patients with AML-M3 negatively correlated with the level of EVI1 expression. The expression of EVI1 correlated with the age of patients（χ =6.684,P<0.05）. The prognosis of AML patients with high expression of EVI1 mRNA was poor（Log-Rank test，P<0.05）and AML-M3 patients with high expression of EVI1 had a significantly poorer prognosis than that of patients without high expression（Log-Rank test，P<0.01）.</p><p><b>CONCLUSION</b>In expression level of EVI1 no difference has been found in AML and ALL, but the distribution of EVI1 expression shows obvious difference and the difference correlats with the age of patients, at the same time, the some clinical features and subtype of acute leukemia correlate with the expression level of EVI1.</p>

Effect of Hypoxia on the Proliferation and Hypoxia Inducible Factor-1α Expression in Human Leukemia K562 Cells / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To explore the effect of hypoxia on the cell proliferation and expression of hypoxia-inducible factor-1α(HIF-1α) of human leukemia K562 cells.</p><p><b>METHODS</b>The leukemia cells were divided into 2 groups: hypoxia-treated group and conventional oxygen group as control. The K562 cells in hypoxia-treated group were treated with 50, 200, 400 and 800 µmol/L of CoCl, while the K562 cells in control group were cultured in conventional oxygen condition, then the K562 cells in 2 groups were colleted after treatment for 24, 48 and 72 hours. The morphological changes of cells were observed by the inverted phase-contrast microscopy, the proliferation-inhibitory rates of cells was detected by MTT method, the expression of HIF-1α at transcription level was detected by real-time fluorescent quantitative PCR.</p><p><b>RESULTS</b>The cell morphology was changed with increase of CoClconcentration and prolonging of treatment time of CoCl. The MTT assay showed that the inhibitory rate of cell proliferation was enhanced also with increase of CoClconcentration and prolonging of treatment time of CoCl(r=0.435, r=0.389, P<0.05). The real-time fluorescent quantitative PCR showed that the mRNA expression of HIF-1α in K562 cells of hypoxia group was up-regulated in concentration- and time- dependant manners. and displayed the positive correlation with concentration of CoCland treatment time (r=0.954, r=0895).</p><p><b>CONCLUSION</b>The hypoxia can inhibit the proliferation of K562 cells and up-requlate the expression of HIF-1α in cells, but does not induce cell differentiation.</p>

Clinical efficacy of domestic porous tantalum rod in treatment of early avascular necrosis of femoral head / 中华创伤杂志

Objective To investigate the clinical efficacy of domestic porous tantalum rod in treatment of early avascular necrosis of femoral head (ANFH).Methods A prospective study was made on 18 cases (19 hips) diagnosed as early ANFH treated by domestic porous tantalum rod from July 2014 to December 2015.There were 14 males and four females, with a mean age of 44.2 years (range, 30-62 years).According to the modified Ficat staging, four cases were identified as stage Ⅱa and 14 stageⅡb.Efficacy of the treatment was evaluated by Harris score, Womac score, radiological images of the hip, complications and bone growth.Results All cases were followed up for 8-24 months (mean, 16 months).No complications such as infection, wound healing problems, immunological rejection, tantalum rod breakage, loosening or displacement were observed at last follow-up.Harris score was (82.7±9.0)points, (84.5±10.8)points and (87.2±10.0)points at postoperative 3, 6 and 12 months respectively, significantly higher than that pre-operation [(75.5±11.9)points] (P<0.05).Harris score was rated excellent in 10 cases, good in three, fair in five and poor in one at the last follow-up, with the excellent and good rate of 68%.Womac score was (17.4±9.4)points, (12.4±7.3)points, and (11.1±8.4)points at postoperative 3, 6 and 12 months respectively, significantly lower than that pre-operation [(28.3±13.1)points] (P<0.05).Seventeen cases (18 hips) showed no obvious deterioration in femoral head necrosis, with femoral head survival rate of 95%.One case underwent total hip arthroplasty after operation because of progressive hip pain and collapsed femoral head.Bone ingrowth was detected in the porous tantalum biomaterial after operation.Conclusion Domestic porous tantalum rod can effectively promote bone ingrowth, relieve pain, prevent the collapse of the femoral head, delay total hip arthroplasty time and finally improve hip function in treatment of early avascular necrosis of femoral head.

Effect of locking plate fixation for proximal humeral fractures in elderly patients / 中华创伤杂志

Objective To investigate the clinical effect of locking plate fixation in treatment of proximal humeral fractures in the elderly.Methods This retrospective case control study enrolled 96 patients with closed proximal humeral fractures admitted from October 2013 and October 2015.There were 52 males and 44 females,with age of (68.2 ± 1.4) years (range,62-74 years).According to the Neer classification of proximal humeral fractures,two-part fractures were noted in 27 patients,three-part fractures in 57,and four-part fractures in 12.According to the surgical methods,the patients were assigned to locking plate fixation (observation group) and anatomic plate fixation (control group),with 48 cases each.Operation time,intraoperative blood loss,hospitalization time,fracture healing time,varus angle of the humeral head,visual analogue score (VAS),Neer shoulder score for shoulder function and related complications were observed.Results All patients were followed up for 13-24 months (mean,18.5 months).Better results were observed in observation group than control group in aspects of operation time [(51.2 ± 14.8) minutes vs.(73.2 ±27.3)minutes],intraoperative bleeding[(158.3 ±32.9)ml vs.(270.9 ± 34.8) ml],hospitalization time [(8.2 ± 2.9) days vs.(13.1 ± 2.2) days],fracture healing time [(93.7 ±18.4)days vs.(122.9±18.9)days],varus angle of the humeral head [(2.2±1.8)° vs.(4.2± 1.3) °],VAS [(2.0 ± 0.7) points vs.(5.1 ± 1.2) points],excellence rate of Neer score (98％ vs.90％) and postoperative complication incidence (10％ vs.21％) (P ＜ 0.05).Conclusion Compared with the anatomical plate,locking plate fixation has advantages of shorter operation time,less intraoperative bleeding,earlier bone healing,better shoulder movement and less postoperative complications in treatment of proximal humeral fractures.

Night Sleep Duration and Risk of Cognitive Impairment in a Chinese Population: A Cross-sectional Study / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>Although sleep is one of the most important health-related behavioral factors, the association between night sleep duration and cognitive impairment has not been fully understood. A cross-sectional study was conducted with a random sample of 2,514 participants (⋝ 40 years of age; 46.6% women) in China to examine the association between night sleep duration and cognitive impairment.</p><p><b>METHODS</b>Night sleep duration was categorized as ⋜ 5, 6, 7, 8, or ⋝ 9 h per night. Cognitive function was measured using the Mini-Mental State Examination. A multivariate regression analysis was used to analyze the association of night sleep duration with cognitive impairment. A total of 122 participants were diagnosed with cognitive impairment.</p><p><b>RESULTS</b>A U-shaped association between night sleep duration and cognitive impairment was found. The odds ratios (95% confidence intervals) of cognitive impairment (with 7 h of daily sleep being considered as the reference) for individuals reporting ⋜ 5, 6, 8, and ⋝ 9 h were 2.14 (1.20-3.83), 1.13 (0.67-1.89), 1.51 (0.82-2.79), and 5.37 (1.62-17.80), respectively (P ⋜ 0.01).</p><p><b>CONCLUSION</b>Short or long night sleep duration was an important sleep-related factor independently associated with cognitive impairment and may be a useful marker for increased risk of cognitive impairment..</p>

Survey regarding difficulties encountered by foreign medical postgraduates in China / 中华医学教育探索杂志

Objective To investigate the general information such as study motivation, study de-mand, and encountered difficulties of foreign medical postgraduates in China. Methods 45 medical post-graduates in Chongqing Medical University participated in this survey in February 2014. The questionnaire consisted of 19 questions, including study motivation, the reasons to learn in China, language proficiency, study expectation, satisfaction rate, and future career plan. In total, 45 questionnaires were handed out, and 42 (93%) were recovered. Results All respondents (42 persons) had already acquired medical license in their own countries. 45%of them (19 persons) had obtained bachelor’s degree in other university and were attracted by the reputation of Chongqing Medical University. 50% of respondents (21 persons) considered language barrier as the biggest problem in their learning process. 60%(25 persons) were generally satisfied with their postgraduate education in China. And lack of clinical practice opportunity was ranked as the No. 1 reason of dissatisfaction (54%, 23 persons). Conclusion Language barrier as well as lack of clinical practice opportunity is the biggest two problems encountered by foreign medical postgraduates in China. Although Chongqing Medical University has gained a lot of experience in foreign medical postgraduate education, improvements regarding training program and mentor selection should still be made.

Effect of continuous femoral nerve block versus patient controlled intravenous analgesia on rehabilitation following total knee arthroplasty / 中华创伤杂志

Objective To compare the effect of continuous femoral nerve block (CFNB) with patient controlled intravenous analgesia (PCIA) on pain relief,rehabilitation efficacy,satisfaction degree following total knee arthroplasty (TKA) in an attempt to find a safe and effective analgesia at the stage of rehabilitation.Methods The records of 116 patients undergone unilateral TKA for osteoarthritis or rheumatoid arthritis of the knee were evaluated.The patients with preoperative American Society of Anesthesiology (ASA) score of 1 to 3 were randomized into CFNB group (58 cases) and PCIA group (58 cases) according to the random number table.Both operations were performed under ultrasound guidance.Postoperative visual analogue score (VAS),knee function,incidence of adverse reaction,and satisfaction degree were compared between the two groups.Results Regardless of the score at postoperative 4 and 12 hours,VAS between CFNB and PCIA groups revealed significant differences at postoperative 24 [(3.2±1.1)pointsvs (4.1 ±1.5)points],48 [(3.4±1.2)pointsvs (4.1 ±1.0) points] and 72 hours [(3.3 ± 1.2) points vs (4.0 ± 1.1) points] (all P ＜ 0.05).Time to achieve knee rehabilitation training objectives like straight leg raise,walking with crutches,and passive bending to 90° were similar between the two groups.Both groups achieved comparable knee function status with respect to Hospital for Special Surgery (HSS) score,Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score,and maximal knee flexion angle at postoperative 3 months.Postoperative nausea and vomit were significantly more frequent in PCIA group (24％) than in CFNB group (14％) (all P ＜O.05),but patients in both groups were satisfactory.Conclusion Ultrasound guided CFNB is an effective analgesic method during the early stage of TKA,for it can control pain,accelerate rehabilitation training and function recovery,reduce adverse reaction as well as improve patients' satisfaction.

Clinical and nerve electrophysiological features of sodium azide poisoning / 临床神经病学杂志

Objective To observe the clinical and nerve electrophysiological features of sodium azide poisonin. Method The clinical data of 11 patients with sodium azide poisonin were analyzed retrospectively.Results In this group, the first symptoms was numbness in 4 cases, weakness in 3 cases, walking instability in 2 cases, dizziness and nausea in 2 cases.The major clinical manifestations were numbness in 8 cases, weakness in 6 cases, walking instability in 4 cases, dizziness and nausea in 3 cases, leptophonia in 2 cases, diplopia in 2 cases, limb muscle strength loss in 7 cases, reducing muscle tension in 3 cases, weakened tendon reflex in 3 cases, skin needle drops in 3 cases.Electrophysiological examination showed motor nerve conduction velocity ( MCV) was slower, distal latency ( DML) and amplitude ( AMP) were reduced; the sensory nerve conduction velocity ( SCV) was slower, and AMP was reduced.The latency (Lat) and wave interval of brainstem auditory evoked potential (BAEP) and visual evoked potential ( VEP) , somatosensory evoked potentials ( SEP) were prolonged, and AMP was reduced.Compared with pre-treatment, the abnormal rates of MCV, AMP, DML of median nerve, ulnar nerve, deep peroneal nerve and SCV, AMP of median nerve, ulnar nerve, superficial peroneal nerve, sural nerve and AMP of SEP after treatment had no statistically significant (all P>0.05).Compared with pre-treatment, the abnormal rates of Lat of BAEP, VEP, SEP andⅢ-Ⅴof BAEP and AMP of BAEP, VEP had no statistically significant (P<0.05-0.01).Conclusions The major clinical symptoms of sodium azide poisoning are numbness, weakness, unstable walking, dizziness, diplopia. Electrophysiological examination showed MCV is slower, DML and AMP are reduced; SCV is slower, and AMP is reduced.The Lat and wave interval of evoked potential are prolonged, and AMP is reduced.