BACKGROUND: Although there are many studies on acute patellar dislocation in adolescents, the optimal treatment strategy is under discussion.OBJECTIVE: To summarize the clinical efficacy of reconstruction of the medial patellofemoral ligament (MPFL) in the treatment of adolescent acute patellar dislocation using double-pulley technique.METHODS: Thirty cases of acute patellar dislocation were enrolled and received reconstruction of the MPFL using double-pulley technique. We proceeded to prepare the bone bed for anchor placement at the medial point of the superior edge of the patella and at the upper 1/3 patella along the long axis of the patella using arthroscopic grinding. Two double-loaded 5.0 anchors were respectively placed at the medial point of patella and at the upper 1/3 patella parallel to the patellar articular surface, and then tied using the double-pulley technique. Long longitudinal incisions were performed at the medial condyle and at the adductor tubercle to expose these two structures, the deep fascias tunnel between two incisions were penetrated to pull the tendon weave end through the tunnel until the lateral side along a femoral tunnel; finally the tendon was fixed using screws in appropriate tightness. All patients were followed for more than 10 months, and the patellar-related parameters and knee function parameters were compared before and after operation. RESULTS AND CONCLUSION: There were 12 cases of intra-articular cartilage injury and 4 cases of meniscus injury. The patella title angle, Q-angle and outward shift distance at the last follow-up were less than those before operation. Lysholm and International Knee Documentation Committee scores at the last follow-up were higher than those before operation. The mean operation time was (90±10.5) minutes. There was one patient with knee movement angle from 0° to 30° and one patient with a patellar fracture caused by slipping and treated with internal fixation. None of patients appeared with patellar dislocation, positive apprehension test infection or poor wound healing. These results indicate that the simple and mini-invasive double-pulley technique is a good treatment strategy for acute patellar dislocation, because it is consistent with patellar anatomical stability, holds patellar trajectory visibility, quick recovery and good curative effect. Additionally, osteotomy is recommended when the simple efficacy is not satisfactory.

Objective To investigate the effect of chronic stress on the expression of uncoupling protein 4 (UCP4) and Bcl-2 protein in hippocampal neurons of rat depression model.Methods Rat depression models were established by chronic unpredicted mild stress.All rats were randomly assigned to 2 groups:control group and model group.Flow cytometry was applied to detect the apoptosis rate and mitochondrial membrane potential.The level of LDH was measured by enzymes labelling instrument.The number of neurons was measured by immunohistochemistry.The expression of UCP4 and Bcl-2 protein was measured by Western blotting.Results After chronic stress,the apoptosis rate((4.35±0.19) ％)and LDH activity ((445.50±91.70) U/mg) in hippocampal tissue in the model group was significantly higher than the control group((0.34±0.06) ％,(167.20±63.40)U/mg).Compared to control group,the number of hippocampal neurons ((72.50±4.25) vs (45.30±2.54)) and the mitochon drial membrane potential decreased in the model group.The expressions of UCP4 and Bcl-2 protein in hippocampal tissue were significantly lower than the control group.Conclusion Chronic unpredicted mild stress can lead to apoptosis in rat hippocampal neurons,which is related with decline of mitochondrial membrane potential and low expression of UCP4 and Bcl-2 protein.

Objective To study the serum levels of brain natriuretic peptide (BNP) and the correlation with the heart function in children with Kawasaki disease(KD), and to explore its clinical value for diagnosis of KD. Method A total of 43 children aged from 5 months to 8 years with mean age of (2.3 + 0.6) years with KD admitted from February 2007 to April 2009 were enrolled into this study as KD group, and patients with myocarditis, myocardiopathy, congenital heart disease and other primary heart disease were ruled out. Another 30 healthy children were taken as control health group. There were no significant differences in age and gender between two groups (P >0.05) .The serum levels of BNP were measured both in acute and recovery stages of KD by using ELISA. The serum levels of BNP in healthy children were measured randomly once. The left ventricular ejection fraction (LVEF), left ventricular shorten fraction ( LVSF), cardiac index (CI) and left ventricular inflow velocity through the mitral annulus (including E-velocity and A-velocity) were measured by using two-dimensional echocardiography in acute and recovery stages of KD. Data were analyzed with t -test and the linear regression analysis test. Results The serum level of BNP in acute stage was (517.26 + 213.40) ng/mL and was significantly higher than that in recovery stage (91.56 + 47.97) ng/mL, and higher than that in control group (91.56 + 47.97) ng/mL (P < 0.01). The levels of LVEF, LVSF and CI in the acute stage were significantly lower than those in the recoverystage ( P < 0.0%), but there was no significant difference in E/A between acute stage and recovery stage (P > 0.05). The BNP level had negative correlation with the levels of LVEF, LVSF and CI(r = -0.63, -0.52, and - 0.53, respectively, P < 0.05), but had no significant correlation with E/A (r = - 0.18, P > 0.05). Conclusions The serum levels of BNP increase significantly in the KD patients, and have negative correlation with the levels of LVEF, LVSF and CI. The detection of serum levels of BNP has an important significance for diagnosis of KD.

Essential tremor (ET) is a common dyskinesia disease characterized by tremor. ET is clinically heterogeneous. In addition to the motor symptoms with tremor as the main manifestation, it also includes non-motor symptoms such as neuropsychiatric symptoms (anxiety, depression), personality changes, sleep disorders, etc. Among them, anxiety and depression are the most common, and gradually worsen as the disease progresses, causing adverse effects on the quality of life of patients. Therefore, the early clinical full text of looking for ET psychiatric symptoms seems to have no content of the evaluation scale and is irrelevant. It is suggested that removing biomarkers plays an important role in the diagnosis and treatment of ET patients. Genome-Wide Association Studies (GWAS) describes the SLC1A2 gene associated with ET, and the EAAT2 or GLT1 encoded by this gene is associated with the anxiety and depression phenotypes of ET patients in non-motor symptoms. Up to now, the pathogenesis of ET patients is not clear, but many reports confirm that genetic factors play an important role in the pathogenesis of ET. Among them, SLC1A2 is expected to become a biomarker of the neuropsychiatric phenotype of the disease, providing a basis for clinical workers to take corresponding intervention measures in time. This article reviews SLC1A2 gene and essential tremor.

Objective: To analyze the occurrence features of adverse events following immunization (AEFI) of Seasonal Influenza Vaccines (InfV) used in China, 2015-2018 influenza season. Methods: InfV (including concurrent administered with other vaccines) AEFI data were collected through the Chinese national AEFI information system during 2015.9.1-2018.8.31 (excluding Chinese Hong Kong, Macao and Taiwan data). The vaccine lot release data were collected from National Institutes for Food and Drug Control published database. Time periods of three influenza season were 2015.9.1-2016.8.31, 2016.9.1-2017.8.31, 2017.9.1-2018.8.31. The vaccines used and included in this analysis were trivalent inactivated influenza vaccine (IIV3)-Split, IIV3-Split (Children) and IIV-subnit. The incidence of AEFI were calculated (per 100 000 release doses), and epidemiological characteristic were analyzed using descriptive methodology. Results: A total of 8 464 InfV AEFIs were collected in 2015-2018 influenza season from National AEFI Information System, in which 5 646 were IIV3-split, with the rate of 10.64/100 000 release doses, 2 818 were IIV3-split (Children), with the rate of 9.355/100 000 release doses. The most common symptom was fever (axillary temperature ≥37.1 ℃) within vaccine reactions, with a number of 6 207 cases. In which, there were 3 554 cases with fever (axillary temperature ≥38.6 ℃) and the estimated reporting rate was 4.274/100 000 release doses. In all rare vaccine reactions, the most common diagnosis was anaphylactic rash(442, 0.531/100 000 release doses) and angioedema (70, 0.084/100 000 release doses). Even the rates of serious rare vaccine reactions were low, febrile Convulsion (27, 0.032/100 000 release doses) and Henoch-Schönlein Purpura(HSP) (21, 0.025/100 000 release doses) were relatively common in serious rare vaccine reactions during the study period. Conclusion The estimated rate of rare vaccine reactions related toInfV was relatively low. In all vaccine reactions, fever was the most common symptoms. The most common diagnosis of non-serious rare vaccine reaction were anaphylactic rash and angioedema. The incidence of serious rare vaccine reactions was low.

Parkinson′s disease (PD) is the second most common neurodegenerative disease in middle-aged and elderly people. In addition to motor symptoms, PD also has many non motor symptoms, such as dysosmia, constipation, cognitive impairment, etc. Among them, dysosmia is a common non motor symptom of early Parkinson′s disease. Research has confirmed that olfactory dysfunction (OD) can appear before the typical clinical symptoms of PD, which is of great significance to the diagnosis and treatment of diseases. However, at present, the pathogenesis of OD is still unclear, and the inspection methods have not been unified, and there is no complete cure. This article reviews the latest research progress of dysosmia in Parkinson′s disease.

BACKGROUND:Unicompartmental knee arthroplasty has been paid more and more attention because of its advantages of fewer traumas,less blood loss,less complications,faster recovery,excellent knee function and high prosthetic survival rate.Most of the relevant reports focused on its clinical effect,but the changes in the levels of relevant inflammatory cytokines in patients after unicompartmental knee arthroplasty were rarely reported. OBJECTIVE:To investigate the effect of unicompartmental knee arthroplasty in patients with medial compartment osteoarthritis of the knee and the changes of interleukin-1,interleukin-6,and tumor necrosis factor-α levels. METHODS:A total of 30 patients with medial compartment osteoarthritis of the knee who received unicompartmental knee arthroplasty from September 2021 to March 2023 and met the inclusion criteria were selected as the study subjects.Medial angle of proximal tibia,femoral and tibial angle,pain visual analog scale score,hospital for special surgery score,knee joint range of motion,synovial fluid interleukin-1,interleukin-6,and tumor necrosis factor-α levels before and after surgery were compared and statistically analyzed. RESULTS AND CONCLUSION:(1)All 30 patients had grade I wound healing.All patients were followed up for more than 6 months after surgery.There were no complications such as prosthesis loosening and dislocation of prosthesis liner in all patients.(2)The medial proximal tibia angle and the femoral and tibial angles measured after operation were significantly improved(P<0.05).(3)The visual analog scale score,hospital for special surgery score and range of motion measured at 1,3,and 6 months after operation were better than those before operation(P<0.05),and showed a gradual improvement(P<0.05).(4)The levels of interleukin-1,interleukin-6,and tumor necrosis factor-α in synovial fluid at 3 and 6 months after operation were decreased gradually compared with those before operation(P<0.05)and showed a gradual downward trend at each time point after operation.(5)It is indicated that unicompartmental knee arthroplasty can effectively treat medial compartment osteoarthritis of the knee,significantly relieve pain,restore knee joint function,improve knee varus deformity and lower limb strength line,and reduce the levels of inflammatory cytokines interleukin-1,interleukin-6,and tumor necrosis factor-α in joints to a certain extent.

Objective: To investigate the molecular mechanisms of lncRNA XIST/miR-34a-5p/SIRT6 axis regulating the proliferation and metastasis of oral squamous cell carcinoma (OSCC) cells. Methods: Specimens of tumor tissues and paracancer tissues of 47 patients with OSCC, who visited the Qingdao Stomatological Hospital from March 2013 to March 2018, were enrolled in this study. qPCR was performed to measure the mRNA expressions of lncRNA XIST, miR-34a-5p and SIRT6 in OSCC tissues and cell lines. WB was performed to measure the protein levels of SIRT6, Ki67, pcDNA, cleaved-caspase3, cleaved-caspase8, E-cadherin and vimentin in OSCC tissues and cell lines. CCK-8 assay was performed to observe the effect of lncRNA XIST knockdown on proliferation of Cal-27 and Tca-8113 cells; Tanswell assay was performed to detect migration and invasion of Cal-27 and Tca-8113 cells; flow cytometry was performed to detect the apoptosis of Cal-27 and Tca-8113 cells; and dual luciferase reporter assay was performed to verify the relationship between lncRNAXIST and miR-34a, or miR-34a and SIRT6. Results: Expressions of lncRNAXIST and SIRT6 were up-regulated in OSCC tissues and cell lines (all P<0.05), reversely, miR-34a-5p was down-regulated in OSCC tissues and cell lines (P<0.01). lncRNA XIST knockdown significantly suppressed OSCC cells proliferation, migration and invasion, and induced apoptosis of OSCC cells (all P<0.01); however, simultaneous transfection with miR-34a-5p inhibitor or pcDNA-SIRT6 vector exerted opposite effect. lncRNA XIST knockdown significantly increased cell proliferation and metastasis related protein expression in OSCC cells (all P< 0.01), and simultaneous transfection with miR-34a-5p inhibitor or pcDNA-SIRT6 vector exerted opposite effect. In addition, lncRNA XIST directly targeted miR-34a-5p, and miR-34a-5p targeted SIRT6, lncRNA XIST upregulated SIRT6 expression via inhibiting miR34a-5p (P<0.01). Conclusion: Taken together, lncRNA XIST/miR-34a-5p/SIRT6 axis regulates the proliferation and metastasis of OSCC cells and provides potential therapeutic targets for OSCC.

This paper analyzes the causes and risks of common design and development changes of laser treatment equipment, studies the changes of key components and their corresponding control measures, forms the identification method of design changes of laser treatment equipment, and gives suggestions on how to deal with design and development changes, so as to provide references for inspectors during on-site inspection.
Humans ; Laser Therapy ; instrumentation ; Risk Factors

OBJECTIVE：To optim ize the water extraction-ethanol precipitation technology of polysaccharide from Litchi chinensis seed，and to evaluate its hypoglycemic activity in vitro . METHODS ：The content of polysaccharides was determined by phenol-sulfuric acid colorimetry ，and the extraction rate of polysaccharides was calculated. Single factor test and response surface methodology were used to optimize the water extraction technology with the ratio of material to liquid ，extraction times and extraction time as factors ，and the extraction rate of polysaccharide as index. Single factor test was used to screen the concentration volume fraction of water extract and ethanol precipitation Using acarbose as contro l，4-nitrophenol-α-D-glucopyranoside method was used to investigate in vitro inhibitory activity of polysaccharide from L. chinensis seed to α-glucosidase. RESULTS ：The optimal technology was the ratio of material to liquid 1∶19 （g/mL），decocting for 3 times，1 h for each time ，concentrating the water extract to 40％ of original volume ，and adding ethanol to 80％ volume fraction. After deproteinization by Sevage method ，the crude polysaccharide of L. chinensis seed was obtained. The results of 3 times of validation tests showed that ，extraction rates of polysaccharide were 7.61％，7.89％，7.99％，average extraction rate was 7.83％（RSD＝2.52％，n＝3）. The contents of polysaccharide were 55.57％，55.83％ and 56.66％，average content was 56.02％（RSD＝1.81％，n＝3）. The inhibitory activity of the polysaccharide from L. chinensis seed to α-glucosidase were increased as concentration ；its IC 50 was 0.056 mg/mL，which was lower than positive control acarbose （0.196 mg/mL）. CONCLUSIONS：The optimal water extraction-ethanol precipitation technology of polysaccharide from L. chinensis seed is stable and feasible. The polysaccharide from L. chinensis seed show significant in vitro inhibitory effect on α-glucosidase，which is better than that of acarbose.