Long-term results of synovectomy in total knee arthroplasty: a prospective, randomized controlled trial / 中华医学杂志(英文版)

BACKGROUND@#Synovectomy has been introduced into total knee arthroplasty (TKA) with the aim of relieving pain and inflammation of the synovium. However, there are no long-term, comparative data to evaluate the effect of synovectomy in TKA. This study was aimed at assessing pain, function, and complications in patients undergoing synovectomy during TKA for osteoarthritis (OA) at long-term follow-up.@*METHODS@#This was a prospective randomized controlled trial of 42 consecutive patients who underwent staged bilateral TKA. Patients undergoing the first-side TKA were allocated to receive TKA with or without synovectomy followed by a 3-month washout period and crossover to the other strategy for the opposite-side TKA. The overall efficacy of both strategies was evaluated by determination of blood loss, the Knee Society score (KSS), and knee inflammation conditions during a 3-month postoperative period. The postoperative pain, range of motion (ROM), and complications were sequentially evaluated to compare the two groups until 10 years after surgery.@*RESULTS@#At the 10-year follow-up, both groups had a similarly significantly improved ROM (114.88 ± 9.84° vs. 114.02 ± 9.43°, t  = 0.221, P  = 0.815) and pain relief with no differences between the two groups (1.0 [1.0] vs. 1.0 [1.5], U  = 789.500, P  = 0.613). Similar changes in total blood loss, KSS, and knee inflammation were found in both groups during 3 months postoperatively ( P  > 0.05). Additionally, there was no significant difference regarding complications and satisfaction between the two groups ( P  > 0.05).@*CONCLUSIONS@#Synovectomy in conjunction with TKA for primary OA does not seem to provide any benefit regarding postoperative pain, ROM, and satisfaction during a 10-year follow-up. In addition, it may not result in more blood loss and increased incidence of long-term complications. Based on our long-term findings, it should not be performed routinely.@*TRIAL REGISTRATION@#Chinese Clinical Trial Registry, ChiCTR-INR-16008245; https://www.chictr.org.cn/showproj.aspx?proj=13334 .

Establishment of TLC identification and HPLC fingerprint of Inonotus obliquus and analysis of chemical pattern recognition / 中国药房

OBJECTIVE To establish thin-layer chromatography （TLC） identification method and high-performance liquid chromatography （HPLC） fingerprint of Inonotus obliquus， and to evaluate the quality of I. obliquus by chemical pattern recognition. METHODS TLC method was used to identify trametenolic acid and inotodiol in I. obliquus qualitatively. HPLC fingerprint of I. obliquus was established； Similarity Evaluation System for Chromatographic Fingerprint of Traditional Chinese Medicine （2012 edition） was used to determine the common peaks and evaluate the similarity； chemical pattern recognition analysis [cluster analysis， principal component analysis and orthogonal partial least squares-discriminant analysis （OPLS-DA）] of 22 batches of I. obliquus was performed with SPSS 23.0 software and SIMCA14.1 software. RESULTS In the TLC， the same color spots were found at the same position in the chromatograms of test sample and substance control. A total of 10 common peaks were marked in the HPLC fingerprints of 22 batches of I. obliquus， with similarities of 0.942-0.995. No. 3 peak was identified as trametenolic acid， No.4 peak as inotodiol， No. 9 peak as ergosterol and No. 10 peak as lanosterol. Results of cluster analysis showed that S1-S15， S19， S21 and S22 could be clustered into the first category， and S16-S18 and S20 were clustered into the second category. Results of principal component analysis showed that top 4 samples in the list of comprehensive score were S17， S18， S16 and S20. Results of OPLS-DA showed that three marking components that may affect the quality of I. obliquus were screened according to the standard of VIP＞1， i.e. No. 4 peak （inotodiol， VIP value of 1.86）， No. 3 peak （trametenolic acid， VIP value of 1.62） and No. 7 peak （VIP value of 1.27）. CONCLUSIONS This study establishes TLC method and HPLC fingerprint of I. obliquus successfully， which can provide reference for the quality control of I.obliquus by combining with chemical pattern recognition.

Effect of potentially inappropriate medication on frailty among community-dwelling elderly patients with mild cognitive impairment: a propensity score-matched analysis / 中华行为医学与脑科学杂志

Objective:To explore the effect of potentially inappropriate medication (PIM) on frailty among community-dwelling elderly patients with mild cognitive impairment (MCI).Methods:From March to July 2021, a total of 252 elderly patients with MCI in Hefei community were selected.The data of basic information and PIM of subjects were collected.All subjects were assessed by the comprehensive frailty assessment instrument (CFAI), Montreal cognitive assessment scale-basic (MoCA-B), and the Barthel index (BI). The subjects were divided into PIM group ( n=136) and non-PIM group ( n=94) according to whether there was PIM.Taking the confounding factors as the matching condition, the subjects of the two groups were matched with 1∶1 propensity score.After matching, there were 52 in the PIM group and 52 in the non-PIM group.SPSS 23.0 was used for data analysis.Multivariate Logistic regression analysis was performed to analyze the effect of PIM on frailty of subjects. Results:(1)Before matching, the incidence of frailty in PIM group and non-PIM group were 80.9% and 19.1%, respectively, with statistically significant differences ( P<0.01). Logistic regression analysis revealed that PIM was a risk factor for the frailty ( β=1.704, OR=5.495, 95% CI=2.539-11.892). (2)After matching, the confounders of age, hearing status, chewing function, activities of daily living, Charlson comorbidity index, handgrip strength, and cognitive function were balanced and comparable between the two groups.The incidence of frailty in PIM group and non-PIM group were 67.9% and 32.1%, respectively.The differences remained statistically significant ( P<0.01). PIM remained a risk factor for frailty ( β=1.791, OR=5.998, 95% CI=2.393-15.032). Conclusion:PIM is a risk factor for the occurrence of frailty in elderly patients with MCI.Therefore, the accurate screening and standardized management of PIM will provide a new target for the frailty management of elderly patients with MCI.

Research on the characteristics of calls from psychological assistance hotline and the coping strategies of operators before and after the outbreak of COVID-19 in Changchun City / 四川精神卫生

ObjectiveTo discuss the characteristics of psychological assistance hotline calls and operators' coping strategies of before and after the COVID-19 outbreak， in order to further improve the assistance ability of the psychological crisis hotline. MethodsA retrospective study was conducted on the demographics characteristics， call problems， coping strategies， and call time trends recorded by Changchun psychological assistance hotline information registration platform before the epidemic in Changchun City （January 20， 2019-April 20， 2019） and during the epidemic period （January 20， 2020-April 20， 2020）. ResultsThe differences between gender， age， marital status， location， and occupation type before and during the epidemic were statistically significant （χ2=11.205， 234.240， 152.083， 265.458， 353.385， P<0.01）. The number of different help calls had a statistically significant difference before and during the epidemic （χ2=185.088，P<0.01）. The difference in the number of operators’ different coping strategies before and during the epidemic was statistically significant （χ2=226.810， P<0.01）. Before the epidemic， the main peak of incoming calls was concentrated at 16∶00 to 17∶00， and the secondary peak was concentrated at 22∶00 to 23∶00. During the epidemic， the main peak of incoming calls was also concentrated at 16∶00 to 17∶00， while the secondary peak was concentrated at 10∶00 to 11∶00. ConclusionDuring the COVID-19 epidemic， the number of calls to the psychological assistance hotline was higher than that before the outbreak. The main peak time for calls was the same， and the secondary peak was adjusted from 22∶00 to 23∶00 to 10∶00 to 11∶00. During the epidemic， the number of calls from male， 30 to 39 years old， married， local and staff in Changchun was the most， psychological problems counseling and operator referral strategy were the most before and after the epidemic.

Expression of VEGF, COX-2 mRNA in esophageal cancer / 肿瘤研究与临床

Objective To study the expression of VEGF isoforms, COX-2 in esophageal cancer Methods VEGF, COX-2 mRNA expression in 40 paired samples (tumor and adjacent normal tissue) were determined by using real time RT-PCR. Results VEGF165 was overexpressed in 25 of 40(62.5 %) tumor tissues compared with in 6 of 40 (15 %) adjacent normal tissue; COX-2 was overexpressed in 28 of 40(70 %) tumor tissues compared with in 5 of 40(12.5 %) adjacent normal tissue. Conclusion This result suggests that VEGF165 and COX-2 overexpression in esophageal cancer.