Objective:To investigate the role of TiRobot combined with O-arm assisted closed reduction and percutaneous screw fixation in unstable pelvic fracture surgery.Methods:Twelve patients with unstable pelvic fractures, 7 males and 5 females, aged 39.41±12.56 years (range 25-60 years), admitted from January 2020 to January 2021, were retrospectively analyzed. The duration between injury and surgery was 9.67±5.81 d (range 4-24 d). The following are the causes of injury, namely traffic injury in 6 cases, fall from height injury in 4 cases, crush injury in 2 cases. Tile type of pelvic fractures were 3 cases of type B (2 cases of type B2, 1 case of type B3), 9 cases of type C (4 cases of type C1, 3 cases of type C2, 2 cases of type C3). Sacral fractures with Denis division were 5 cases of zone I, 7 cases of zone II. Seven patients were repositioned by intraoperative traction on the injured side of the limb and maintained by fixation with a Starr frame. Two cases were repositioned by intraoperative longitudinal bone traction on each lower limb for fracture displacement. The other 3 B-type fractures were repositioned by inserting Schanz nails into the anterior inferior iliac spine bilaterally. Then, the fractures were maintained with external pelvic fixators. The fractures were assessed by O-arm fluoroscopy. Hollow screws were placed with the aid of orthopedic robotic guidance, and the screw positions were verified by O-arm fluoroscopy again after the nail placement. The duration of each screw placement and operation were recorded. The quality of fracture repositioning, hip function and postoperative complications were observed at the follow-up.Results:All patients were followed up for 8.17±1.99 months (range, 6-12 months). There were 27 screws inserted in 12 patients, with a single screw insertion duration of 19.9±1.8 min (range, 9-31 min). In all patients, one O-arm fluoroscopy was performed in each row after closed reduction and after completion of nail placement. The operative duration was 257.78±80.63 min (range, 160-450 min). The O-arm fluoroscopy after nail placement verified that 23 screws were placed in a satisfactory position at one time, with satisfactory rate of 85% (23/27) for the first nail placement. Two patients with preoperative grade II sacral plexus nerve injury recovered to grade I in one case and grade II in one case. However, the numbness was reduced after operation. No further aggravation of nerve injury occurred after surgery. The quality of fracture repositioning was evaluated according to the Matta score, including excellent in 9 cases, good in 2 cases, and acceptable in 1 case, with an excellent rate of 92% (11/12). At the last follow-up, the Majeed pelvic fracture quantitative assessment system scored 85.75±5.82 (range, 74-96). There were 8 cases in excellent and 4 cases in good. Twelve patients had one-stage wound healing. No complications, such as incision infection, nerve injury, loosening and breaking of the internal fixation occurred during the follow-up.Conclusion:TiRobot combined with O-arm assisted closed reduction and percutaneous screw fixation for unstable pelvic fractures has some advantages, including safety, precision, convenient nail placement, and less fluoroscopic radiation.

Objective: To trace and characterize the whole genome of SARS-CoV-2 of confirmed cases in the outbreak of COVID-19 on July 31, 2021 in Henan Province. Method: Genome-wide sequencing and comparative analysis were performed on positive nucleic acid samples of SARS-CoV-2 from 167 local cases related to the epidemic on July 31, 2021, to analyze the consistency and evolution of the whole genome sequence of virus. Results: Through high-throughput sequencing, a total of 106 cases of SARS-CoV-2 whole genome sequences were obtained. The results of genome analysis showed that the whole genome sequences of 106 cases belonged to the VOC/Delta variant strain (B.1.617.2 clade), and the whole genome sequences of 106 cases were shared with the genomes of 3 imported cases from Myanmar admitted to a hospital in Zhengzhou. On the basis of 45 nucleotide sites, 1-5 nucleotide variation sites were added, and the genome sequence was highly homologous. Conclusion: Combined with the comprehensive analysis of viral genomics, transmission path simulation experiments and epidemiology, it is determined that the local new epidemic in Henan Province is caused by imported cases in the nosocomial area, and the spillover has caused localized infection in the community. At the same time, it spills over to some provincial cities and results in localized clustered epidemics.
Humans ; COVID-19 ; SARS-CoV-2/genetics* ; Genome, Viral ; Epidemics ; Phylogeny

OBJECTIVE: To evaluate the effect of comprehensive therapy based on Chinese medicine (CM) patterns on self-efficacy and satisfaction with its effectiveness in patients with chronic obstructive pulmonary disease (COPD). METHODS: A total of 216 patients were randomly divided into the trial group (n =108) and the control group (n=108) based on the stratified and block randomization design. Patients in the trial group were treated with conventional Western medicine combined with Bufei Jianpi Granules (), Bufei Yishen Granules (), and Yiqi Zishen Granules () according to the CM patterns respectively, and patients in the control group were treated with conventional Western medicine. The COPD Self-Efficacy Scale (CSES) and the Effectiveness Satisfaction Questionnaire for COPD (ESQ-COPD) were employed in a 6-month treatment and in further 6 month follow-up visit. RESULTS: Among the 216 patients, 191 patients (97 in the trial group and 94 in the control group) fully completed the study. After 12-month treatment and follow-up, the mean scores of the trial group all continued to increase over time, which were significantly higher than those of the control group (P <0.05), and the improvement in the following trial group domain: negative affect domain (12.13%), intense emotional arousal domain (12.21%), physical exertion domain (11.72%), weather/environmental domain (13.77%), behavioral risk domain (7.67%) and total score (10.65%). The trial group also exhibited significantly higher mean scores in the ESQ-COPD (P <0.05) and the improvement in the following domain: capacity for life and work domain (30.59%), clinical symptoms domain (53.52%), effect of therapy domain (35.95%), convenience of therapy domain (35.54%), and whole effect domain (52.47%). CONCLUSIONS Bufei Jianpi Granules, Bufei Yishen Granules and Yiqi Zishen Granules can improve the self-efficacy and satisfaction of COPD patients.

PURPOSE: ORM1-like 3 (ORMDL3) belongs to a highly conserved protein family which is anchored as transmembrane protein in the endoplasmic reticulum. Gasdermin B (GSDMB) is adjacent to ORMDL3 on chromosome 17q21.2 and belongs to the gasdermin-domain containing the protein family (GSDM family). Recent reports suggest that GSDMB and ORMDL3 are associated with asthma in several populations. However, genetic association studies that examined the association of GSDMB and ORMDL3 gene variants with asthma showed conflicting results. To assess whether combined evidence shows the association between GSDMB/ORMDL3 polymorphism and asthma. METHODS: A bibliographic search from MEDLINE identified 13 original articles using the search keywords 'GSDMB', 'ORMDL3', and 'asthma'. An updated literature-based meta-analysis involving 6,691 subjects with asthma, 9,281 control individuals, and 1,360 families were conducted. Meta-odds ratios (ORs) and 95% confidence intervals (CIs) based on the fixed effects model or the random effects model depended on Cochran's Q-statistic and I2 values. Data from case-control and TDT studies were analyzed in an allelic model using the Catmap software. RESULTS: We selected and identified 3 SNPs of ORMDL3 associated with asthma (rs8076131: OR=1.10; 95% CI, 1.02-1.20; P=0.012. rs12603332: OR=1.15; 95% CI, 1.05-1.25; P=0.002. rs3744246: OR=1.10; 95% CI, 1.02-1.17; P=0.008) and 1 SNP of GSDMB associated with asthma (rs7216389: OR=1.37; 95% CI, 1.27-1.47; P<0.01). Publication bias was estimated using modified Egger's linear regression test proposed by Harbordetal and revealed no evidence of biases. Furthermore, cumulative meta-analysis in chronological order showed the inclination toward significant association for rs7216389 and rs12603332 with continually adding studies, and the inclination toward null-significant association for rs3744246 and rs8076131. CONCLUSIONS: Moderate evidence exists for associations of the ORMDL3 rs8076131, rs12603332, and rs3744246 and GSDMB rs7216389 variants with asthma. Large sample size and representative population-based studies and TDT studies with homogeneous asthmatic patients and well-matched controls are warranted to confirm this finding.
Asthma* ; Bias (Epidemiology) ; Case-Control Studies ; Endoplasmic Reticulum ; Genetic Association Studies ; Humans ; Linear Models ; Polymorphism, Single Nucleotide ; Publication Bias ; Sample Size

OBJECTIVETo investigate the clinicopathologic characteristics of epithelioid hemangioendothelioma (EHE).

METHODSThirteen cases of EHE were analyzed by gross examination, light microscopy and immunohistochemical staining.

RESULTSThe patients included 6 males and 7 females. The age of patients ranged from 11 to 74 years (mean = 43 years). The tumors were located in soft tissue, liver, lung, mediastinum, sacrum, and pleura. The tumor cells were epithelioid, spindled or polygonal-shaped and exhibited cord-like or small nest growth pattern. Some tumor cells formed cytoplasmic vacuoles, which contained erythrocytes. The tumor cells showed abundant eosinophilic cytoplasm. The stroma varied from highly myxoid to hyaline. In 3 cases, the tumors contained areas with significant atypia, brisk mitotic activity and necrosis. Immunohistochemical study showed that the tumor cells were positive for CD31, ERG, FLI-1, CD34, factor VIII and CKpan to different extents. Follow-up information was available in 10 patients with duration ranging from 8 to 65 months. Seven patients were alive and three died.

CONCLUSIONSEHE is easily a rare maligant vascular tumor,occurs in many organs other than soft tissue.EHE is misdiagnosed as carcinoma for its significant epithelioid morphology. Recognizing its clinicopathologic characteristics and combined application of specific vascular endothelial immunohistochemical markers are important to avoid confusion with other lesions.

Objective To investigate the clinicopathologic characteristics of epithelioid hemangioendothelioma ( EHE) .Methods Thirteen cases of EHE were analyzed by gross examination, light microscopy and immunohistochemical staining.Results The patients included 6 males and 7 females.The age of patients ranged from 11 to 74 years ( mean=43 years) .The tumors were located in soft tissue, liver, lung, mediastinum, sacrum, and pleura.The tumor cells were epithelioid,spindled or polygonal-shaped and exhibited cord-like or small nest growth pattern.Some tumor cells formed cytoplasmic vacuoles, which contained erythrocytes.The tumor cells showed abundant eosinophilic cytoplasm.The stroma varied from highly myxoid to hyaline.In 3 cases, the tumors contained areas with significant atypia, brisk mitotic activity and necrosis.Immunohistochemical study showed that the tumor cells were positive for CD31, ERG, FLI-1, CD34, factor Ⅷ and CKpan to different extents.Follow-up information was available in 10 patients with duration ranging from 8 to 65 months.Seven patients were alive and three died.Conclusions EHE is easily a rare maligant vascular tumor,occurs in many organs other than soft tissue.EHE is misdiagnosed as carcinoma for its significant epithelioid morphology.Recognizing its clinicopathologic characteristics and combined application of specific vascular endothelial immunohistochemical markers are important to avoid confusion with other lesions.

OBJECTIVETo evaluate the clinical effects of the modified lamina replantation for the treatment of unstable lumbar intervertebral disc herniation.

METHODSFrom March 2009 to August 2011,63 patients with unstable lumbar intervertebral disc herniation were treated by discectomy, interbody fusion, pedicle screw fixation, and modified lamina replantation. There were 33 males and 30 females with an average age of 48.4 years old ranging from 22 to 68 years old. The average duration of disease was 38.8 months ranging from 3 months to 13 years. All patients had lower back and leg pains. X-ray,CT and MR results showed unstable lumbar intervertebral disc herniation. Preoperative and postoperative ODI, JOA scores, complication incident rates,radiographic healing rates,and lower back and leg pain recurrence rates were observed and recorded.

RESULTSSixty-two incisions were healed at first stage, 1 at second stage. There were no complications such as deep vein thrombosis, intervertebral infection and so on. Sixty-one patients were followed up for more than one year, and the mean duration was 33 months. Nerve and dural injury occurred in 2 patients and 1 patient respectively. One-year fusion happened in 58 patients while the recurrence of lower back pain and leg pain after 1 year were noted in 4 patients and 1 patient respectively. ODI, and JOA scores were respectively re-assessed at 2 weeks, 6 months and 1 year after the operation, and the results showed a significant difference from the preoperative scores (P < 0.05).

CONCLUSIONModified lamina replantation for unstable lumbar intervertebral disc herniation showed lower rates of dural and nerve damage, as well as a higher lamina healing rate, lower back and leg pain recovery rate, and a better clinical score. It is a safe and efficient operation choice for lumbar spine surgery.

Adult ; Aged ; Bone Screws ; Diskectomy ; Female ; Humans ; Intervertebral Disc ; Intervertebral Disc Displacement ; surgery ; Lumbar Vertebrae ; surgery ; Male ; Middle Aged ; Osteotomy ; methods ; Replantation ; methods ; Young Adult

This study was aimed to clone the gene coding mouse CXC chemokine receptor 4 (CXCR4), to construct the recombinant lentiviral vector carrying enhanced green fluorescence protein (EGFP) and to explore its expression in eukaryotic cells (293FT cells). The full length CXCR4 gene was cloned by RT-PCR using bone marrow cells from C57BL/6 mouse as template and inserted into PCR-Blunt vector. CXCR4 fragment was generated by digestion with restriction endonuclease and subcloned into a lentiviral vector to generate recombinant lentiviral vector LV-IRES-EGFP-CXCR4, which was co-transfected into 293FT cells together with envelope plasmid and packaging plasmid by lipofectamine 2000. Viruses were gathered and concentrated using ultracentrifuge, and then transfected into 293FT cells. Expression of EGFP was detected by fluorescent microscopy and flow cytometry (FCM). And the expression of CXCR4 protein was detected by Western blot. The results demonstrated that mouse CXCR4 gene was cloned and the lentiviral vector was successfully constructed. The lentiviral particles were correctly packaged, and the virus titers were above 10(8) TU/ml in the supernatant after concentration. Expression of EGFP was detected by fluorescent microscopy in the transfected 293FT cells, and the transfection efficacy > 95% was determined by FCM. Expression of CXCR4 protein detected by FCM and Western blot was significantly higher than that in control group. It is concluded that the CXCR4 gene along with the gene coding EGFP is successfully inserted into a lentiviral vector to construct a recombinant lentiviral vector, which can be expressed in eukaryotic cells.
Animals ; Cell Line ; Gene Expression ; Genetic Vectors ; Green Fluorescent Proteins ; genetics ; Humans ; Lentivirus ; genetics ; Mice ; Mice, Inbred C57BL ; Plasmids ; Receptors, CXCR4 ; genetics ; Transfection

Objective To investigate the effect of nutritional risk to nutritional status of peroperative elderly rectal cancer patients.Methods 85 elderly patients with rectal cancer were screened for preoperative nutritional status by NRS-2002 and divided into nutritional risk group and non-nutritional risk group.ALB,PALB,TLC and TFN of two groups were measured 1day before operation,1day and 7 days after operation.The values were compared between two groups.Results Before operation,25 patients out of 85 were at nutritional risk with NRS-2002≥3 and incidence of nutritional risk of 29.4％.The PALB value of the nutritional risk group was significantly lower than that of the non-nutritional risk group 1day after operation [(12.4±37)mg/L vs ( 14.3 ± 3.9 ) mg/L ;t =2.026,P＜0.05].After 7 days,the average levels of all indexes of the nutritional risk group were lower than those of the non-nutritional risk group.Among those,differences of ALB and TFN values between two groups were significant ( t =2.412,2.153,respectively; P ＜ 0.05 ).Conclusions Perioperative nutritional status of elderly rectal cancer patients at nutritional risk changes conspicuously and should be given relevant nutritional guidance by nurses.

OBJECTIVETo evaluate methods and clinical performance of crown lengthening surgery for aesthetic restoration improvement of short anterior teeth. Various surgery methods, proper restoration time after surgery, and indications for crown lengthening surgery were discussed.

METHODSCrown lengthening surgery and prosthetic treatment were applied to 148 short anterior teeth of 22 cases. Modified Ryge criteria were used to assess the gingival health after treatment. Restoration results before and after treatment were evaluated by use of Kay's altered dental esthetics classification.

RESULTSWhen patients were re-examined after restoration of two weeks, obvious inflammation was found in 7.4% teeth. After providing the treatment and instruction on oral hygiene, 98.6% gingival health was significantly improved during the follow-up period. Two cases were examined during more than 4-year period and no obvious gingival inflammation and change in dental crown ratio were found. After treatment, all of 22 cases met Kay dental esthetics classification Class II-I (cosmetic) or Class II-I criteria.

CONCLUSIONSRight selection of indications, accurate restoration design, delicate surgery operation, enough recover period for the gingival after surgery, and proper oral hygiene training method, all contribute to the satisfactory aesthetic restoration of anterior teeth.

Adolescent ; Adult ; Crown Lengthening ; Esthetics, Dental ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Young Adult