ObjectiveTo evaluate the intermediate term efficacy of posterior stabilized (PS) total knee arthroplasty(TKA) and posterior cruciate-retaining(CR) TKA and explore the clinical related problem.MethodsThe clinical data of 84 patients (87 knees) who treated with primary TKA from May 1992 to May 2006 were analyzed retrospectively.The intermediate term efficacy was compared between PS TKA (PS group,41 cases with 43 knees) and CR TKA (CR group,43 cases with 44 knees).ResultsAll the patients were followed up for 5-10(7.6 ± 1.5 ) years,no infection,dislocation or neurovascular injury occurred in both groups.But 1 knee occurred intraoperative posterolateral femoral condyle fracture in PS group.The lateral retinacular release rate was 2.3％ ( 1/43 ) and 2.3％ (1/44) in PS group and CR group,respectively.The incidence of anterior knee pain was 4.7％(2/43 ) and 4.5％(2/44) after 6 months surgery in PS group and CR group.The incidence of anterior knee pain was 0 at the end of follow-up in both groups.There was no significant difference in the lateral retinacular release rate and the incidence of anterior knee pain between two groups (P ＞0.05).The range of motion and American knee society score(KSS) was similar and no statistical difference was found between two groups(P ＞ 0.05 ).The incidence of patellar tilt or subluxation in X-ray was 2.3％ (1/43) and 2.3％ (1/44) at the end of follow-up in PS group and CR group.There was no significant difference between two groups (P ＞ 0.05 ).At the end of follow-up,no osteolysis,X-ray radiolucent zone and prosthesis loosening were found in both groups.There was no revision owing to loosening or other reasons.ConclusionsThe intermediate term efficacy of PS TKA and CR TKA is near a tie.However,the future efficacy still need further follow-up.

BACKGROUND:Joint replacement surgery becomes difficult because of the abnormal changes in hip joint, especial y on the acetabular side. Therefore, the treatment on acetabulum is very important during total hip arthroplasty in patients with hip dysplasia. OBJECTIVE:To investigate the clinical therapeutic effects of total hip arthroplasty with onlay bone graft for treatment of CroweIII and IV adult hip dysplasia. METHODS:A total of in 14 patients with adult hip dysplasia were retrospectively analyzed. According to Crowe method, there were 11 cases of type III and 3 cases of type IV. Al patients underwent total hip arthroplasty. Autologous femur neck was used to make an onlay bone graft around the acetabulum during replacement. Radiographs were analyzed after replacement and during fol ow-up. Clinical efficacy was assessed using Harris standard. RESULTS AND CONCLUSION:Al patients were fol owed up for 1-9 years, averagely 4.5 years. Bone graft was partial y absorbed within 1 year after replacement in 4 patients, and began to grow 2 years later. Radiographs showed that al bone graft was fused to host bone. The average coverage rate of bone grafts on acetabulum was 36%. None hip was needed to be rebuilt up to now. Harris score of hip joint function increased from 35 points (26-52 points) before surgery to 91 points during final fol ow-up. Total hip arthroplasty with onlay bone graft is an effective method in treatment of CroweIII and IV adult hip dysplasia.

In this paper, a new conception pressure displacement wave of vascular wall (PDWVW) and a novel method for diagnosing the vascular disease early were proposed for the first time in accordance to the principle of Frank elasticity of vascular wall; moreover, an original diagnostic equipment noninvasive diagnostic system of human vascular wall, was developed. The feasibility and practicability of the method and equipment assessed in the clinical experiment are also presented.
Blood Flow Velocity ; Blood Vessels ; physiology ; physiopathology ; Elasticity ; physiology ; Humans ; Hypertension ; diagnosis ; physiopathology ; Monitoring, Physiologic ; instrumentation ; Pattern Recognition, Automated ; Pulsatile Flow ; Signal Processing, Computer-Assisted

Objective To explore the clinical value of resistance index(RI)of prostatic capsular artery in predicting or screening of prostate cancer(PCa)by comparing prostatic capsular artery RI with the serum total prostatic specific antigen(TPSA),fPSA/tPSA ratio and prostatic specific antigen dernsity(PSAD).Methods RI of prostate capsular artery,serum TPSA,of fPSA/tPSA ratio and PSAD were measured with colour Doppler ultrasonography in this subset of 203 patients who had undergone transrectal ultrasound guided prostate puncture biopsy.The patients were divided into two groups [PCa and benign prostatic hyperplasia(BPH)group] for comparative study.Results Of them,the level of TPSA were between 4 and 10 ng/ml(grey area)in 34 cases,accounts for 16.75%of the total subjects.All the others were outside the grey area.ROC curve analysis showed that the area under the curve(AUC)of RI of the capsular artery was 0.77,which was close to 0.84 and 0.86 of TPSA and PSAD.It indicated a similar value in predicting or screening PCa; while the AUC of fPSA/tPSA ratio was only 0.49,which had little clinical value.The fPSA/tPSA ratio and the mean value of PSAD in the grey area had significant differences(t=2.78,3.94,P＜0.02)between the two groups.However,the fPSA/tPSA ratio had no statistical significance in the high value area outside the grey area(t=0.873,P ＞ 0.05).And the mean value of RI of prostatic capsular artery had significant differences between the two groups both in the grey area and in the high value area outside the grey area(t=4.56,5.10,P ＜ 0.001).Conclusions RI of prostatic capsular artery can be steadily used to predict or screen PCa.It is not affected by the gray area of TPSA and is of great value in clinical practice.

Substances addiction is one of the important factors that deeply affect human health.At present, there is still lack of effective treatment drugs in the clinic.Exploring mechanisms of substances addiction, finding new therapeutic targets and developing effective therapeutic drugs are important issues to be solved.Hyperpolarization-activated cyclic nucleotide gated cation channels (HCN channels) participate in many advanced brain activities and are closely related to the occurrence and progression of various brain diseases.Among them, the researches on the role and mechanism of HCN channels in substances addiction are gradually gaining attention.Reviewing the researches regarding substances addiction, abnormal function and abnormal expression of HCN channels were observed in many brain regions under the condition of psychoactive substances addiction.However, it has not yet been able to fully understand the mechanism and the behavioral consequences of this change.Therefore, we review the neurobiological mechanisms of HCN channels in substances addiction induced by opioids, cocaine, cannabis, amphetamines, alcohol and tobacco, in order to provide new ideas for the mechanism researches and treatment of substance addiction.

In the 42 nd and 44 th workshops of CSPEN-nutritional risk-undernutrition-support-outcome-cost effectiveness ratio (NUSOC) multi-center database collaboration group, Jens Kondrup and Henrik Rasmussen described again the application of NRS 2002, the evidence-based basis of NRS 2002 development and the methodology for prospective validation of clinical effectiveness. There is no gold standard for validation. They both considered that malnutrition could be identified as a score of 3 or more for impaired nutritional status in NRS 2002. Although NRS 2002 is simple and easy to be applied, it is not comprehensive enough for malnutrition diagnosis. ASPEN and ESPEN on-line published the Global Leadership (nutritional) Initiative on Malnutrition(GLIM)diagnosis criteria in September 2018. With the gradual implementation of medicare payment based on diagnosis related groups(DRG)in China, the nutritional risk and the malnutrition diagnosis with Chinese version of ICD-10 (2016) code should be recorded in the first page of the medical records. In this terminology interpretations, the terms of nutritional risk screening(NRS 2002.01.016)and malnutrition diagnosis (GLIM-phenotypic criteria 01.028, etiologic criteria 01.029) published in Parenteral and Enteral Nutrition Terminology 2019 are discussed based on the reports given by Kondrup and Rasmussen in Beijing and Zhengzhou.

Following the rapid advancement of artificial intelligence technologies, especially the development of large language models like ChatGPT, the field of medical clinical practice is undergoing an unprecedented technological revolution. These advanced technologies, through efficient processing and analysis of large datasets, not only provide medical professionals with auxiliary diagnoses and treatment suggestions but also significantly enhance the quality and efficiency of medical education. This study conducts a comprehensive analysis and review of the applications of large language models in various aspects, including clinical inquiry, history collection, medical literature writing, clinical decision support, optimization of medical portal websites, patient health management, medical education, academic research, and scientific writing. However, the application of these technologies is not without flaws and presents several limitations and ethical challenges. This paper focuses on challenges related to technological errors, academic dishonesty, abuse risks, over-reliance, possibilities of misdiagnosis and treatment errors, and issues of accountability. In conclusion, large language models demonstrate tremendous potential in the integration and advancement of medical practices. Nevertheless, while fully harnessing the benefits brought by ChatGPT, it is essential to acknowledge and address these ethical challenges to ensure that the application of ChatGPT in the medical field is responsible and effective.

ABSTRACT: Meningiomas are the most common primary intracranial neoplasm with diverse pathological types and complicated clinical manifestations. The fifth edition of the WHO Classification of Tumors of the Central Nervous System (WHO CNS5), published in 2021, introduces major changes that advance the role of molecular diagnostics in meningiomas. To follow the revision of WHO CNS5, this expert consensus statement was formed jointly by the Group of Neuro-Oncology, Society of Neurosurgery, Chinese Medical Association together with neuropathologists and evidence-based experts. The consensus provides reference points to integrate key biomarkers into stratification and clinical decision making for meningioma patients. REGISTRATION Practice guideline REgistration for transPAREncy (PREPARE), IPGRP-2022CN234.
Humans ; Meningioma/pathology* ; Consensus ; Neurosurgical Procedures ; Meningeal Neoplasms/pathology*