The pivotal role of autophagy in bone cells:bone-related cell activity and bone metabolism / 中国组织工程研究

BACKGROUND:The importance of autophagy for maintaining cellular homeostasis and stress response has long been recognized.As a way for cells to selectively clear their damaged organelles to achieve the recycling of cellular components,autophagy has a pivotal role in bone metabolism.OBJECTIVE:To review the role and possible mechanisms of autophagy in regulating bone-related cell activity and function among bone marrow mesenchymal stem cells,osteoblasts,osteocytes,and osteoclasts.METHODS:PubMed was searched for studies related to autophagy using the keywords of "autophagy;bone marrow mesenchymal stem cells;osteoblasts;osteocytes;osteoclasts."RESULTS AND CONCLUSION:We finally included 84 papers.Autophagy plays an important role in bone metabolism.Autophagy is involved in maintaining the balance between mineralization and absorption,and then maintaining bone homeostasis.An appropriate autophagy inducer may also benefit bone remodeling.Abnormal autophagy can lead to disorders of bone balance,leading to diseases such as osteoporosis.We may prevent or treat bone-related diseases by regulating the level of autophagy as its function in maintaining the balance of mineralization and resorption in bone homeostasis.

Acute interstitial pneumonia in elderly patients after thoracic surgery: a report of 5 cases and literature review / 中华老年医学杂志

Objective:To analyze the clinical characteristics of elderly patients with acute interstitial pneumonia after thoracic surgery, and to provide evidence for the diagnosis and treatment of acute interstitial pneumonia after surgery.Methods:Data from 2578 elderly patients who had undergonethoracic surgery at Beijing Hospital from October 2014 to October 2021were collected.Five patients developed acute interstitial pneumonia after thoracic surgery.The diagnosis and treatment of the patients were analyzed and major relevant issues were discussed in combination with the literature.Results:Of the 5 patients aged from 60 to 74 years, including 4 men and 1 woman, 3 had idiopathic pulmonary interstitial fibrosis and 2 had Sjogren's syndrome with secondary pulmonary interstitial fibrosis.Preoperative chest CT images were characterized by sporadic interlobular septal thickening and ground-glass, reticular and linear opacities in both lungs.After surgery, all 5 patients presented unexplained and progressively aggravating dyspnea in 1~3 days and chest imaging showed newly emerged and more diffuse ground-glass, reticular and linear opacities in both lungs, in addition toprevious pulmonary interstitial fibrosis.Four patients were treated with glucocorticoids, and four underwent endotracheal intubation and mechanical ventilation.Two cases were treated successfully, 1 case improved after treatment but died after re-aggravation, and 2 cases died after treatment failure.Conclusions:Patients with pulmonary interstitial fibrosis after thoracic surgery may have progressive and aggravated dyspnea in the early postoperative period.Early CT imaging and pathogenic examinations will be helpful in differential diagnosis.Acute interstitial pneumonia often involves both lungs, with rapid progression and high mortality.Once the disease has progressed to respiratory failure, mechanical ventilation should be initiated as early as possible to improve organ function.Glucocorticoids should be used early with sufficient doses and lengths to prevent re-aggravation.

Clinical characteristics in elderly patients with thymic epithelial tumors and prognostic analysis of more than 3 years postoperative follow-up / 中华老年医学杂志

Objective:To evaluate the clinical characteristics and the surgical safety in patients aged 65 years and over with thymic epithelial tumor, and analyze the prognosis of 3-10 years postoperative tumor and myasthenia gravy.Methods:A total of 228 patients diagnosed as thymic tumor and undergoing surgical surgery to remove the tumor in Beijing Hospital from Jan.2011 to Dec.2018 were retrospectively enrolled.Patients were divided into a young(≤ 65 yrs)and old(>65 yrs)groups.The operation time, intra-operative bleeding, drainage volume in the first 3 days after operation, days with drainage tube after operation, postoperative days of hospital stays, the diameter of the tumors, pathological classification, Tumor-Node-Metastasis(TNM)staging, Masaoka-Koga staging, whether or not complicated with myasthenia gravis and complications were compared between two groups.The patients were followed up by outpatient or telephone, and recurrence of thymoma, survival status and improvement of myasthenia gravis were tracked.Results:There were significant differences in pathological classification between the two groups( P=0.002). The postoperative days with drainage tube were longer in patients≥65 years old than in patients<65 years old[4(2-17)days and 3(1-9), Z=2.316, P=0.021]. Thymic atrophy was more common in patients ≥ 65 years old than in patients <65 years old(10.2% and 1.7%, χ2=5.937, P=0.015). Incidence of thymoma plus myasthenia gravis were higher in patients aged <65 years than those aged ≥65years(68.2% vs.40.8%, χ2=12.240, P<0.001), and incidence of thymic hyperplasia were higher in patients aged <65 years than those aged ≥65years(58.1% and 38.8%, χ2=2.316, P=0.016). The recurrence of thymoma was a poor prognostic factor affecting the survival of patients.Meanwhile, Masaoka-Koga stage Ⅲ and Ⅳ and TNM stage Ⅲ and Ⅳ were independent risk factors for postoperative recurrence of thymoma. Conclusions:Thymectomy is safe and effective in the patients aged 65 and over, and may have a better long-term prognosis.

Research advances in microRNA-200c in pancreatic cancer / 临床肝胆病杂志

MicroRNA-200c (miR-200c) is a type of non-coding small molecule RNA, which is involved in the post-transcriptional regulation of genes and is closely associated with the development and progression of tumor. This article introduces the inhibitory effect of miR-200c on the invasion and metastasis of pancreatic cancer and the clinical application value of miR-200c in the early diagnosis and prognostic evaluation of pancreatic cancer. It is pointed out that miR-200c can be used as a tumor suppressor gene and an effective molecular marker for further clinical research.

Clinical Characteristics and Prognosis of Patients with Hematological Malignancies Superimposed with Solid Tumors / 中国实验血液学杂志

OBJECTIVE@#To investigate the clinical characteristics and prognosis of hematological malignancies superimposed patients with solid tumors.@*METHODS@#The clinical data of 30 patients with more than two kinds of malignancy (the second is hematological malignancy) from October 2011 to October 2020 in Department of Hematology, Jiangning Hospital Affiliated to Nanjing Medical University were collected and analyzed retrospectively. The overall survival time was used as the prognostic evaluation standard, and the survival of patients were analyzed by KaplanMeier method. Logrank test and Cox regression model were used to carry out univariate and multivariate retrospective analysis on clinical and laboratory parameters of 30 patients.@*RESULTS@#Among 30 cases, 20 were male, 10 were female, the median age of onset of the second tumor was 70 years old. The common types of the secondary hematological malignancies to solid tumors are myelodysplastic syndrome, acute myeloid leukemia, multiple myeloma. Univariate analysis showed that patients' gender, age, type of solid tumors, the onset of interval between two kinds of tumor, chromosome karyotype were not related to do with the patients' overall survival time. Type of hematologic disease, ECOG score were associated with patients' overall survival time, and the multivariate analysis showed that the type of hematologic disease and ECOG score were independent risk factors for patients with poor prognosis.@*CONCLUSION@#Patients superimposed with solid tumors complicated with myelodysplastic syndrome or acute leukemia and ECOG score ≥3 have poor prognosis and shorter overall survival time, which are independent risk factors influencing the prognosis. Bone marrow injury, immune dysfunction and genetic susceptibility after chemoradiotherapy may be the main causes of these diseases.

Successful Rescue of Acute Exacerbation of Idiopathic Pulmonary Fibrosis after Surgery for Lung Cancer: Case Report / 中国肺癌杂志

Idiopathic Pulmonary fibrosis (IPF) is a chronic, progressive, fibrotic interstitial lung disease with unknown cause, which is closely related to lung cancer. A serious complication called Acute exacerbation of IPF (AE-IPF) is prone to occur after lung resection. It progresses rapidly without effective treatment and has a poor prognosis. A typical case of AE-IPF after lung cancer surgery was reported, and its clinical characteristics, imaging features, diagnosis and treatment were summarized.
.

Research on gait recognition and prediction based on optimized machine learning algorithm / 生物医学工程学杂志

Aiming at the problems of individual differences in the asynchrony process of human lower limbs and random changes in stride during walking, this paper proposes a method for gait recognition and prediction using motion posture signals. The research adopts an optimized gated recurrent unit (GRU) network algorithm based on immune particle swarm optimization (IPSO) to establish a network model that takes human body posture change data as the input, and the posture change data and accuracy of the next stage as the output, to realize the prediction of human body posture changes. This paper first clearly outlines the process of IPSO's optimization of the GRU algorithm. It collects human body posture change data of multiple subjects performing flat-land walking, squatting, and sitting leg flexion and extension movements. Then, through comparative analysis of IPSO optimized recurrent neural network (RNN), long short-term memory (LSTM) network, GRU network classification and prediction, the effectiveness of the built model is verified. The test results show that the optimized algorithm can better predict the changes in human posture. Among them, the root mean square error (RMSE) of flat-land walking and squatting can reach the accuracy of 10 -3, and the RMSE of sitting leg flexion and extension can reach the accuracy of 10 -2. The R 2 value of various actions can reach above 0.966. The above research results show that the optimized algorithm can be applied to realize human gait movement evaluation and gait trend prediction in rehabilitation treatment, as well as in the design of artificial limbs and lower limb rehabilitation equipment, which provide a reference for future research to improve patients' limb function, activity level, and life independence ability.

Comparative study of characteristics and safety of video-assisted thoracoscopic thymectomy between artificial pneumothorax combining subxiphoid-costal margin approach versus right thoracic cavity approach / 中华老年医学杂志

Objective:To proceed a comparative study of characteristics and safety of video-assisted thoracoscopic thymectomy between artificial pneumothorax combining subxiphoid-costal margin approach versus right thoracic cavity approach.Methods:From January 2018 to December 2021, 251 patients(including myasthenia gravis with thymic hyperplasia or thymoma, thymic cysts and anterior mediastinal occupying lesions)undergoing thoracoscopic extended thymectomy in our department were retrospectively studied, and their clinical data were collected.The surgical methods were divided into artificial pneumothorax combining xiphoid costal margin approach(artificial pneumothorax group, n=165)and via right thoracic approach(right thoracic group, n=86). Clinical data such as preoperative information, operative duration, blood loss, postoperative drainage, drainage duration, and surgical complication were compared between two groups.Results:There were no statistical differences in age, gender and pathology between two groups(all P>0.05). Compared with the right thoracic group, operative duration[(108.6±45.2)min vs.(127.6±42.1)min, t=-3.628, P=0.000], intraoperative blood loss[(37.9±131.7)ml vs.(107.4±284.8)ml, t=-8.215, P=0.000], postoperative drainage volume[(379.0±285.5)ml vs.(646.6±373.3 ml), t=-6.277, P=0.000]and drainage duration[(2.2±1.0)d vs.(3.1±1.0)d, t=-7.275, P=0.000]were statistically significantly decreased in the artificial pneumothorax group.No significant difference was found(all P>0.05)in phrenic nerve injury(1/165 vs.0/86, P=1.000), myasthenia crisis(3/89 vs.2/66, χ2=0.014, P=0.906), and the conversion to thoracotomy(3/165 vs.2/86, P=1.000). Conclusions:VATS thymectomy by artificial pneumothorax combining subxiphoid-costal margin approach is a safer method, having a less trauma, less bleeding and less incidence rate of complication.Especially, it is more suitable for elderly female patients who cannot be intubated in double lumen, cannot tolerate one-lung ventilation, and have pulmonary insufficiency.

Clinical advances of 18F-FDG PET/CT in evaluating differentiation of recurrent or metastatic differentiated thyroid cancer and guiding 131I therapy / 中华核医学与分子影像杂志

Differentiated thyroid cancer (DTC) is prone to relapse and metastasize. In addition to thyroglobulin (Tg) and its antibodies, ultrasound and 131I whole-body scan (WBS), 18F-FDG PET/CT gains more use in the setting of recurrent or metastatic DTC and shows promise. This article mainly reviews the value of 18F-FDG PET/CT in the location of recurrent or metastasized DTC with negative 131I WBS but positive Tg ( 131I WBS-/Tg+ ), evaluating their differentiation, predicting the prognosis, guiding 131I treatment and its value in restaging DTC with moderate and high risk of relapse and guiding treatment decision.

Guideline for postoperative rehabilitation treatment following vertebral augmentation for osteoporotic vertebral compression fracture (version 2022) / 中华创伤杂志

Osteoporotic vertebral compression fracture (OVCF) can lead to lower back pain and may be even accompanied by scoliosis, neurological dysfunction and other complications, which will affect the daily activities and life quality of patients. Vertebral augmentation is an effective treatment method for OVCF, but it cannot correct unbalance of bone metabolism or improve the osteoporotic status, causing complications like lower back pain, limited spinal activities and vertebral refracture. The post-operative systematic and standardized rehabilitation treatments can improve curative effect and therapeutic efficacy of anti-osteoporosis, reduce risk of vertebral refracture, increase patient compliance and improve quality of life. Since there still lack relevant clinical treatment guidelines for postoperative rehabilitation treatments following vertebral augmentation for OVCF, the current treatments are varied with uneven therapeutic effect. In order to standardize the postoperative rehabilitation treatment, the Spine Trauma Group of the Orthopedic Branch of Chinese Medical Doctor Association organized relevant experts to refer to relevant literature and develop the "Guideline for postoperative rehabilitation treatment following vertebral augmentation for osteoporotic vertebral compression fracture (2022 version)" based on the clinical guidelines published by the American Academy of Orthopedic Surgeons (AAOS) as well as on the principles of scientificity, practicality and advancement. The guideline provided evidence-based recommendations on 10 important issues related to postoperative rehabilitation treatments of OVCF.

Research progress in the role of distal femoral valgus cut angle in accurate total knee arthroplasty / 中华创伤杂志

The distal femoral fracture, tibial plateau fracture and patellar fracture may all develop into traumatic knee arthritis, which is probably associated with knee dysfunction problems. Total knee arthroplasty (TKA) is an effective treatment for end-stage knee arthritis. The distal femoral valgus cut angle (VCA) is an important reference for distal femoral resection in TKA and significantly affects postoperative prosthesis position and lower extremity alignment after TKA. For VCA, the specific methods for definition, measurement methods, clinical application and influencing factors are currently controversial. Hence, the authors review the research progress in the role of VCA in TKA from the above-mentioned four aspects, hoping to provide a reference for accurate preoperative planning and intraoperative performance of TKA.

Clinical expert consensus on platelet-rich plasma treatment for lateral epicondylitis (2022 version) / 中华创伤杂志

Lateral epicondylitis is a common clinical disease with characteristics of lateral elbow pain, insidious onset and easy recurrence, which can cause forearm pain and decreased wrist strength, seriously affecting patients′ daily life and work. Although there are various treatment methods for lateral epicondylitis with different effects, standard treatments are still lacking nowadays. Platelet-rich plasma (PRP) has good effects on bone and tendon repair, and is now widely used in the treatment of lateral epicondylitis. However, there is a lack of a unified understanding of the technology and specifications of PRP in the treatment of lateral epicondylitis. Therefore, the Sports Medicine Branch of the Chinese Medical Association and Physical Medicine and Rehabilitation Branch of the Chinese Medical Association organized experts in the fields of sports medicine and rehabilitation medicine in China to formulate the "clinical expert consensus on platelet-rich plasma treatment for lateral epicondylitis (2022 version)", and proposed suggestions based on evidence-based medicine mainly from the concept, epidemiology and pathophysiology of lateral epicondylitis, symptoms, signs and imaging manifestations of lateral epicondylitis, PRP concept and application component requirements, quality control of PRP preparation technology, indications and contraindications of PRP in the treatment of lateral epicondylitis, PRP injection in the treatment of lateral epicondylitis, application of PRP in the operation of lateral epicondylitis, related problems after PRP treatment of lateral epicondylitis, evaluation of the results after PRP treatment of lateral epicondylitis, and health and economic evaluation of PRP treatment of lateral epicondylitis, so as to provide guidance for clinical diagnosis and treatment.

The differential diagnosis of pancreatic acinar cell carcinoma and pancreatic ductal adenocarcinoma based on multidetector computed tomography features / 中华胰腺病杂志

Objective:To explore the differential diagnosis of pancreatic acinar cell carcinoma (PACC) and pancreatic ductal adenocarcinoma (PDAC) based on multidetector computed tomography (MDCT) features.Methods:The clinical, pathological and MDCT imaging data of 26 patients with pathologically confirmed PACC and 145 patients with pathologically confirmed PDAC who underwent MDCT from November 2013 to April 2021 were retrospectively studied. The differences of MDCT features including tumor location, tumor size, common pancreatic duct and bile duct dilatation, pancreatitis, lymph node metastasis, cyst, pancreatic parenchyma atrophy, duodenal involvement, bile ductal and vascular involvement between the two groups were compared. Univariate analysis and multivariate analysis by logistic regression models were performed to identify the independent predictive factors for PACC.Results:The tumor size, bile duct dilatation, lymph node metastasis, pancreatic parenchyma atrophy and vascular involvement were significantly different between PACC group and PDAC group (all P value<0.05). Multivariate analysis revealed that the tumor size ( OR=1.07, 95% CI 1.028-1.15, P=0.001), lymph node metastasis ( OR=0.23, 95% CI 0.065-0.800, P=0.02), pancreatic parenchyma atrophy ( OR=0.15, 95% CI 0.048-0.490, P=0.002) were closely associated with PACC. Conclusions:The tumor size, bile duct dilatation, lymph node metastasis, pancreatic parenchyma atrophy and vascular involvement evaluated by MDCT had a certain value in differentiating PACC from PDAC, and the tumor size, lymph node metastasis and pancreatic parenchyma atrophy were independent predictors for the diagnosis of PACC.

Relationship between perineural invasion scores based on multidetector computed tomography and extrapancreatic perineural invasion in pancreatic ductal adenocarcinoma / 中华胰腺病杂志

Objective:To investigate the relationship between the perineural invasion score based on multidetector computed tomography (MDCT) and extrapancreatic perineural invasion (EPNI) in pancreatic ductal adenocarcinoma (PDAC).Methods:The clinical, radiological, and pathological data of 374 patients pathologically diagnosed as pancreatic cancer who underwent radical resection in the First Affiliated Hospital of Naval Medical University from March 2018 to May 2020 were analyzed retrospectively. Patients were divided into EPNI negative group ( n=111) and EPNI positive group (n=263) based on the pathological presence of EPNI. The perineural invasion score was performed for each patient based on radiological images. Univariate and multivariate logistic regression models were used to analyze the association between the perineural invasion score based on MDCT and EPNI in PDAC. Results:There were significant statistical differences between EPNI negative group and positive group on both pathological characteristics (T stage, N stage, invasion of common bile duct, and positive surgical margin) and radiological characteristics (tumor size, vascular invasion, lymph node metastasis, perineural invasion score based on MDCT, pancreatic border, parenchymal atrophy, invasion of duodenum, invasion of spleen and splenic vein and invasion of common bile duct) (all P value <0.05). Univariate analysis revealed that the tumor size, vascular invasion, lymph node metastasis, perineural invasion score based on MDCT, pancreatic border, pancreatic atrophy, invasion of duodenum, invasion of spleen and splenic vein and invasion of common bile duct were independently associated with EPNI. Multivariate analyses revealed that the perineural invasion based on MDCT was an independent risk factor for EPNI in pancreatic cancer (score=1, OR=2.93, 95% CI 1.61-5.32, P<0.001; score=2, OR=5.92, 95% CI 2.68-13.10, P<0.001). Conclusions:The perineural invasion score based on MDCT was an independent risk factor for EPNI in pancreatic cancer and can be used as an evaluation indicator for preoperative prediction of EPNI in PDAC.

A nomogram based on CT characteristics for differentiating mass-forming chronic pancreatitis from pancreatic ductal adenocarcinoma patients with chronic pancreatitis history / 中华胰腺病杂志

Objective:To develop a visualized nomogram with a predictive value to differentiate mass-forming chronic pancreatitis (MFCP) from pancreatic ductal adenocarcinoma (PDAC) patients with chronic pancreatitis (CP) history.Methods:The clinical and radiological data of 5 433 CP patients acoording to the Asia-Pacific Diagnostic Criteria between February 2011 and February 2021 in the First Affiliated Hospital of Naval Medical University were retrospectively analyzed, and 71 PDAC patients with CP history and 67 MFCP who underwent surgery or biopsy and pathologically confirmed were eventually enrolled. The training set included 44 patients with MFCP and 59 patients with PDAC who were diagnosed between February 2011 and April 2018. The validation set consisted of 23 patients with MFCP and 12 patients with PDAC who were diagnosed between May 2018 and February 2021. Univariate and multivariate logistic regression analyses were performed to develop a prediction model for PDAC and MFCP, and the model was visualized as a nomogram. ROC was used to evaluate the predictive efficacy of the nomogram, and the clinical usefulness was judged by decision curve analysis.Results:The univariate analysis showed that a significant association with pancreatic cancer were observed for the duct-to-parenchyma ratio ≥0.34, pancreatic duct cut-off, pancreatic portal hypertension, arterial CT attenuation, portal venous CT attenuation, delayed CT attenuation, and vascular invasion in both the training and validation cohorts, but the duct-penetrating sign in the training cohort only. The multivariable logistic regression analysis showed that statistically significant differences (all P value <0.05) existed in cystic degeneration, a duct-to-parenchyma ratio ≥0.34, the duct-penetrating sign, pancreatic portal hypertension and arterial CT attenuation between the two cohorts. The above parameters were selected for the logistic regression model. The predicted model=3.65-2.59×cystic degeneration+ 1.26×duct-to-parenchyma ratio≥0.34-1.40×duct-penetrating sign+ 1.36×pancreatic portal hypertension-0.05×arterial CT attenuation. Area under the curve, sensitivity, specificity and accuracy of the model-based nomogram were 0.87 (95 CI 0.80-0.94), 89.0%, 75.0% and 83.5% in the training cohort, and 0.94 (95 CI 0.82-0.99), 91.7%, 100% and 97.1% in the validation cohort, respectively. Decision curve analysis showed that when the nomogram differentiated MFCP from PDAC patients with CP history at a rate of 0.05-0.85, the application of the nomogram could benefit the patients. Conclusions:The nomogram based on CT radiological features accurately differentiated MFCP from PDAC patients with CP history and provide reference for guiding the treatment and judging the prognosis.

Long Noncoding RNA PVT1 Promotes Stemness and Temozolomide Resistance through miR-365/ELF4/SOX2 Axis in Glioma

Long non-coding RNA (lncRNA) are a class of non-coding RNAs demonstrated to play pivotal roles in regulating tumor progression. Therefore, deciphering the regulatory role of lncRNA in the development of glioma may offer a promising therapeutic target for treatment of glioma. We performed RT-qPCR analysis on the expression of lncRNA plasmacytoma variant translocation 1 (PVT1) and miR-365 in glioma tissues and cell lines. Cell proliferation and viability was assessed with CCK8 assay. Cell migration was assessed by wound healing assay. Transwell assay was used to assess cell invasion capacity. Expression of CD133+ cells was detected by flow cytometry. Western blot assay was used to detection the expression of ELF4 and stemness-related protein SOX2, Oct4 and Nanog. Bioinformatics and dual-luciferase assay were used to predict and validate the interaction between PVT1 and miR-365. Elevated PVT1 expression was observed in glioma tissues and cells. Knockdown of PVT1 and overexpression of miR-365 inhibited proliferation, migration, invasion and promoted stemness and Temozolomide (TMZ) resistance of glioma cells. PVT1 regulated ELF4 expression by competitively binds to miR-365. PVT1 regulated the stemness and sensitivity of TMZ of glioma cells through miR-365/ELF4/ SOX2 axis. This study identified that PVT1 promoted glioma stemness through miR-365/ELF4/SOX2 axis.

Effects of Dynesys dynamic fixation versus fusion fixation on sagittal alignment of lumbar degenerative diseases involving 2 to 4 segments / 中华骨科杂志

Objective:To compare the effects of Dynesys dynamic fixation and fusion fixation on the sagittal parameters of lumbar degenerative diseases of 2-4 segments.Methods:A total of 45 patients with 2-4 segments lumbar degenerative diseases, who underwent decompression and internal fixation in our hospital from March 2014 to July 2019, were retrospectively analyzed. There were 23 males and 22 females with an average age of 55±18 years (range 15-86 years). Dynesys dynamic fixation was performed in 22 cases and fusion fixation in 23 cases. Lumbar anteroposterior, flexion and extension lateral and standing full-length spine radiographs were taken before surgery, 2 weeks postoperatively, 3 months postoperatively and at the last follow-up. Sagittal alignment parameters were measured on those radiographs and compared between two groups. Lumbar parameters included lumbar lordosis (LL), lordosis of the fixed segments (LFx), lordosis of the adjacent level to fixed segment (LAdj) and lumbar range of motion (ROM). Pelvic parameters included pelvic incidence (PI), pelvic tilt (PT) and sacral slope (SS).Results:All cases were followed up for 12-50 months with an average of 18.5 months. There was no significant intra- and inter-group difference of LL value between Dynesys dynamic fixation and fusion fixation group before and after surgery ( P>0.05). The overall difference of LFx between groups was not statistically significant ( F=0.700, P=0.406). There was statistically significant variance between time points ( F=7.960, P<0.001) and an interaction effect between group and time ( F=3.940, P=0.006). The LFx of the fusion fixation group was more than that of the dynamic fixation group at 3 months postoperatively and at the last follow-up ( P<0.05). The difference of LAdj value between the two groups was not statistically significant ( F=0.520, P=0.476), while the difference between time points was significant ( F=4.810, P=0.002) with interaction effect between group and time ( F=3.560, P=0.010). Postoperative ROM values of the two groups showed statistically significant differences in group effect, time effect and interaction effect, respectively ( F=4.770, P=0.034; F=18.510, P<0.001; F=5.940, P=0.002). Dynamic fixation group's ROM was more than that of the fusion fixation group at 3 months postoperatively and at the last follow-up ( P<0.05). There was no significant difference of PI between groups and between different time points ( F=0.580, P=0.451; F=0.750; P=0.477). There was no interaction effect in PI between group and time ( F=0.120, P=0.886). There was no significant difference of PT and SS between two groups ( F=0.320, P=0.576; F=0.020, P=0.901). Both time effect and interaction effect were statistically significant ( P<0.05). One complication of unilateral S 1 screw loosening happened in one patient with dynamic fixed at 2 years after surgery. There was no complication in the fusion fixation group during the follow-up. Conclusion:Both Dynesys dynamic fixation and fusion fixation can effectively reconstruct the lumbar lordosis. The fixed segments' lordosis of Dynesys was less than that of fusion fixation from 3 months after operation. Theoretically, the similar increasing trends of LAdj after fixation implied that the degeneration of adjacent segments may occur in both fixation systems. The dynamic fixation can retain more ROM than the fusion fixation. Both two fixation systems have similar influence on the pelvic parameters.

Subtalar arthroscopy combined with locking plate fixation through anterolateral longitudinal incision of the Achilles tendon for treatment of displaced intra-articular calcaneal fractures / 中华创伤杂志

Methods:A retrospective case-series study was performed to analyzed the data of 38 patients (38 feet) with displaced intra-articular calcaneal fractures admitted to Xuzhou Central Hospital from January 2016 to May 2018. There were 21 males (21 feet) and 17 females (17 feet), with the age of (33.7±6.2)years (range, 21-53 years). According to the Sanders' classification, 7 patients were classified as type II, 27 as type III and 4 as type IV. All patients underwent the procedure of subtalar arthroscopy combined with locking plate fixation through anterolateral longitudinal incision of the Achilles tendon procedure. The operation time, intro-operative management, incision healing, and post-operative complications (nerve, vessels and tendon injuries)were recorded. B?hler angle, Gissane angle, length, width and height of the calcaneus, and bone healing time were recorded at postoperative 2 days and at final follow-up. The visual analogue score (VAS), American Orthopaedic Foot & Ankle Society (AOFAS) ankle and hindfoot scale, and Foot and Ankle Outcome Score (FAOS) were recorded at final follow-up, and were used to evaluate the clinical and functional outcomes.Results:All patients were followed up for 12-42 months [(18.7±5.3)months]. The operation time ranged from 45 to 100 minutes [(72.4±22.6)minutes]. Bone grafting was not observed, and microfracture of the posterior articular surface of the calcaneus were involved in 9 patients. The first-stage incision healing was achieved in all patients, without early complications of nerve, vessel and tendon injuries. The post-operative angles of B?hler and Gissane, length, width and height of the calcaneus were significantly improved compared to preoperative values ( P<0.01), while there were no significant difference at postoperative 2 days and at final follow-up ( P>0.05). At final follow-up, the VAS decreased from 5(3, 9)points to 0(0, 3)points, AOFAS improved from (68.3±10.5)points to (90.6±5.0)points, and FAOS improved from (66.9±9.1)points to (89.8±4.3)points, respectively ( P<0.01). According to the AOFAS ankle and hindfoot scale, the result was excellent in 27 patients, good in 8, and fair in 3, with the excellent and good rate of 92%. Conclusions:For displaced intra-articular calcaneal fractures, subtalar arthroscopy combined with locking plate fixation through anterolateral longitudinal incision of the Achilles tendon has advantages of precise fracture reduction, low postoperative complications and reliable functional outcomes.

Prevalence and influencing factors of mental violence in intimate partner violence / 中华行为医学与脑科学杂志

Objective:To explore the prevalence and influencing factors of mental violence in intimate partner violence.Methods:A total of 900 people, who aged 18 to 65 with marriage or love experience, were selected from Xinjiang Uygur Autonomous Region using stratification cluster method. A self-designed questionnaire for general information, the brief conflict tactics scale 2 (CTS-2), perceived stress scales (PSS) and personality diagnostic questionnaire-4+ (PDQ-4+ ) were used for questionnaire investigation. The influencing factors of mental violence were analyzed by binary logistic regression analysis model using SPSS 17.0 software.Results:The scores of CTS-2, PPS and PDQ-4+ were (21.46±6.38), (42.48±18.91), and (3.05±0.62), respectively. In the past one year, the incidence of abusing partners, emotional violence, destroying each other's goods and threatening to hit each other in mental violence were 41.67% (375/900), 33.44% (301/900), and 8.44% (76/900), respectively. Based on the scores of three items, the incidence of mental violence was 55.44% (499/900). Multi-factor logistic regression analysis showed age≤29 ( β=0.57, OR=2.53, 95% CI=1.11-5.99), male ( β=0.64, OR=3.68, 95% CI=1.22-4.56), rural ( β=0.12, OR=2.49, 95% CI=1.17-5.36), moderate and severe drinking ( β=0.33, OR=2.87, 95% CI=2.57-6.63), higher perceived stress level ( β=0.51, OR=1.05, 95% CI=1.03-1.09), personality factors deviate ( β=0.43, OR=2.26, 95% CI=2.13-2.39), lower marital satisfaction ( β=0.18, OR=2.05, 95% CI=1.03-8.76), behavior control over partner ( β=0.16, OR=2.55, 95% CI=1.68-3.69), economic control over partners ( β=0.19, OR=1.36, 95% CI=1.28-1.55) were risk factors of mental violence in intimate partner violence, while individual opposed attitude towards violence ( β=0.29, OR=0.88, 95% CI=0.80-0.94) was the protective factor of mental violence in intimate partner violence. Conclusion:The annual incidence of mental violence is high. Therefore, it is necessary to focus on the young, male, rural and personality deviant people. The incidence of mental violence may be reduced by reducing the individual's perceived stress level, drinking level, behavior control and economic control over partners, and strengthening the marital satisfaction and the individual's opposition to violence.

Research progress of transplantation acquired food allergy / 中华消化外科杂志

Transplantation acquired food allergy (TAFA) is a rare complication of solid organ transplantation. The pathogenesis of TAFA has not been fully elucidated. There are two possible mechanisms for its occurrence: food allergy mediated by IgE delivery of the donor and food allergy caused by food intolerance after transplantation. At present, there is still insufficient understanding of this complication among transplant physicians. Through systematic review of relevant literature, the authors summarized the research progress of TAFA, which mainly included the pathogenesis, clinical characteristics, treatment and prognosis of TAFA. In order to provide reference for the diagnosis and treatment of TAFA.