Comparison of clinical outcomes among total knee arthroplasties using posterior-stabilized, cruciate-retaining, bi-cruciate substituting, bi-cruciate retaining designs: a systematic review and network meta-analysis / 中华医学杂志(英文版)

BACKGROUND@#Despite the advent of innovative knee prosthesis design, a consistent first-option knee implant design in total knee arthroplasty (TKA) remained unsettled. This study aimed to compare the clinical effects among posterior-stabilized (PS), cruciate-retaining (CR), bi-cruciate substituting (BCS), and bi-cruciate retaining designs for primary TKA.@*METHODS@#Electronic databases were systematically searched to identify eligible randomized controlled trials (RCTs) and cohort studies from inception up to July 30, 2021. The primary outcomes were the range of knee motion (ROM), and the secondary outcomes were the patient-reported outcome measures (PROMs) and complication and revision rates. Confidence in evidence was assessed using Confidence in Network Meta-Analysis. The Bayesian network meta-analysis was performed for synthesis.@*RESULTS@#A total of 15 RCTs and 18 cohort studies involving 3520 knees were included. The heterogeneity and inconsistency were acceptable. There was a significant difference in ROM at the early follow-up when PS was compared with CR (mean difference [MD] = 3.17, 95% confidence interval [CI] 0.07, 7.18) and BCS was compared with CR (MD = 9.69, 95% CI 2.18, 17.51). But at the long-term follow-up, there was no significant difference in ROM in any one knee implant compared with the others. No significant increase was found in the PROMs and complication and revision rates at the final follow-up time.@*CONCLUSIONS@#At early follow-up after TKA, PS and BCS knee implants significantly outperform the CR knee implant in ROM. But in the long run, the available evidence suggests different knee prostheses could make no difference in clinical outcomes after TKA with extended follow-up.

Research progress of optic atrophy 1-mediated mitochondrial dynamics in skeletal system diseases / 中国修复重建外科杂志

OBJECTIVE@#To review the research progress of mitochondrial dynamics mediated by optic atrophy 1 (OPA1) in skeletal system diseases.@*METHODS@#The literatures about OPA1-mediated mitochondrial dynamics in recent years were reviewed, and the bioactive ingredients and drugs for the treatment of skeletal system diseases were summarized, which provided a new idea for the treatment of osteoarthritis.@*RESULTS@#OPA1 is a key factor involved in mitochondrial dynamics and energetics and in maintaining the stability of the mitochondrial genome. Accumulating evidence indicates that OPA1-mediated mitochondrial dynamics plays an important role in the regulation of skeletal system diseases such as osteoarthritis, osteoporosis, and osteosarcoma.@*CONCLUSION@#OPA1-mediated mitochondrial dynamics provides an important theoretical basis for the prevention and treatment of skeletal system diseases.

Effect evaluation of PBL and LBL combined teaching method in teaching the skeletal motor system diseases / 中华医学教育探索杂志

Objective:To explore the effect of combined problem-based learning (PBL) and lecture-based learning (LBL) on the teaching of skeletal motor system diseases for eight-year clinical medicine program students.Methods:The clinical eight-year medical students from Batch 2014 and 2015 participating in the teaching of "osteoarthritis" in the course of Skeletal Motor System Diseases in West China Clinical Medical College of Sichuan University were divided into control group (60 students) and experimental group (82 students). The control group was taught by LBL teaching method, while the experimental group was taught by PBL+LBL teaching method. A questionnaire survey was conducted to retrospectively analyze the teaching effects, including learning enthusiasm, knowledge understanding, thinking ability, teamwork ability, practical ability, self-learning ability and teacher-student relationship, as well as the evaluation of teaching satisfaction. The SPSS 22.0 software was used for t test and chi-square test. Results:The survey results showed that students in the experimental group were significantly superior to those in the control group in such aspects as learning enthusiasm (8.00±1.61 vs. 7.28±1.98), knowledge understanding (8.02±1.59 vs. 7.33±1.79), thinking ability (8.34±1.66 vs. 7.42±1.90), teamwork ability (8.32±1.76 vs. 6.60±2.79), practical ability (7.70±1.69 vs. 6.87 ± 2.57), self-learning ability (8.05±1.65 vs. 7.35±2.48) and teacher-student relationship (7.96±1.75 vs. 7.25±2.10), with statistically significant differences ( P<0.05). Meanwhile, the PBL+LBL group was more satisfied with the teaching mode than the LBL group, and the difference was statistically significant ( P<0.05). Conclusion:The application of PBL+LBL teaching method in clinical medicine eight-year program course teaching of "osteoarthritis" in Skeletal Motor System Diseases can effectively improve the learning enthusiasm of students, improve the quality of education, and obtain good teaching effect.