Meta-analysis of clinical efficacy of ankle arthrodesis and total ankle arthroplasty in the treatment of end-stage ankle arthritis / 中国骨伤

OBJECTIVE@#To systematically review the clinical efficacy of total ankle arthroplasty (TAA) and ankle arthrodesis (AA) in the treatment of end-stage ankle arthritis.@*METHODS@#The PubMed, EMBASE and Cochrane Library databases were searched for articles published in the treatment of end-stage ankle arthritis with AA or TAA from the establishment of the database to June 2021. Bias risk tool was used to evaluate the quality of the literature. The American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Scale(AOFAS), visual analog scale (VAS), ankle osteoarthritis scale(AOS), gait analysis (pace, frequency, stride), range of motion (ROM), satisfaction, complications and reoperation rate were analyzed by meta-analysis between AA and TAA groups by RevMan 5.3 software.@*RESULTS@#A total of 12 articles were included, including 1 050 patients in the AA group and 3 760 patients in the TAA group, totaling 4 810 patients. Meta-analysis showed that the total score of AOFAS[MD=-3.12, 95%CI(-9.02, 2.96), P=0.31], pain score [MD=1.60, 95%CI(-1.35, 4.54), P=0.29], alignmentl score[MD=-0.04, 95%CI(-0.52, 0.44), P=0.88], VAS[MD=0.10, 95%CI(-0.49, 0.68), P=0.74], and AOS total score [MD=-4.01, 95%CI(-8.28, 0.25), P=0.06], the difference was not statistically significant (P>0.05). The score of AOFAS functional in TAA group was significantly higher than that in TAA group[MD=44.22, 95%CI(-8.01, -0.43), P=0.03]. There was no significant difference in gait analysis between the two groups (P>0.05). Postoperative ROM [MD=-4.93, 95%CI(-6.35, -3.52), P<0.000 01] and change in ROM from preoperative to follow-up[MD=-5.74, 95%CI(-8.88, -2.61), P=0.0003] between two groups, the difference was statistically significant. There was no significant difference in satisfaction between the two groups [OR=1.011, 95%CI(0.46, 2.23), P=0.98]. Complications [OR=1.61, 95%CI(1.26, 2.06), P=0.0002] and non-revision reoperation [OR=1.61, 95%CI(1.17, 2.21), P=0.003] were significantly lower in the TAA group than in the AA group. There was no significant difference in the rate of revision and reoperation(P>0.05) between the two groups [OR=1.02, 95%CI(0.37, 2.78), P=0.97].@*CONCLUSION@#The clinical efficacy of AA is similar to that of TAA, but the non revision reoperation rate and main surgical complications of TAA are significantly reduced. Therefore, further high-quality methodological research and long-term follow-up are needed to confirm this conclusion.

Analysis of Gene Mutation and Clinical Characteristics in 19 Children with Juvenile Myelomonocytic Leukemia / 中国实验血液学杂志

OBJECTIVE@#To analyze the gene mutations of children with juvenile myelomonocytic leukemia (JMML) and their correlation with clinical characteristics.@*METHODS@#The genetic mutation results and clinical data of 19 children with JMML in Fujian from January 2015 to December 2018 were collected and analyzed retrospectively. According to the results of gene mutation, they were divided into PTPN11 gene mutation group and non-PTPN11 gene mutation group, and the clinical characteristics and prognosis of children with JMML between two groups were compared.@*RESULTS@#Among the 19 children with JMML, 14 cases were male and 5 cases were female, and male/female ratio was 2.8∶1. The median age at diagnosis was 13(3-48) months, and 14 cases (73.68%) were less than 2 years old. Abdominal distension and pyrexia were the common initial symptoms, and all the children with JMML had splenomegaly. The median white blood cell count was 39.82(4.53-103.4)×10@*CONCLUSION@#JMML is more common in male infancy and toddlerhood, and the main gene mutation types are PTPN11 and Ras mutations. Because the JMML children with PTPN11 mutations show particularly rapid disease progression, if there is no timely intervention, most children die in a short period of time. Therefore, early HSCT may improve the prognosis of the children with JMML.

A meta-analysis of risk factors of postoperative delirium of elderly hip fracture patients in China / 中国组织工程研究

BACKGROUND: At present, there is no consensus on the risk factors for delirium after hip fracture in the elderly, and there is no risk prediction system that can effectively assess the risk of delirium after hip fracture in the elderly. OBJECTIVE: To identify the risk factors of postoperative delirium of elderly hip fracture. METHODS: Studies about delirium of elderly hip fracture patients were retrieved by computer. Quality of the studies was assessed. Analysis of sensitivity and heterogeneity was performed by RevMan 5.3 software and cumulative effects were calculated by either fixed or random effects models. RESULTS AND CONCLOUSION: (1) Totally 15 studies included 872 cases of delirium and 3 221 cases of non-delirium. (2) The results of meta-analysis showed that:univariate analysis indicated that preoperative cognitive dysfunction[pooled OR=4.99,95%CI(2.66,9.37),P=0.000],age[pooled MD=3.60,95%CI(2.21, 5.00),P=0.000],preoperative complications ≥ 3[pooled OR=2.83,95%CI(2.12,3.79),P=0.000],preoperative hemoglobin<100 mg/L[pooled OR=2.09, 95%CI(1.17,3.76),P=0.01],preoperative albumin<35 g/L[pooled OR=2.29,95%CI(1.77,2.97),P=0.01],general anesthesia[pooled OR=2.17,95%CI(1.41, 3.34),P=0.000 4],the type or treatment of hip fracture[pooled OR=1.36,95%CI(1.04,1.78),P=0.02],operation time[pooled OR=2.88,95%CI(1.42,5.82), P=0.003],and intraoperative blood loss[pooled MD=36.97,95%CI(25.74,48.19),P=0.000]were the risk factors of postoperative delirium of elderly hip fracture patients.(3)Multivariate analysis showed that preoperative cognitive dysfunction[pooled=4.94,95%CI(2.23,10.95),P=0.000],age[pooled MD=2.84,95% CI(1.89, 3.78),P=0.000],preoperative complications ≥ 3[pooled OR=3.05,95%CI(2.11,4.41),P=0.000],general anesthesia[pooled OR=4.29,95%CI(1.40,13.14), P=0.01],and operation time ≥ 2.5 hours[pooled OR=2.62,95%CI(1.68,4.08),P=0.000]were independent risk factors for postoperative delirium of elderly hip fracture patients. (4) In conclusion, the independent risk factors of postoperative delirium of elderly hip fracture patients are preoperative cognitive dysfunction, age, preoperative complications ≥ 3, general anesthesia and operation time ≥ 2.5 hours. The type of fracture, preoperative waiting time, and type of operation are not related to postoperative delirium. However, due to the low quantity and quality of the included literature, the conclusion needs the support from many high-quality studies.

Efficacy of the modified incision versus standard incision in proximal femoral nail antirotation for femoral intertrochanteric fractures / 中国组织工程研究

BACKGROUND: Proximal femoral nail antirotation (PFNA) is the most commonly used internal fixation for femoral intertrochanteric fracture. However, a large amount of hidden blood loss makes negative effect on the functional recovery postoperatively. OBJECTIVE: To compare the clinical efficacy of the modified incision and standard incision in PFNA for femoral intertrochanteric fracture. METHODS: Sixty-nine patients with femoral intertrochanteric fractures were analyzed retrospectively, and were then divided into two groups, followed by treated with modified incision of PFNA (group A) or standard incision of PFNA (group B). The postoperative biomechanical stability, fracture healing time, complications, Harris scores at the last follow-up, proximal incision length, operation time, and blood loss were compared between two groups. RESULTS AND CONCLUSION: (1) All the patients were followed up for more than 12 months. The fracture healing time, Harris scores at the last follow-up and incidence of postoperative complications did not differ significantly between two groups. (2) The intraoperative blood loss, total blood loss and total blood transfusion in the group A were significantly less than those in the group B (P < 0.05). (3) The proximal incision length and operation time in the group A were significantly shorter than those in the group B. (4) These results manifest that in the treatment of femoral intertrochanteric fracture, both methods exhibit good biomechanical properties and stability. Notably, compared with the standard incision method, the modified incision method has less trauma, shorter operation time, less blood loss and blood transfusion.

Preparation of PLLA/bpV(pic) microspheres and their effect on nerve cells / 华中科技大学学报（医学）（英德文版）

In this study, we prepared PLLA/bpV(pic) microspheres, a bpV(pic) controlled release system and examined their ability to protect nerve cells and promote axonal growth. PLLA microspheres were prepared by employing the o/w single emulsification-evaporation technique. Neural stem cells and dorsal root ganglia were divided into 3 groups in terms of the treatment they received: a routine medium group (cultured in DMEM), a PLLA microsphere group (DMEM containing PLLA microspheres alone) and a PLLA/bpV(pic) group [DMEM containing PLLA/bpV(pic) microspheres]. The effects of PLLA/bpV(pic) microspheres were evaluated by the live-dead test and measurement of axonal length. Our results showed that PLLA/bpV(pic) granulation rate was (88.2±5.6)%; particle size was (16.8±3.1)%, drug loading was (4.05±0.3)%; encapsulation efficiency was (48.5±1.8)%. The release time lasted for 30 days. In PLLA/bpV(pic) microsphere group, the cell survival rate was (95.2 ±4.77)%, and the length of dorsal root ganglion (DRG) was 718±95 μm, which were all significantly greater than those in ordinary routine medium group and PLLA microsphere group. This preliminary test results showed the PLLA/bpV(pic) microspheres were successfully prepared and they could promote the survival and growth of neural cells in DRG.

Preparation of PLLA/bpV(pic) microspheres and their effect on nerve cells / 华中科技大学学报（医学）（英德文版）

In this study, we prepared PLLA/bpV(pic) microspheres, a bpV(pic) controlled release system and examined their ability to protect nerve cells and promote axonal growth. PLLA microspheres were prepared by employing the o/w single emulsification-evaporation technique. Neural stem cells and dorsal root ganglia were divided into 3 groups in terms of the treatment they received: a routine medium group (cultured in DMEM), a PLLA microsphere group (DMEM containing PLLA microspheres alone) and a PLLA/bpV(pic) group [DMEM containing PLLA/bpV(pic) microspheres]. The effects of PLLA/bpV(pic) microspheres were evaluated by the live-dead test and measurement of axonal length. Our results showed that PLLA/bpV(pic) granulation rate was (88.2±5.6)%; particle size was (16.8±3.1)%, drug loading was (4.05±0.3)%; encapsulation efficiency was (48.5±1.8)%. The release time lasted for 30 days. In PLLA/bpV(pic) microsphere group, the cell survival rate was (95.2 ±4.77)%, and the length of dorsal root ganglion (DRG) was 718±95 μm, which were all significantly greater than those in ordinary routine medium group and PLLA microsphere group. This preliminary test results showed the PLLA/bpV(pic) microspheres were successfully prepared and they could promote the survival and growth of neural cells in DRG.

Epidemiology and etiology of hand-foot-and-mouth disease in Hainan, 2010 / 病毒学报

To reveal the epidemiological and pathogenic characteristics of Hand-foot-and-mouth disease (HFMD) in Hainan province in 2010, epidemiology data of HFMD reporting cases were analyzed, clinical specimens from 1346 HFMD cases were collected for enterovirus (EV) detection. Viral isolation was performed for EV nucleic acid positive samples. Complete VP1 encoding region of EV71 were sequenced and analyzed with Sequencher (version 5.0) and MEGA software (version 5.0). The epidemiology data showed that all 18 prefectures in Hainan had reporting cases during 2010, with higher incidence in the northeast; and the children less than 4 years old accounted for the majority of the suffered; the epidemic reached peak during September to October, which was different from other Provinces in China. The laboratory results indicated that EV71 and CA16 were identified as the major causative pathogens in Hainan in 2010, however, EV71 infection was absolutely dominant among severe and fatal cases. In addition, some HFMD cases were identified associated with other serotypes of EV infections. Molecular epidemiological analysis showed that all the EV71 strains belonged to C4a evolutionary branch, which is the dominant evolutionary branch in China in recent years, and at least three transmission chains existed. This study has an important information in clarifying the characteristics of epidemics and transmission of HFMD in Hainan, and to provide the guidance for HFMD prevention and control in the future.

Application of timolol in preventing variceal hemorrhage in patients with portal hypertension / 中国医学科学院学报

<p><b>OBJECTIVE</b>To determine the effectiveness of timolol in preventing first variceal hemorrhage in portal hypertensive patients with esophageal varices.</p><p><b>METHODS</b>A total of 42 cirrhotic patients with esophageal varices were enrolled in this study and received timolol or band ligation therapy randomly,with 21 patients in each group. The diameters of portal vein (PV), superior mesenteric vein (SMV), and splenic vein (SPV) as well as the portal venous flow and the splenic venous flow were measured. The first esophageal variceal bleeding of the two groups was recorded.</p><p><b>RESULTS</b>The diameters of PV, SMV, and SPV as well as the flow of PV and SPV showed no significant difference before and after treatment in band ligation group (P>0.05). In timolol group,however,the diameter of portal vein significantly decreased after treatment [(14.11±2.96) mm vs. (12.15±1.61)mm, P<0.05], and the average blood flow of portal vein also significantly decreased after treatment [(1277.33±495.19) ml/min vs. (719.17±245.16)ml/min, P<0.05]. Both timolol and band ligation effectively prevented esophageal variceal bleeding, and the risk of first esophageal variceal bleeding in these two groups were not significantly different (15% vs. 10%, P<0.05).</p><p><b>CONCLUSIONS</b>Timolol is safe and effective in preventing the first variceal bleeding in portal hypertensive patients with esophageal varices.</p>

Effect of percutaneous vertebroplasty and kyphoplasty in the treatment of osteoporotic vertebral compression fractures / 南方医科大学学报

<p><b>OBJECTIVE</b>To analyze the therapeutic effects of percutaneous vertebroplasty versus percutaneous kyphoplasty for treatment of osteoporotic vertebral compression fractures.</p><p><b>METHODS</b>Fifteen patients (24 vertebrae) underwent percutaneous vertebroplasty and 15 (18 vertebrae) received percutaneous kyphoplasty for osteoporotic vertebral compression fractures. The postoperative recovery of the anterior vertebral body height, visual analogue scale (VAS) and locomotor activity before and after the operations were compared between the two groups.</p><p><b>RESULTS</b>All the patients were available for the follow-up lasting for 3-15 months (average 7 months). In the vertebroplasty group, the VAS score decreased from 8.68 preoperatively to 1.74 postoperatively and to 1.13 at the final follow-up. The VAS score in the kyphoplasty group decreased from 8.62 preoperatively to 1.72 postoperatively and to 1.21 at the final follow-up. Both vertebroplasty and kyphoplasty were effective in improving the anterior vertebral body height, but kyphoplasty showed a better effect. None of the patients developed serious complications associated with the operations.</p><p><b>CONCLUSION</b>Percutaneous vertebroplasty and percutaneous kyphoplasty both achieve rapid and significant improvement of back pain in patients with osteoporotic vertebral compression fractures, but kyphoplasty shows a better effect in terms of vertebral body height restoration and cement leakage reduction.</p>

Evaluation on the effect of implementation regarding the measles surveillance system in Hainan province / 中华流行病学杂志

<p><b>OBJECTIVE</b>To evaluate the development and operation on measles surveillance system.</p><p><b>METHODS</b>To formulate surveillance program, and then establish surveillance system on measles in Hainan province before the case surveillance was conducted. Descriptive epidemiological method was used to analyze the measles cases reported through the notifiable diseases epidemic situation report system and measles surveillance system during 2004 - 2008 in Hainan province.</p><p><b>RESULTS</b>From 2004 to 2008, through surveillance system, 3040 suspected measles cases were reported which was 96.00% higher than that from the notifiable diseases epidemic situation report system. When the measles surveillance system was first established in 2004, the number of cases reported by the surveillance system was less than that from the epidemic report system, however, the sensitivity of the surveillance system had been increasing since 2005. In 2008, the number of suspected cases reported by surveillance system was 19.12 times more than from the epidemic report system. The proportion of confirmed cases in the total suspected cases was decreasing annually, from 90.34% to 4.48%, along with the increase of the sample collection rate, from 22.73% to 99.12%. The proportion of laboratory confirmed cases in the total confirmed cases increased from 7.55% to 86.97%. With suspected cases, the IgM antibody positive rate on measles and rubella were 31.57% and 34.52%, respectively. In Hainan, the epidemic pattern of measles had been sporadic, except for 2006 as there occurred several outbreaks in that year. The of disease incidence had an obvious seasonal peaks, from March to June. Measles mainly attacked children under 15 years of age, accounted for 86.68% of the age group. Children with no immunity or unknown immune history accounted for 85.67%.</p><p><b>CONCLUSION</b>The sensitivity of surveillance system had been increasing annually since it was developed and the incidence had been dropping to its lowest level. These achievements had built a solid foundation for the eventual elimination of measles.</p>

Determination of flavones in Elsholtzia bodinieri by HPLC / 中国中药杂志

<p><b>OBJECTIVE</b>To develop an HPLC method for the measurement of flavones in Elsholtzia bodinieri.</p><p><b>METHOD</b>Analysis was carried out on Shimadzu LC-2010A HPLC system. The separation was performed on Agilent Extend-RP C18 column (4. 6 mm x 250 mm, 5 microm), with methanol-acetonitrile-0.2% phosphoric acid as mobile phase, and the flow rate was 1.0 mL min(-1) and the detective wavelength was 280 nm.</p><p><b>RESULT</b>A good linear relationship and the mean recovery was found within the range.</p><p><b>CONCLUSION</b>This method is rapid, simple and accurate.</p>