Feasibility and anteversion accuracy of a patient-specific instrument for femoral prosthesis implantation in total hip arthroplasty.

BACKGROUND: The aim of this study was to evaluate the precision and feasibility of patient-specific instruments (PSI) in total hip arthroplasty (THA) as compared to the traditional free-hand (FRH) approach. METHODS: During the period of January 1, 2021 to December 31, 2022, a randomized allocation was used for patients receiving unilateral primary THA to either the PSI or conventional operation group. The placement and size of the PSI were specifically chosen to guide femoral neck resection and prosthesis implantation. The study analyzed component positions and evaluated radiographic and clinical outcomes in 30 patients who received PSI-assisted THAs and 30 patients who received FRH THAs. This study was registered at China Clinical Trial Registry (number: ChiCTR2300072325) on June 9th, 2023. RESULTS: The use of PSI in THA resulted in significantly higher precision in achieving the desired component position as compared to the FRH approach. The PSI group showed significantly smaller absolute errors of femoral anteversion (p < 0.001). No significant differences were found in operation time, intra-operative blood loss, hospitalization duration, or time to walk after surgery. CONCLUSION: In conclusion, the application of patient-specific instruments in THA provides a simple and reliable solution to enhance the precision of femoral prosthesis placement with high accuracy and feasibility. This study highlights the potential benefits of using the PSI in THA.

Pyrotinib combined with trastuzumab and chemotherapy for the treatment of human epidermal growth factor receptor 2-positive metastatic breast cancer: a single-arm exploratory phase II trial.

PURPOSE: A substantial need for effective and safe treatment options is still unmet for patients with heavily pre-treated human epidermal growth factor receptor 2 (HER2)-positive metastatic breast cancer (MBC). Herein, we assessed the efficacy and safety of pyrotinib plus trastuzumab and chemotherapy in patients with heavily treated HER2-positive MBC. METHODS: In this single-arm exploratory phase II trial, patients with HER2-positive MBC previously treated with trastuzumab plus lapatinib or pertuzumab, received pyrotinib plus trastuzumab and chemotherapy. The primary end point was progression-free survival (PFS) in the total population (TP). Secondary end points included PFS in the subgroup with brain metastases (Sub-BrM), confirmed objective response rate (ORR), clinical benefit rate (CBR), disease control rate (DCR), exploration of predictive factors of PFS, and safety. RESULTS: Between November 1, 2018, and March 31, 2021, 40 patients were eligible for this study. The median PFS reached 7.5 months (95% confidence interval [CI] 4.7 to 9.9 months) and 9.4 months (95% CI 6.6 to 12.1 months) in the TP and Sub-BrM, respectively. ORR was 50.5% (20/40). CBR was 75.5% (30/40) and DCR reached 97.5% (39/40). Cox univariate and multivariate analyses demonstrated that liver or/and lung metastases was the significant adverse prognostic factor for PFS (p = 0.018; p = 0.026; respectively). The most frequent grade 3 or 4 treatment-related adverse events were diarrhea, neutropenia and leukopenia. No new safety signals were observed. CONCLUSION: Pyrotinib plus trastuzumab and chemotherapy offered a promising option with manageable safety profile for heavily pre-treated HER2-positive MBC, especially for those without liver or/and lung metastases.

[Anti-Helicobacter pylori effect and regulation of T helper response of chitosan].

OBJECTIVE: To study the anti-Helicobacter pylori (Hp) effect and the regulation of T helper (Th) response of chitosan. METHODS: Hp infected grade one female BALB/c mice model was established by inoculating Hp Sydney strain 1 and the mice were randomly divided into eight groups and administrated with (1) Arabia glue solution (control group), (2) omeprazole, (3) amoxicillin, (4) amoxicillin plus omeprazole, (5) chitosan, (6) chitosan plus omeprazole, (7) chitosan plus amoxicillin, (8) chitosan plus amoxicillin plus omeprazole respectively twice daily for 14 consecutive days. Four weeks after the last administration, these mice were all killed and samples of gastric mucosa were embedded in paraffin, sectioned and assayed with Giemsa stain. The remaining gastric mucosa was used to quantitatively culture Hp. An quantitative ELISA was used to detect IL-2, IFNgamma, IL-12, IL-4, IL-10 content in gastric mucosa. RESULTS: The eradication rate of Hp was 0, 0, 41.7%, 58.3%, 58.3%, 66.7%, 83.3% and 91.7% respectively among these eight groups (P < 0.01). The Hp colony density in the (1) group and (2) group was significantly higher than that in the other six groups (P < 0.05). The Hp colony density in (3) group was significantly higher than that in (6) group, (7) group and (8) group (P < 0.05) and that in (4) group was significantly higher than that in (8) group (P < 0.05). There was no difference in the content of IL-2 in the gastric mucosa among these eight groups (P > 0.05). The content of IFNgamma, IL-12, IL-4 and IL-10 in the gastric mucosa in groups with chitosan was significantly higher than that in groups without chitosan (P < 0.05). CONCLUSIONS: Chitosan has anti-Hp effect and synergism with amoxicillin in vivo. Chitosan can up-regulate Th1 and Th2 response.

Purification, characterization, and cDNA cloning of a myofibril-bound serine proteinase from the skeletal muscle of crucian carp (Carassius auratus).

A myofibril-bound serine proteinase (MBSP) was highly purified from the skeletal muscle of crucian carp (Carasius auratus) by acidic treatment of myofibril solution and chromatographies on Q-Sepharose and benzamidine-Sepharose 6B. MBSP revealed a main protein band of approximately 28 kDa on SDS-polyacrylamide gel electrophoresis (PAGE) and was particularly inhibited by serine proteinase inhibitors. Substrate-specificity analysis revealed that the enzyme specifically cleaved at the carboxyl side of arginine and lysine residues, suggesting the characteristics of a trypsin-type serine proteinase. MBSP gene was cloned on the basis of the N-terminal sequence and the conserved active site peptide of serine proteinases together with 5'-rapid amplification of cDNA ends (5'-RACE) and 3'-RACE. The coding region gave an amino acid sequence of 242 residues including the initiation methionine and a signal peptide of 20 residues. Amino acid residues of His60, Asp106, and Ser196 consisting of the catalytic triad of serine proteinases were conserved in the sequence. Crucian carp MBSP shared relatively high identities with other serine proteinases, especially in well-conserved regions.

Investigation of polarization-induced fading in fiber-optic interferometers with polarizer-based polarization diversity receivers.

A technique is described to eliminate polarization-induced fading in fiber-optic interferometers with two or three polarizers. Modeling and simulation show that two polarizers should be angularly spaced by 90 degrees to alleviate polarization-induced fading. A test system is set up with two 6.5 km fiber coils to link the data. A bistate polarization diversity receiver is tested for reducing polarization-induced fading. The signal is demodulated using a digital phase-generated carrier and the system demonstrates self-noise up to 7.7 microrad/square root Hz (at 1 kHz).