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Anti-neutrophil cytoplasmic antibody-associated vasculitis (AAV) has a wide range of symptoms, and it is difficult for clinicians to make a quick and correct diagnosis. On November 11, 2021, a 36-year-old male patient with AAV was admitted to the emergency and critical care department of Yichang Central People's Hospital. He was admitted to the emergency intensive care unit (EICU) with gastrointestinal symptoms (abdominal pain, black stool) as the main physical signs, and was initially diagnosed as AAV with gastrointestinal hemorrhage (GIH). No bleeding point was found after repeated gastroscopy and colonoscopy. Abdominal emission CT (ECT) showed diffuse hemorrhage in the ileum, ascending colon and transverse colon. Multi-disciplinary consultation in the whole hospital considered the diffuse hemorrhage caused by small vascular lesions in the digestive tract caused by AAV. Pulse therapy with methylprednisolone 1 000 mg/d and immunosuppressive therapy with cyclophosphamide (CTX) 0.2 g/d were administered. The patient's symptoms quickly relieved and transferred out of the EICU. After 17 days of treatment, the patient finally died of massive gastrointestinal bleeding. A systematic review of relevant literatures combined with the case diagnosis and treatment process found that only a minority of AAV patients present with gastrointestinal symptoms as their first symptoms, and patients with GIH were very rare. Such patients had a poor prognosis. This patient delayed the use of induced remission and immunosuppressive agents due to the treatment of gastrointestinal bleeding, which may be the main cause of life-threatening GIH secondary to AAV. Gastrointestinal bleeding is a rare and fatal complication of vasculitis. Timely and effective induction and remission treatment is the key to survival. Whether patients should receive maintenance therapy, the duration of maintenance therapy, and the search for markers of disease diagnosis and treatment response are directions and challenges for further research.
Subject(s)
Male , Humans , Adult , Gastrointestinal Hemorrhage , Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis , Critical Care , Cyclophosphamide , DeathABSTRACT
Diabetic foot ulcers are common in elderly people with diabetes.Ongoing research is aimed at unraveling the complicated molecular mechanisms underlying diabetic foot ulcers.The role of cellular aging in delayed healing of diabetic foot ulcers has been recognized.Analyzing the relationship between cellular aging and diabetic foot ulcers, examining how cellular aging delays the healing of diabetic foot wounds, and identifying treatment methods for the removal of senescent cells and for slowing down cellular senescence will provide new therapeutic targets and strategies for the development of drugs for diabetic foot ulcers.
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Adipokines play an important role in judging the severity and prognosis of coronary heart disease. In recent years, a series of studies have further proved the correlation between adipokines and coronary heart disease. Adipokines can be included in the risk stratification of patients with coronary heart disease and guide the formulation of clinical diagnosis and treatment strategies, and may become a potential therapeutic target of coronary heart disease. This paper mainly summarizes the role of adipokines in the clinical diagnosis and treatment of coronary heart disease.
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Objective:To explore the effect of repetitive transcranial magnetic stimulation(rTMS) combined with cognitive behavioral therapy for insomnia(CBT-I)for menopausal women with insomnia.Methods:A total of 76 menopausal women with insomnia who were hospitalized from April 2020 to October 2021 were enrolled.Then they were randomly divided into observation group and control group, with 38 cases in each group.Both observation group and control group were treated with CBT-I. Meanwhile, the patients in observation group were treated with low-frequency repetitive rTMS, on the contrary, the patients in control group were treated with sham rTMS.The intervention lasted for 4 weeks.Insomnia severity index (ISI), Pittsburgh sleep quality index (PSQI) and polysomnography (PSG) were all recorded at baseline and 4 weeks after intervention, as well as adverse events. Data was analyzed by SPSS 22.0 software. Data which was normally distributed, was compared by independent t-test and paired t-test. Results:(1)The scores of ISI (16.39±4.03, 15.66±4.89) and the PSQI(14.97±2.70, 14.11±3.60) in observation group and control group at baseline were not significantly different( t=-0.716, -1.190, both P>0.05). After treatment, the ISI and PSQI scores of the observation group (10.08±3.65, 9.58±1.73)were lower than those of the control group (12.82±4.47, 12.13±2.32), and the differences were statistically significant ( t=2.926, 5.440, both P<0.05). (2) After treatment, all sleep parameters were significantly improved from baseline in observation group (all P<0.05). Sleep efficiency, wake time during sleep, and number of awakenings were significantly improved from baseline in control group(all P<0.05). Compared with control group((70.38±12.99)%, (17.39±11.75)%, (13.98±6.35)%), the observation group reported a greater statistically improvement in sleep efficiency, N3% and REM%((79.52±9.31)%, (22.80±6.05)%, (18.78±6.68)%, respectively)( t=-3.526, -2.524, -3.212, all P<0.05). Neither group had serious adverse effects. Conclusion:The rTMS combined with CBT-I can significantly improve the sleep quality in menopausal women with insomnia. With its high safety rTMS combined with CBT-I may be a recommended non-drug therapy among menopausal women with insomnia.
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OBJECTIVE@#To assess the practical and health economical values of non-invasive prenatal test (NIPT) in Changsha Municipal Public Welfare Program.@*METHODS@#A retrospective analysis was carried out on 149 165 women undergoing NIPT test from April 9, 2018 to December 31, 2019. For pregnant women with high risks, invasive prenatal diagnosis and follow-up of pregnancy outcome were conducted. The cost-benefit of NIPT for Down syndrome was analyzed.@*RESULTS@#NIPT was carried out for 149 165 pregnant women and succeeded in 148 749 cases (99.72%), for which outcome were available in 148 538 (99.86%). 90% of pregnant women from the region accepted the screening with NIPT. 415 (0.27%) were diagnosed as high risk. Among these, 381 (91.81%) accepted amniocentesis, which led to the diagnosis of 212 cases of trisomy 21 (PPV=85.14%), 41 cases with trisomy 18 (PPV=48.81%) and 10 cases with trisomy 13 (PPV=20.83%). The sensitivity and specificity of NIPT for trisomy 21, trisomy 18 and trisomy 13 were (97.70%, 99.98%), (97.62%, 9.97%) and (100%, 99.97%), respectively. In addition, 213 and 30 cases were diagnosed with sex chromosomal aneuploidies (PPV=46.2%) and other autosomal anomalies (PPV=16.57%), respectively. For Down syndrome screening, the cost and benefit of the project was 120.79 million yuan and 1,056.95 million yuan, respectively. The cost-benefit ratio was 1: 8.75, and safety index was 0.0035.@*CONCLUSION@#NIPT is a highly accurate screening test for trisomy 21, which was followed by trisomy 18 and sex chromosomal aneuploidies, while it was less accurate for other autosomal aneuploidies. The application of NIPT screening has a high health economical value.
Subject(s)
Female , Humans , Pregnancy , Aneuploidy , Cost-Benefit Analysis , Noninvasive Prenatal Testing , Retrospective Studies , Trisomy 18 Syndrome/geneticsABSTRACT
Objective:To analyze any changes in the functional connectivity between the seed points of the dorsolateral prefrontal cortex (DLPFC) and the whole brain, as well as any fluctuations in the low-frequency amplitude among persons with post-stroke depression (PSD). The aim was to develop correlations among functional imaging results, clinical scales, and inflammation indicators including high-sensitivity C-reactive protein (hs-CRP), interleukin 6 (IL-6), interleukin 2 (IL-2), interleukin 10 (IL-10), interleukin 17a (IL-17a) and interferon-γ (IFN-γ).Methods:Between 2016 and 2020, 55 ischemic stroke survivors were tested. The 28 scoring 7 or more on the Hamilton Depression Scale (HAMD-17) formed the PSD group, while the 27 others formed the control group. Functional magnetic resonance images were collected, and serum inflammation indicators were determined.Results:When seed points in the left DLPFC were used, in the PSD group the frontal cortex (FC) decreased in one cluster, with a voxel of 129mm3 and the MNI coordinates (x=9, y=30, z=33) indicating that the anatomical automatic labeling (AAL) brain regions were the Cingulum_Ant_L, Cingulum_Mid_R and the frontal_Sup_Medial_L. When the right DLPFC was used as the seed point the FC again decreased in one cluster, with voxels of 44mm 3 and the MNI coordinates (x=-27, y=12, z=47) referring to the AAL brain region of the frontal_Mid_L. In the PSD group, the FC value of abnormal brain areas with the R-DLPFC as the seed point was positively correlated with time since stroke. In the control group, the FC value of abnormal brain areas with L-DLPFC as the seed point was negatively correlated with MoCA, while with R-DLPFC as the seed point it was positively correlated with IFN-γ. The FC values of abnormal areas of the brain showed no significant correlation with other clinical scales, inflammation indicators or lesion volume. Conclusion:Abnormal functional connections within the executive control network and between the salience networks may participate in the mechanism of PSD, and may be related to the time since stroke, cognitive functioning, and IFN-γ levels.
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Objective:To compare the difference of clinical effects between multidisciplinary treatment (MDT) mode and traditional consultation mode in diagnosis and treatment of patients with dangerous upper gastrointestinal hemorrhage.Methods:The clinical data of patients with dangerous upper gastrointestinal hemorrhage admitted to the department of emergency and critical care medicine of Yichang Central People's Hospital from January 2018 to December 2019 were analyzed retrospectively, taking 30 patients in traditional consultation mode from January 2018 to December 2018 as traditional consultation group, and 26 patients in MDT mode from January 2019 to December 2019 as MDT group. The recovery time of vital signs, length of intensive care unit (ICU) stay, length of hospital stay, medical expenses, rebleeding rate, surgical operation rate, amount of blood transfusion, hospital mortality, and clinical effect of the two groups were observed.Results:The recovery time of vital signs, length of ICU stay and length of hospital stay in the MDT group were significantly shorter than those in the traditional consultation group (days: 1.62±1.30 vs. 2.20±0.93, 10.04±2.82 vs. 13.27±2.86, 3.50±1.63 vs. 4.70±2.17, both P < 0.05), and the medical expenses, rebleeding rate and blood transfusion volume were lower than those in the traditional consultation group [medical expenses (ten thousands Yuan): 6.40±3.07 vs. 8.56±4.07, rebleeding rate: 15.38% (4/26) vs. 43.33% (13/30), blood transfusion volume (U): 5.54±3.20 vs. 7.71±3.83, plasma volume (mL): 330.77±258.87 vs. 458.33±322.73, cold precipitation volume (U): 4.52±4.15 vs. 6.67±4.85, platelet volume (U): 0.40±0.19 vs. 0.77±0.60, all P < 0.05]. The clinical total efficiency in the MDT group was significantly higher than that in the traditional consultation group (88.5% vs. 80.0%, P < 0.05). There was no significant difference in the surgical operation rate and hospital mortality between the two groups. Conclusions:Compared with the traditional consultation mode, MDT mode can significantly shorten the recovery time of vital signs, the length of ICU stay, the length of hospital stay, reduce blood transfusion volume, medical expense and rebleeding risk of patients with upper gastrointestinal hemorrhage, and has better clinical effect. However, there is no significant difference in surgical operation rate and hospital mortality between the two modes.
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Corynebacterium glutamicum, an important microorganism to produce amino acids and organic acids, has been widely applied in food and medicine fields. Therefore, using editing tools to study the function of unknown genes in C. glutamicum has great significance for systematic development of industrial strain with efficient and novel production capability. Recently, gene editing has been greatly developed. Traditional gene editing based on homologous recombination and gene editing mediated by nuclease are successfully applied in C. glutamicum. Among these, the CRISPR system has been developed to be a main tool used for gene knockout of C. glutamicum due to its advantages of efficiency, simplicity and good target specificity. However, more efficient and reliable knockout system is still urgently demanded, to help develop high-performing strains in industrial application.
Subject(s)
CRISPR-Cas Systems , Clustered Regularly Interspaced Short Palindromic Repeats , Corynebacterium glutamicum , Genetics , Gene Editing , Glutamic Acid , Industrial MicrobiologyABSTRACT
OBJECTIVE@#To establish a clinical prediction model of the mid-term fatality risk after radical resection in patients with primary hepatocellular carcinoma (HCC) based on the albumin-bilirubin (ALBI) grade and to assess its prediction value.@*METHODS@#Clinical data of 533 patients who received HCC radical resection in Jinhua Hospital of Zhejiang University, Jinhua People's Hospital, Jinhua Hospital of Traditional Chinese Medicine and Jinhua Guangfu Hospital from January 2010 to August 2016 were retrospectively reviewed. In the training group ( =407), Cox model was used to screen the clinical risk factors of postoperative death, and a predictive model based on ALBI grade was established and then examined in the validation group ( =126). The value of the prediction model was assessed by ROC curve and calibration curve; the prediction results of the model were visualized by the nomogram for the convenience of clinical use.@*RESULTS@#Cox model showed that ALT ≥ 80 U/L, tumor maximum diameter ≥ 5 cm, portal vein tumor thrombus and ALBI grade 2 were independent risk factors for the prognosis of patients with HCC radical resection. The prognosis index (PI) was 0.550×ALT+0.512×ALBI grade+0.872×maximum tumor diameter+1.377×portal vein tumor thrombus. The AUCs for predicting the risk of death in 12, 36 and 60 months were 0.872, 0.814 and 0.810, respectively (all < 0.01), and the goodness of fit ( ) of the established model were 0.953, 0.976 and 0.994. AUC of the established model for predicting risk of death in 36 months after resection was 0.814, which was higher than those of ALBI (AUC=0.683), BCLC (AUC=0.713), CLIP (AUC=0.689), Child-Pugh (AUC=0.645), TNM (AUC=0.612) ( < 0.05 or < 0.01).@*CONCLUSIONS@#ALT ≥ 80 U/L, maximum tumor diameter ≥ 5 cm, portal vein tumor thrombus and ALBI grade 2 are independent risk factors of patients after HCC resection, and ALBI grade-based prediction model is satisfactory in prediction of mid-term death risk of the patients.
Subject(s)
Humans , Albumins , Bilirubin , Carcinoma, Hepatocellular , Liver Neoplasms , Prognosis , Retrospective StudiesABSTRACT
Yichang Central People's Hospital is a large prefecture-level tertiary hospital in Hubei Province. Since the late foundation and interdisciplinary characteritics, the department of emergency and critical care medicine faced many difficulties during development. Based on the actual situation of the hospital, leaders of the hospital and two disciplines advocated their core values of "putting patients' interests first and building team spirit". In consideration of the timeliness, multidisciplinary collaboration and importance of critical care, the department of emergency and critical care medicine in Yichang Central People's Hospital of Hubei Province was set up, and an integrated first-aid platform was established. The concept of "5-minute emergency life chain" was proposed, which highlighted the status and role of the department of emergency and critical care medicine in modern medical rescue and modern general hospitals. In the past 5 years, the emergency department and intensive care unit have made rapid development, including successful establishment of national demonstration centers for chest pain and stroke. Quality of the discipline has also been greatly improved, and a new construction path of department of the emergency and critical care medicine has been created.
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Yichang Central People's Hospital is a large prefecture-level tertiary hospital in Hubei Province. Since the late foundation and interdisciplinary characteritics, the department of emergency and critical care medicine faced many difficulties during development. Based on the actual situation of the hospital, leaders of the hospital and two disciplines advocated their core values of "putting patients' interests first and building team spirit". In consideration of the timeliness, multidisciplinary collaboration and importance of critical care, the department of emergency and critical care medicine in Yichang Central People's Hospital of Hubei Province was set up, and an integrated first-aid platform was established. The concept of "5-minute emergency life chain" was proposed, which highlighted the status and role of the department of emergency and critical care medicine in modern medical rescue and modern general hospitals. In the past 5 years, the emergency department and intensive care unit have made rapid development, including successful establishment of national demonstration centers for chest pain and stroke. Quality of the discipline has also been greatly improved, and a new construction path of department of the emergency and critical care medicine has been created.
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Yichang Central People's Hospital is a large prefecture-level tertiary hospital in Hubei Province. Since the late foundation and interdisciplinary characteritics, the department of emergency and critical care medicine faced many difficulties during development. Based on the actual situation of the hospital, leaders of the hospital and two disciplines advocated their core values of "putting patients' interests first and building team spirit". In consideration of the timeliness, multidisciplinary collaboration and importance of critical care, the department of emergency and critical care medicine in Yichang Central People's Hospital of Hubei Province was set up, and an integrated first-aid platform was established. The concept of "5-minute emergency life chain" was proposed, which highlighted the status and role of the department of emergency and critical care medicine in modern medical rescue and modern general hospitals. In the past 5 years, the emergency department and intensive care unit have made rapid development, including successful establishment of national demonstration centers for chest pain and stroke. Quality of the discipline has also been greatly improved, and a new construction path of department of the emergency and critical care medicine has been created.
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OBJECTIVE： To evaluate the efficacy and safety of nalbuphine for postoperative analgesia systematically， and to provide evidence-based reference in clinic. METHODS： Retrieved from Embase， Medline， PubMed， CNKI， VIP and Wanfang database， RCTs about nalbuphine hydrochloride （trial group） vs. other analgesics （control group） for postoperative analgesia were collected. After literature screening， data extraction and literature quality evaluation with modified Jadad scale， Meta-analysis was performed by using Rev Man 5.3 statistical software. RESULTS： A total of 10 RCTs were included， involving 796 patients. Results of Meta-analysis showed that there was no statistical significance in satisfaction rate of analgesia [OR＝1.11，95％CI（0.70，1.74），P＝0.66]， the incidence of nausea [OR＝1.20，95％CI（0.79，1.83），P＝0.39]， vomiting [OR＝1.02，95％CI（0.69，1.50），P＝0.92] or narcolepsy [OR＝1.32，95％CI（0.47，3.76），P＝0.06] between 2 groups. The incidence of pruritus [OR＝0.29，95％CI（0.14，0.58），P＝0.000 6]， respiratory depression [OR＝0.21，95％CI（0.08，0.58），P＝0.003] and uroschesis [OR＝0.05，95％CI（0.01，0.37），P＝0.004] in trial group were significantly lower than control group. CONCLUSIONS： Nalbuphine has better efficacy and safety for postoperative analgesia.
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Painful leg ulcers are very common in clinic,including arterial ulcers,venous ulcers,autoimmune diseases-related ulcers,gangrenous pyoderma,necrobiosis lipoidica and hypertensive ulcers.At present,few painful leg ulcer-related researches have been conducted in China,and pain is only treated as a concomitant symptom of leg ulcers.However,a series of painful leg ulcer-related researches have been carried out in other countries.This review comprehensively expounds the definition,epidemiological characteristics,etiology and management of,as well as pain mechanism and assessment in painful leg ulcers.
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To analyze the application of ear-acupuncture for post-operative syndromes of breast cancer so as to provide method and evidence for the syndromes. The related clinical literature was retrieved from CNKI, WANFANG and VIP databases from the database establishment time to August 30, 2017. We found ear-acupuncture are mainly used in treating nausea and vomiting caused by radiation and chemotherapy (shenmen (TF), jiaogan (AH), wei (CO), pi (CO), etc), insomnia in the rehabilitation period (xin (CO), pizhixia (AT), shenmen (TF), etc), depression and anxiety (pizhixia (AT), shenmen (TF), pi (CO), wei (CO), xin (CO), gan (CO), etc), and joint pain (pain point), etc.
Subject(s)
Humans , Acupuncture Points , Acupuncture, Ear , Breast Neoplasms , Postoperative Period , SyndromeABSTRACT
Objective To study the effect of electroacupuncture combined with repetitive transcranial magnetic stimulation on the infarct volume of rats with cerebral infarction as well as their behavior and their learning and memory ability.Methods Forty male Sprague-Dawley rats were randomly divided into a normal group,a sham-operation group,a model group and a treatment group,each of 10.Focal cerebral ischemia and reperfusion was modeled in the latter two groups using thread occlusion of the middle cerebral artery.The treatment group was treated for 14 days with electroacupuncture combined with repetitive transcranial magnetic stimulation,started 24 hours after the operation.The animals' neurological functioning was quantified using modified neurological severity scores.The area of cerebral infarct was measured using 5-triphenyltetrazolium chloride staining.The rats' learning and memory abilities were assessed using a Morris water maze and the expression of growth-associated protein 43 (GAP-43) in the peripheral area of the cerebral infarction.Results The average neurological deficit score (2.8± 0.84) was significantly lower in the treatment group than in the model group,the average infarct volume was smaller and the escape latency was less.In the treatment group the average expression of GAP-43 was greater than in the model group.Conclusion Electroacupuncture combined with repetitive transcranial magnetic stimulation can promote the expression of GAP-43 in the peripheral area of a cerebral infarct,promoting neuronal remodeling and thereby improving neurological functioning as well as learning and memory ability.
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Laboratory red crucian carp is a native fish in China. It has been an established inbred fish strain,the laboratory red crucian carp C1HD strain. Based on the standardization research and verification test of laboratory red crucian carp,the local standard of Hunan Province,the called"Laboratory Fish Genetic Quality Control of Laboratory Red Crucian Carp C1HD Strain", has been established. This standard includes preface, scope, normative reference documents,terms and definitions, major biological characteristics, mating and breeding method, breeding environment, genetic quality testing and appendix A,B,C and so on.
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PURPOSE: Various inflammation-based prognostic biomarkers such as the platelet to lymphocyte ratio and neutrophil to lymphocyte ratio, are related to poor survival in patients with intrahepatic cholangiocarcinoma (ICC). This study aims to investigate the prognostic value of the aspartate aminotransferase to neutrophil ratio index (ANRI) in ICC after hepatic resection. MATERIALS AND METHODS: Data of 184 patients with ICC after hepatectomy were retrospectively reviewed. The cut-off value of ANRI was determined by a receiver operating characteristic curve. Preoperative ANRI and clinicopathological variables were analyzed. The predictive value of preoperative ANRI for prognosis of ICC was identified by univariate and multivariate analyses. RESULTS: The optimal cut-off value of ANRI was 6.7. ANRI was associated with tumor size, tumor recurrence, white blood cell, neutrophil count, aspartate aminotransferase, and alanine transaminase. Univariate analysis showed that ANRI, sex, tumor number, tumor size, tumor differentiation, lymph node metastasis, resection margin, clinical TNM stage, neutrophil count, and carcinoembryonic antigen were markedly correlated with overall survival (OS) and disease-free survival (DFS) in patients with ICC. Multivariable analyses revealed that ANRI, a tumor size > 6 cm, poor tumor differentiation, and an R1 resection margin were independent prognostic factors for both OS and DFS. Additionally, preoperative ANRI also had a significant value to predict prognosis in various subgroups of ICC, including serum hepatitis B surface antigen‒negative and preoperative elevated carbohydrate antigen 19-9 patients. CONCLUSION: Preoperative declined ANRI is a noninvasive, simple, and effective predictor of poor prognosis in patients with ICC after hepatectomy.
Subject(s)
Humans , Alanine Transaminase , Aspartate Aminotransferases , Aspartic Acid , Biomarkers , Blood Platelets , Carcinoembryonic Antigen , Cholangiocarcinoma , Disease-Free Survival , Hepatectomy , Hepatitis B , Leukocytes , Lymph Nodes , Lymphocytes , Multivariate Analysis , Neoplasm Metastasis , Neutrophils , Prognosis , Recurrence , Retrospective Studies , ROC CurveABSTRACT
Direct spray mass spectrometry was used to simply and rapidly differentiate Mutong of Aristolochiaceae from other two kinds of Mutong medicinal materials (Lardizabalaceae and Ranunculacea) by analyzing the chemical profile of Mutong of Aristolochiaceae.A novel method for determination of magnoflorine content in Mutong of Aristolochiaceae was established.The results showed that Mutong of Aristolochiaceae could be identified according to the symbolic component, magnoflorine.Under positive ion mode, semi-quantitative result based on the signal strength ratio of magnoflorine and nuciferin was obtained by choosing nuciferin as an internal standard.The method showed good linear coefficient in the concentration range of 0.50-20.00 mg/L of magnoflorine.The limit of detection was 0.1 mg/L.The method was simple and fast, and could be used for direct and rapid in-situ analysis and identification of Mutong of Aristolochiaceae from other closely related Mutong herbal species without sample pre-treatment.The results were important for the quality control of Mutong herbal medicine.
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Objective To evaluate the effect of the single energy metal artifact reduction (SEMAR) algorithm with a 320 multi-slice computed tomography (MSCT) volume scanner in patients with knee tumor prostheses.Methods From November 2015 to March 2016,23 consecutive patients with knee tumor prostheses who underwent a 320-MSCT scan were collected.And the raw data were reconstructed using two different methods:conventional iterative reconstruction (IR) alone and IR associated with SEMAR.The ROI were objectively and subjectively assessed at osteotomy level and articular level,and the Wilcoxon signed rank test was used for them.Results Compared with IR,objectively,artifact index (AI) values of the osteotomy level decreased 44.8％ to 74.1％ and that of the articular level decreased 73.2％ to 93.2％;subjectively,the scores of image quality of two levels were increased 0.5 to 2.0 scores and 1.0 to 4.0 scores by SEMAR respectively.The objective and subject image quality of periprosthetic structures were all significantly improved by the SEMAR algorithm (P＜0.05).Conclusion The SEMAR algorithm significantly reduced the metal artifact of knee tumor prostheses,improved the image quality of periprosthetic structures and may increase diagnostic confidence of prosthetic complications in patients with modular knee tumor prostheses,especially at the osteotomy level.