Objective: To systematically evaluate effectiveness of exercises on inflammatory response among obese adolescents. Methods: By searching CNKI, PubMed, Web of Science, EBSCOhost and other databases, randomized controlled trials (RCTs) on the influence of different exercises on inflammatory indicators in obese adolescents were collected according to the inclusion and exclusion criteria. Cochrane evaluation tools were conducted methodological studies on the included literature quality evaluation, and RevMan 5.3 analysis software was used for statistical analysis. Results: A total of 21 RCTs were included, involving 1 020 subjects. The results of Meta analysis showed that aerobic training (AT) and aerobic plus resistance training (AT+RT) could significantly reduce BMI, serum C reactive protein (CRP) and leptin levels in obese adolescents. In addition, the effects of AT+RT on pro inflammatory CRP ( MD=-0.52, 95%CI=-0.75--0.30, P <0.01), leptin ( MD=-7.20, 95%CI=-10.45--3.94, P <0.01) and anti inflammatory adiponectin ( MD=1.28, 95%CI=1.01-1.55, P <0.01) were stronger than AT. High intensity interval training (HIIT) was associated with BMI reduction ( MD=-1.14, 95%CI=-1.92--0.36, P <0.01) and increased adiponectin in obese adolescents ( MD=1.79, 95%CI=1.09-2.50, P <0.01), and HIIT was superior in improving adiponectin level in obese adolescents than AT and AT+RT. Conclusion Long term and regular AT, AT+RT and HIIT can reduce inflammation in obese adolescents. HIIT is a notable exercise method for obese adolescents to resist inflammation.

At present , methamphetamine has become a major hidden danger in global public health safety. In order to judge methamphetamine addicts and methamphetamine abstainers more scientifically and reliably, this study analyzed the endogenous metabolites in plasma, serum and urine of methamphetamine addicts, methamphetamine abstainers and healthy volunteers by highly sensitive high-throughput liquid chromatography quadrupole time-of-flight mass spectrometry (LC-QTOF-MS) analytical instrument. The obtained metabolomic data were processed by univariate analysis (t-test) and multivariate analysis (PLS-DA and OPLS-DA) and eligible potential biomarkers were then screened.The identified biomarkers set enrichment analysis to find the connection between metabolites and metabolic pathways.Multivariate statistical results showed that methamphetamine acute group, recovery group and healthy group were clearly separated.3, 18 and 6 regulated metabolites were identified in serum, plasma and urine, respectively, suggesting that lipid metabolism was abnormal in methamphetamine acute group, and that fatty acid metabolism, sulfate/sulfite metabolism and sex hormone metabolism were abnormal in methamphetamine recovery group.The selected potential biomarkers in this study provide the possibility for scientific judgment of the clinical stage of methamphetamine detoxification.

Objective To discuss the diagnosis and treatment of non-specific ureteritis. Methods Considered by the Court left pelvis area occupying one case, and there are special non-specific symptoms in patients with treatment ureteritis recalled while literature and discuss the effective non-specific ureteritis diagnosis and treatment. Results Surgery did not undergo resection of the left kidney ureter, only stripping, removal of parcels renal pelvis, ureter choco-late-like substance. Conclusion Patients with a lower back pain, clinical history of macroscopic haematuria, imag-ingstudies revealed hydronephrosis, renal pelvis and ureter wall thickening, irregular, or beaded change, ureteral peri-stalsis is poor, should be carefully and spontaneous perirenal hemorrhage, ureteral cancer identification, If by related tests, imaging examination and cytological examination failed to diagnose patients, feasible with bilateral renal pelvis ureter surgical exploration, avoid blindly kidney ureteral resection.

Objective:To observe the curative effects of triplane intra-articular osteotomy in the treatment of malunion of calcaneal intra-articular fracture.Methods:The 16 patients were retrospectively analyzed who had been admitted to Foot and Ankle Surgery Department, Honghui Hospital from January 2016 to December 2019 for malunion of calcaneal intra-articular fracture. They were 12 males and 4 females, with an average age of 43.4 years (from 31 to 58 years). The left side was affected in 10 cases and the right side in 6 cases. All malunions were type Yu Ⅱ (compressed bone fragments on the posterior articular surface) and treated with triplane intra-articular osteotomy. The curative effects were assessed by comparing the radiological parameters, American Orthopaedic Foot and Ankle Surgery Society (AOFAS) ankle-hindfoot score, pain visual analog scale (VAS) and psychological and physical scores in Health Survey 12-item Short Form (SF-12) between preoperation and the final follow-up.Results:All the patients were followed up for 20 to 60 months (average, 42.9 months); the bone healing time was 10 to 14 weeks (average, 11.5 weeks). At the final follow-up, their B?hler angle (25.7°±2.3°), Gissane angle (117.1°±5.8°), Meary angle (2.9°±1.3°), talocalcaneal angle (31.3°±3.0°), hindfoot alignment angle (3.9°±1.8°), ankle height [(82.3±2.6) mm], calcaneus height [(56.9±2.4) mm], calcaneus width [(41.4±2.1) mm], AOFAS ankle-hindfoot score [(82.3±7.3) points], median VAS score [3 (2, 3) points], SF-12 psychological score [(46.6±3.6) points], and SF-12 physiological score [(43.6±3.5) points] were significantly improved than the preoperative values [8.4°±2.7°, 137.5°±9.3°, 8.3°±4.3°, 24.6°±3.7°, -4.6°±3.2°, (76.1±3.1) mm, (53.8±3.0) mm, (50.2±2.2) mm, (51.9±7.7) points, 6 (6, 7) points, (37.5±3.8) points, and (31.0±2.6) points] (all P<0.01) Conclusion:In the treatment of type Yu Ⅱ malunion of calcaneal intra-articular fracture, triplane osteotomy can anatomically reduce the bone fragments of collapsed posterior articular surface, reshape the normal anatomy of the calcaneus, and preserve the subtalar joint, leading to positive short- and mid-term follow-up effects.

Objective To compare the outcomes of surgical treatment of ankle fracture with or without repair of deltoid ligament(DL) rupture.Methods Between March 2009 and December 2015,75 patients were treated surgically at Department of Foot and Ankle Surgery,Honghui Hospital for ankle fracture with DL rupture.Of them,the DL rupture was repaired in 20(repair group) and not in 54(non-repair group).The 2 groups were compared in terms of pre- and post-operative medial clear space(MCS),rate of radiological MCS malreduction(MCS>5mm),rate of surgical failure,the American Orthopaedic Foot and Ankle Society(AOFAS) ankle-hindfoot score and visual analogue scale(VAS).The outcomes of AO/OTA types B and C were also compared between the 2 groups.Results The 2 groups were compatible due to insignificant differences in their preoperative general data and follow-up time(46.9±22.5 months versus 56.3±23.9 months)(P>0.05).The MCSs after operation(3.3±0.3 mm) and at the last follow-up(3.2±0.3mm) in the repair group were significantly shorter than those in the non-repair group(3.8±1.0mm and 3.8±1.2mm)(P<0.05).The rate of radiological MCS malreduction in the repair group(0) was significantly lower than that in the non-repair group(20.4%)(P<0.05).There were no significant differences between the 2 group in rate of surgical failure(0 versus 7.4%),AOFAS ankle-hindfoot score(88.0±5.8 versus 85.9±8.7) or VAS(1.2±0.8 versus 1.6±1.6)(P>0.05).The rate of radiological MCS malreduction for AO/OTA type C ankle fracture in the non-repair group was significantly higher than those for AO/OTA types B and C in the repair group and AO/OTA type B in the non-repair group(P<0.05).Conclusion Surgical repair of the DL rupture may help decrease the rate of postoperative MCS malreduction,especially for AO/OTA type C ankle fractures.

Objective:To compare the clinical efficacy between fusion with anterior plate and cross screw (APCS) via the anterolateral approach and that with posterior plate (PP) via the posterior approach in ankle arthrodesis.Methods:A retrospective study was conducted to analyze the 64 patients (64 feet) with end-stage ankle arthritis who had been admitted to Department of Foot and Ankle Surgery, Honghui Hospital of Xi'an Jiaotong University from January 2017 to March 2021. They were 24 males and 40 females with an age of (57.7±5.5) years; by the Kellgren-Lawrence staging, 25 cases were in grade Ⅲ and 39 ones in grade Ⅳ. According to the different surgical approaches and internal fixation methods, the patients were divided into a APCS group of 31 cases subjected to the fusion with APCS via the anterolateral approach and a PP group of 33 cases subjected to the fusion with PP via the posterior approach. The clinical efficacy was compared between the 2 groups and between preoperatoion and postoperation in terms of talus center migration (TCM), sagittal talar migration (STM), foot and ankle ability measure (FAAM), and visual analog scale (VAS).Results:There was no statistically significant difference in the preoperative baseline data between the 2 groups of patients, indicating comparability ( P>0.05). In the PP group, the postoperative STM [(4.45±2.21)] mm was significantly smaller than the postoperative one [(7.22±4.22)] mm ( P<0.001). There were no statistically significant differences in the postoperative comparisons of TCM and STM between the 2 groups, in the comparison between postoperative TCM and preoperative TCM in the PP group, or in the comparisons between postoperative and preoperative TCM and STM in the APCS group ( P>0.05). All patients were followed up for (28.1±6.8) months. At the last follow-up, there was no statistically significant difference between the 2 groups in the FAAM life score, FAAM exercise score, or VAS pain score ( P>0.05). The FAAM life score, FAAM motor score, and VAS pain score at the last follow-up were significantly improved in all the patients compared with the preoperative values ( P<0.05). Fusion failure was found in only 1 patient in the APCS group. Conclusion:Both PP and APCS fusion techniques can lead to similarly fine clinical outcomes in ankle arthrodesis, but PP may lead to a significant correction of sagittal talar migration.

Objective To explore the method and clinical value of sentinel lymph node biopsy for penile carcinoma guided by multispectral separate-merge guided surgery device (MGS).Methods The clinical data of 7 patients with sentinel lymph node biopsy of penile cancer guided by MGS from April 2017 to April 2018 were analyzed retrospectively at First Hospital of Shanxi Medical University.They were 62-78 years old,with an average age of 65 years.All of carcinoma was located in the glans or coronal sulcus,which diameter was 1.0-3.5 cm,with an average of 2.5 cm.Three cases of inguinal lymph nodes could be non-palpable and the others palpable.All patients were injected 0.25 ml (2.5 mg/ml) of indocyanine greensolution with 1 ml syringe at 12,4,6 and 9 points in the proximal normal skin of penile tumors.Immediately,the imaging probe was aligned with the injection point to observe the dynamic changes of fluorescence image on MGS display.Results There were 14 sides of groin in 7 patients,except for 1 side without images,other 13 sides developed well.The images displayed by MGS include visible image,fluorescent image and merged image,and the merged image was green pseudo color.According to the dynamic changes of the image,it could be divided into five parts:injection point,penile body,pubic symphysis,inguinal region and sentinel lymph node.In 13 well-developed sides,fluorescence gradually disappeared in other parts about 15 minutes after injection,and the location of sentinel lymph nodes was determined in vitro by gradually consolidating and fixing the fluorescence images in the inguinal region.The lymph node-like tissue with strong fluorescence intensity was observed immediately after the skin incision.There was a clear boundary between the lymph node-like tissue and the surrounding tissue.Along this boundary,lymph nodes were separated,ligated,excised.No lymph nodes were found on the undetected side.Postoperative pathology confirmed that lymph nodes were located by fluorescence imaging in vitro and traced by fluorescence imaging in vivo,the coincidence rate was 100％.There were residual fluorescent tissues on three sides and lymphatic vessels were removed.Conclusions MGS-assisted intraoperative fluorescence imaging could improve the doctor's visual depth so that physicians can real-time,dynamic,accurate in vitro location and in vivo tracking of sentinel lymph nodes of penile cancer.

OBJECTIVE: To summarize the progress of clinical diagnosis and treatment of diabetic Charcot neuroarthropathy (CNO) of foot and ankle to provide reference for clinical treatment. METHODS: The research literature on diabetic CNO of foot and ankle at home and abroad was widely reviewed, and the stages and classification criteria of CNO were summarized, and the treatment methods at different stages of the disease course were summarized. RESULTS: CNO is a rapidly destructive disease of bone and joint caused by peripheral neuropathy, which leads to the formation of local deformities and stress ulcers due to bone and joint destruction and protective sensory loss, which eventually leads to disability and even life-threatening. At present, the modified Eichenholtz stage is a commonly used staging criteria for CNO of foot and ankle, which is divided into 4 stages by clinical and imaging manifestations. The classification mainly adopts the modified Brodsky classification, which is divided into 6 types according to the anatomical structure. The treatment of diabetic CNO of foot and ankle needs to be considered in combination with disease stage, blood glucose, comorbidities, local soft tissue conditions, degree of bone and joint destruction, and whether ulcers and infections are present. Conservative treatment is mainly used in the active phase and surgery in the stable phase. CONCLUSION The formulation of individualized and stepped treatment regimens can help improve the effectiveness of diabetic CNO of foot and ankle. However, there is still a lack of definitive clinical evidence to guide the treatment of active and stable phases, and further research is needed.
Humans ; Ankle ; Ulcer/complications* ; Arthropathy, Neurogenic/therapy* ; Ankle Joint ; Diabetes Mellitus ; Diabetic Foot/therapy*

Menopausal syndromes are mostly based on kidney deficiency， which could be expalined that kidney governing essence storage and controlling innateness， so when the kidney water was deficient and the liver fail to nourish， then led to liver depression and transform into fire； deficiency of the kidney， loss of warmth of the spleen， and inability to transport and transform the water and dampness will easily lead to phlegm and fire； the decline of the kidney yin and loss of water and fire will easily cause the exuberance of heart fire. Therefore， clinical symptoms of hot flashes， insomnia， and palpitations are common due to phlegm， depressions， and fire. Based on this， at the beginning of the treatment， we should treat the symptoms firstly by resolving phlegm， relieving depression and clearing fire， and commonly use Huanglian Wendan Decoction （黄连温胆汤）， Yigan Powder （抑肝散）， Chaihu plus Longgu Muli Decoction （柴胡加龙骨牡蛎汤）， and Qingxin Zishen Decoction （清心滋肾饮）， etc. After improving the symptoms of hot flashes and sweating， irritability， dreaming and frightening， then we should give the prescriptions to tonify kidney yang and nourish kidney yin， in order to eliminate the pathogens and reinforce healthy qi， and to treat both the manifestations and the root cause， so that the symptoms of the patients can be better alleviated.

OBJECTIVE: To assess the effectiveness of supramalleolar osteotomy (SMOT) as a therapeutic intervention for varus-type ankle arthritis, while also examining the associated risk factors that may contribute to treatment failure. METHODS: The clinical data of 82 patients (89 feet) diagnosed with varus-type ankle arthritis and treated with SMOT between January 2016 and December 2020 were retrospectively analyzed. The patient cohort consisted of 34 males with 38 feet and 48 females with 51 feet, with the mean age of 54.3 years (range, 43-72 years). The average body mass index was 24.43 kg/m ² (range, 20.43-30.15 kg/m ²). The preoperative tibial anterior surface angle (TAS) ranged from 77.6° to 88.4°, with a mean of 84.4°. The modified Takakura stage was used to classify the severity of the condition, with 9 feet in stage Ⅱ, 41 feet in stage Ⅲa, and 39 feet in stage Ⅲb. Clinical functional assessment was conducted using the Maryland sore, visual analogue scale (VAS) score, and psychological and physical scores in Health Survey 12-item Short From (SF-12). Radiology evaluations include TAS, talar tilt (TT), tibiocrural angle (TC), tibial medial malleolars (TMM), tibiocrural distance (TCD), tibial lateral surface angle (TLS), and hindfoot alignment angle (HAA). The results of clinical failure, functional failure, and radiology failure were statistically analyzed, and the related risk factors were analyzed. RESULTS: The operation time ranged from 45 to 88 minutes, with an average of 62.2 minutes. No complication such as fractures and neurovascular injuries was found during operation. There were 7 feet of poor healing of the medial incision; 9 pin tract infections occurred in 6 feet using external fixator; there were 20 cases of allograft and 3 cases of autograft with radiographic bone resorption. Except for 1 foot of severe infection treated with bone cement, the remaining 88 feet were primary healing, and the healing area was more than 80%. All patients were followed up 24-82 months, with an average of 50.2 months. Maryland score, VAS score, SF-12 psychological and physiological scores, and TAS, TC, TLS, TCD, TT, TMM, HAA, and Takakura stage were significantly improved at last follow-up ( P<0.05). Postoperative clinical failure occurred in 13 feet, functional failure in 15 feet, and radiology failure in 23 feet. Univariate analysis showed that obesity, TT>10°, and Takakura stage Ⅲb were risk factors for clinical failure, HAA≥15° and Takakura stage Ⅲb were risk factors for functional failure, and TT>10° was risk factor for radiographic failure ( P<0.05). Further logistic regression analysis showed that TT>10°, HAA≥15°, and TT>10° were risk factors for clinical failure, functional failure, and radiographic failure, respectively ( P<0.05). CONCLUSION SMOT is effective in the mid- and long-term in the treatment of varus-type ankle arthritis, but it should be used with caution in patients with obesity, severe hindfoot varus, severe talus tilt, and preoperative Takakura stage Ⅲb.
Male ; Female ; Humans ; Middle Aged ; Ankle ; Ankle Joint/surgery* ; Retrospective Studies ; Osteoarthritis/surgery* ; Osteotomy/methods* ; Risk Factors