Re-evaluation of systematic reviews of acupuncture and moxibustion for childhood autism / 中国针灸

OBJECTIVE@#To re-evaluate the systematic review/Meta-analysis of acupuncture and moxibustion for childhood autism (CA), aiming to provide decision-making basis for clinical diagnosis and treatment.@*METHODS@#The systematic review and/or Meta-analysis of acupuncture and moxibustion for CA were searched in PubMed, EMbase, Cochrane Library, SinoMed, CNKI and Wanfang databases. The retrieval time was from the database establishment to May 5th, 2022. PRISMA (preferred reporting items for systematic reviews and Meta-analyses) was used to evaluate the report quality, and AMSTAR 2 (a measurement tool to assess systematic reviews 2) was used to evaluate the methodological quality, bubble map was used to construct the evidence map and GRADE was used to evaluate the quality of evidence.@*RESULTS@#A total of 9 systematic reviews were included. The PRISMA scores ranged from 13 to 26. The report quality was low, and there was a serious lack in the aspects of program and registration, search, other analysis and funding. The main problems in methodology included not making prespecified protocol, incomplete retrieval strategy, not providing a list of excluded literatures, and incomplete explanation on heterogeneity analysis and bias risk. The evidence map showed that 6 conclusions were valid, 2 conclusions were possible valid and 1 conclusion was uncertain valid. The overall quality of evidence was low, and the main factors leading to the downgrade were limitations, followed by inconsistency, imprecision and publication bias.@*CONCLUSION@#Acupuncture and moxibustion has a certain effect for CA, but the quality of reporting, methodology and evidence in included literature need to be improved. It is suggested to perform high-quality and standardized research in the future to provide evidence-based basis.

Post-stroke dysphagia treated with four-step acupuncture therapy for opening orifices and benefiting throat combined with neuromuscular electrical stimulation: a randomized controlled trial / 中国针灸

OBJECTIVE@#To observe the clinical efficacy on post-stroke dysphagia treated with four-step acupuncture therapy for opening orifices and benefiting throat combined with neuromuscular electrical stimulation.@*METHODS@#Sixty patients with post-stroke dysphagia were randomly divided into an observation group and a control group, with 30 cases in each group. The neuromuscular electrical stimulation was adopted in the control group. Besides the treatment as the control group, in the observation group, the four-step acupuncture therapy for opening orifices and benefiting throat was supplemented. Step 1: the three areas of scalp acupuncture on the affected side were stimulated. Step 2: pricking method was operated on the posterior pharyngeal wall. Step 3: bleeding technique was operated at Jinjin (EX-HN 12) and Yuye (EX-HN 13). Step 4: deep insertion of needle was operated at three-pharynx points. The needles were retained for 30 min at the three areas of scalp acupuncture and the three-pharynx points. The intervention of each group was delivered once daily, 6 times a week, at the interval of 1 day. One course of treatment was 1 week and 4 successive courses were required. The rating of Kubota water swallow test, the score of standardized swallowing assessment (SSA) and the rating of Rosenbek penetration- aspiration scale (PAS) were observed before and after treatment in patients of the two groups. The incidence of clinical complications and clinical efficacy were compared between the two groups.@*RESULTS@#Compared with those before treatment, the rating of Kubota water swallow test, the scores of SSA and the rating of PAS of patients in the two groups were decreased after treatment (P<0.01), and the values of the observation group were lower than those of the control group after treatment (P<0.05). The incidence of clinical complications in the observation group was 13.3% (4/30), lower than 36.7% (11/30) in the control group (P<0.05). The total effective rate in the observation group was 93.3% (28/30), which was better than 70.0% (21/30) in the control group (P<0.05).@*CONCLUSION@#The four-step acupuncture therapy for opening orifices and benefiting throat combined with neuromuscular electrical stimulation can improve the swallowing function of patients with post-stroke dysphagia and reduce the incidence of clinical complications.

Early prenatal exposure to air pollutants and congenital heart disease: a nested case-control study

BACKGROUND@#Congenital heart disease (CHD) is one of the most common congenital malformations in humans. Inconsistent results emerged in the existed studies on associations between air pollution and congenital heart disease. The purpose of this study was to evaluate the association of gestational exposure to air pollutants with congenital heart disease, and to explore the critical exposure windows for congenital heart disease.@*METHODS@#The nested case-control study collected birth records and the following health data in Tianjin Women and Children's Health Center, China. All of the cases of congenital heart disease from 2013 to 2015 were selected matching five healthy controls for each case. Inverse distance weighting was used to estimate individual exposure based on daily air pollution data. Furthermore, the conditional logistic regression with distributed lag non-linear model was performed to identify the association between gestational exposure to air pollution and congenital heart disease.@*RESULTS@#A total of 8,748 mother-infant pairs were entered into the analysis, of which 1,458 infants suffered from congenital heart disease. For each 10 µg/m3 increase of gestational exposure to PM2.5, the ORs (95% confidence interval, 95%CI) ranged from 1.008 (1.001-1.016) to 1.013 (1.001-1.024) during the 1st-2nd gestation weeks. Similar weak but increased risks of congenital heart disease were associated with O3 exposure during the 1st week and SO2 exposure during 6th-7th weeks in the first trimester, while no significant findings for other air pollutants.@*CONCLUSIONS@#This study highlighted that gestational exposure to PM2.5, O3, and SO2 had lag effects on congenital heart disease. Our results support potential benefits for pregnancy women to the mitigation of air pollution exposure in the early stage, especially when a critical exposure time window of air pollutants may precede heart development.

Prevalence of albuminuria and its association with cardiovascular diseases in Chinese residents aged over 35 years / 中华内科杂志

Objective:To investigate the prevalence of albuminuria in Chinese residents aged >35 years and its potential association with cardiovascular disease (CVD).Methods:A total of 34 647 Chinese subjects aged ≥35 years were selected by stratified multi-stage random sampling from 2012 to 2015. Data were collected through questionnaires, physical examinations, and laboratory tests. Albuminuria was categorized into 3 types according to urinary albumin-to- creatinine ratio: normal (<30 mg/g), microalbuminuria (MAU, 30-300 mg/g), and macroalbuminuria (≥300 mg/g). Measurement data were expressed as xˉ±s, and t-tests were used for comparisons between indicators. Qualitative data were expressed as rate or constituent ratio, and the χ2 test or Kruskal-Wallis test was used to examine differences. Logistic regression was used for multivariate analyses. SAS 9.4 software was used for statistical analyses, and P<0.05 was considered statistically significant. Results:The prevalence of abnormal albuminuria was 19.1%; the prevalence was 17.2% for MAU and lower in males (13.8%) than females (20.1%, P<0.01). The risk of CVD was higher among subjects with MAU ( OR=1.23, 95% CI 1.12-1.35) and macroalbuminuria ( OR=1.86, 95% CI 1.50-2.32). When MAU was complicated by hypertension and diabetes mellitus, the CVD risk was 1.76 times higher. Conclusions:The prevalence of MAU is high among Chinese subjects aged 35 years and over. Those with MAU have higher CVD risk, especially those with hypertension and diabetes mellitus.

Ambient radiation of patients undergoing 18F-FDG PET/CT myocardial metabolism imaging / 中国辐射卫生

Objective To study the ambient radiation of patients undergoing 18F-FDG PET/CT myocardial metabolism imaging, and to provide data for protection of surrounding people against radiation. Methods A total of 33 patients were selected for 18F-FDG PET/CT myocardial metabolism imaging. Dose equivalent rate was measured at the height of patient chest, in different directions, at different time points and at different distances, to investigate the distribution of ambient radiation of the patient. Results At the same time point and distance, the dose equivalent rates at the left and right sides of the patient were lower than the front and back sides. The dose equivalent rate at 1 m in front of the patient was 13-21 μSv/h after 18F-FDG injection, and decreased to 5-14 μSv/h after PET/CT imaging, with a mean decrease of 46%. The ambient dose equivalent rate decreased exponentially with distance (10~300 cm), and the mean power was −1.2. Conclusion The ambient radiation of patients undergoing 18F-FDG PET/CT myocardial metabolism imaging was high after 18F-FDG injection, and the ambient dose equivalent rate decreased rapidly with time and distance. Our results suggest that patients undergoing myocardial metabolism imaging should avoid prolonged and close contact with other people on the day of examination.

Investigation on status of dyslipidemia in Chinese females aged 35 years or above / 中华心血管病杂志

Objective: To investigate the prevalence, awareness, treatment and control status of dyslipidemia among females aged ≥35 years old across China. Methods: Participants were selected by stratified multistage random sampling method in the "Twelfth Five-Year Plan" National Science and Technology Support Project "Survey on the Prevalence of Important Cardiovascular Diseases and Key Technology Research in China" project. This study is a retrospective, cross-sectional study. A total of 17 418 females aged 35 years and over were included in the current study. The basic information such as age, medical history and menopause was collected by questionnaire. The blood lipid parameters were derived from clinical laboratory examinations. The prevalence of dyslipidemia and the rate of awareness, treatment, and control of dyslipidemia were analyzed in females aged 35 years and over. Results: The age of participants was (56.2±13.0) years old, and the prevalence of dyslipidemia was 33.1% (5 765/17 418). The prevalence rates of high total cholesterol, hypertriglyceridemia, low HDL-C and high LDL-C were 9.7% (1 695/17 418), 11.1% (1 925/17 418), 10.9% (1 889/17 418) and 7.3% (1 262/17 418), respectively. The prevalence of dyslipidemia increased with age and the prevalence of dyslipidemia in women who were not married, Han, menarche age>16 years, obesity, central obesity, alcohol consumption, diabetes, hypertension and family history of cardiovascular disease were higher than those without such characteristics (P<0.05). There were 10 432 (59.9%) menopausal females in this cohort and prevalence of dyslipidemia of these participants was 38.8% (4 048/10 432), which was higher than that of non-postmenopausal females (24.6%, 1 717/6 986) (P<0.05). The awareness rates, treatment rates and control rates of dyslipidemia were 33.9% (1 953/5 765), 15.1% (870/5 765) and 2.5% (143/5 765) respectively among females aged 35 years and over in China. Conclusion: The prevalence of dyslipidemia in Chinese females aged 35 years and over is high, and its awareness, treatment, and control rates need to be optimized.

Identification and Expression Analysis of PP2C Gene Family Members in Cannabis sativa / 中国实验方剂学杂志

ObjectiveThe type 2C protein phosphatases （PP2C） are involved in numerous plant signal transduction pathways. They mainly participate in plant stress response and regulate second metabolites biosynthesis via negatively regulating MAPK signaling pathway. Herein，we were to identify and analyze PP2C （CsPP2C） gene family from hemp genome，in hope of providing comprehensive insights for studying CsPP2C function during the development of hemp. MethodMolecular Evolutionary Genetics Analysis （MAGA）-X was used to construct phylogenetic tree. Expert Protein Analysis System （ExPASy），WoLF PSORT，Multiple EM for Motif Elicitation （MEME），Batch Conserved Domain Search （Batch-CD-Search），PlantCare，and TBtools were used，respectively，to predict CsPP2C physicochemical properties，subcellular localization，conserved motifs，protein structure，cis-element in promoter and collinearity with Arabidopsis PP2C. Cannabis sativa transcriptome and Real-time polymerase chain reaction（Real-time PCR） were used to analyze and verify gene expressions，respectively. ResultFifty-two CsPP2C with conserved domains were identified from the entire genome of hemp，encoding proteins ranging from 244 to 1 089 aa in length and with molecular weights ranging from 26.76 to 122.53 kDa. Those genes were mainly distributed in the nucleus，cytoplasm and chloroplast. The 47 CsPP2C were divided into 10 subfamilies，and the remaining 5 were not clustered. Seven pairs of homologous genes between hemp and Arabidopsis thaliana were identified according to collinear analysis. The light-responsive elements and abscisic acid elements are most abundant in the prediction. The gene expression heat map showed varied expression pattern of CsPP2C in different tissues. Real-time PCR results of three CsPP2C were consistent with transcriptome data. Moreover，alternative splicing analysis showed that some CsPP2C had alternative-splicing genes during evolution. ConclusionWe predicted and analyzed CsPP2C gene family in genomic scale and showed that CsPP2C are involved in many biological processes，whereby provides foundation for CsPP2C functional study.

Identification and Expression Analysis of PP2C Gene Family Members in Cannabis sativa / 中国实验方剂学杂志

ObjectiveThe type 2C protein phosphatases （PP2C） are involved in numerous plant signal transduction pathways. They mainly participate in plant stress response and regulate second metabolites biosynthesis via negatively regulating MAPK signaling pathway. Herein，we were to identify and analyze PP2C （CsPP2C） gene family from hemp genome，in hope of providing comprehensive insights for studying CsPP2C function during the development of hemp. MethodMolecular Evolutionary Genetics Analysis （MAGA）-X was used to construct phylogenetic tree. Expert Protein Analysis System （ExPASy），WoLF PSORT，Multiple EM for Motif Elicitation （MEME），Batch Conserved Domain Search （Batch-CD-Search），PlantCare，and TBtools were used，respectively，to predict CsPP2C physicochemical properties，subcellular localization，conserved motifs，protein structure，cis-element in promoter and collinearity with Arabidopsis PP2C. Cannabis sativa transcriptome and Real-time polymerase chain reaction（Real-time PCR） were used to analyze and verify gene expressions，respectively. ResultFifty-two CsPP2C with conserved domains were identified from the entire genome of hemp，encoding proteins ranging from 244 to 1 089 aa in length and with molecular weights ranging from 26.76 to 122.53 kDa. Those genes were mainly distributed in the nucleus，cytoplasm and chloroplast. The 47 CsPP2C were divided into 10 subfamilies，and the remaining 5 were not clustered. Seven pairs of homologous genes between hemp and Arabidopsis thaliana were identified according to collinear analysis. The light-responsive elements and abscisic acid elements are most abundant in the prediction. The gene expression heat map showed varied expression pattern of CsPP2C in different tissues. Real-time PCR results of three CsPP2C were consistent with transcriptome data. Moreover，alternative splicing analysis showed that some CsPP2C had alternative-splicing genes during evolution. ConclusionWe predicted and analyzed CsPP2C gene family in genomic scale and showed that CsPP2C are involved in many biological processes，whereby provides foundation for CsPP2C functional study.

Progress in five coronaviruses with cross-species transmission potential / 中华微生物学和免疫学杂志

Coronaviruses (CoVs) are a group of common viruses that can infect humans and pose a great threat to global public health. Mounting evidence has shown that seven zoonotic CoVs can infect human through cross-species transmission. These continuously occurring yet unpredictable events of CoVs repeatedly crossing species barriers have attracted special attention to CoVs and caused panic worldwide. It is generally believed that the spike (S) protein is the key factor determining the cross-species transmission and the invasion potential of CoVs. This review focused on the new-found coronaviruses with potential cross-species transmission capabilities, and summarized and analyzed the research progress in S protein-mediated viral invasion as well as the potential mechanisms, aiming to provide reference for developing effective prevention and control strategies against potential cross-species transmission of CoVs in the future.

The role of neutrophil density in neutrophils-mediated inflammatory response induced by monosodium urate crystals / 中华内科杂志

Objective:To study the role of neutrophil density and molecular mechanism in neutrophils-mediated inflammatory response induced by monosodium urate (MSU) crystals.Methods:Polymorphonuclear neutrophils (PMNs) isolated from healthy human peripheral blood were treated with MSU crystals at different density (5×10 6/ml, 20×10 6/ml, 100×10 6/ml) in vitro. The mean fluorescence intensity (MFI) of PMNs and production of reactive oxygen species (ROS) were detected by flow cytometry. The distribution of MSU crystals was observed by polarized light microscopy. The neutrophil extracellular traps (NETs) formation was detected by immune fluorescence. The cytokines in cell supernatant were measured by beads assay including interleukin 1β (IL-1β) , tumor necrosis factor α (TNFα) , interleukin 8 (IL-8) , interferon inducible protein 10 (IP-10) , macrophage inflammatory protein 1 (MIP-1) , monokine induced by interferon-γ (MIG) , macrophage inflammatory protein 1α (MIP-1α) , macrophage inflammatory protein 1β (MIP-1β) . Results:(1) After MSU crystal intervention, the side scatters (SSC) of neutrophils with medium-cell density (20×10 6/ml) and high-cell density (100×10 6/ml) were 128±13 and 93±9 respectively, both significantly lower than 170±19 in low-cell density (5×10 6/ml) group.(2) Similarly, compared with low-cell density group, the MFI (lucifer yellow) of PMNs with high-cell density was 1.8±0.2, also significantly decreased ( P<0.05). When co-treated with oxygenated adenosine triphosphate (oxATP), MFI of PMNs were all enhanced consistently. (3) In MSU crystals stimulated PMNs, after adding 2′,7′-dichlorodihydrofluorescein diacetate, the MFI values were 0.85±0.32, 2.49±0.78, 4.54±1.02 in low cell density groups, medium cell density groups, and high cell density groups respectively, indicating that the generation of ROS was positively correlated with the increase of PMN density ( P<0.05). After the intervention of oxATP, the ROS production was significantly reduced. (4) MSU crystal induced NETs formation, especially at high cell density. NETs formation promotes MSU crystal aggregation, which could be partially overcome by oxATP pretreatment. (5) The expression of cytokines were all significantly decreased in the supernatant of PMNs at high cell density exposed to MSU crystals compared with PMNs at medium cell density ( P<0.05) . Conclusion:The PMN-mediated inflammation induced by MSU crystals is cell density dependent, and ATP may play a role in partially overcoming the process.

Association between smoking and the risk of type 2 diabetes in Asian adults: a systematic review and meta-analysis based on prospective cohort studies / 中华健康管理学杂志

Objective:To evaluate the association between smoking and the risk of type 2 diabetes (T2DM) incidence among Asian adults based on the prospective studies.Methods:Prospective studies conducted on Asian adults through May, 2019 were retrieved from the following databases: SinoMed, CNKI, VIP, WanFang, PubMed, Web of Science, Embase, and Cochrane Library. Then data were extracted on smoking status, smoking quantity, the number of newly-onset T2DM cases, and effect sizes.Results:A total of 31 studies were included. There were 2 159 787 investigators, 599 340 (27.75%) smokers, and 124 883 (5.78%) T2DM cases identified during the mean follow-up period of 8.3 years. Compared with non-smokers, the combined relativerisk ( RR) and 95% confidence interval ( CI) of current smokers and quitting smokers were 1.52 (1.34- -1.72) ( P<0.001) and 1.22 (1.09- -1.37) ( P=0.047), respectively. The RR and 95% CI of light smokers (<20/day), moderate smokers (20- -29/day), and heavy smokers (≥30/day) were 1.31(1.21- -1.53) ( P=0.001),1.42(1.14- -1.76)( P=0.212), and 2.17(1.50- -3.16) ( P=0.198), respectively. In males and females, the RR and 95% CI were 1.15 (1.08- -1.21) ( P<0.001) and 1.20 (1.11- -1.30) ( P=0.038), respectively. In addition, compared with non-smokers, the RR and 95% CI of current smokers were 1.57 (1.22- -2.03) ( P<0.001) and 1.47 (1.30- -1.66) ( P=0.063) during the follow-up periods of less than and more than 8.0 years, respectively, while the RR and 95% CI of quitters were 1.23 (1.06- -1.43) ( P=0.091)and 1.20 (1.07- -1.34) ( P=0.041), respectively. Conclusions:Prospective studies based on Asian adults have shown that smoking significantly increases the risk of diabetes incidence. That is, as cigarette consumption increases, the risk of diabetes increases accordingly. Moreover, compared to males, the risk for female smokers is greater. In addition, longer durations of smoking cessation are associated with a lower risk of T2DM.

18F-FDG PET/CT images quality and its impact factors in diabetic and non-diabetic patients with coronary artery disease / 中华核医学与分子影像杂志

Objective:To evaluate the image quality (IQ) of 18F-fluorodeoxyglucose (FDG) PET/CT imaging and identify its influenfial factors in diabetes mellitus (DM) and non-DM patients with coronary artery disease (CAD). Methods:A total of 196 consecutive CAD patients (174 males, 22 females, 68 DM; age: (57±10) years) in Beijing Anzhen Hospital between June 2016 and February 2018 were retrospectively analyzed. All patients underwent 18F-FDG myocardial PET/CT imaging. The standardized fasting+ oral glucose loading (OGL) and intravenously injection of insulin protocol was performed. According to the FDG uptake by myocardium, background activity in blood and other visceral organ nearby the heart, the IQ was visually evaluated and scored by 0-4. Zero-two was considered as good IQ, 3-4 was regarded as poor IQ. Patients were divided into three groups: group 1 (non-DM+ good IQ), group 2 (DM+ good IQ), group 3 (DM+ poor IQ). Factors which may affect IQ were analyzed, which including OGL, the injection dose of insulin, fasting blood glucose (FBG), peak blood glucose (PBG), blood glucose (BG) level at 18F-FDG injection (BG injnection), BG increasing rate ((PBG-FBG)/FBG, %), and BG decreasing rate ((PBG-BG injection)/PBG, %). One-way analysis of variance, Spearman correlation analysis and logistic regression analysis were used for data analysis. Results:There were significant differences ( F values: 13.074-38.371, all P<0.05) of FBG, PBG, OGL, BG decreasing rate and the injection dose of insulin among group 1 ( n=132, 67.3%), group 2 ( n=53, 27.1%), group 3 ( n=11, 5.6%). All those parameters, except for OGL, were positively correlated with FDG PET/CT IQ ( r s values: 0.142-0.262, all P<0.05). OGL was negatively correlated with IQ ( r s=-0.324, P<0.05). Logistic regression analysis showed that FBG (odds ratio ( OR)=0.687, 95% CI: 0.633-0.746), PBG( OR=0.786, 95% CI: 0.746~0.829), BG injection( OR=0.631, 95% CI: 0.595-0.716), OGL( OR=0.897, 95% CI: 0.873-0.922), the injection dose of insulin( OR=0.680, 95% CI: 0.618-0.748) were predictive factors (all P<0.01) for good IQ in all patients. For DM patients, OGL was the only predictive factor for good IQ( OR =0.940, 95% CI: 0.904-0.960; P<0.01). Conclusions:FBG, PBG, BG injection, OGL, the injection dose of insulin can predict IQ for all patients with CAD. For DM patients with CAD, OGL is the only predictive factor for good IQ. A good IQ of 18F-FDG PET/CT could be obtained in majority of CAD patients, with the standardized fasting + OGL and intravenously injection of insulin protocol and adjust according to the personal status, and prevent the hypoglycemia from happening.

Progress in cross-species transmission of human coronaviruses (HCoVs) / 中华微生物学和免疫学杂志

Coronaviruses (CoVs) are a group of ancient and common viruses, posing a severe threat to the health of humans and other animals. Currently, seven human CoVs (HCoVs) have been identified. They are all animal-derived zoonotic pathogens that jump the species barrier from their natural host animals to humans in a direct or indirect manner and lead to interpersonal transmission. The receptor binding domain (RBD) on the S1 subunit of CoV spike (S) protein is one of the key factors determining the cross-species transmission and the invasion potential. This review summarized and analyzed the transmission modes of seven HCoVs and the available structures of HCoV-RBD that mediated the cross-species transmission in order to better understanding the mechanism of CoV cross-species transmission and providing valuable knowledge in response to the potential cross-species transmission of novel CoVs in the future.

Headless pressure screw with local complication of PRP for the treatment of intra-articular fracture of old metatarsal / 中国骨伤

<p><b>OBJECTIVE</b>To discuss clinical effects of headless pressure screw with local complication of PRP in treating old metatarsal intra-articular fracture.</p><p><b>METHODS</b>From January 2010 to June 2016, 7 patients with old metatarsal intra-articular fracture treated by open reduction headless compression screw internal fixation by local application PRP, including 5 males and 2 females, aged from 21 to 52 years old, 5 patients injured by falling down and 2 patients caused by crushing, the time from injury to operation ranged from 3 to 6 weeks. Preoperative anteroposterior, lateral and oblique X-ray film and three-dimensional CT reconstruction were examined, and the results showed 2 patients on the second metatarsal, 2 patients on the third metatarsal, 3 patients on the fourth metatarsal. Regular X-ray as postoperative examination was observed, and American Orthopaedic Foot and Ankle Society (AOFAS) ankle scoring system at the final follow-up was evaluated.</p><p><b>RESULTS</b>Seven patients were followed up from 6 to 17 months. All incisions healed at stage I without joint stiffness, traumatic arthritis and related complications. Imaging examination showed fracture reached bone healing, healing time ranged from 3 to 6 months. No joint stiffness and traumatic arthritis occurred. One of seven patients occurred stiffness of metatarsophalangeal joints. AOFAS score increased from 40.5±4.2 before operation to 85.0±10.5 at 12 months after operation, and 4 patients got excellent results, 2 moderate and 1 poor. The active motion of metatarsophalangeal joint showed dorsal flexion ranged from 35° to 40°, plantar flexion ranged from 25° to 35°.</p><p><b>CONCLUSIONS</b>Headless pressure screw with local complication of PRP in treating old metatarsal intra-articular fracture could recover articular surface of metatarsal head, improve metatarsophalangeal joints activity, which do not need the second operation, and could receive good clinical results with early exercise.</p>

Systematic Review on Curative Effect of Small-needle-knife Therapy Combined with Manipulation on Frozen Shoulder / 中国中医药信息杂志

Objective To systematically evaluate the efficacy of small-needle-knife therapy combined with manipulation in treating frozen shoulder. Methods Articles about small-needle-knife therapy combined with manipulation treating frozen shoulder clinical randomized controlled trials in CNKI, CBM, VIP, Wanfang Data, Embase, Cochrane Library and Pubmed database were searched. Retrieval time was from the establisment of the database to February 2017. Two researchers screened literature, extract materials independently. The quality of the included studies was evaluated according to the Cochrane System Evaluation Manual 5.1.0. Meta-analysis was performed by using RevMan 5.3 software. Results 12 articles were included in a systematic review, a total of 1118 cases of patients. Meta-analysis showed that, compared with small-needle-knife therapy alone, small-needle-knife therapy combined with manipulation in the treatment of frozen shoulder could significantly improve the total effective rate [OR=5.07, 95%CI(3.07, 8.37), P<0.000 01] and cure rate [OR=2.89, 95%CI(2.21, 3.78), P<0.000 01], enhance motor function score [MD=63.98, 95%CI(38.61, 89.35), P<0.000 01], with statistical significance. Conclusion Small-needle-knife therapy combined with manipulation had definite efficacy in the treatment of frozen shoulder. However, the quality of included research is relatively low, so large-sample, multi-center and high-quality randomized controlled trials are required for verification.

Clinical therapeutic effect of a new bundle-to-bundle suturing method for acute Achilles tendon rupture / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the clinical effect of a new bundle-to-bundle suturing method for acute Achilles tendon rupture.</p><p><b>METHODS</b>From April 2013 to January 2015, 15 patients with acute Achilles tendon rupture were treated with a new bundle-to-bundle suturing method including 12 males and 3 females with an average age of 37.5 years old ranging from 27 to 56 years old. All of them were immobilized by cast for 6 weeks on the underlying limbs, and were educated for a rehabilitation training during the follow-up.</p><p><b>RESULTS</b>All the patients were followed up for 9 to 17.5 months with an average of 13.5 months. According to the American Ankle Surgery Association (AOFAS), ankle and foot score was 93.3±3.5 at 6 months after operation. All patients got incomplete weight-bearing at 1.6 months on average after the operation, and back to primary work position 4.7 months later on average. All the wounds got primary healing. No incisional infection, necrosis of incisional marginal necrosis, rupture of the Achilles tendon, and gastrocnemius injury occurred.</p><p><b>CONCLUSIONS</b>The surgical treatment of acute Achilles tendon rupture with bundle-to-bundle suturing method has advantages of mini-invasion, a low rate of incision problems and quick function recovery, and was valuable spread in clinic.</p>

Dermal hypoesthesia surrounding the incision after total knee arthroplasty: how to treat? / 中国组织工程研究

BACKGROUND: Dermal hypoesthesia surrounding the incision usually occurs after total knee arthroplasty (TKA), which severely affects the patients' life quality. But the relevant studies are still immature, and its prevention methods and prognosis remain controversial.OBJECTIVE: To review the research and progress of dermal hypoesthesia following TKA.METHODS: A computer-based online research of CJFD, WanFang, VIP and Medline databases was performed for the literature addressing the dermal hypoesthesia surrounding the incision after TKA published from December 2001 to December 2016. The keywords were "total knee arthroplasty, incision, numbness, abnormal sensation" in English and Chinese, respectively. Finally, 36 eligible articles were selected for result analysis after excluding the repetitive ones.RESULTS AND CONCLUSION: (1) Dermal hypoesthesia surrounding the incision following TKA is commonly seen, but the related researches are few. Most of researches concentration on protecting against cutaneous nerve injury by modifying surgical approach, nerve conduit, neural nutrients and surgical repair, but all possess certain shortcomings, so there is a lack ideal prevention scheme. (2) The repairing methods for peripheral nerve injury, including biomolecular, cell and catheter therapies, have been applied in the repair of cutaneous nerve injury following TKA, but still on initial stage,and its effectiveness and safety need to be confirmed in depth. (3) Therefore, whether dermal hypoesthesia surrounding the incision following TKA needs treatment or not, and how to treat is an urgent problem for joint surgeon.

LINK fixed-bearing versus Oxford mobile-bearing unicompartmental knee arthroplasty for medial unicompartment knee osteoarthritis / 中国组织工程研究

BACKGROUND: In the treatment of unicompartmental knee osteoarthritis, unicompartmental knee arthroplasty has the advantages of less blood loss, less trauma, quick recovery, maximum retention of bone mass, low cost, fewer complications and higher patient satisfaction. However, for the mobile bearing and the fixed bearing, the choice of single condylar prosthesis is till controversial.OBJECTIVE: To investigate the difference of LINK fixed-bearing and Oxford mobile-bearing unicompartment arthroplasty in relieving knee joint pain, reconstruction of the knee joint function, correct the knee joint deformity for medial unicompartment knee osteoarthritis, thus providing the basis for selecting a better prosthesis.METHODS: Ninety patients with medial unicompartment knee osteoarthritis undergoing unicompartmental knee arthroplasty in the Department of Joint Surgery, Guangdong Provincial Hospital of TCM from December 2014 to June 2016 were analyzed retrospectively, followed by allotted into Oxford mobile-bearing and LINK fixed-bearing groups (n=45 per group). The preoperative and postoperative pain level, range of motion of the knee, complications, and limb alignment were assessed. The range of motion and function of the knee were evaluated by Knee Society Score system.RESULTS AND CONCLUSION: (1) The two kinds of prosthesises both could obtain good clinical effectiveness. (2)There was no significant difference in the Knee Society Score, Visual Analogue Scale scores, or the range of motion of the knee between two groups (P > 0.05). (3) No complications such as deep vein thrombosis, prosthesis loosening and joint revision were found in both groups. (4) The correction of limb alignment showed significant difference between two groups (P < 0.05). The corrective femorotibial angle in the Oxford mobile-bearing group was larger than that in the LINK fixed-bearing group. (5) These findings manifest that under the precondition of strictly mastering the indications, both fixed-bearing and Oxford mobile-bearing unicompartment arthroplasties can effectively relieve the pain and improve the function of knee joint in the treatment of unicompartmental knee osteoarthritis. Oxford mobile-bearing prosthesis exhibits advantage in restoring the limb alignment; the movable platform lower limb alignment correction angle is often bigger than fixed platform correction angle, but may accelerate the lateral cartilage wear.

Periprosthetic joint infection following total knee arthroplasty: its bacteriological characteristics and treatment strategies / 中国组织工程研究

BACKGROUND: Periprosthetic infection after total knee arthroplasty (TKA) has become the most serious complication. However, there is still a lack of clinical study on the distribution of pathogenic bacteria. Therefore, understanding the distribution characteristics of the main pathogenic bacteria is critical for preventing and treating OBJECTIVE: To analyze the bacteriological characteristics in the patients with periprosthetic joint infection following TKA, so as to provide reference for early prevention and treatment. METHODS: CNKI, VIP, WanFang and PubMed databases were retrieved for the literature concerning periprosthetic infection following TKA published before 2016. The incidence of periprosthetic joint infection after TKA was statistically analyzed. RESULTS AND CONCLUSION: (1) 103 articles were included, involving 1 399 patients. (2) The main pathogenic bacteria were Staphylococcus aureus,coagulase negative Staphylococcus aureus,Staphylococcus epidermidis,Escherichia coli, Streptococcus and Enterococcus.There is no significant difference in the distribution of bacteria at home and abroad. Treatment strategies are divided into conservative and surgical treatments. (3) The key for successfully preventing and treating periprosthetic infection after TKA lies in the multiple disciplinary team collaboration, understanding the distribution of bacteria, early diagnosis and active preventive measurements, as well as rational treatment strategies.

Podiatric Conditions of Athletes in the Sixth National Special Olympics / 中国康复理论与实践

Objective To analyze the podiatric conditions of athletes with intellectual disabilities.Methods From May eleventh to 17th, 2015,779 athletes who participated in the sixth National Special Olympics were enrolled partly.Their lower limbs and feet were evaluated with Fit Feet Healthy Athletes Screening Form.Results Common podiatric conditions found in Special Olympics athletes included flat feet (52.2% in left side and 51.7% in right side), over pronation (56.1% in left side and 56.9% in right side), callus (44.7%), wrong nail cut (46.6%),ingrown nail(21.1%),and cross over toes(6.8%),etc.Conclusion Special Olympics athletes have podiatric structural,functional, nail and skin problems,which may relate to intellectual disabilities.