Gonioscopy-assisted transluminal trabeculotomy for secondary high intraocular pressure after vitrectomy / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To investigate the clinical efficacy of gonioscopy-assisted transluminal trabeculotomy(GATT)for secondary high intraocular pressure after vitrectomy.METHODS: A retrospective study was conducted on 10 patients(15 eyes)with secondary high intraocular pressure(IOP)after vitrectomy treated with GATT in Department of Ophthalmology, Chengdu First People's Hospital from January 2019 to May 2022. The best-corrected visual acuity(BCVA), IOP, number of IOP-lowering drugs, and complications before operation and at 1d, 1wk, 1, 3 and 6mo after operation were recorded, and the surgical success rate was analyzed.RESULTS:There was no difference in BCVA before and 6mo after operation(Z=0, P=1). The mean IOP decreased from 28.33±9.48mmHg to 17.47±3.78(1d), 18.8±3.29(1wk), 19.13±3.62(1mo), 20.31±3.66(3mo)and 18.03±3.23mmHg(6mo; all P<0.05). The average medication used before surgery was 2(2, 4), and the average medication used 6mo after surgery was 1(0, 2), which was significantly decreased(P<0.001). The total success rate of surgery at 1d, 1wk, 1, 3 and 6mo after surgery was 87%(13 eyes), 93%(14 eyes), 87%(13 eyes), 73%(11 eyes)and 93%(14 eyes)respectively. The main postoperative complications were transient hyphema(10 eyes, 67%)and transient elevated IOP(5 eyes, 33%). No complications seriously affecting the vision occurred.CONCLUSION: GATT is safe and effective in the treatment of secondary high intraocular pressure after vitrectomy.

Correlation between selenium and chronic kidney disease: a meta-analysis / 预防医学

Objective@#To systematically evaluate the correlation between selenium in the body and the risk of chronic kidney disease (CKD), so as to provide insights into CKD prevention and control.@*Methods@#Publications pertaining to the correlation between selenium level and CKD were retrieved from electronic databases, including CNKI, WanFang Data, PubMed and Web of Science from inception until July 28, 2022. Meta-analysis was performed using the software Stata 16.0, and all measures were expressed with standardized mean difference (SMD) and its 95%CI. The source of heterogeneity was analyzed using subgroup analysis and meta-regression, and sensitivity analysis was performed using the leave-one-out method. In addition, the publication bias was evaluated with d funnel plot, Egger's test and Begg's test, and the robustness of the result was evaluated using the trim and filling method.@*Results@#A total of 2 990 publications were screened, and 63 eligible publications were included in the final analysis, including 18 cross-sectional studies, 40 case-control studies, 2 cohort studies and 3 randomized controlled trials (RCTs), which covered 5 099 CKD patients and 6 334 controls. Meta-analysis showed lower selenium levels in CKD patients than in controls (SMD=-1.828, 95%CI: -2.132 to -1.523, P<0.001). Subgroup analysis showed lower selenium levels among CKD patients than among controls from Asia, Europe and multiple continents (P<0.05), and lower selenium levels were detected in patients undergoing conservative treatment, hemodialysis and peritoneal dialysis than in controls (P<0.05), while the selenium levels were significantly lower in CKD patients than in controls in cross-sectional studies, case-control studies and RCTs (P<0.05). The selenium level was significantly lower among CKD patients than among controls regardless of the study year, sample size and score for quality of publications (P<0.05). Sensitivity analysis showed robustness of this meta-analysis. Publication bias was identified by funnel plot, Begg's test and Egger's test, and the robustness of the result was found using the trim-and-fill method. @*Conclusion @#There may be a possible correlation between selenium and the risk of CKD.

Multivariate analysis of varus after Oxford unicompartmental knee arthroplasty / 北京大学学报(医学版)

OBJECTIVE@#To analyze the preoperative influencing factors of varus after Oxford unicompartmental knee arthroplasty.@*METHODS@#A total of 660 patients (767 knees) undergoing Oxford unicompartmental knee arthroplasty in adult joint reconstruction surgery department of Beijing Jishuitan Hospital from January 2018 to December 2019 were retrospectively analyzed. Inclusive criteria: diagnosis was osteoarthritis, single compartment lesions in the medial side of the knee; preoperative flexion deformity was less than 10°, active range of motion was greater than 90°; preoperative X-ray full-length images of both lower limbs showed less than 15° varus (Noyes method); anterior cruciate ligament was well functioned, The cartilage of lateral compartment of knee joint was intact.@*EXCLUSION CRITERIA@#combined with other inflammatory arthropathy; combined with extraarticular deformity; previous knee surgery history. The average age of the patients was (64.4±8.1) years, including 153 males and 497 females. The degree of post-operative varus was measured with Noyes method. The total patients were divided into varus group (Noyes≥3 °) and normal group (Noyes < 3 °). Gender, age, body mass index (BMI), range of motion (ROM), preoperative flexion deformity (FD), American Knee Society pain score (AKS) and American Knee Society function score (AKS function) were recorded. The standard anteroposterior and lateral X-ray films of knee joint and full-length lower extremity kinematic line films were taken by Sonialvision Safine Ⅱ (Shimadzu, Japan) multi-function digital tomography system. The image was measured by picture archiving and communication system (PACS). The following angles were measured preoperative Noyes angle, lateral distal femoral angle (LDFA), medial proximal tibial angle (MPTA) and joint line converge angle (JLCA) were measured and analyzed.@*RESULTS@#Gender(P=0.346), operative side (P=0.619), age (P=0.746), BMI (P=0.142), preoperative ROM (P=0.102), preoperative knee pain score (P=0.131) and functional score (P=0.098) were not risk factors for postoperative varus. The influencing factors of postoperative varus were preoperative MPTA < 84 ° (P= 0.018, OR= 3.712, 95%CI: 1.250-11.027), preoperative Noyes > 5°(P=0.000, OR= 3.105, 95%CI: 1.835-5.254), preoperative FD > 5° (P= 0.001, OR=1.976, 95%CI: 1.326-3.234). Pre-operative LDFA (P=0.146) and preoperative JLCA (P= 0.709) had no significant effect on postoperative kinematic line.@*CONCLUSION@#Patients with severe preoperative varus, especially those with varus deformity mainly from the tibial side, and those with preoperative flexion deformity are more prone to get varus lower extremity kinematic line after Oxford unicompartmental knee arthroplasty.

Meta-analysis of effect of Qishen Yiqi Dripping Pills combined with Western medicine on adverse cardiovascular events and quality of life after percutaneous coronary intervention / 中国中药杂志

To systemically evaluate the effect of Qishen Yiqi Dripping Pills combined with Western medicine on adverse cardiovascular events and quality of life after percutaneous coronary intervention(PCI). A total of 7 Chinese and English databases including CNKI, Wanfang, VIP, SinoMed, PubMed, Cochrane Library and Web of Science were searched by computer to collect the randomized controlled trials(RCTs) on Qishen Yiqi Dripping Pills combined with Western medicine in the treatment of patients with coronary heart disease after PCI with the retrieval time from the database establishment to April 1, 2020. Two researchers independently conducted li-terature screening, data extraction and bias risk assessment. Then, Meta-analysis was performed by using RevMan 5.3 software. A total of 31 RCTs were included, involving 3 537 patients. The results of Meta-analysis showed that in terms of major adverse cardiovascular events(MACE) after PCI, the combination of Qishen Yiqi Dripping Pills could significantly reduce the recurrence of angina pectoris, incidence of arrhythmia, heart failure and re-revascularization, and the effect was better than that of Western medicine treatment alone. However, there was no significant difference between the two groups in the improvement of non-fatal myocardial infarction, cardiac death, stent restenosis, stroke and other adverse cardiovascular events. In terms of improving left ventricular ejection fraction(LVEF), 6 min walking test(6 MWT), high-sensitivity C-reactive protein(hs-CRP) and Seattle angina pectoris scale(SAQ), the combination of Qishen Yiqi Dripping Pills and Western medicine treatment had obvious advantages over Western medicine treatment alone in increasing LVEF, 6 MWT and SAQ, and reducing the level of hs-CRP, with statistically significant differences. There were few adverse reactions in both groups, and there was no significant difference between the two groups. The main manifestations were gastrointestinal reactions, rash, gingiva and other small bleeding, and no serious adverse reactions occurred. The above reactions could disappear after drug withdrawal or symptomatic treatment. The application of Qishen Yiqi Dripping Pills combined with Western medicine in the treatment of patients after PCI could reduce the occurrence of MACE, improve the clinical efficacy, quality of life and prognosis in a safe and reliable manner. However, due to the quantity and quality limitations of included studies, more standardized, rigo-rous and high-quality clinical studies are still needed to further verify the above conclusions.

Status Quo and Analysis of the Cardiovascular Clinical Practice Guidelines/Expert Consensuses of Chinese and Integrative Medicine: A Systematic Review / 中国结合医学杂志

OBJECTIVE@#To describe and analyze the status quo of cardiovascular clinical practice guidelines or expert consensuses including both Chinese medicine (CM) and integrative medicine, through systematic literatures searching and quality assessment.@*METHODS@#Data bases including Chinese Biomedical Literature Database, the China National Knowledge Infrastructure, Wanfang Data, China Science and Technology Journal Database were searched for published CM or integrative cardiovascular clinical practice guidelines or expert consensuses. The website www. medlive.cn was also retrieved as supplementary. The clinical practice evaluation tool AGREE II was used to assess the quality of included guidelines or consensuses.@*RESULTS@#A total of 31 relevant clinical practice guidelines or expert consensuses were included, covering diagnosis, treatment, Chinese patent and patient fields. Common cardiovascular diseases like coronary heart diseases, heart failure and arrhythmia were also involved. Through analysis it was found that both the quantity and quality of included guidelines have been improved year by year. A total of 4 evidence-based clinical practice guideline has been found, one of which was a guideline project plan. Except that, the remaining 27 reports were all consensus-based guidelines. The scores of each field, from highest to lowest, were clarity of presentation (58%), scope and purpose (54%), stakeholder involvement (28%), rigor of development (21%), applicability (13%) and editorial independence (8%).@*CONCLUSIONS@#Although clinical practice guidelines in cardiovascular domain of Chinese have gained increasing concern, with both quantity and quality improved, there is still huge gap in methodology and reporting standards between CM guidelines and international ones. On the one hand, it is essential to improve and standardize the methodology of developing CM guidelines. On the other hands, the evaluation system of evidence and recommendation with CM characters should be developed urgently.

Role of MiR-20a-3p in Axonal Repair in Rats with Spinal Cord Injury / 中国康复理论与实践

@#Objective:To study the molecular biology mechanisms of Wistar rats after spinal cord injury, and find out key microRNAs. Methods:A total of 15 Wistar rats were divided into control group (<italic>n</italic> = 3) and spinal cord injury group (<italic>n</italic> = 12). The latter group was divided into four hours, three days, seven days and 14 days subgroups, with three rats in each subgroup. Microarray 3.0 was used to investigate microRNA expression profiles of Wistar rats with spinal cord injury. Bioinformatics was used to predict microRNAs playing key regulatory roles, and to predict target genes. Reverse transcription real-time quantitative polymerase chain reaction (RT-qPCR) was applied to detect the expression of miR-20a-3p. Western blotting was employed to detect the signal transducer and activator of transcription (STAT) 3 level. The correlation between target protein and microRNA expression trend in each group was analyzed. The key microRNA was inhibited in the neurons. The relationship between target protein expression and axon growth was observed with immunofluorescence. Results:In the rats with spinal cord injury, totally 658 microRNAs had changed at least once. In all the altered microRNAs, miR-20a-3p was upregulated obviously. It predicted that the target gene of miR-20a-3p was STAT3 via application of bioinformatics analysis. The expression trend of STAT 3 and miR-20a-3p in spinal cord was opposite. After the inhibition of miR-20a-3p, the expression of STAT3 in neurons was unregulated and axonal growth was extended. Conclusion:The upregulation of miR-20a-3p leads to downregulation of STAT3, and miR-20a-3p is one of the key targets in the treatment of spinal cord injury.

Mechanism of PRDX3 Involved in Development and Progression in Clear Cell Renal Cell Carcinoma / 中山大学学报(医学科学版)

@#【Objective】 To investigate the relationship between the expression of PRDX3 （thioredoxin-dependent peroxide reductase）and the occurrence and development of ccRCC （clear cell renal cell carcinoma）. 【Methods】 The expression of PRDX3 was first verified in 16 cases of ccRCC tissues and adjacent normal tissues. In the present study ， according to the PRDX3 over-expression level，we established the stable PRDX3 overexpression cell lines and knockdown cell lines in 786-O cell lines. We detected the growth rate of tumor cells after overexpression and knockdown of PRDX3. Interaction proteins with PRDX3 were searched by anti-flag pull-down test combined with LC- MS/MS technique. The interaction between PRDX3 and PRDX1（peroxiredoxin 1）was preliminarily explored.【Results】The western blot results showed that PRDX3 were down- regulated in 14 out of 16 ccRCC tissue samples about 1.78 times. Stable PRDX3 overexpression and knockdown cell lines and those control group were successfully established［786O- PRDX3（+）and 786O- PRDX3（-），786O- PRDX3 KN and 786O- PRDX3 NCi］. PRDX3 expression in 786O- PRDX3（+）was 2.1 times higher than 786O- PRDX3（-）at mRNA level and 1.8 times at protein level. PRDX3 expression in 786O- PRDX3 KN was 0.48 times lower than 786O-PRDX3 NCi at mRNA level and 0.51 times at protein level. The cell growth rate of 786O-PRDX3 （+）cell lines was significantly lower than that of 786O-PRDX3（-）. Meanwhile ，there was no significant difference in 786O-PRDX3 KN and NCi cell lines. Pull-down results shows that PRDX3 may interact with PRDX1 through disulfide bond and the binding sites of those two proteins were identified respectively.【Conclusion】PRDX3 was down- regulated expression in renal clear cell carcinoma and the interaction with PRDX1 may be involved in the occurrence and development of tumor. Increasing the expression level of PRDX3 can significantly reduce the growth rate of tumor cells. Based on PRDX3 ，it is possible to develop targeted drugs for treating renal clear cell carcinoma.

Association between EGF +61 A>G polymorphism and gastric cancer risk: A meta-analysis / 华中科技大学学报（医学）（英德文版）

Previous studies suggested an association between the EGF +61 A>G polymorphism and susceptibility to gastric cancer, but the results have been inconsistent. To draw a more precise risk estimation of the association, we performed a meta-analysis of published studies. PubMed, EMBASE, Google Scholar and the Chinese Wanfang databases were systematically searched to identify relevant studies. There were 7 studies involving 1992 cases of gastric cancer and 3202 controls in this meta-analysis. Our study showed that, overall, the EGF +61 A>G polymorphism was significantly associated with the increased risk of gastric cancer in allele model (G vs. A: OR=1.18, 95% CI=1.00-1.39), dominant model (GG + GA vs. AA: OR=1.28, 95% CI=1.05-1.55), homozygous model (GG vs. AA: OR=1.31, 95% CI=1.06-1.63) and heterozygous model (GA vs. AA: OR=1.25, 95% CI=1.01-1.53). The stratified analysis by ethnicity revealed a significant association between EGF +61 A>G polymorphism and gastric cancer risks in Asians. This meta-analysis indicates that EGF +61 A>G polymorphism may increase the risk of gastric cancer, especially in Asians. Large-sized, well-designed studies involving different ethnic groups should be conducted to confirm this association.

Effect of Joint Line Elevation after Posterior-stabilized and Cruciate-retaining Total Knee Arthroplasty on Clinical Function and Kinematics / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Joint line (JL) is a very important factor for total knee arthroplasty (TKA) to restore. The objective of this study was to evaluate the early clinical and kinematic results of TKAs with posterior-stabilized (PS) or cruciate retaining (CR) implants in which the JL was elevated postoperatively.</p><p><b>METHODS</b>Data were collected from patients who underwent TKA in our department between April 2011 and April 2014. The patients were divided into two groups based on the prosthesis they received (PS or CR). At 1-year postoperatively, clinical outcomes were evaluated by the American Knee Society (AKS) knee score, AKS function score, and patella score. In vivo kinematic analysis after TKA was performed on all patients and a previously validated three-dimensional to two-dimensional image registration technique was used to obtain the kinematic data. Anteroposterior (AP) translation of the medial and lateral femoral condyles, and axial rotation relative to the tibial plateau, were analyzed. The data were assessed using the Mann-Whitney test.</p><p><b>RESULTS</b>At time of follow-up, there were differences in the AKS knee scores (P = 0.005), AKS function scores (P = 0.025), patella scores (P = 0.015), and postoperative range of motions (P = 0.004) between the PS group and the CR group. In the PS group, the magnitude of AP translation for the medial and lateral condyle was 4.9 ± 3.0 mm and 12.8 ± 3.3 mm, respectively. Axial rotation of the tibial component relative to the femoral component was 12.9 ± 4.5°. In the CR group, the magnitude of AP translation for the medial and lateral condyle was 4.3 ± 3.5 mm and 7.9 ± 4.2 mm, respectively. The axial rotation was 6.7 ± 5.9°. There were statistically different between PS group and CR group in kinematics postoperatively.</p><p><b>CONCLUSION</b>Our results demonstrate that postoperative JL elevation had more adverse effects on the clinical and kinematic outcomes of CR TKAs than PS TKAs.</p>

Association between EGF +61 A>G polymorphism and gastric cancer risk: A meta-analysis / 华中科技大学学报（医学）（英德文版）

Previous studies suggested an association between the EGF +61 A>G polymorphism and susceptibility to gastric cancer, but the results have been inconsistent. To draw a more precise risk estimation of the association, we performed a meta-analysis of published studies. PubMed, EMBASE, Google Scholar and the Chinese Wanfang databases were systematically searched to identify relevant studies. There were 7 studies involving 1992 cases of gastric cancer and 3202 controls in this meta-analysis. Our study showed that, overall, the EGF +61 A>G polymorphism was significantly associated with the increased risk of gastric cancer in allele model (G vs. A: OR=1.18, 95% CI=1.00-1.39), dominant model (GG + GA vs. AA: OR=1.28, 95% CI=1.05-1.55), homozygous model (GG vs. AA: OR=1.31, 95% CI=1.06-1.63) and heterozygous model (GA vs. AA: OR=1.25, 95% CI=1.01-1.53). The stratified analysis by ethnicity revealed a significant association between EGF +61 A>G polymorphism and gastric cancer risks in Asians. This meta-analysis indicates that EGF +61 A>G polymorphism may increase the risk of gastric cancer, especially in Asians. Large-sized, well-designed studies involving different ethnic groups should be conducted to confirm this association.

Analysis of prognostic factors related to triple-negative breast cancer / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the prognostic factors related to triple-negative breast cancer (TNBC) by analyzing clinicopathologic characteristics, treatment and prognosis.</p><p><b>METHODS</b>Three hundred and five TNBC patients treated between January 2004 and December 2011 were enrolled and retrospectively reviewed with Kaplan-Meier and Cox proportional hazards models. All patients were females and the age onset were 24-82 years old (the median were 50 years old).</p><p><b>RESULTS</b>The follow-up period was 1 to 114 months, with median 38 months. The 5-year disease free survival (DFS) rate was 68% and overall survival (OS) rate 75%. The peak risk of recurrence occurs within the first 2-3 years after initial treatment of the disease, but distant relapse after this time is much less common. Survival analysis showed that surgery type (χ(2) = 4.030, P = 0.045), tumor grade (χ(2) = 8.000, P = 0.046), lymph-vascular invasion (χ(2) = 10.386, P = 0.001) and lymph node stage (χ(2) = 119.36, P = 0.000), TNM stage (χ(2) = 65.961, P = 0.000) and treatment plan (χ(2) = 28.371, 21.874, 32.163, all P = 0.000) were statistically related to DFS; while age (χ(2) = 10.226, P = 0.006), lymph-vascular invasion (χ(2) = 18.881, P = 0.000), lymph node stage (χ(2) = 98.958, P = 0.000), TNM stage (χ(2) = 65.342, P = 0.000) and type of treatment (χ(2) = 17.862, 18.708, 31.921, all P = 0.000) were related to OS. The lymph nodes stage was prognostic factor related to both DFS and OS.</p><p><b>CONCLUSIONS</b>TNBC was characterized by poor prognosis and rapid progression. The lymph nodes metastatic status was the most important prognostic factor of TNBC.</p>

Development of national neglect norm for urban primary school students of China / 中华预防医学杂志

<p><b>OBJECTIVE</b>To develop the national neglect norms for urban primary school students in China.</p><p><b>METHODS</b>According to multi-stage stratified cluster sampling principle, 24 cities of 13 provinces (municipalities) in China were selected during December 1 to 31, 2008. A total of 1491 students in grade 1 - 3 and 2236 students in grade 4 - 6 were selected. Questionnaire was designed by authors and the final norms were determined through several statistical analysis methods, such as item analysis method, factor analysis method, reliability analysis method. The reliability analysis and validity analysis were used to test the stability and reliability of the norms. The evaluation criteria of the scale was determined by the percentile method, then the initial development of the norm was completed.</p><p><b>RESULTS</b>The two questionnaires of grade 1 - 3 and grade 4 - 6 students consisted of 55 and 57 items, respectively, whose item loadings were ranged from 0.301 to 0.687 and 0.321 to 0.730, which met the statistical requirements. For grade 1 - 3 students, the scale's total Cronbach α coefficients was 0.914, the total split-half reliability coefficients was 0.896, the Cronbach α coefficients of four level was above 0.737 except medical and social neglect, split-half reliability was ranged from 0.461 to 0.757; for grade 4-6 students, the scale's total Cronbach α coefficients was 0.916, split-half reliability was 0.883, except social neglect, the Cronbach α coefficients of other level was ranged 0.457 to 0.856, split-half reliability was ranged from 0.500 to 0.798. The total neglect cut-off score of the two scales grade 1-3 and 4-6 were 125 and 155, respectively.</p><p><b>CONCLUSION</b>The structure of two norms was reasonable. The scales have good stability and reliability.</p>

Expression of mitogen activated protein kinase phosphatase-1 in pancreatic cancer / 中国医学科学院学报

<p><b>OBJECTIVE</b>To evaluate the expression of mitogen activated protein kinase phosphatase-1(MKP-1)in pancreatic cancer.</p><p><b>METHODS</b>Totally 60 cases of normal pancreas, chronic pancreatitis(CP), and pancreatic cancer tissues were collected by operation in our hospital. Pancreatic tissues were analyzed by Northern blot analysis and Western blot analysis. Meanwhile, MKP-1 expression was detected in 6 pancreatic cancer cell lines by Western blot analysis.</p><p><b>RESULTS</b>Northern blot analysis of total RNA revealed relatively low MKP-1 mRNA expression in 7 of 20(35%)normal pancreatic samples. In the remaining 13 samples, the MKP-1 mRNA was absent to faint detectable. In 7 of the 20 CP samples, MKP-1 was demonstrated moderate to high expression. In contrast, 12 of 20(60%)pancreatic cancer samples MKP-1 mRNA was expressed at high levels, whereas in the remaining 8 cancer tissues this mRNA moiety was present at low to moderate levels. Densitometric analysis with normalization to 7S revealed that the median level of MKP-1 mRNA in CP and cancerous tissues was increased by 6.2 folds(P=0.035)and 8.1 folds(P=0.016)in comparison with the median level in the normal pancreatic samples, respectively. Overexpression of MKP-1 was also found in 6 pancreatic cancer cell lines, in which the expression of MKP-1 was slightly lower in one pancreatic cancer cell line but high in the remaining 5 cell lines.</p><p><b>CONCLUSIONS</b>MKP-1 is over-expressed in pancreatic cancer, CP tissues, and pancreatic cell lines. It is speculated that MKP-1 may play an important role in tumorigenesis of pancreatic cancer.</p>

Kinematic study on tibiofemoral joint after TKA using 2D-3D automatic registration technique / 医用生物力学

Objective To reconstruct the 3D motion of the knee joint after total knee arthroplasty (TKA) and measure the kinematics and the articular contacts between the posterior stabilized TKAs. Methods Sixteen knees undergoing TKAs were scanned by fluoroscopy. An algorithm of automatic registration was developed to match the 3D TKA models and 2D images. The kinematical parameters and articular contact of the tibiofemoral joint was investigated. ResultsThe time for a single image was less than 30 seconds. The in-plane repeatability was within 0.4 mm and 0.5 degree. The application of the high-flex insert didn’t obviously improve the ability of the flexion and the internal/external tibial rotation. When the knee flexed, the contact point on the lateral side moved more posteriorly than that on the medial side. The contact between the post-cam and the femoral prosthesis occurred with the flexion at about 30 degrees. The average range of the contact was within 9 mm. Conclusions The 3D kinematics of the in vivo TKA knee joint was accurately measured by using 2D-3D automatic registration technique. The result can provide references for the biomechanical study of TKA knees and the improvement of TKA prosthesis design.

Comparative analysis of early diagnostic tools for breast cancer / 中华肿瘤杂志

<p><b>OBJECTIVE</b>Mammography is the principle imaging modality used for early diagnosis of breast cancer in Western countries. It has not been well-established whether this Western diagnostic modality is adoptable for Chinese women. The aim of this study was to evaluate the respective accuracy of the common diagnostic tools for breast cancer including history-taking, physical examination, ultrasound and mammography.</p><p><b>METHODS</b>Clinical presentation and investigations for consecutive patients undergoing history-taking, physical examination, ultrasound, mammography and pathological assessment at Peking Union Medical College Hospital were prospectively recorded between April 2010 and September 2011. Breast cancer high-risk factors acquired by history-taking were input into the risk assessment model established previously by Eleventh Five Year Key Programs for Science and Technology Development of China (Grant No. 2006BAI02A09) and classified into low-, medium-, high- and extremely high-risk groups. The low- and medium-risk groups were defined as test negative, while the high- and extremely high-risk groups were defined as test positive. Each mammogram and ultrasound was reported prospectively using a five-point reporting scale of the American College of Radiology (ACR) Breast Imaging Reporting and Data System (BI-RADS). Clinical data were compared with pathological findings. Sensitivity, specificity, positive predictive value (PRV), negative predictive value (NPV) and accuracy of respective diagnostic methods were calculated and compared. The patients were divided into two groups, above and below 50 years of age for subgroup analysis.</p><p><b>RESULTS</b>A total of 1468 patients (1475 breast lesions) constituted the study population. The median age was 44 (range 13 - 92) years. Five hundred and fifty-one patients were diagnosed as breast cancer. The median age at diagnosis was 51 years and breast cancer peaked in the age group of 40 - 60 years. The sensitivity of risk assessment model, physical examination, ultrasound and mammogram was 47.5%, 86.2%, 89.8% and 79.3%, respectively; specificity was 68.8%, 83.3%, 81.0% and 88.7%, respectively; PRV was 47.6%, 75.5%, 73.8% and 80.8%, respectively; NPV was 68.8%, 91.0%, 93.0% and 87.8%, respectively; and accuracy was 60.9%, 84.4%, 84.3% and 85.2%, respectively. Further subgroup analysis demonstrated that age is an important factor influencing the sensitivity and specificity of physical examination, ultrasound and mammography.</p><p><b>CONCLUSIONS</b>Ultrasound is more sensitive than mammography for early diagnosis of breast cancer in Chinese women and should be routinely used as a first-line diagnostic tool. Only a single diagnostic method is not enough sometimes and combined examination is needed for some high-risk populations.</p>

Development of the National Norms of Negligence on children aged 0 to 35 months in rural areas of China / 中华流行病学杂志

Objective To develop the National Norms of Negligence (NNN) for rural children aged 0 to 35 months.Methods According to multi-stage stratified cluster sampling principle,10 provinces or municipalities (Jilin,Shaanxi,Shanxi,Beijing,Anhui,Jiangsu,Hunan,Hubei,Yunnan,Chongqing) in China were selected.A national research group was formed collaboratively.A questionnaire was designed by ourselves.According to several statistical analysis methods,such as item,factor and reliability analysis etc.we determined the norm.The evaluation criteria of the scale were determined by percentile method.Finally,the reliability and validity of the norm were evaluated.Results In total,2310 children were surveyed,in which the effective sample were 2227,with an effective rate as 96.4％.The scale consisted of 6 neglected dimensions and 65 items in total.The total Cronbach's α coefficient of the scale was 0.903,with the split-half reliability coefficient as 0.829,the parallel reliability as 0.720 and the re-test reliability as 0.678,respectively.The total neglect cut-off score of this scale was 139.Conclusion The scale seemed to have perfect stability and reliability and all the statistical indicators met the psychometric demands.

Development of national neglect norms for children aged 3 to 6 years in rural areas of China / 中华预防医学杂志

<p><b>OBJECTIVE</b>To develop the national neglect norms for rural children aged 3 to 6 years, which are suitable for Chinese situations.</p><p><b>METHODS</b>According to the multi-stage stratified cluster sampling principle, 84 towns of 10 provinces or municipalities were selected in China. Children aged 3 to 6 years were surveyed in November 2010, the sample of analysis were 3240 (of whom males were 49.6% (1608/3240) and the Han nationality were 93.3% (3023/3240)). Questionnaire was designed by authors and deleted items that did not meet the requirements through several statistical analysis methods, such as item analysis method, factor analysis method, reliability analysis method. The reliability analysis and validity analysis were used to test the stability and reliability of the norm. The evaluation criteria of the scale was determined by the percentile method, then the initial development of the norm completed.</p><p><b>RESULTS</b>After deleting inappropriate items by statistical processing, finally, the scale consisted of 57 items, and included 6 neglected dimensions (physical neglect, emotional neglect, educational neglect, safe neglect, medical neglect and social neglect). Its item loadings ranged from 0.359 to 0.789, which met the statistical requirements. The scale's total Cronbach α coefficients 0.904, the total split-half reliability coefficients were 0.820, the 6 neglect dimensions' Cronbach α coefficients ranged from 0.620 to 0.815, the 6 neglect dimensions' split-half reliability coefficients ranged from -0.034 to 0.789, the scale's parallel reliability were 0.785 and it's re-test reliability were 0.613. After construct validity, external validity and content validity testing, the result showed that this scale could effectively reflect the real neglected status of children investigated. The total neglect cut-off score of this scale were 121.</p><p><b>CONCLUSION</b>The scale has good stability and reliability. And it adapts Chinese conditions and it's convenient to operate.</p>

The status of child neglect among rural areas children aged 0 - 6 years in China / 中华预防医学杂志

<p><b>OBJECTIVE</b>To explore the status of child neglect among rural areas children aged 0 - 6 years in China.</p><p><b>METHODS</b>A total of 7411 rural children aged 0 - 6 years old who were composed of two age groups (3315 children aged 0 - 2 years old and 4096 children aged 3 - 6 years old) were multistage stratified randomly sampled from 84 villages which were representative of 10 provinces of China, in accordance with sex and age in November 2010. To identify the child neglect based on the Neglect Norms for Children Aged 0 to 2 and 3 to 6 Years Old in Rural Areas of China, SPSS 13.0 was employed for analyzing neglect frequency and degree for every group of different age, sex and neglect type (including physical, emotional, educational, medical, safety and social neglects). χ(2) test and analysis of variance were also used.</p><p><b>RESULTS</b>The degree of child neglect for the children aged 0 - 2 years old was 45.01 ± 7.56, the neglect frequency was 54.9% (1819/3315); the degree of child neglect for the children aged 3 - 6 years old was 44.42 ± 7.57, the neglect frequency was 53.8% (2203/4096). The neglect frequency of children aged 0, 1, 2 years old were 58.5% (654/1117), 52.2% (597/1144), 53.9% (568/1054) (P < 0.05). For children aged 3 - 6 years old, the degrees of emotional and safety neglect for males (44.60 ± 7.86, 36.82 ± 9.03) were higher than females (44.03 ± 7.72, 36.25 ± 9.05) (P < 0.05); and the frequencies of emotional and social neglect for males (16.8% (349/2072), 28.3% (586/2072)) were also higher than females (14.1% (286/2024), 24.8% (503/2024)) (P < 0.05). All children of two age groups suffered neglect mainly on one of the six neglect types (incidences were 20.6% (683/3315) and 22.7% (931/4096)). For 0-2 age groups, the higher neglect frequencies happened in the single-parent family and the remarried family (62.5% (15/24) and 63.2% (12/19)), but for children aged 3 - 6 years old groups, it happened in the single-parent family (60.0%, 27/45).</p><p><b>CONCLUSION</b>Degree and frequency of child neglect among children aged 0 to 6 years old in the rural areas of China are high, and we should find out risk factors and provide efficient prevention measures.</p>

The status of child neglect for children aged 3 - 17 years in China / 中华预防医学杂志

<p><b>OBJECTIVE</b>To explore the status of child neglect among urban areas children and adolescents aged 3 - 17 years in China.</p><p><b>METHODS</b>Using multi-stage stratified cluster sampling method, 8001 children and adolescents were recruited from 30 cities of 14 provinces in December 2008. The investigation was carried based on The 3 - 6 years old children Neglect Norms of city in China and The 6 - 17 years old children Neglect Norms of city in China. SPSS 13.0 was employed for analyzing neglect rate and degree for group of areas, age, sex and neglect type (including neglect of physical, emotional, educational, medical, safety and social).</p><p><b>RESULTS</b>The degrees of child neglect for urban children aged 3 - 6 (children aged 6 were not in school), 6 - 8 (children aged 6 were school children), 9 - 11, 12 - 14 and 15 - 17 were 42.2 ± 6.9, 42.8 ± 8.4, 42.1 ± 9.1, 46.4 ± 9.2 and 49.7 ± 8.4(P < 0.05), the neglect rates were 28.0% (326/1163), 28.8% (431/1496), 27.2% (543/1962), 22.4% (373/1664) and 32.8% (563/1716) (P < 0.05), respectively. There were differences in six neglect types for each group; the neglect degrees and rates were high in the group aged 12 - 14 and 15 - 17 (46.4 ± 9.2 and 49.1 ± 8.4, 22.4% (373/1664) and 32.8% (563/1716), respectively); for each neglect type, the neglect degree of children aged 15 - 17 were highest (52.8 ± 8.0, 47.3 ± 11.6, 49.5 ± 10.8, 42.4 ± 10.3, 52.2 ± 16.0, 56.0 ± 10.1). The degree and rate of neglect in West were highest, Middle was next, the East was lowest (the neglect degrees were 45.4 ± 9.1, 45.0 ± 9.3 and 44.0 ± 8.8, P < 0.05;the rates were 30.7% (1340/4361), 25.0% (756/3024) and 21.2% (131/616), P < 0.05). Degree and rate of child neglect for children without siblings were lower than children with siblings (the neglect degrees were 44.2 ± 9.0 and 47.6 ± 9.1, P < 0.01; the rates were 26.1% (1572/6017) and 33.0% (655/1984), P < 0.01). Neglect degree of school children aged 6 years old (43.1 ± 7.3) was higher than children not in school (40.7 ± 7.8) (P < 0.01), but neglect rate was lower (the rates were 35.4% (60/169) and 21.3% (84/394), P < 0.01).</p><p><b>CONCLUSION</b>Neglect degree and rate of urban children and adolescents aged 3 - 17 years in China were both high, and neglect deserved more attentions.</p>

Influence of the insert design on clinical results and kinematics of the knee after total knee arthroplasty / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the influence of the insert design of knee prosthesis on clinical results and kinematics of the knee after total knee arthroplasty (TKA).</p><p><b>METHODS</b>Forty-two knees in 28 patients with knee osteoarthritis undergoing TKA using the GENESIS II from July 2007 to June 2009 were included in this study, mean follow-up of 27.7 months. The cases were divided into 2 groups according to the type of insert, one was high flexion insert group (23 knees) and the other was standard insert group (19 knees). Two groups were compared by clinical ratings of knee function. The motion of flexion and extension of the two groups was observed by cyclic fluoroscopy and the data was analyzed by mapping software. The influence of the insert design of knee prosthesis on kinematics of the knee after TKA was investigated by comparing the parameters of the two groups during the movement of knee joint, including femoral roll back and extensor mechanism arm.</p><p><b>RESULTS</b>The range of motion of standard insert group and high flexion insert group was 120° and 123° respectively with no difference between them. There was no difference of knee society clinical rating system in both groups. Feller score of high flexion insert group was higher than the standard insert group, the difference was significant statistically (P = 0.012). In the imaging measurement, the two groups had no differences in femoral rollback and extensor mechanism arm during the 0 to 120° range of movement. The two groups appeared significant statistically (P = 0.034) in the extensor mechanism arm when flexion extended to 130°.</p><p><b>CONCLUSIONS</b>The high flexion improved design may play a certain role on reducing anterior knee pain and improving knee function after TKA. However, the improved design may be reduced the extensor mechanism arm when high flexion, so that affecting the work ability of quadriceps.</p>