Robot-assisted total knee arthroplasty research on safety and effectiveness / 中华骨科杂志

Objective:To investigate the safety and effectiveness of robot-assisted total knee arthroplasty (TKA).Methods:From August 2021 to March 2022, the data of 69 patients who received robot-assisted TKA for inflammatory disease of knee in 6 hospitals were collected, including 24 males and 45 females, aged 52±6 years (range, 46-72 years), including 53 cases of knee osteoarthritis,10 cases of rheumatoid arthritis, and 6 cases of traumatic arthritis. Imaging data examination of patients was completed according to the multicenter specification. Preoperatively, the patient's CT data were extracted before surgery and a personalized prosthesis positioning plan was designed by the robotic system to determine the prosthesis size, lower limb force lines, and femoral and tibial osteotomy volumes; intraoperatively, the osteotomy template was robotically controlled to complete the osteotomy according to the prosthesis positioning plan, and the intraoperative osteotomy volumes were measured to verify the accuracy of the robot-assisted TKA osteotomy with the preoperative planning. Postoperatively, the lateral angle of the distal femur, the medial angle of the proximal tibia and the hip-knee-ankle angle were measured in the coronal plane according to radiographs; the postoperative outcome was evaluated 3 months after operation, using the American Knee Society score (KSS), including the KSS knee score and functional score.Results:The operative time was 97.3±2.3 min (range, 80-110 min) and the amount of bleeding was 320.0±6.2 ml (range, 300-350 ml) in 69 patients. Three months after operation, the mean range of motion of knee joint was increased from 82.2°±1.1° before surgery to 119.7°±0.8° after surgery ( t=27.65, P<0.001), and the line of force of lower limb was improved from 160.9°±0.5° before surgery to 178.0°±0.2° after surgery ( t=32.03, P<0.001). KSS-knee score increased from 54.8±0.7 points before operation to 85.0±0.5 points after operation, and KSS-functional score increased from 56.5±0.7 points before operation to 85.9±0.4 points after operation, the difference was statistically significant ( t=35.45, 36.58, P<0.001). The proportion of patients with intraoperative femoral and tibial osteotomies within 2 mm osteotomy error compared with preoperative planning was 97% for the lateral tibial plateau, 100% for the medial tibial plateau, 100% for the lateral distal femur, 99% for the medial distal femur, 93% for the lateral posterior femoral condyle, and 100% for the medial posterior femoral condyle; The proportion of patients with postoperative anteroposterior X-ray measurement angle error within 3° was: 100.0% for the distal lateral femoral angle, 100.0% for the proximal medial tibial angle, and 100% for the hip-knee-ankle angle. No complications occurred in all patients except for one case in which fat liquefaction occurred in the postoperative wound. Conclusion:Robot-assisted TKA is a safe and effective surgical method for the treatment of inflammatory disease of knee with accurate prosthesis installation and good postoperative recovery of lower limb alignment.

Research, development and application of collagen: a review / 生物工程学报

Collagen, which widely exists in skin, bone, muscle and other tissues, is a major structural protein in mammalian extracellular matrix. It participates in cell proliferation, differentiation, migration and signal transmission, plays an important role in tissue support and repair and exerts a protective effect. Collagen is widely used in tissue engineering, clinical medicine, food industry, packaging materials, cosmetics and medical beauty due to its good biological characteristics. This paper reviews the biological characteristics of collagen and its application in bioengineering research and development in recent years. Finally, we prospect the future application of collagen as a biomimetic material.

Effects of Different Processed Methods on Anti-gouty Arthritis and Cardiotoxicity of Aconiti Radix / 中国实验方剂学杂志

Objective:To study the effects of different processing methods on the anti-gouty arthritis and cardiotoxicity of Aconiti Radix， and to explore the possible attenuation and synergism mechanism of these different processing methods. Method:The swelling degree of knee joint， levels of inflammatory factors ［interleukin （IL） -1<italic>β</italic>， IL-18， tumor necrosis factor （TNF）-<italic>α</italic>］ and the activities of liver energy metabolism-related enzymes ［Ca²⁺-Mg²⁺-adenosine triphosphatase （ATPase）， Na⁺-K⁺-ATPase， succinate dehydrogenase （SDH）］ in rats with gouty arthritis were used as indicators to evaluate the effects of pharmacopoeia steaming Aconiti Radix， pharmacopoeia boiling Aconiti Radix， Jianchang faction processed Aconiti Radix， Zhang faction processed Aconiti Radix and raw Aconiti Radix. The activity of creatine kinase （CK）， lactate dehydrogenase （LDH） and the content of B-type natriuretic peptide （BNP） were used as indexes to evaluate the cardiotoxicity of Aconiti Radix and its different processed products. Result:In the anti-gouty arthritis test， compared with the blank group， the knee joint of the model group was significantly swollen （<italic>P</italic><0.01）， the levels of IL-1<italic>β</italic>， IL-18， and TNF-<italic>α</italic> in serum were significantly increased （<italic>P</italic><0.01）， and the Ca²⁺-Mg²⁺-ATPase activity was significantly decreased （<italic>P</italic><0.01）. Compared with the model group， raw Aconiti Radix and the four processed products could reduce knee joint swelling and decrease IL-1<italic>β</italic>， IL-18， and TNF-<italic>α</italic> levels in serum of rats. The activity of Ca²⁺-Mg²⁺-ATPase in the liver of rats from the pharmacopoeia steaming Aconiti Radix group was significantly higher than that in the model group （<italic>P</italic><0.01）， and there was no statistical difference in other groups. In the cardiotoxicity test， compared with the blank group， the activities of CK and LDH were significantly increased and the level of BNP was significantly increased in the raw Aconiti Radix group and the pharmacopoeia steaming/boiling Aconiti Radix groups （<italic>P</italic><0.01）. In terms of LDH activity and BNP content， the Zhang faction and Jianchang faction processed Aconiti Radix groups were significantly lower than those in the raw Aconiti Radix group （<italic>P</italic><0.01）. In the CK activity， the Zhang faction processed Aconiti Radix group was significantly lower than that in the raw Aconiti Radix group （<italic>P</italic><0.01）. Conclusion:Raw Aconiti Radix and the four processed products have certain anti-inflammatory effects， but there are some differences among different indicators. There are significant differences in cardiotoxicity between the raw products and processed products of Aconiti Radix， and the cardiotoxicity of Jianchang faction and Zhang faction processed products was the weakest.

Age-related differences in the management and outcome of acute coronary syndrome under the chest pain center model: a multicenter retrospective study / 中华危重病急救医学

Objective:To assess the age-related differences in the management strategies and outcomes of patients with acute coronary syndrome (ACS) under the chest pain center model.Methods:Clinical data of 2 833 patients with ACS were enrolled in the retrospective observational registry between January 2017 and June 2019 at 11 hospitals with chest pain centers in Chengdu. The patients were divided into four groups according to their ages: < 55 years old group ( n = 569), 55-64 years old group ( n = 556), 65-74 years old group ( n = 804), ≥ 75 years old group ( n = 904). The collected data included the patients' demographic characteristics, cardiovascular risk factors, medical history, symptoms and signs of onset, experimental examination, types of ACS and the time from the symptom to the hospital (S-to-D), etc., and the clinical characteristics, management strategies, all-cause mortality in the hospital, and the incidence of major adverse cardiovascular and cerebrovascular events (MACCE) within 1 year after discharge were compared. The primary end point was the clinical outcome of ACS patients in different age groups, including all-cause deaths in the hospital and the incidence of MACCE within 1 year after discharge. The secondary end point was the proportion of ACS patients underwent percutaneous coronary intervention (PCI) in different age groups. Multivariate Logistic regression was used to analyze the risk factors of all-cause deaths in ACS patients. Kaplan-Meier curve was used to express the incidence of MACCE within 1 year after discharge in different age groups. Multivariate Cox regression was used to analyze the factors affecting the incidence of MACCE within 1 year after discharge of ACS patients. Results:As age increased, the proportion of male patients gradually decreased, and the percentages of male patients aged < 55 years old, 55-64 years old, 65-74 years old, and ≥ 75 years old were 87.2% (496/569), 77.0% (428/556), 66.4% (534/804), and 60.1% (543/904), respectively; and ACS patients combined with hypertension, diabetes, coronary heart disease, and stroke history were more common [the percentages of patients with hypertension aged < 55 years old, 55-64 years old, 65-74 years old, ≥ 75 years old were 41.3% (235/569), 52.2% (290/556), 59.7% (480/804), and 66.9% (605/904); the percentages of diabetes were 18.6% (106/569), 25.5% (142/556), 27.0% (217/804), and 28.2% (255/904); the percentages of coronary heart disease were 10.1% (57/564), 13.9% (77/555), 17.6% (141/803), and 23.7% (213/899); the percentages of stroke were 0.7% (4/564), 4.0% (22/552), 4.5% (36/801), and 8.6% (77/894)]. But the percentages of patients with a history of active smoking, typical chest pain/chest tightness and dyslipidemia were significantly reduced [the percentages of smoking history were 60.2% (340/565), 48.0% (266/554), 33.7% (270/801), and 21.7% (195/899), typical chest pain/chest tightness were 96.9% (536/553), 96.4% (516/535), 91.8% (716/780), 90.2% (776/860); the percentages of dyslipidemia were 11.2% (63/565), 9.2% (51/553), 5.7% (46/802), and 4.9% (44/896)], the time of S-to-D was significantly prolonged [minutes: 176.0 (73.5, 557.0), 194.5 (89.3, 682.3), 221.0 (98.8, 940.5), and 270.0 (115.0, 867.0)], hemoglobin (Hb) level was significantly reduced(g/L: 145.44±17.43, 135.95±19.25, 129.75±19.03, 122.19±20.55), and the incidence of non-ST-segment elevation myocardial infarction (NSTEMI) increased significantly [18.6% (106/569), 20.5% (114/556), 26.6% (214/804), 26.5% (240/904)], and the differences were statistically significant (all P < 0.05). The proportion of Killip grade Ⅲ -Ⅳ were the highest in patients aged ≥ 75 years old, 9.0% and 12.6%, respectively. Compared with the groups aged < 55 years old, 55-64 years old, and 65-74 years old, the proportion of patients aged ≥ 75 years old who underwent PCI was the lowest, and the all-cause mortality in the hospital and the incidence of 1-year MACCE of patients underwent PCI were significantly lower than those of patients underwent conservative treatment [6.0% (28/463) vs. 10.4% (45/434), 14.6% (43/294) vs. 24.3 % (55/226), both P < 0.05]. As age increased, the hospital all-cause mortality and the 1-year MACCE incidence increased (all-cause mortality rates in < 55 years old, 55-64 years old, 65-74 years old, ≥ 75 years old groups were 0.9%, 2.2%, 5.5%, 8.3%, and the 1-year MACCE incidences were 5.0%, 6.7%, 13.9%, 18.7%, both P < 0.01). The multivariate Logistic regression analysis showed that age, cardiogenic shock, ST-segment elevation myocardial infarction (STEMI), the number of vascular disease and underwent PCI were the independent risk factors of all-cause mortality [the odds ratio ( OR) and 95% confidence interval (95% CI) were 1.644 (1.356-1.993), 11.794 (7.469-18.621), 2.449 (1.419-4.227), 1.334 (1.096-1.624), 0.391 (0.247-0.619), all P < 0.001]. Cox regression analysis showed that age, STEMI, the number of vascular disease and underwent PCI were independent risk factors of the occurrence of MACCE within 1 year after discharge [hazard ratio ( HR) and 95% CI were 1.354 (1.205-1.521), 1.387 (1.003-1.916), 1.314 (1.155-1.495), 0.547 (0.402-0.745), all P < 0.05]. Conclusions:In the chest pain center model, compared with other age of ACS patients, the proportion of NSTEMI in elderly patients group aged ≥ 75 years old was higher, the proportion of PCI was lower, and the clinical outcome was worse. However, the prognosis of elderly patients receiving PCI treatment was better than the patients receiving conservative treatment.

Analyzing quality of life and influencing factors in patients with bone metastasis of hepatocellular carcinoma before and after radiotherapy by bone pain scale / 中华放射医学与防护杂志

Objective:To study the effect of radiotherapy on the quality of life (QOL) of patients with bone metastasis of hepatocellular carcinoma by analyzing the Function Assessment of Cancer Treatment(FACT), and to analyze the influence of clinical factors on the improvement of the QOL after radiotherapy.Methods:The FACT bone pain scale in 43 patients with bone metastasis of hepatocellular carcinoma before and after radiotherapy was retrospectively analyzed. The changes in QOL score before and after radiotherapy were analyzed by T test from five aspects: overall QOL score, general functional status, pain degree, physical function and social psychology. Further analysis was made on the scores of patients whose QOL had not been improved. Chi-square test was used to analyze the correlation between clinical factors and QOL improvement after radiotherapy. Results:After radiotherapy, the QOL of patients were improved in all aspects compared with those before radiotherapy, and there were statistical differences ( t=7.621, 5.887, 9.407, 7.785, 4.487, P<0.05). In patients whose QOL did not improve after radiotherapy, the scores of overall QOL and psychosocial assessment decreased significantly, and there were significant differences ( t=3.381, 4.982, P<0.05). Among the clinical factors, soft tissue mass at bone metastasis site and radiotherapy prescription dose had significant effects on the improvement of patients′ life after radiotherapy (χ 2=5.180, 7.457, P<0.05). Whether there were soft tissue masses in bone metastases before radiotherapy, the improvement rates of QOL after radiotherapy were 50.00% and 85% respectively. The improvement rates of QOL after radiotherapy were 44.44% and 84% in patients with prescription dose of <40 Gy and≥40 Gy respectively. Multivariate analysis showed that soft tissue mass at bone metastasis site, the dose of radiotherapy prescription and numeric rating scale (NRS) of pain had more significant effects on QOL ( OR=0.296, 0.020, 1.592, P<0.05). Conclusions:Radiotherapy at bone metastasis sites can significantly improve the QOL of liver cancer patients with bone metastasis. Psychosocial status can affect the QOL of patients. In the case of soft tissue mass in bone metastasis site, the prescription dose of radiotherapy (≥40 Gy) can better improve the QOL.

Research and Practice of " Three Suitability" Theory in Processing of Traditional Chinese Medicine / 中国实验方剂学杂志

As an important part of clinical medication, the main function of processing of traditional Chinese medicine (TCM) is to reduce toxicity and increase efficiency. The key to the best clinical efficacy of TCM after processing lies in three aspects of moderation, adaptation and timeliness, namely " three suitability" theory. In recent years, scholars have done a lot of research under the guide of " three suitability" theory, fully explaining the scientific connotation of the theory, which greatly promoted the inheritance and innovation of TCM processing. In this paper, the basic connotation of " three suitability" theory was summarized, combining with a large number of modern research reports, the pharmacodynamics and composition changes of processed drugs were analyzed and discussed under the guide of " three suitability" theory. At the end of the paper, the authors proposed that we should not only systematize the traditional processing theories, but also use modern advanced technologies to explain the essence of traditional processing theories, and to innovate and develop new processing theories, promote the development of TCM processing discipline and the progress of TCM processing industry.

Research Progress on Multi-material and Multi-process Processing of Aconiti Radix / 中国实验方剂学杂志

Aconiti Radix is a kind of medicinal material with great toxicity, which has more than 2 000 years of clinical application history, in the folk, there are often poisoning accidents caused by improper processing. The main processing purpose of Aconiti Radix in the early period was to reduce the toxicity with simple procedure and single excipient. Since the Song dynasty, with the deepening of physicians' cognition of processing and the theory of medicinal properties, the application of procedures and materials in the processing of Aconiti Radix began to become complicated, and the scope of clinical application was further expanded. In modern times, the processing technology of Aconiti Radix is mainly based on steaming and boiling, which is quite different from the traditional processing method with multiple materials and multiple processes. Based on the characteristics of many kinds of materials and processes, this paper discusses the change in processing methods of Aconiti Radix from the perspective of excipients and processes, as well as modern processing research, in order to lay a scientific foundation for exploring the effects of many kinds of materials and processes on the quality of Aconiti Radix and revealing its processing mechanism, and provide basis and reference for establishing a more reasonable and scientific processing method for Aconiti Radix in the future.

Effects of Exercise Preconditioning on Blood-brain Barrier Permeability in Rats after Cerebral Ischemia-reperfusion Injury / 中国康复理论与实践

Objective:To observe the effects of exercise preconditioning on blood-brain barrier (BBB) permeability, and connexin 43 (Cx43) and pannexin 1 (Panx1) protein after cerebral ischemia-reperfusion injury in rats. Methods:Fifty-four male Sprague-Dawley rats were randomly divided into sham group (n = 18), model group (n = 18) and exercise preconditioning group (n = 18). The exercise preconditioning group was trained with treadmill for three weeks before modeling. The middle cerebral arteries were occluded in the model group and the exercise preconditioning group using the modified Koizumi suture. After reperfusion of 24 hours, the rats were assessed with modified Neurological Severity Score (mNSS). The permeability of BBB was observed with Evans blue (EB). The expression of Cx43 and Panx1 was detected with Western blotting and immunohistochemistry in the ischemic tissues. Results:Compared with the model group, the mNSS score decreased in the exercise preconditioning group (P < 0.05), while the Evans blue content and the expression of Cx43 and Panx1 decreased (P < 0.05), as well as the the positive areas of Cx43 and Panx1 (P < 0.05). Conclusion:Exercise preconditioning can improve the permeability of BBB in cerebral ischemia-reperfusion rats, which may associate with down-regulation of Cx43 and Panx1, to protect brain from injury.

Effects of ginsenoside Rg1 on survivin protein expression and apoptosis in rats with spinal cord ischemia-reperfusion injury / 西安交通大学学报(医学版)

Objective: To observe the effects of ginsenoside Rg1 pretreatment on the expression of survivin protein and apoptosis after spinal cord ischemia-reperfusion injury (SCII) in rats so as to explore the possible mechanism of ginsenoside Rg1 on motor function recovery after SCII in rats. Methods: We selected 120 adult healthy SD rats to construct the model of SCII and randomly divided them into four groups: sham operation group, ischemia group, ischemia-reperfusion group, and drug group. Basso Beattie and Bresnahan score (BBB score) was used to evaluate the motor function of the hind limbs of the rats. The expressions of survivin protein and apoptosis-inducing factor (AIF) was observed by immunohistochemistry. The expression and activity of survivin protein and Caspase-9 in each group were observed and analyzed by Western blot and RT-PCR. Results: The intervention of ginsenoside Rg1 could increase the score of the motor function of the rat hind limbs. It could decrease the number of AIF positive cells, but increase the number of survivin protein positive cells. Ginsenoside Rg1 could decrease the expressions of survivin and Caspase-9, and decrease the apoptosis of nerve cells in SCII. Conclusion: Ginsenoside Rg1 could inhibit the expression of Caspase-9 by promoting the expression of survivin protein and decrease the apoptosis of rat SCII induced by the level of cytoplasmic AIF.

Research Progress of Exosomes in Ischemic Stroke (review) / 中国康复理论与实践

Exosome is a hot topic in the field of medical research in recent years, which can serve as new carriers for cell-to-cell communication, and show great potential in the diagnosis and treatment of ischemic stroke. microRNA containing in exosomes plays an important role in it. This article reviewed the research progress of exosomes in ischemic stroke on biomarkers, drug carriers, neurovascular remodeling, and treatment.

Protective Effect of Ginsenoside Rb1 on Spinal Cord Ischemic-reperfusion Injury in Rats by Alleviating Mitochondrial Damage / 中国康复理论与实践

@#Objective To observe the effects of ginsenoside Rb1 pretreatment on spinal cord ischemia-reperfusion injury in rats, and to explore the possible mitochondrial mechanism of ginsenoside Rb1 against ischemia-reperfusion injury. Methods The spinal cord ischemia-reperfusion injury model was established. The rats were randomly divided into sham operation group (n=12), ischemia-reperfusion group (n=12) and drug group (n=12). The drug group received gin-senoside Rb1 peritoneal injection with 10 mg/kg, 20 mg/kg, 40 mg/kg and 80 mg/kg, respectively, 30 minutes be-fore modeling and once a day after modeling. After 48 hours of reperfusion, the BBB score was tested, the levels of superoxide dismutase (SOD) and malonaldehyde (MDA) in the serum and spinal cord tissue, and the cyto-chrome C oxidase (COX) activity in spinal cord tissue were detected. Results Compared with the ischemia-reperfusion group, the BBB score increased (P<0.05), the SOD level increased, and the MDA level decreased both in serum and spinal cord tissue, the activity of COX increased in the spinal cord tissue (P<0.05). All the indexes were dose-dependent, however, no difference was found between 40 mg/kg and 80 mg/kg. Conclusion Ginsenoside Rb1 can inhibit oxidative stress induced by spinal cord ischemia-reperfusion injury in rats by inhibiting mitochondrial damage. The protective effect of ginsenoside Rb1 on the spinal cord ischemia-reperfu- sion injury is dose-dependent during 10 to 40 mg/kg dose.

Relationship of Neurovascular Units and Neurodegenerative Diseases(review) / 中国康复理论与实践

The concept of neurovascular units studies the interaction between neural cells and blood vessels, regards the blood-brain barrier as the core,and relates with the neurodegenerative diseases.This paper reviewed the relationship be-tween neurovascular units and neurodegenerative diseases, such as Alzheimer's disease, amyotrophic lateral sclerosis, Huntington's disease,multiple sclerosis,etc.

Role of p53 Protein in Improving Nerve Function of Rats with Acute Cerebral Ischemia-reperfusion Injury by Electroacupuncture Pretreatment / 中国康复理论与实践

@#Objective To investigate the effect of p53 protein on the nerve function of rats with acute cerebral ischemia-reperfusion by electro-acupuncture pretreatment. Methods A total of 72 male Sprague-Dawley rats were randomly divided into sham group(n=24),model group(n=24) and electroacupuncture pretreatment group(n=24).Each group was equally divided into two hours and 72 hours subgroups. The neurological behavior was assessed with modified Neurological Severity Score (mNSS). HE staining and TUNEL assay were used to observe the injury and cell apoptosis in ischemic brain,and Western blot-ting was used to detect the expression of p-p53(ser392),p53 and microtubule associated protein 1 light chain 3 (LC3)II in ischemic area. Results Compared with the model group,the mNSS scores,the injury of brain tissue,the number of TUNEL-positive cells, and the level of p-p53 and LC3II decreased (P<0.05) in the electroacupuncture pretreatment group.Two hours after reperfusion,there was no significant difference in the level of p53 between the model group and the electroacupuncture pretreatment group(P>0.05),however,72 hours after reperfusion,the level of p53 decreased in the electroacupuncture pretreatment group(P<0.05). Conclusion Electroacupuncture pretreatment can improve neurological deficit in cerebral ischemia-reperfusion injury rats,which may be related to the involvement of p53 protein in autophagy and apoptosis.

Effects of Electroacupuncture Preconditioning on Apoptosis and Expression of Apoptosis-related Proteins in Rats after Cerebral Ischemia-reperfusion / 中国康复理论与实践

Objective To investigate the effect of electroacupuncture (EA) preconditioning on apoptosis after cerebral ischemia-re-perfusion (I/R). Methods A total of 72 male Sprague-Dawley rats were randomly divided into sham group (n=24), model group (n=24) and EA group (n=24). The rats in latter two groups were occluded the right middle cerebral arteries for two hours and reperfused. EA group was treated with EA at Baihui (GV20) for two weeks before modeling. They were as-sessed with modified Neurological Severity Scores (mNSS) 24 hours after modeling. Then, the cerebral infarct volume was measured with TTC staining, the apoptosis was detected with TUENL assay, and the expression of p53, Bax and Bcl-2 proteins in ischemic penumbra was detected with Western blotting. Results Compared with the model group, the score of mNSS, cerebral infarct volume and the number of TUNEL-posi-tive cells all significantly decreased (P<0.05) in EA group; while the expression of p53 and Bax proteins de-creased (P<0.05), Bcl-2 increased (P<0.05), and Bax/Bcl-2 decreased (P<0.05).Conclusion EA preconditioning can induce tolerance to cerebral I/R injury, which might associate with the inhibition of p53 protein and down-regulation of the Bax/Bcl-2 ratio in ischemic penumbra, to inhibit cerebral cell apoptosis.

Preliminary experience and mid-term follow up results of patients after transcatheter aortic valve replacement / 中国介入心脏病学杂志

Objective To evaluate the preliminary experience and mid-term outcome of transcatheter aortic valve replacement(TAVR)in patients with calcifi ed severe aortic stenosis.Methods From December 2014 to February 2016, 10 TAVR cases were admitted in the Cardiovascular Hospital, Xiamen University. The baseline characteristics, echocardiography parameters and clinical follow-up data were analyzed. Results All cases were complicated with impaired heart function(NYHAⅢ in 4 cases, NYHA Ⅳ in 6 cases). The mean age was (75.1±6.2) years and 4(4/10) of them were men. The mean logistic EuroSCORE was (27.2±23.6) % and the mean society of thoracic surgery (STS) mortality score was (9.1±4.8) %. Five cases had bicuspid aortic valve. TAVR was successfully performed in all 10 patients, and valve-in-valve implantation was done in 1 (10%) case. Immediately after procedure, the peak trans-aortic valve pressure gradient decreases from (85.9±22.7) mmHg to (23.2±5.4) mmHg. One case had marginal moderate periprosthetic leak and one case received stent implantation for femoral artery complication during the procedure. During hospitalization, 1 case had blood transfusion for gastrointestinal bleeding and permanent pacemakers were implanted in 2 (2/10) cases. The survival rate was 10/10 at 30 days after TAVR. One case with end-stage renal disease died for gastrointestinal bleeding 36 days after TAVR. For the other 9 patients, 12 months echocardiography data showed that the peak and mean trans-aortic valve gradient was (20.0±5.2) mmHg and (10.6±3.1) mmHg respectively. The lef t ventricular diastolic diameter(LVDD)decreased[(56.5±9.4)mm vs.(51.8±7.6)mm,P=0.035] and left ventricular ejection fraction(LVEF)increased significantly[(46.9±22.2)% vs.(63.7±9.4)%, P=0.029].To date,median follow-up period was(22.0±4.8)month.Clinical symptoms improved in all the 9 cases. The patient with periprosthetic leak had record of hospitalization for several times due to heart failure. Conclusions From the initial TAVR experience of our hospital, TAVR can be done safely and smoothly after strictly TAVR candidate cases selection.

The effects of estrogen on the degenerative changes of rat condylar cartilage and subchondral bone / 实用口腔医学杂志

Objective: To study the effects of estrogen on the degenerative changes of condylar cartilage and subchondral bone in rats. Methods: 18 female SD rats aged 6 weeks were divided into control(C),unilateral anterior cross-bite(UAC) and UAC treated with estrogen(UAC + E) groups(n = 6). UAC metal prosthesis was cemented to the left incisors of maxilla and mandible of the rats in group UAC and UAC + E. Rats in UAC + E group were given pexitoneal injection of 80 μg 17β-estradiol per day. The rats in group C were untreated. Animal were sacrificed at the 4th weeks. The micro-structure of subchondral bone was observed by Micro-CT scanning. HE staining,Safranin O staining,immunohistochemical staining,TUNEL staining and TRAP staining for the observation of pathological changes of histomorphology,extracellular matrix,chondrocyte apoptosis in condylar cartilage,and osteoclasts number in subchondral bone. Results: UAC and UAC + E group showed evident osteoarthritis(OA)-like lesions. Compare with UAC group,there was a significant decrease in the expression of proteoglycan(P ＜ 0. 05),type Ⅱ collagen(P ＜ 0. 01),and a significant increase in the number of apoptotic chondrocytes(P ＜ 0. 01) in UAC + E group. As for subchondral bone,the BV/TV,Tb. Th parameters in C and UAC + E groups were significant higher than in UAC group(P ＜ 0. 01),while the BS /BV,Tb. N,Tb. Sp parameters and the osteoclasts number in C and UAC + E groups were significant fewer than in UAC groups(P ＜ 0. 01). There was no significant difference in bone ultra-parameters and osteoclasts number between C and UAC + E groups(P＞ 0. 05). Conclusion: In the model of rat TMJOA induced by unilateral anterior crossbite prosthesis,supra-physiological level of estrogen can reverse bone loss in subchondral bone,but accelerate the degradation of condylar cartilage.

Advance in Gut Microbiota Function and Its Correlation with Exercise (review) / 中国康复理论与实践

@#Gut microbiota, as a "microbial organ" in human body, has important physiological functions and participates in regulating body's homeostasis and health. Exercise can improve metabolism and immune regulation of body by promoting the composition and structure of gut microbiota, and even affects interaction of the "microbiota-gut-brain axis". This article reviewed the effects of various functions of gut microbiota on body and relationship between gut microbiota and exercise.

Advance in Intestinal Flora Affecting Central Nervous System Diseases (review) / 中国康复理论与实践

@# Intestinal flora plays an important role in the process of human health and disease conversion. It not only participates in a number of physiological processes in the host, but also affects the central nervous system (CNS) -related diseases, which may involve in neurotransmitter, immune, endocrine, metabolites, etc. Intestinal dysbacteriosis plays a role in the development of CNS diseases, such as ischemic brain injury, Parkinson's disease, Alzheimer's disease, multiple sclerosis, hepatic encephalopathy, and mental disorders, etc. Fecal microbes transplantation, exercise training, acupuncture and Tuina therapy can improve the intestinal flora balance, which may be potential for the treatment and prevention of some nervous system diseases.

Effects of Acupuncture-rehabilitation Therapy on Neurological Function and Expression of Apoptosis-related Proteins in Ischemic Penumbra of Rats with Cerebral Ischemia / 中国康复理论与实践

@#Objective To investigate the effect of acupuncture-rehabilitation therapy on the neurological function and the expression of cleaved-caspase-8, cleaved-caspase-3 and cellular inhibitor of apoptosis 1 (cIAP1) in ischemic penumbra of rats with cerebral ischemia. Methods A total of 90 male Sprague-Dawley rats were randomly divided into sham group, model group, acupuncture group, rehabilitation group and acupuncture-rehabilitation group. Each group was divided into three days, seven days and 14 days subgroups (n=6). The cerebral ischemia model was established with the modified Koizumi suture method. The sham group and the model group received no treatment. The acupuncture group received cluster needling of scalp acupuncture, the rehabilitation group received treadmill training, and the acupuncture-rehabilitation group received both acupuncture and treadmill training. Three days, seven days and 14 days after modeling, their neurological function was assessed with modified Neurological Severity Score (mNSS) and Rota-rod test, and the expression of cleaved-caspase-8, cleaved-caspase-3 and cIAP1 protein in cerebral ischemic penumbra were detected with Western blotting. Results Compared with the model group, the mNSS scores decreased, the retention time of Rota-rod test increased, the expression of cleaved-caspase-8, cleaved-caspase-3 protein decreased and the expression of cIAP1 protein increased in each treatment group at each time point (P<0.05). Compared with the other two treatment groups, the mNSS scores further decreased, the retention time further increased, the expression of cleaved-caspase-8, cleaved-caspase-3 protein further decreased, and the expression of cIAP1 protein further increased (P<0.05) seven days and 14 days after modeling in the acupuncture-rehabilitation group.Conclusion Acupuncture-rehabilitation therapy can improve the neurological function in rats with cerebral ischemia, that is better than the simple acupuncture or exercise, which may relate to the inhibition of caspase-8 and caspase-3 protein activation, and promotion of cIAP1 protein expression, to inhibit the apoptotic caspases cascade reaction.

Effects of Electroacupuncture Pretreatment on Neurological Function, and Expression of Toll-like Receptor 4 and Nuclear Factor κB in Ischemic Penumbra in Rats after Cerebral Ischemia-reperfusion Injury / 中国康复理论与实践

Objective To investigate the effect of electroacupuncture (EA) pretreatment on neurological function, and the expression of Toll-like receptor 4 (TLR4) and nuclear factorκB (NF-κB) protein in ischemic penumbra after cerebral ischemia-reperfusion (CIR) injury. Methods A total of 36 male Sprague-Dawley rats were randomly divided into sham group (n=12), model group (n=12) and EA group (n=12). The later two groups were occluded their right middle cerebral arteries for two hours and reperfused. The EA group was pretreated with EA at Baihui (GV20) for two weeks before modeling. They were assessed with modified Neurological Severity Scores (mNSS), the injury in ischemic brain was detected with HE staining, and the expression of TLR4 and NF-κB protein in ischemic penumbra were detected with Western blotting, 24 hours after reperfusion. Results The score of mNSS decreased (P<0.05), the injury of brain tissue ameliorated, and the expression of TLR4 and NF-κB decreased in ischemic penumbra (P<0.05) in EA group compared with those in the model group. Conclu-sion EA pretreatment can reduce the injury and improve the neurological function in rats after CIR by down-regulating the expression of TLR4 and NF-κB protein in ischemic penumbra.