OBJECTIVE: To analyze the current status and trends of the disease burden of knee osteoarthritis (KOA) in China from 1990 to 2023, and to examine the epidemiological characteristics of age, gender differences, and attribution to high body mass index (BMI), in order to provide a basis for formulating prevention and treatment strategies to reduce the disease burden of KOA in China. METHODS: Based on the 2023 Global Burden of Disease Study (GBD) database, data on the number, rate, and age-standardized rate of incidence, prevalence, disability-adjusted life years (DALYs) for KOA, and DALYs for KOA attributable to high BMI in the Chinese population from 1990 to 2023 were integrated. The Joinpoint 5.4.0.0 software was used to analyze the age and gender differences in KOA and the epidemiological characteristics attributable to high BMI. RESULTS: The standardized incidence, prevalence, and DALYs rates of KOA in China in 2023 increased by 6.46%, 6.43%, and 6.93%, respectively, compared with 1990. In terms of age, the disease burden of KOA in China was lowest in the age group of 30-34 years, with the highest incidence rate in the age group of 50-54 years, whereas the prevalence rate and DALYs rate continued to increase with age, and both were highest in the age group of ≥70 years. In terms of gender, all disease burden standardized rate indicators were higher in females than in males, and the difference widened with age. The rate of BMI-attributable DALYs increased at an annual average rate of 1.57% (95% CI: 1.55, 1.59) from 1990 to 2023, again with significant age and gender differences. CONCLUSION The continued growth of the KOA disease burden and significant population differences characterizing China call for focused attention on the female middle-aged and elderly population, enhanced weight management, and implementation of targeted preventive and control measures.
Humans ; Osteoarthritis, Knee/epidemiology* ; China/epidemiology* ; Male ; Female ; Middle Aged ; Incidence ; Aged ; Adult ; Prevalence ; Body Mass Index ; Disability-Adjusted Life Years ; Cost of Illness ; Aged, 80 and over ; Sex Factors ; Global Burden of Disease ; Age Factors ; Young Adult ; Quality-Adjusted Life Years

Objective:To investigate the feasibility of individualized primary clinical target volume (CTV) delineation in intensity-modulated radiotherapy for nasopharyngeal carcinoma (NPC).Methods:Clinical data of 87 consecutive patients newly diagnosed with lateralized NPC in Jiangsu Cancer Hospital between October 2016 and February 2018 were retrospectively analyzed. Lateralized NPC is defined as tumor invasion not exceeding the contralateral wall. According to the tumor spread, the primary CTV was optimized as follows: CTV2 only covered the medial part of the contralateral pterygopalatine fossa, whereas the contralateral foramen oval was not included; on the level of parapharyngeal space, the contralateral side of CTV only covered the posterior lateral lymph nodes, whereas the contralateral internal jugular vein was not regularly covered. Failure patterns and 5-year survival [local control rate (LCR), progression-free survival (PFS) and overall survival (OS)] were evaluated by Kaplan-Meier method. Paired t-test and rank-sum test were used to analyze the dose variation in the optimized region and adverse reactions. Results:The median follow-up time was 59.5 months. The 5-year LCR, PFS, and OS were 98.9%, 86.5% and 92.1%, respectively. There was no local recurrence in the optimized area of CTV. Dosimetric comparison results showed that the doses of parotid gland, temporal lobe, cochlea and middle ear on the contralateral side were reduced by 13.45%, 9.14%, 38.83%, and 29.36%, respectively. Four cases (4.6%) developed grade 3 hearing loss, all on the ipsilateral side. The optimized scheme significantly alleviated the hearing loss on the contralateral side compared to that on the ipsilateral side ( P<0.001). Other grade 3 late adverse reactions included cranial nerve injury, subcutaneous fibrosis in the neck and visual impairment, with 1 case each. Conclusion:Individualized primary CTV for lateralized NPC is feasible and safe, with obvious dosimetric advantages and reduced adverse reaction rate, which is worthy of clinical promotion.

Objective:To evaluate the effects of different rates of compliance with the enhanced recovery after surgery (ERAS) protocol on postoperative recovery in patients undergoing hysterectomy.Methods:A total of 312 patients, aged 18-60 yr, with body mass index of 18-30 kg/m 2, of American Society of Anesthesiologists physical status Ⅰ-Ⅲ, scheduled for hysterectomy, were enrolled in the study.ERAS protocol was implemented.The patients were divided into 3 groups based on compliance rates: compliance rate<70% group (group A), 70%≤compliance rate<85% group (group B) and compliance rate≥85% group (group C). The development of postoperative complications, hospitalization time, patients′ satisfaction score and hospitalization cost were recorded. Results:Compared with group A ( n=88) and group B ( n=118), the total incidence of complications was significantly decreased in group C ( n=96) ( P<0.05). The patients′ satisfaction scores were gradually increased in A, B, and C groups on the day of discharge and at 30 days after discharge ( P<0.05). Conclusions:Higher compliance with the ERAS protocol is helpful for postoperative recovery in patients undergoing hysterectomy.

Objective:To accurately estimate the health burden and corresponding economic loss attributed to PM 2.5 pollution in the Beijing-Tianjin-Hebei (BTH) area in China in 2015. Method:By using satellite-retrieved PM 2.5 concentration data and population data provided by NASA (the spatial resolution was 1 km×1 km), this study estimated excess mortality attributed to long-term PM 2.5 exposure in BTH area in 2015 based on Global Exposure Mortality Model (GEMM). Besides, Value of Statistic Life (VSL) method was used to evaluate the corresponding health economic loss. Result:In BTH area, the population-weighted average PM 2.5 concentration during 2012-2014 was 46.25 μg/m 3, and 56.6% of total population lived in the area where annual average PM 2.5 concentration exceeded Grade Ⅱ of National Ambient Air Quality Standard in China (35 μg/m 3); The PM 2.5-related premature deaths amounted to 193.8 thousand (95 %CI: 140.9 thousand-233.3 thousand), Beijing, Tianjin, Baoding, Shijiazhuang, and Handan were the top five cities with high incidences of PM 2.5-related premature deaths; The corresponding health economic loss was about 35.934 billion (95 %CI: 26.099 billion - 43.255 billion) RMB, accounting for 0.70% (95 %CI: 0.51%-0.85%) of the area’s GDP in 2015, Beijing, Tianjin, Baoding, Shijiazhuang, and Cangzhou were the top five cities with high health economic loss. Conclusions:PM 2.5 pollution has caused severe disease and economic burden in BTH area. Its spatial distribution suggested that it is particularly necessary to develop the air pollution prevention and control policies for key cities.

Time perspective therapy (TPT) which belongs to positive psychology is a new psychological intervention to post-traumatic stress disorder (PTSD).A large number of studies abroad have testified that TPT is very long-term effective,what′s more, TPT has been popularized and improved by foreign scholars but not been applied in China.TPT has been a study issue in mental and psychological fields,but that how to apply TPT rightly in China needs to explore.Therefore, this paper systematically introduced and analyzed TPT theory, the problems of applying TPT and the enlightenment of nursing PTSD,so as to help Chinese scholars apply TPT to solve problems and status of nursing PTSD in China.

Objective To evaluate the long-term clinical outcome of percutaneous coronary intervention ( PCI) with drug-eluting stents ( DES) for distal unprotected left main coronary artery (ULMCA) lesions. Methods Between Jan 2005 and Dec 2009, 111 patients with distal ULMCA disease who underwent drug-eluting stents implantation were enrolled in this retrospective study. The primary end points were major adverse cardiac and cerebrovascular event (MACCE) at follow-up, including death, non-fatal myocardial infarction, cerebrovascular event and target lesion revascularization ( TLR) . Results Patients were 65. 6 ± 10 years old. 21. 6% were diabetic. 31. 5% of the left main bifurcations were classed as Medina 1, 1, 1. Provisional T stent technique was performed for 79. 3% of the population. 30. 6% of cases underwent angiography follow-up. The median follow-up time was 2. 3 years, the MACCE-free survival was 87. 4% and the estimated freedom from TLR was 94. 6% . Diabetes mellitus was identified as the predictor of TLR. Conclusions PCI with DES for distal ULMCA disease was safe and effective when the strategy was made based on the case-by-case assessment.

Objective: To observe the changes of circulating fractalkine and its receptor CX3CR1 level in patients with chronic congestive heart failure (CHF).
Methods: Our work included 2 group, CHF group, n=55 patients and Control group, n=25 healthy subjects. Plasma level of soluble fractalkine (sFKN) was measured by ELISA, CX3CR1 in peripheral blood mononuclear cell was examined by lfow cytometry method. The relationship between sFKN and NT-proBNP was studied.
Results: Compared with Control group, CHF group had increased sFKN level, P=0.004, and the patients with NYHY III, IV were more than NYHY II, and CHF group also had the higher CX3CR1 expression (14.7 ± 8.1), P<0.05. The CX3CR1 level increased accordingly with NYHY classiifcation, as the patients with NYHY II, CX3CR1 was at (25.1 ± 12.4), P=0.03 compare with Control group;with NYHY III, CX3CR1 was at (37.3 ± 11.0) , P=0.04 compared with NYHY II;with NYHY IV, CX3CR1 was at (41.7 ± 11.1), P=0.009 compared with NYHY II. The circulating sFKN level was positively related to pro-BNP level (r=0.364, P<0.01).
Conclusion: The circulating FKN l and its receptor CX3CR1 might be involved in pathogenesis of immune-inlfammatory pathogenesis in CHF patients.

Objective The aim of this study was to evaluate the safety and efficacy of 135 cm Corsair microcatheter inpercutaneous coronary intervention (PCI) for coronary chronic total occlusion (CTO) with antegrade approach via radial artery. Methods From June 2010 to February 2014, a total of 81 patients with CTO lesions treated with 135cm Corsair microcatheter (Asahi Intec Co, Japan) and transradial antegrade approach was enrolled in this study. The success rate of CTO-PCI, the rate of Corsair microcatheter crossing the CTO lesions and the number of balloon catheters utilization were retrospectively analyzed. Unique complications related to the Corsair microcatheter were also documented. Results Success recanalization of CTO were achieved in 73 (90.1%) patients. Crossing the CTO body with Corsair microcatheter was found in 56(84.8%) patients. The number of balloon utilized after Corsair microcatheter crossing the CTO was much lower than that of patients who Corsair microcatheter failed to cross (1.3±0.6 per patient versus 2.8±1.2per patient, P < 0.05). The success recanalization rate of combined using Fielder XT guidewire with Corsair microcatheter was 51.5%. There was no complications related to Corsair microcatheter during the index procedure, no major adverse cardiac events during in-hospital clinical follow-up. Conclusions Corsair microcatheter was safe and effective in the recanalization for CTO with transradialantegrade approach. It can simplify the CTO-PCI procedure and reduce the number of balloon catheters.

Objective To study investigate the dose accuracy that can be achieved with the method of bulk density assignment.Methods Sixteen cases of nasopharyngeal cancer patients and nineteen cases of esophageal cancer patients who accept radiotherapy in our department were selected.The planning CT images with bulk density assignment to different classes of tissues were applied to calculate the dose distributions,and then the resulting dose volume histograms (DVH) of the tumor and organs of risk were compared with the original treatment plan.The paired t-test was taken for dose comparison between two plans.Results The DVH comparison based on the planning CT and the bulk density assignment CT showed good agreements.With nasopharyngeal cancer patients,differences between the two plans about target and normal tissue were less than 1％.With esophageal cancer patients,the dose differences were less than 2％.Conclusion Preliminary results confirm that the bulk density assignment method can be applied to calculate the dose distributions.

Objective To observe the differences of the radio-biological characteristics between the human malignant glioma cell line SHG-44 and its progeny cells SHG-4410 Gy and to probe the underlying mechanism.Methods The SHG-4410 Gy cells were the progeny of SHG cells that had been irradiated with 10 Gy X-rays and then passaged for 15 generations.The radiosensitivity of SHG-44 and SHG-4410 Gy wre measured by clonogenic assay and the multi-target single-hit model was used to fit the survival curve.The cell cycle redistribution and apoptosis were analyzed by flow cytometry assay.Quantitative Real Time-PCR (qRT-PCR) was used to determine the relative levels of cyclin B1 mRNA and miR-21.Stat3 protein levels were detected by Western blot.Results The values of D0,Dq and SF2 of SHG-4410 Gy cells were significantly higher than those of SHG-44 cells.Flow cytometric analysis showed that there was less G2/M phase arrest in SHG-4410 Gy (F =22.21,P ＜ 0.05).Radiation-induced early apoptotic population was increased from (17.60 ± 0.26) ％ to (28.00 ± 0.36) ％ for SHG-44 cells,but increased from only (4.20 ± 0.30)％ to (5.17 ± 0.65)％ for SHG-4410 Gy.miR-21 in SHG-4410 Gy cells were increased by 1.44 fold of SHG-44 cells,which was associated with the increase of Stat3 protein expression.Conclusions Radioresistance is observed in the progeny of human malignant glioma cell line SHG-44 which had been irradiated with 10 Gy X-rays.The underlying mechanisms may be relative to the upregulation of cyclin B1 that acts as a key downstream gene in the signaling pathway of G2/M phase transition.In addition,the upregulation of miR-21 may be involved in the apoptosis of SHG-4410 Gy cells.