Aim To investigate the clinical importance of a newly designed tenodesis with polymolecular polyethlene fastener. Methods Eighty-nine patients with knee ligaments injuries were reconstructed with the technique of newly designed tenodesis. Rehabilitation program started under the instruction of the therapist from the next day of the surgery.Results The tenodesis on all patients in our study were successful. The fasteners in two patients and the transplants in three patients were blocked in the bone tunnel during the operation. One fastener was taken out from the bone tunnel under arthroscopy. The patients were followed up for 19 months averagely (from 6 months to 49 months), most of them showed a stable knee without complain, except two patients feel uncomfortable after vigorous activities; seven patients show little laxity in anterior drawer test (ADT) or posterior drawer test (PDT) and three patients had 20-degree limitation of knee flexion. Lysholm scale score were 56?8 and 89?5 before and after operation, respectively ( P

Objective:To evaluate the effect of electroacupuncture (EA) on pyroptosis of hippocampal neurons in mice with sepsis-associated encephalopathy (SAE).Methods:Ninety male C57BL/6 mice, aged 8-12 weeks, weighing 22-25 g, were divided into 3 groups ( n=30 each) by a random number table method: sham operation group (Sham group), SAE group and EA treatment group (EA group). Sepsis model was established by cecal ligation and puncture in anesthetized animals.Bilateral acupoints Zusanli (ST36) were stimulated at 2, 24, 48 and 72 h after surgery in group EA.The survival was observed on day 7 after surgery.Cognitive function was assessed by Morris water maze.Then the animals were sacrificed, and hippocampal tissues were obtained for determination of the expression of nucleotide-binding oligomerization domain-like receptor protein 1 (NLRP1), cysteine-containing aspartate-specific protease 1 (caspase-1), and Gasdermin D (GSDMD) in hippocampal neurons (by Western blot) and content of activated caspase-1 (by enzyme-linked immunosorbent assay). Results:Compared with group Sham, the survival rate was significantly decreased, postoperative escape latency was prolonged, the activity time spent in the target quadrant was shortened, the number of crossing the original platform was decreased, the expression of NLRP1, caspase-1 and GSDMD was up-regulated, and the content of activated caspase-1 was increased in group SAE ( P<0.05). Compared with group SAE, the survival rate was significantly increased, postoperative escape latency was shortened, the activity time spent in the target quadrant was prolonged, the number of crossing the original platform was increased, the expression of NLRP1, caspase-1 and GSDMD was down-regulated, and the content of activated caspase-1 was decreased in group EA ( P<0.05). Conclusion:The mechanism by which EA reduces SAE may be related to inhibiting pyrolysis in hippocampal neurons of mice.

Objective:To evaluate the role of NIMA-related kinase 7 (NEK7)/Nod-like receptor family pyrin domain-containing protein 3 (NLRP3) signaling pathway in sepsis-associated encephalopathy in mice.Methods:A total of 150 healthy adult male C57BL/6 mice, aged 8-12 weeks, weighing 20-25 g, were divided into 5 groups ( n=30 each) by a random number table method: sham operation group (Sham group), sepsis group (CLP group), sepsis+ NLRP3 inhibitor MCC950 group (CLP+ MCC950 group), sepsis+ NEK7 siRNA group (CLP+ NEK7 siRNA group), and sepsis+ NC siRNA group (CLP+ NC siRNA group). Sepsis was induced by classic cecal ligation and puncture (CLP) in anesthetized animals.MCC950 10 mg/kg was intraperitoneally injected for 3 consecutive days after operation in CLP+ MCC950 group, while the equal volume of normal saline was given instead in Sham group.Immediately after operation and on 3rd day after operation, NEK7 siRNA 3 nmol/20 g was injected into the ventricle in CLP+ NEK7 siRNA group, and the equal dose of NC siRNA was injected into the ventricle instead in Sham group.The survival of mice was recorded on 4th postoperative day.On 4th and 7th days after operation, 10 mice in each group were selected for Y maze space recognition experiment.On 7th day after operation, 5 mice in each group were randomly sacrificed and hippocampal tissues were taken for determination of the contents of interleukin-1beta (IL-1β), interleukin-18 (IL-18) and tumor necrosis factor-alpha (TNF-α) (by enzyme-linked immunosorbent assay), and 6 mice in each group were sacrificed and hippocampal tissues were taken for determination of the expression of NEK7, NLRP3, cleaved-caspase-1 and apoptosis-associated speck-like protein containing a caspase-1 recruitment domain (ASC) (by Western blot). Results:The survival rates were 100%, 50%, 73%, 60% and 53% in Sham, CLP, CLP+ MCC950, CLP+ NEK7 siRNA, and CLP+ NC siRNA groups, respectively, on day 4 after surgery.Compared with Sham group, the frequency of entries into novel arm was significantly reduced, and the time spent in the novel arm was shortened at 4th and 7th days after operation, and the contents of IL-1β, IL-18 and TNF-α in hippocampus were increased, and the expression of NEK7, NLRP3, cleaved-caspase-1 and ASC was up-regulated at 7th day after operation in CLP group ( P<0.05). Compared with CLP group, the frequency of entries into novel arm was significantly increased, and the time spent in the novel arm was prolonged at 4th and 7th days after operation, and the contents of IL-1β, IL-18 and TNF-α in hippocampus were decreased at 7th day after operation in CLP+ MCC950 and CLP+ NEK7 siRNA groups, the expression of NLRP3, cleaved-caspase-1 and ASC was significantly down-regulated at 7th day after operation in CLP+ MCC950 group, the expression of NEK7, NLRP3, cleaved-caspase-1 and ASC was significantly down-regulated in CLP+ NEK7 siRNA group ( P<0.05), and no significant change was found in the parameters mentioned above in CLP+ NC siRNA group ( P>0.05). Conclusions:NEK7/NLRP3 signaling pathway is involved in SAE in mice, and the underlying mechanism may be related to promotion of inflammatory responses.

Cognitive impairment seriously affects the quality of life of patients. Clinically, it is common in cerebral ischemia, sepsis and postoperative. Its etiology includes abnormal expression of regulatory molecules in the brain, ischemic injury of brain tissue and abnormal expression of genes and proteins in brain tissues. However, there is no effective treatment at present. Electroacupuncture has a certain effect on cognitive impairment. Its mechanism mainly includes inhibiting oxidative stress response, enhancing synaptic plasticity, inhibiting neuroinflammation, regulating glial cell activity, regulating excitatory amino acids, and improving glucose metabolism.

Objective:To investigate cases of delayed lactation initiation in women with transvaginal delivery and the influencing factors, in order to provide a basis for effective control of delayed lactation initiation and promotion of breastfeeding.Methods:Inpatients who were admitted to the obstetric ward of Affiliated Hospital of Jining Medical College from November 6, 2020 to January 16, 2021 were selected for the study using convenience sampling method and investigated by general information questionnaire and Chindbirth Experience Questionnaire (CEQ). Binary Logistic regression analysis was used to determine the factors influencing delayed lactation initiation.Results:The incidence of delayed lactation initiation in 622 women with transvaginal delivery was 38.75% (241/622). Binary Logistic regression analysis showed that age 20-35 years, full-term delivery, labor and delivery, use of labor analgesia, and good experience of transvaginal delivery were protective factors for delayed lactation initiation ( OR values were 0.012 to 0.868, all P<0.05); age >35 years, excessive weight gain during pregnancy, presence of pregnancy complications, use of induction of labor during delivery, long labor process, and damage to perineal skin after delivery were risk factors for delayed lactation initiation ( OR values were 1.097 to 13.235, all P<0.05). Conclusions:The high incidence of delayed lactation initiation in women with transvaginal delivery is influenced by a number of factors, which reminds the clinic that lactation in women after transvaginal delivery also needs to be taken into account, with priority assessment and prevention for those who are elderly (age≥35 years), primiparous, have other diseases during pregnancy, have gained too much weight during pregnancy, have preterm delivery, have a long duration of labor, have not received labor analgesia, have had a single or combined induction of labor, have had an episiotomy or perineal laceration during labor, and have a poor transvaginal delivery experience.

Objective To provide theoretic rationales and clinical experience for post-transplant lymphoproliferative disorder (PTLD ) by comparing the characteristics of PTLD in kidney and hematopoietic stem cell transplant recipients and reviewing the relevant literature reports .Methods Twenty-seven adult PTLD patients from 2000 to 2017 were retrospectively reviewed .There were 11 kidney transplant recipients (KT group) and 16 hematopoietic stem cell transplant recipients (HSCT group) .Clinical characteristics and outcomes were analyzed between two groups .Cox's proportional hazard model was utilized for evaluating the prognostic factors .Results The incidence of PTLD for KT and HSCT groups were 0 .5 ％ and 1 .1 ％ respectively .PTLD patients of KT group had a later onset than that of HSCT group (105 .1 vs 3 .1 months , P<0 .01) .Also Epstein-Barr virus was less frequently detected in KT group (36 .4 ％ vs 81 .3 ％ , P< 0 .05) .The 5-year overall survival was (46 .8％ ± 10 .5％ ) .According to Cox analysis ,application of antithymocyte globulin (ATG) and high ECOG scores were risk factors for a poor prognosis of PTLD .Conclusions Most cases of KT-PTLD have a late onset . In contrast , HSCT-PTLD has an earlier onset and a higher incidence of EBV infectious .And application of ATG and high ECOG scores are poor prognosis factors of PTLD .

Objective To analyze the incidence and risk factors of de novo malignant tumors in renal transplant recipients. Methods Clinical data of 1 549 renal transplant recipients were retrospectively analyzed, including the basic status, pathological type and incidence rate of patients with de novo malignant tumors after renal transplantation. The survival situation of these patiensts was assessed. And the risk factors of de novo malignant tumors after renal transplantation were identified. Results The incidence rate of de novo malignant tumors in renal transplant recipients was 3.03%(47/1 549). The 47 recipients were (48±12) years old when undergoing renal transplantation, and they were (55±12) years old when diagnosed malignant tumors. The time interval between transplantation and diagnosis was 66 (36, 100) months. Among the de novo malignant tumors, colorectal cancer was the most common, with a cumulative incidence rate (CIR) of 0.58%. The survival time of 47 recipients with de novo malignant tumors after renal transplantation was 59 (2, 135) months, and the 5-year survival rate was 50%. The recipients with the age > 45 years old when undergoing renal transplantation was a risk factor for de novo malignant tumors after renal transplantation (P < 0.05). Conclusions The incidence rate of de novo malignant tumors is relatively high in renal transplant recipients. The recipients with the age > 45 years old when undergoing renal transplantation is a risk factor for de novo malignant tumors.

Objective:To investigate the current status of women′s level of birth experience and lactation initiation time and explore the effect of level of birth experience on lactation initiation time.Methods:This was a cross-sectional study. A convenience sampling method was used to select 622 maternal cases attending the Affiliated Hospital of Jining Medical College from November, 2020 to January, 2021, and the distribution of their labor experience level and lactation initiation time was investigated by questionnaire and follow-up assessment.Results:There were 622 women with transvaginal deliveries who had lactation initiation times of more than 72 h in 241 cases (38.75%). The scores for each dimension of the Childbirth Experience Questionnaire (CEQ) were (49.63 ± 8.58)points, and the scores for each dimension of CEQ were perceived safety, professional support, involvement and self-efficacy in descending order. The results of the correlation analysis showed that there was a negative correlation between the scores on each dimension of CEQ and the total score and lactation initiation time ( r values were -0.436 to -0.146, all P<0.01). Stratified regression analysis showed that after controlling for age, number of births, gestational weeks of labour, illness during pregnancy and labour analgesia as the underlying variables affecting lactation initiation time, the scores for self-efficacy, involvement, perceived safety and professional support in the CEQ all affected lactation initiation time after delivery ( t values were -6.76 to -2.02, all P<0.05). Conclusions:The birth experience and lactation of women who deliver via vaginal birth need to be taken into account. The more negative the birth experience, the longer the lactation initiation time. The women′s involvement in the birth process, their own competence, perceived safety and level of professional support are all valid influencing indicators of lactation initiation time.