Diagnostic value of magnetic resonance imaging for patients with periprosthetic joint infection: a systematic review.

PURPOSE: The purpose of this study was to provide a critical systematic review of the role of magnetic resonance imaging (MRI) as a noninvasive method to assess periprosthetic joint infections (PJIs). METHODS: The electronic databases PubMed and EMBASE were searched, since their inception up to March 27, 2022. The included studies evaluated the reproducibility and accuracy of MRI features to diagnose PJIs. The article quality assessment was conducted by the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) and Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2). RESULTS: Among 1909 studies identified in the initial search, 8 studies were eligible for final systematic review. The included studies evaluated the reproducibility and accuracy of MRI features to diagnose PJIs. Seven of 8 studies showed good to excellent reliability, but only one article among them in which accuracy was evaluated had a low risk of bias. The intraclass correlation coefficient (ICC) and Cohen coefficient (κ) varied between 0.44 and 1.00. The accuracy varied between 63.9% and 94.4%. Potential MRI features, such as lamellated hyperintense synovitis, edema, fluid collection, or lymphadenopathy, might be valuable for diagnosing PJIs. CONCLUSION: The quality of the evidence regarding the role of MRI for PJIs diagnosis was low. There is preliminary evidence that MRI has a noteworthy value of distinguishing suspected periprosthetic joint infection in patients with total knee arthroplasty or total hip arthroplasty, but the definition of specific MRI features related to PJIs diagnosis lacks consensus and standardization. Large-scale studies with robust quality were required to help make better clinical decisions in the future.

Surgical interventions for symptomatic knee osteoarthritis: a network meta-analysis of randomized control trials.

BACKGROUND: Multiple surgical interventions exist for the treatment of symptomatic knee osteoarthritis, but the surgeon and patient may often have difficulty deciding which interventions are the best option. METHODS: We conducted a systematic review to identify randomized clinical trials (RCTs) that compared complications, revisions, reoperations, and functional outcomes among TKA (total knee arthroplasty), UKA (unicompartmental knee arthroplasty), HTO (high tibial osteotomy), BCA (bicompartmental knee arthroplasty), BIU (bi-unicompartmental knee arthroplasty), and KJD (knee joint distraction). The PubMed, Embase, and Cochrane databases were reviewed for all studies comparing two or more surgical interventions. Direct-comparison meta-analysis and network meta-analysis (NMA) were performed to combine direct and indirect evidence. The risk of bias was assessed using the revised Cochrane risk of bias tool for RCTs. RESULTS: This NMA and systematic review included 21 studies (17 RCTs), with a total of 1749 patients. The overall risk-of-bias assessment of the RCTs revealed that 7 studies had low risk, 5 had some concerns, and 9 had high risk. SUCRA (the surface under the cumulative ranking curve) rankings revealed that KJD had the greatest risk of appearing postoperative complications, revisions, and reoperations, and UKA or TKA had the lowest risk. The majority of comparisons among various treatments showed no difference for functional outcomes. CONCLUSION: Each surgical intervention is noninferior to other treatments in functional outcomes, but UKA and TKA are better options to treat OA according to SUCRA rankings by comparing complications, revisions, and reoperations. KJD is an imperfect option for treating OA. Other treatments should be carefully considered for each patient in accordance with their actual conditions. However, this conclusion is limited by the selection of reviewed publications and individual variation of surgical indications for patients. TRIAL REGISTRATION: This study was registered with Research Registry (reviewregistry1395).

Downregulation of cardiac PIASy inhibits Cx43 SUMOylation and ameliorates ventricular arrhythmias in a rat model of myocardial ischemia/reperfusion injury / 中华医学杂志(英文版)

BACKGROUND@#Dysfunction of the gap junction channel protein connexin 43 (Cx43) contributes to myocardial ischemia/reperfusion (I/R)-induced ventricular arrhythmias. Cx43 can be regulated by small ubiquitin-like modifier (SUMO) modification. Protein inhibitor of activated STAT Y (PIASy) is an E3 SUMO ligase for its target proteins. However, whether Cx43 is a target protein of PIASy and whether Cx43 SUMOylation plays a role in I/R-induced arrhythmias are largely unknown.@*METHODS@#Male Sprague-Dawley rats were infected with PIASy short hairpin ribonucleic acid (shRNA) using recombinant adeno-associated virus subtype 9 (rAAV9). Two weeks later, the rats were subjected to 45 min of left coronary artery occlusion followed by 2 h reperfusion. Electrocardiogram was recorded to assess arrhythmias. Rat ventricular tissues were collected for molecular biological measurements.@*RESULTS@#Following 45 min of ischemia, QRS duration and QTc intervals statistically significantly increased, but these values decreased after transfecting PIASy shRNA. PIASy downregulation ameliorated ventricular arrhythmias induced by myocardial I/R, as evidenced by the decreased incidence of ventricular tachycardia and ventricular fibrillation, and reduced arrythmia score. In addition, myocardial I/R statistically significantly induced PIASy expression and Cx43 SUMOylation, accompanied by reduced Cx43 phosphorylation and plakophilin 2 (PKP2) expression. Moreover, PIASy downregulation remarkably reduced Cx43 SUMOylation, accompanied by increased Cx43 phosphorylation and PKP2 expression after I/R.@*CONCLUSION@#PIASy downregulation inhibited Cx43 SUMOylation and increased PKP2 expression, thereby improving ventricular arrhythmias in ischemic/reperfused rats heart.

Comparison of volatile components and principal component analysis of Cuscuta chinensis and its processed pro- ducts / 中国药房

OBJECTIVE To compar e the volatile components of Cuscuta chinensis and its processed products ，and to conduct principal component analysis （PCA）. METHODS The volatile components of C. chinensis ，C. chinensis stir-frying with saltwater ， C. chinensis stir-frying with wine were identified by headspace solid phase microextraction combined with gas chromatography- mass spectrometry. The relative percentage of each component was calculated by area normalization method. The PCA was conducted by using SPSS 21.0 software. RESULTS A total of 117 compounds were identified from C. chinensis ，C. chinensis stir-frying with saltwater and C. chinensis stir-frying with wine ，of which 68 compounds were identified from C. chinensis （relative percentage of 92.41％），such as phytone ，2-methoxy-3-（2-propenl）phenol，n-pentadecane，β-caryophyllene. Sixty compounds （relative percentage of 89.41％） were identified from C. chinensis stir-frying with saltwater ，such as maltol ，2，3-dihydro- benzofuran，4-vinyl-2-methoxyphenol. Fifty-eight compounds （relative percentage of 87.02％）were identified from C. chinensis stir-frying with wine ，such as phenylethanol ，β-caryophyllene，macrocarehe D. There were 24 common components in the three ， and relative percentage of them were 38.56％，30.61％，33.07％，respectively. After processing ，there were 49 new components ， such as furfural ，n-hexanoic acid ，caryophyllene oxide. The results of PCA showed that the cumulative contribution rate of the former two principal components was 100％ ；comprehensive score of volatile components of C. chinensis was the highest ， followed by C. chinensis stir-frying with wine and C. chinensis stir-frying with saltwater. CONCLUSIONS The quality of volatile components in C. chinensis is good ；the volatile components in processed products are more than those in C. chinensis .

Role of angiotensin Ⅱ type 2 receptor in repeated propofol anesthesia-induced neuroapoptosis in basal ganglia of newborn rats / 中华麻醉学杂志

Objective To evaluate the role of the angiotensin Ⅱ type 2 receptor (AT2R) in repeated propofol anesthesia-induced neuroapoptosis in the basal ganglia of newborn rats.Methods Fiftyfour pathogen-free Sprague-Dawley rats,aged 7 days,weighing 10-15 g,were divided into 3 groups (n=18 each) using a random number table:control group (group C),repeated propofol anesthesia group (group P) and AT2R agonist CGP42112A group (group G).In group C,0.9％ sodium chloride injection 3 ml/kg was intraperitoneally injected,and half of the initial dose 1.5 ml/kg was given every 20 min for 5 times in total,lasting for 3 consecutive days.In group P,propofol 30 mg/kg was intraperitoneally injected,and half of the initial dose 15 mg/kg was given every 20 min for 5 times in total,lasting for 3 consecutive days.In group G,CGP42112A 1 mg/kg was intraperitoneally injected,propofol 30 mg/kg was intraperitoneally injected 5 min later,and half of the initial dose of propofol 15 mg/kg was given every 20 min for 5 times in total,lasting for 3 consecutive days.Six rats were sacrificed at 2 h after emergence from anesthesia,and brains were removed for detection of neuroapoptosis in the basal ganglia by TUNEL assay.The apoptosis index was calculated.Another 6 rats were sacrificed,and the basal ganglia were isolated from brains to detect the expression of activated caspase-3,AT2R and peroxisome proliferator-activated receptor gamma (PPARγ) (by Western blot) and the expression of AT2R and PPARγ mRNA (by real-time polymerase chain reaction).The other 6 rats were fed until 28 days old,and the cognitive function was then assessed using Morris water maze test.Results Compared with group C,the escape latency was significantly prolonged,the time of staying at the target quadrant was shortened,the frequency of crossing the platform was decreased,the apoptosis index of the basal ganglia was increased,the expression of activated caspase-3 was up-regulated,and the expression of AT2R and PPARγprotein and mRNA was down-regulated in group P (P＜0.05),and no significant change was found in the parameters mentioned above in group G (P＞0.05).Compared with group P,the escape latency was significantly shortened,the time of staying at the target quadrant was prolonged,the frequency of crossing the platform was increased,the apoptosis index of the basal ganglia was decreased,the expression of activated caspase-3 was down-regulated,and the expression of AT2R and PPARγ protein and mRNA was up-regulated in group G (P＜0.05).Conclusion Inhibited activation of AT2R is involved in repeated propofol anesthesia-induced neuroapoptosis in the basal ganglia of newborn rats.

Role of angiotensin H type 2 receptor in repeated propofol anesthesia-induced neuroapoptosis in hippocampus of newborn rats / 中华麻醉学杂志

Objective To evaluate the role of the angiotensin Ⅱ type 2 receptor (AT2R) in repeated propofol anesthesia-induced neuroapoptosis in the hippocampus of newborn rats.Methods Fiftyfour pathogen-free Sprague-Dawley rats,aged 7 days,weighing 10-15 g,were divided into 3 groups (n=18 each) using a random number table:control group (group C),repeated propofol anesthesia group (group P) and AT2R agouist CGP42112A group (group G).In group C,0.9％ sodium chloride injection 3 ml/kg was intraperitoneally injected,and half of the initial dose 1.5 ml/kg was given every 20 min for 5 times in total,lasting for 3 consecutive days.In group P,propofol 30 mg/kg was intraperitoneally injected,and half of the initial dose 15 mg/kg was given every 20 min for 5 times in total,lasting for 3 consecutive days.In group G,a single bolus of CGP42112A 1 mg/kg was intraperitoneally injected,propofol 30 mg/kg was intraperitoneally injected 5 min later,and half of the initial dose of propofol 15 mg/kg was given every 20 min for 5 times in total,lasting for 3 consecutive days.At 2 h after emergence from anesthesia,6 rats were sacrificed and brains were removed for detection of neuroapoptosis in the hippocampus by TUNEL assay.The apoptosis index was calculated.Another 6 rats were sacrificed,brains were removed and hippocampi were isolated for determination of the expression of activated caspase-3,AT2R and peroxisome proliferator-activated receptor gamma (PPARγ) in hippocampal tissues by Western blot.The other 6 rats were fed until 28 days old,and the cognitive function was then assessed using Morris water maze test.Results Compared with group C,the escape latency was significantly prolonged,the time of staying at the target quadrant was shortened,the frequency of crossing the platform was decreased,the apoptosis index was increased,the expression of activated caspase-3 was up-regulated,and the expression of AT2R and PPARγ was down-regulated in group P (P＜0.05),and no significant change was found in the parameters mentioned above in group G (P＞0.05).Compared with group P,the escape latency was significantly shortened.the time of staying at the target quadrant was prolonged,the frequency of crossing the platform was increased,the apoptosis index was decreased,the expression of activated caspase-3 was down-regulated,and the expression of AT2R and PPARγ was up-regulated in group G (P＜0.05).Conclusion Inhibited activity of AT2R is involved in repeated propofol anesthesia-induced neuroapoptosis in the hippocampus of newborn rats.

Discussion for the Problems in Intravenous Thrombolysis with Recombinant Tissue Plasminogen Activator in Acute Cerebral Infarction / 中国康复理论与实践

@#This paper points out the importance of intravenous thrombolysis with recombinant tissue plasminogen activator(r-tPA)according to the international guidelines in acute ischemic stroke.Some practical problems,such as the lower rate of thrombolysis for ischemic stroke,the price of r-tPA being too expensive to clinical using,the dosage of r-tPA in Chinese being not clear,the curative effect being not so good,and traditional Chinese medicine (TCM) applied in intravenous thrombolysis,and so on,should be further discussed.

Pondering on the diagnosis and treatment criteria for syndromes of epilepsy in traditional Chinese medicine / 中西医结合学报

International League Against Epilepsy announced the new International Classification of Epilepsy in 2001. One of the main objectives of the project is to adopt standard terms to describe seizure phenomena according to the terminological database. The project may profit academic communication and resource integration, and provide evidence for the individual treatment for epilepsy. Treatment based on syndrome differentiation is one of the characteristics of the treatment for epilepsy in traditional Chinese medicine (TCM). As far as the individuation on diagnosis and treatment is concerned, TCM and Western medicine present to reach the same goal by different routes gradually for the treatment of epilepsy. But for TCM, the diagnosis and treatment criteria for epilepsy are imperfect and the experts, opinions are not unified, so that the treatment based on syndrome differentiation becomes confused, hence the credit of treatment based on TCM is restricted accordingly. It is necessary to formulate advanced diagnosis and treatment criteria for syndromes of epilepsy in TCM.

Effect on Nervous Tissue and Anaphase Diagnostic Ultrasound in Early Pregnancy / 医学研究杂志

Objective To assess the diagnosis safety by detecting the biological character of prenatal fetus rats’nervous tissue exposed to diagnostic ultrasound during earlier period. Methods Cell culture, morphology examining, cell proliferation curve measurement and flow cytometry detection were adopted. Results ①After morphology examining, there are no difference between the treated group and control group. ② We can see from the growth curve, the two groups has identical growth tendency. ③Through flow cytometry detection, results show that there are no significance between two groups. Conclusion Diagnostic ultrasound in early pregnancy have no significant effect on prenatal fetus rats’nervous tissue.

Effect of Diagnostic Ultrasound on SOD of Mother and Progeny in Early Pregnancy / 医学研究杂志

0.05).②The animal experiment showed ,in contrast to the control , embryonate rats’ rhodocyte SOD were significantly different after 2 days but no difference before prenatal. ③in contrast with the control , SOD of placenta were significantly different only after 9 days. Conclusions Diagnostic ultrasound in early pregnancy can make SOD change ,but the changes can be reparable.

The ethical and juristic practical comprehension of hearing with living-related kidney transplantation:a report of 18 cases / 中国医学伦理学

Objective: To explore the ethical and juristic signif-icance of hearing with living-related kidney transplantation. Methods: This study involved 18 donors and recipients who received medical e-valuating and informing the related medical risk between Jul.2006 and Jun.2007. Our experience of 18 hearings with living-related kidney transplantation, which comprised members of Human Organ Transplant Te-chnique and Ethics Committee,donors,recipients and their direct rela-tives,was analyzed. Results the 16 hearings were successful, one res-igned donation,and two were controvertible and succeeded after re-ev-aluating. Conclusion:The hearing should have known,voluntary,equitab-le, unclassified and no commercial principle,and endeavour to ensure the medical,ethical and juristic entirety and integrity of living-re-lated kidney transplantation.