Objective To explore the expression of ribosomal protein L6 (RPL6) in prostate cancer and its clinical sig-nificance. Methods RT-qPCR and Western blot assay were used to measure the mRNA transcription and protein expres-sion levels of RPL6 in prostate cancer tissues (n=80) and adjacent non-cancerous tissues (n=62). The relationship between RPL6 mRNA expression level and clinicopathological factors of prostate cancer was statistically analyzed. Results The mRNA and protein expression levels of RPL6 were significantly higher in prostate cancer tissues compared with those of non-cancerous tissues (P<0.05). There were higher serum expression levels of prostate specific antigen (PSA) and higher Gleason score in prostate cancer tissues. The expression level of RPL6 mRNA was significantly higher in patients with lymph node metastasis and late clinical stage (P<0.05). There were no significant differences in PSA levels between different ages, with or without seminal vesicle invasion and different surgical margin status (P>0.05). Kaplan-Meier survival analysis of biochemical recurrence (BCR)-free survival time showed the significantly lower recurrent rate in patients with high RPL 6 mRNA expression(χ2=4.530,P=0.033). Conclusion The elevated expression of RPL6 may play a role in the development of prostate cancer, and which can be used as a tumor marker to assess the prognosis of prostate cancer.

Objective To study the early diagnosis and treatment of the blunt popliteal artery injury without fracture or dislocation of the knee. Methods From March 1984 to November 2002, 11 cases of blunt popliteal artery injury without fracture or dislocation of the knee were diagnosed as earlier as possible based on clinical analysis including injury condition, clinical examination and Doppler-Duplex ultrasonography and treated with early repair of the injured arteries, intraoperative or postoperative anticoagulation, immediate fasciotomy and thorough debridement of the ischemic and necrotic muscules and soft tissue. Results There was one with amputation and two with slight dysfunction of the lower extremity, as did not affect normal daily lives. One case had serious dysfunction of the lower extremity due to thrombosis at the injured popliteal artery after first operation and had to receive second operation so as to remove thrombus and repair the popliteal by autograft of the saphena magna vein. However, there left severe function disorder of the extremities. Conclusion A rational and prompt diagnosis and treatment for blunt popliteal artery injury without fracture or dislocation of the knee will decrease the adverse effect of ischemia and reduce overall morbidity.

Objective To explore the anatomical morphology of femoral trochlear groove and the difference between normal males and females.Methods Eighty healthy volunteers were recruited,including 42 males and 38 females with an average age of 36.2 years (range,21-55 years).All the volunteers without knee unstabilization,pain and wound.CT scan of right femurs were performed and 3-D model were reconstructed.The anatomical parameters of right femoral trochlear groove were measured,which included transepicondylar axis,medial and lateral length of trochlear groove,medial and lateral condylar height,sulcus angle,depth of trochlear groove,transcondylar axis,anterior femoral condylar angle,trochlear groove position,and then compared the morphologic difference of trochlear groove between males and females.Results The average width of transepicondylar axis was 79.21±3.80 mm for males and 70.73±2.91 mm for females (t=-53.40,P=0.00).The minimum sulcus angle was acquired at 45° flexion for males and 42° flexion for females.It was 133.92°±4.76° for males and 132.71°±4.36° for females.The maximum length of transepicondylar axis was acquired at 87° flexion for males and 90° flexion for females.It was 42.36±3.48 mm for males and 39.03 ±3.36 mm for females.The anterior femoral condylar angle decreased with the increasing flexion angle of knee (P＞0.05).The position of the trochlear groove moved laterally with the increasing flexion angle of knee (P＞0.05).Conclusion There is no significant difference between male and female in the geometry of femoral trochlear groove,however there is a significant difference in sizes.Therefore,during design the knee prosthesis,close approximation of size is essential,while gender differences in morphology need not be considered a factor.

Objective To evaluate the efficacy and safety of local infiltration analgesia in the multimodal analgesia protocol.Methods Sixty patients who were scheduled to undergo TKA were randomly divided two groups:local infiltration analgesia (LIA) group (n=30) or the non-local infiltration analgesia (N-LIA) group (n=30).All patients were given Celecoxib 200 mg bid,3 days preoperative,and a single-injection femoral nerve block (SFNB) half an hour before the surgery (ropivacaine 3.3 g/L,30 ml).The LIA group was given local infiltration analgesia with ropivacaine (2.5 g/L,60 ml) and 0.1 mg epinephrine before suture the operative incision.The N-LIA group didn't do the LIA.Both of the two groups didn't use the patient controlled analgesia.The VAS scores,the knee joint range of motion,the muscle strength of quadriceps femoris and the side effects and complications were recorded.Results The VAS scores were lower in LIA group than in the N-LIA group,these scores at 2 h to 48 h after surgery at rest and after 24 h at motion had statistical significance.The range of motion and the muscular strength of quadriceps femoris in the LIA group were better than in the N-LIA group.In the LIA group the use of opioids was less and the side effects were lower.The average length of hospital stay after the operation was shorter in the LIA group than the N-LIA group.Conclusion This multimodal perioperative analgesia protocol that include SFNB and LIA offered improved pain control and minimal side effects to patients undergoing TKA.

Objective To investigate the perioperative management,coagulation factor regulation in total knee arthroplasty (TKA) for hemophilia arthritis and evaluate its short-term clinical efficacy.Methods A retrospective study was performed in hemophilia arthritis patients who had undergone TKA from March,2009 to March,2014.Patients with type A hemophilia received Lyophilized Human Factor Ⅷ,and type B hemophilia patients received Prothrombin Complex.Perioperative accurate dosage of coagulation factor was determined by preliminary test.AORI T1,T2 bone defects were filled with PMMA,and severe contained AORI T3 defects were fixed with impaction allograft and screws,and for non-contained AORI T3 bone defects,structural allografts and stem extension may be considered.Knee function was evaluated by HSS score,and imaging change was evaluated by anteroposterior and lateral radiographs of knee at latest follow-up.Results Eight patients (10 knees) were included with a mean age of 38.3±5.0 years,in which 6 were type A,and the other 2 were type B.Preoperative APTT was 63.9±4.0 s,and coagulation factor activity was 2.6％±0.9％.All the patients had flexion deformity with extension of-12.0°±5.9° and flexion of-88.0°± 11.4°.Three patients (3 knees) had valgus deformity with-3.0°±5.4°,and 2 patients (4 knees) had varus deformity with-4.5°±6.0°.All the 8 patients were followed for a mean of 14.3 months.The range of motion was improved with 0°-98.5°±6.7° at latest follow-up,and the postoperative HSS score was 88.3±4.6 compared with 42.3±10.9 preoperatively.Bone-grafting was survival,and no loosening of prosthesis or screws were detected from X-ray at latest follow-up.Conclusion The early results of TKA in Hemophilia arthritis patients are satisfactory.Preoperative preliminary test was helpful to determine the accurate dosage of coagulation factor.A stable high level of coagulation factor was vital to control bone-cement bleeding and make prosthesis stable.Tibial bone defects involving ＜ 1/3 area and ＜ 1 cm in depth could be filled with PMMA,and impaction allograft and screws could be used to fix severe contained bone defects.For segmental bone defects,except of structural allograft,stem extension was recommended to reduce stress and increase stability.

Objective To explore the perioperative efficiency and safety of different regimen of tranexamic acid (TXA) in total knee arthroplasty (TKA).Methods From February 2013 to May 2013,150 female patients with knee osteoarthritis underwent unilateral TKA were randomly divided into three groups,50 cases in each group.Patients received 10 mg/kg TXA by fast intravenous infusion before closing the wound in first group (single dose group),patients in second group received two doses of 10 mg/kg TXA before closing the wound and 3 hours postoperation (repeated dose group),patients in the third group didn't receive TXA (control group).The postoperative blood loss via drainage,the total blood loss,the hidden blood loss,the postoperative hemoglobin concentration at different times and the numher of patients need blood transfusion were recorded.All patients were observed for detecting deep vein thrombosis (DVT) by the color doppler ultrasonography within 5 days postoperation,and the symptomatic DVT and pulmonary embolism (PE) were observed within 90 days postoperation.Results The blood loss via drainage was significantly less in the single dose group (273.6±99.6 ml) and repeated dose group (168.5±80.8 ml) compared with the control group (447.2±101.9 ml),and it was significantly less in the repeated dose group than the single dose group; the total blood loss was significantly less in the single dose group (959.1±291.7 ml) and repeated dose group (818.7±206.9 ml) compared with the control group (1 100.8±288.3 ml),and it was significantly less in the repeated dose group than in the single dose group; there was no differ ences about the hidden blood loss among the three groups.The hemoglobin concentration was significantly higher in the single dose group and repeated dose group than in the control group in day 1,3 and 5 postoperation; and it was significantly higher in the repeated dose group compared with the single dose group.The ratio of transfusion was significantly less in the single and repeated dose groups than in the control group,but no differences exists between the single dose group and repeated dose group.There was no DVT in all of the three groups within 5 days postoperation,and there was no symptomatic DVT and PE in all of the three groups within 90 days.Conclusion 10 mg/kg of TXA infused intravenous before closing the wound is effective and safe in TKA,another dose 3 hours postoperation is much more effective and will not increase the danger of DVT and PE.

Objective To explore the therapeutic mechanism of compound Yuye Decoction against diabetic cardiomyopathy(DCM).Methods Drugbank,Gene Cards,OMIM and PharmGKb databases were used to obtain DCM-related targets,and the core targets were identified and functionally annotated by protein-protein interaction network analysis followed by GO and KEGG enrichment analysis.The"Traditional Chinese Medicine-Key Component-Key Target-Key Pathway"network was constructed using Cytoscape 3.9.1,and molecular docking was carried out for the key components and the core targets.In the animal experiment,Wistar rat models of DCM were treated with normal saline or Yuye Decoction by gavage at low(0.29 g/kg)and high(1.15 g/kg)doses for 8 weeks,and the changes in cardiac electrophysiology and histopathology were evaluated.The changes in serum levels of LDH,CK,and CK-MB were examined,and myocardial expressions of PI3K,P-PI3K,Akt,P-AKT,BAX,IL-6,and TNF-α were detected using Western blotting.Results We identified 61 active compounds in Yuye Decoction with 1057 targets,3682 DCM-related disease targets,and 551 common targets between them.Enrichment of the core targets suggested that apoptosis,inflammation and the PI3K/Akt pathways were the key signaling pathways for DCM treatment.Molecular docking studies showed that the active components in Yuye Decoction including gold amidohydroxyethyl ester and kaempferol had strong binding activities with AKT1 and PIK3R1.In DCM rat models,treatment with Yuye Decoction significantly alleviated myocardial pathologies,reduced serum levels of LDH,CK and CK-MB,lowered myocardial expressions of BAX,IL-6 and TNF-α,and increased the expressions of P-PI3K and P-AKT.Conclusion The therapeutic effect of compound Yuye Decoction against DCM is mediated by its multiple active components that act on multiple targets and pathways to inhibit cardiomyocyte apoptosis and inflammatory response by regulating the PI3K/Akt signaling pathway.

Objective To explore the therapeutic mechanism of compound Yuye Decoction against diabetic cardiomyopathy(DCM).Methods Drugbank,Gene Cards,OMIM and PharmGKb databases were used to obtain DCM-related targets,and the core targets were identified and functionally annotated by protein-protein interaction network analysis followed by GO and KEGG enrichment analysis.The"Traditional Chinese Medicine-Key Component-Key Target-Key Pathway"network was constructed using Cytoscape 3.9.1,and molecular docking was carried out for the key components and the core targets.In the animal experiment,Wistar rat models of DCM were treated with normal saline or Yuye Decoction by gavage at low(0.29 g/kg)and high(1.15 g/kg)doses for 8 weeks,and the changes in cardiac electrophysiology and histopathology were evaluated.The changes in serum levels of LDH,CK,and CK-MB were examined,and myocardial expressions of PI3K,P-PI3K,Akt,P-AKT,BAX,IL-6,and TNF-α were detected using Western blotting.Results We identified 61 active compounds in Yuye Decoction with 1057 targets,3682 DCM-related disease targets,and 551 common targets between them.Enrichment of the core targets suggested that apoptosis,inflammation and the PI3K/Akt pathways were the key signaling pathways for DCM treatment.Molecular docking studies showed that the active components in Yuye Decoction including gold amidohydroxyethyl ester and kaempferol had strong binding activities with AKT1 and PIK3R1.In DCM rat models,treatment with Yuye Decoction significantly alleviated myocardial pathologies,reduced serum levels of LDH,CK and CK-MB,lowered myocardial expressions of BAX,IL-6 and TNF-α,and increased the expressions of P-PI3K and P-AKT.Conclusion The therapeutic effect of compound Yuye Decoction against DCM is mediated by its multiple active components that act on multiple targets and pathways to inhibit cardiomyocyte apoptosis and inflammatory response by regulating the PI3K/Akt signaling pathway.

Femoral neck fracture (FNF) in the elderly patients is currently a major health challenge worldwide, with excessive consumption of medical resources, high incidence of complications as well as suboptimal outcome and prognosis. Hip joint arthroplasty (HJA) has been the mainstream treatment for FNF in the elderly, but the conventional surgical approaches and techniques are still confronted with a series of bottlenecks such as dislocation, limp and limb length discrepancy. In recent years, direct anterior approach (DAA) for HJA (DAA-HJA) has been a major new choice in the field of joint replacement, which achieves improved clinical effectiveness of HJA in the treatment of elderly FNF, due to the fact that DAA approach involves the neuromuscular interface and accords with the idea of soft tissue retention and enhanced recovery after surgery. However, there is still a lack of unified understanding of standard technique and procedure of DAA-HJA in the treatment of elderly FNF. Therefore, relevant experts from the Hip Joint Group of Chinese Orthopedics Association of Chinese Medical Association, Youth Arthrology Group of Orthopedic Committee of PLA, Orthopedic Committee of Chongqing Medical Association, Branch of Orthopedic Surgeons of Chongqing Medical Doctor Association and Sport Medicine Committee of Chongqing Medical Association were organized to formulate the " Chinese expert consensus on the technical standard of direct anterior hip arthroplasty for elderly femoral neck fracture ( version 2023)" based on evidence-based medicine. This consensus mainly proposed 13 recommendations covering indications, surgical plans, prosthesis selections, surgical techniques and processes, and postoperative management of DAA-HJA in elderly patients with FNF, aiming to promote standardized, systematic and patient-specific diagnosis and treatment to improve the functional prognosis of the patients.