A bivalent chimeric virus-like particle(ND-FAdV-4/8a/8b cVLPs)displaying NDV HN protein,FAdV4 fiber-2 protein,FAdV-8a Fiber protein and FAdV-8b Fiber protein was construc-ted based on insect baculovirus expression system and Newcastle disease virus-like particle vector platform and was identified using indirect immunofluorescence,Western blot and transmission e-lectron microscopy.The results showed that recombinant baculoviruses rBV-c8aFiber and rBV-c8bFiber expressing FAdV-8a Fiber and FAdV-8b Fiber were successfully constructed.In addition,all components of ND-FAdV-4/8a/8b cVLPs were correctly expressed,and ND-FAdV-4/8a/8b cVLPs was a nanoparticle about 100 nm in size,with a capsule membrane and fibers,providing a green and safe virus-like particle vaccine candidate for the control of Newcastle disease and avian adenovirus disease.

BACKGROUND:The key to preventing the recurrence of intrauterine adhesions is to reconstruct the endometrium with normal function.The latest breakthrough in the treatment of recurrent intrauterine adhesions in and outside China is the use of degradable materials to prepare hydrogels to prevent the recurrence of adhesions. OBJECTIVE:To review the research advance in hydrogel-promoted endometrial repair in intrauterine adhesions. METHODS:PubMed,Web of Science,China National Knowledge Infrastructure(CNKI),and WanFang databases were searched systematically,with the keywords"intrauterine adhesions,endometrial injury,endometrium regeneration,hydrogel"in Chinese and English.Relevant articles published in each database from January 1990 to March 2023 were collected. RESULTS AND CONCLUSION:In recent years,research on hydrogel-promoted endometrial repair in uterine adhesions in and outside China has made some progress and plays an important role in the prevention and treatment of intrauterine adhesions and the promotion of endometrial repair:(1)As an important carrier in tissue engineering,hydrogel itself has excellent biocompatibility,biodegradability and three-dimensional network structure,which can be better applied in the treatment of intrauterine adhesions.(2)The hydrogel-based carrier system can promote the proliferation and differentiation of endometrial epithelial cells by transporting drugs/biologics/stem cells,and restore normal uterine morphology to prevent adhesion recurrence.(3)Hyaluronic acid hydrogels can not only meet good biocompatibility,but also promote the proliferation and differentiation of endometrial epithelial cells,and will be hydrolyzed by corresponding enzymes in utero,without affecting the normal metabolism of the body.They are currently commonly used uterine anti-adhesion agents in the clinic and are also the most commonly used hydrogel carriers in tissue engineering research.(4)Poloxamer hydrogel with excellent temperature-sensitive properties can rapidly gelate into the body,quickly form a physical barrier,and can play a slow-release effect on carrying substances and provide a platform for cell growth/adhesion.(5)There are broad prospects for the preparation of therapeutic hydrogels using materials with different characteristics,such as temperature-sensitive hydrogels,pH-responsive hydrogels and photosensitive hydrogels,but there are still many problems to be solved,such as the safety of the hydrogel system,whether the degradation products cause immune reactions,and whether they have an impact on the normal body's menstrual period.A large number of animal experiments and clinical trials are needed to verify its safety and efficacy,and continuously improve the treatment strategy.

Osteoporotic proximal humeral fracture (OPHF) is one of the common osteoporotic fractures in the aged, with an incidence only lower than vertebral compression fracture, hip fracture, and distal radius fracture. OPHF, secondary to osteoporosis and characterized by poor bone quality, comminuted fracture pattern, slow healing, and severely impaired shoulder joint function, poses a big challenge to the current clinical diagnosis and treatment. In the field of diagnosis, treatment, and rehabilitation of OPHF, traditional Chinese and Western medicine have accumulated rich experience and evidence from evidence-based medicine and achieved favorable outcomes. However, there is still a lack of guidance from a relevant consensus as to how to integrate the advantages of the two medical systems and achieve the integrated diagnosis and treatment. To promote the diagnosis and treatment of OPHF with integrated traditional Chinese and Western medicine, relevant experts from Orthopedic Expert Committee of Geriatric Branch of Chinese Association of Gerontology and Geriatrics, Youth Osteoporosis Group of Orthopedic Branch of Chinese Medical Association, Osteoporosis Group of Orthopedic Surgeon Branch of Chinese Medical Doctor Association, and Osteoporosis Committee of Shanghai Association of Integrated Traditional Chinese and Western Medicine have been organized to formulate Expert consensus on the diagnosis and treatment of osteoporotic proximal humeral fracture with integrated traditional Chinese and Western medicine ( version 2024) by searching related literatures and based on the evidences from evidence-based medicine. This consensus consists of 13 recommendations about the diagnosis, treatment and rehabilitation of OPHF with integrated traditional Chinese medicine and Western medicine, aimed at standardizing, systematizing, and personalizing the diagnosis and treatment of OPHF with integrated traditional Chinse and Western medicine to improve the patients ′ function.

The incidence of osteoporotic thoracolumbar vertebral fracture (OTLVF) in the elderly is gradually increasing. The kyphotic deformity caused by various factors has become an important characteristic of OTLVF and has received increasing attention. Its clinical manifestations include pain, delayed nerve damage, sagittal imbalance, etc. Currently, the definition and diagnosis of OTLVF with kyphotic deformity in the elderly are still unclear. Although there are many treatment options, they are controversial. Existing guidelines or consensuses pay little attention to this type of fracture with kyphotic deformity. To this end, the Lumbar Education Working Group of the Spine Branch of the Chinese Medicine Education Association and Editorial Committee of Chinese Journal of Trauma organized the experts in the relevant fields to jointly develop Clinical guidelines for the diagnosis and treatment of osteoporotic thoracolumbar vertebral fractures with kyphotic deformity in the elderly ( version 2024), based on evidence-based medical advancements and the principles of scientificity, practicality, and advanced nature, which provided 18 recommendations to standardize the clinical diagnosis and treatment.

Humans ; Female ; Prevalence ; Breast Neoplasms ; Cancer Survivors ; Non-alcoholic Fatty Liver Disease ; Liver

Objective:To explore the feasibility and advantages and disadvantages of local anesthesia for TiRobot-assisted removal of sacroiliac screws by comparison with general anesthesia for TiRobot-assisted removal of sacroiliac screws.Methods:A retrospective study was performed in 39 patients with posterior pelvic ring fracture-dislocation who had undergone removal of percutaneous sacroiliac screws after fracture union from January 2017 to December 2020 at Department of Orthopaedic Surgery, Hospital Affiliated to Chengdu University. Their sacroiliac screws were removed with TiRobot assistance under local anesthesia (LA group) or general anesthesia (GA group). In the LA group of 18 cases, there were 10 males and 8 females, aged (43.3 ± 8.4) years (from 25 to 58 years); in the GA group of 21 cases, there were 12 males and 9 females, aged (44.9 ± 9.0) years (from 23 to 60 years). The 2 groups were compared in terms of time for planning screw removal path, fluoroscopy frequency, fluoroscopy time, operation time, anesthesia time, anesthesia cost, postoperative visual analogue scale (VAS) and postoperative ambulation time.Results:There was no statistically significant difference in baseline data between the 2 groups, showing comparability ( P>0.05). Follow-ups revealed grade A wound healing in all patients. There were no significant differences between the 2 groups in time for planning screw removal path, fluoroscopy frequency, fluoroscopy time or operation time ( P>0.05). The anesthesia time [(41.6 ± 8.3) min], anesthesia cost [(653.5 ± 102.6) yuan] and postoperative ambulation time [(2.6 ± 0.6) h] in the LA group were significantly less than those in the GA group [(52.3 ± 9.5) min, (2,475.6 ± 261.8) yuan and (8.7 ± 2.4) h] while the VAS score in the former group (3.8 ± 1.5) was significantly higher than that in the latter group (2.5 ± 1.3) (all P<0.05). Conclusions:It is feasible to use local anesthesia for TiRobot-assisted removal of sacroiliac screws. In TiRobot-assisted removal of sacroiliac screws, compared with general anesthesia, local anesthesia may lead to shorter anesthesia time, lower anesthesia cast and shorter ambulation time, but the patients need to be compliant enough.

Objectives:To explore the feasibility of anterior medial fenestration approach in situ reduction and fixation in the treatment of PipkinⅠ and Ⅱ femoral head fractures,and to explore the clinical effect of this operation.Methods:Hips of two anti-corrosion adult specimens treated with formalin were dissected, then anatomical structures and directional characteristics of anterior medial main muscles,ligaments,blood vessels and nerves were observed.The anterior medial fenestration approach was performed on bilateral hips of four fresh frozen specimens to determine pulling direction of stripped muscles and ligaments required during operation,and to observe and analyze vascular and nerve traction protection directions exposed in the approach.Determine extent of exposure to the approach and assess feasibility of this approach.The clinical data of 12 patients with Pipkin Ⅰ and Ⅱ femoral head fractures who underwent in situ reduction and fixation of anterior medial fenestration at Department of Orthopaedics,Affiliated Hospital of Chengdu University from February 2016 to April 2018 were retrospectively analyzed.There were 3 males and 9 females with an age of 48.5 years(range:37 to 59 years).There were 8 cases of Pipkin type Ⅰ and 4 cases of Pipkin type Ⅱ.The operation time,blood loss,fracture healing time,last Thompson-Epstein evaluation and Harris score were observed.Results:Anterior medial fenestration approach to expose the femoral head in 4 bilateral hips with a total of 8 sides of fresh frozen specimens.The upper boundary of observation fenestration was pubic body (anterior acetabulum),and the outer upper boundary was iliacus and psoas muscle.The lateral boundary was rectus femoris and femoral vessels,the lower boundary was transverse branch of the medial femoral circumflex artery and vein.The medial boundary was pubis muscle,short adductor muscle and long adductor muscle.Pubofemoral and iliofemoral ligament were seen in fenestration. Four quadrants in front of femoral head in fenestration can be seen after cutting switch capsule active hip joint. In 12 patients with femoral head fracture,the operation time was 107.5 minutes(range:90 to 135 minutes),and the intraoperative bleeding volume was 115.0 ml(range:85 to 150 ml).The patients were followed up for 18.6 months(range:12 to 28 months).The fracture healing time of 12 patients was 144.2 days(range:120 to 180 days).The curative effect was evaluated according to Thompson-Epstein standard at the last follow-up:excellent in 6 cases,good in 4 cases and fair in 2 cases.At the last follow-up,the Harris score of hip joints was 85.1(range:75 to 93).Conclusions:Anterior medial fenestration in situ reduction and fixation surgery is feasible for the treatment of Pipkin Ⅰ and Ⅱ femoral head fractures. The short and midterm follow-up results reveal satisfactory effect.

Objectives:To explore the feasibility of anterior medial fenestration approach in situ reduction and fixation in the treatment of PipkinⅠ and Ⅱ femoral head fractures,and to explore the clinical effect of this operation.Methods:Hips of two anti-corrosion adult specimens treated with formalin were dissected, then anatomical structures and directional characteristics of anterior medial main muscles,ligaments,blood vessels and nerves were observed.The anterior medial fenestration approach was performed on bilateral hips of four fresh frozen specimens to determine pulling direction of stripped muscles and ligaments required during operation,and to observe and analyze vascular and nerve traction protection directions exposed in the approach.Determine extent of exposure to the approach and assess feasibility of this approach.The clinical data of 12 patients with Pipkin Ⅰ and Ⅱ femoral head fractures who underwent in situ reduction and fixation of anterior medial fenestration at Department of Orthopaedics,Affiliated Hospital of Chengdu University from February 2016 to April 2018 were retrospectively analyzed.There were 3 males and 9 females with an age of 48.5 years(range:37 to 59 years).There were 8 cases of Pipkin type Ⅰ and 4 cases of Pipkin type Ⅱ.The operation time,blood loss,fracture healing time,last Thompson-Epstein evaluation and Harris score were observed.Results:Anterior medial fenestration approach to expose the femoral head in 4 bilateral hips with a total of 8 sides of fresh frozen specimens.The upper boundary of observation fenestration was pubic body (anterior acetabulum),and the outer upper boundary was iliacus and psoas muscle.The lateral boundary was rectus femoris and femoral vessels,the lower boundary was transverse branch of the medial femoral circumflex artery and vein.The medial boundary was pubis muscle,short adductor muscle and long adductor muscle.Pubofemoral and iliofemoral ligament were seen in fenestration. Four quadrants in front of femoral head in fenestration can be seen after cutting switch capsule active hip joint. In 12 patients with femoral head fracture,the operation time was 107.5 minutes(range:90 to 135 minutes),and the intraoperative bleeding volume was 115.0 ml(range:85 to 150 ml).The patients were followed up for 18.6 months(range:12 to 28 months).The fracture healing time of 12 patients was 144.2 days(range:120 to 180 days).The curative effect was evaluated according to Thompson-Epstein standard at the last follow-up:excellent in 6 cases,good in 4 cases and fair in 2 cases.At the last follow-up,the Harris score of hip joints was 85.1(range:75 to 93).Conclusions:Anterior medial fenestration in situ reduction and fixation surgery is feasible for the treatment of Pipkin Ⅰ and Ⅱ femoral head fractures. The short and midterm follow-up results reveal satisfactory effect.

Objective:To evaluate the application of a multi-task learning-based light-weight convolution neural network (MTLW-CNN) for the automatic segmentation of organs at risk (OARs) in thorax.Methods:MTLW-CNN consisted of several layers for sharing features and 3 branches for segmenting 3 OARs. 497 cases with thoracic tumors were collected. Among them, the computed tomography (CT) images encompassing lung, heart and spinal cord were included in this study. The corresponding contours delineated by experienced radiation oncologists were ground truth. All cases were randomly categorized into the training and validation set ( n=300) and test set ( n=197). By applying MTLW-CNN on the test set, the Dice similarity coefficients (DSCs) of 3 OARs, training and testing time and space complexity (S) were calculated and compared with those of Unet and DeepLabv3+ . To evaluate the effect of multi-task learning on the generalization performance of the model, 3 single-task light-weight CNNs (STLW-CNNs) were built. Their structures were totally the same as the corresponding branches in MTLW-CNN. After using the same data and algorithm to train STLW-CNN, the DSCs were statistically compared with MTLW-CNN on the testing set. Results:For MTLW-CNN, the averages (μ) of lung, heart and spinal cord DSCs were 0.954, 0.921 and 0.904, respectively. The differences of μ between MTLW-CNN and other two models (Unet and DeepLabv3+ ) were less than 0.020. The training and testing time of MTLW-CNN were 1/3 to 1/30 of that of Unet and DeepLabv3+ . S of MTLW-CNN was 1/42 of that of Unet and 1/1 220 of that of DeepLabv3+ . The differences of μ and standard deviation (σ) of lung and heart between MTLW-CNN and STLW-CNN were approximately 0.005 and 0.002. The difference of μ of spinal cord was 0.001, but σof STLW-CNN was 0.014 higher than that of MTLW-CNN.Conclusions:MTLW-CNN spends less time and space on high-precision automatic segmentation of thoracic OARs. It can improve the application efficiency and generalization performance of the models.

Objective:To investigate the clinical efficacy of laparoscopic adrenalectomy and traditional open adrenalectomy for adrenal tumors in children.Methods:In Department of Pediatric Surgery, Fujian Provincial Maternity and Children′s Hospital from June 2008 to June 2016, the clinical data of 31 pediatric adrenal tumors was retrospectively analyzed.According to different surgical methods, they were divided into traditional open adrenalectomy group and laparoscopic adrenalectomy group.Bleeding loss, operation duration, incision length, abdominal drainage time, postoperative hospital stay, postoperative complications and recurrence were compared between the 2 groups.Results:There was no significant difference in age, sex, weight, and tumor size between the 2 groups (all P>0.05). The intraoperative bleeding loss was (18.06±4.86) mL for open adrenalectomy group and (15.20±4.48) mL for laparoscopic adrenalectomy group, and there existed no significant difference in the amount of bleeding between the 2 groups( T=-1.702, P>0.05). The operation duration was (137.44±19.32) min for open adrenalectomy group versus (134.80±6.21) min for laparoscopic adrenalectomy group, and there was no significant difference in operation duration between the 2 groups ( T=-0.504, P>0.05). The length of incision was (7.94±1.34) cm for open adrenalectomy group versus (3.44±0.21) cm for laparoscopic adrenalectomy group, the length of incision in laparoscopic group was shorter than that in open adrenalectomy group.There was significant difference in the length of incision between the 2 groups ( T=-12.843, P<0.001). The hospitalization time was (9.63±2.55) d for open adrenalectomy group versus (7.20±1.37) d for laparoscopic adrenalectomy group, the hospitalization time in laparoscopic group was shorter than those in open adrenalectomy group.The difference of operation time between the 2 groups was statistically significant ( T=-3.261, P=0.003). The average indwelling time of abdominal drainage tube was(5.94±1.53) d for open adrenalectomy group versus (4.80±1.74) d for laparoscopic adrenalectomy group, with no significant difference in postoperative abdominal drainage time between the 2 groups( T=-1.938, P>0.05). There was 1 case of retroperitoneal hematoma in laparoscopic adrenalectomy group and 2 cases of complications in open adrenalectomy group.There was no significant difference in the incidence of complications between the 2 groups ( P=1.000). There were 3 cases of distant metastasis and 1 case of recurrence in laparoscopic group, and 2 cases of distant metastasis and 1 case of recurrence in open adrenalectomy group.There was no significant difference in recurrence between the 2 groups ( P=1.000). Conclusions:Compared with open adrenalectomy surgery, laparoscopic adrenalectomy in children has various advantages, including beautiful incision, less trauma and fast recovery.However, it is necessary to select the appropriate cases.