Progress in the metacarpophalangealgeal joint implantation has drawn increasing attention to its role in treatment of chronic arthritis of the hand. This paper summarizes the biomechanic research and devolvement of the prosthesis, preoperative evaluation and plan for metacarpophalangealgeal joint implantation and the clinical results of different designs of the MCP prosthetic joint in the past decade. With improvement of prosthesis designs and operative technology, the MCP implantation will play a better role in clinical treatment of chronic arthritis of the hand, such as relief of pain, rectification of abnormality and functional recovery of the hand.

Objective To explore the effect of Jiangzhipailuan decoction in regulating PPARα( belong to the nuclear receptor family of ligand-activated transcription factors ), PGC- 1α ( peroxime proliferator activated releptour)and SREBP-1c( belong to the baichelix-loop-helix-leucine zipper class of transcription factors), SCAP( SREBP cleavage activating protein) related to lipid metabolism in the treatment of polycystic ovarian syndrome. Methods 84 patients suffered polycystic ovary syndrome were randomly divided into 4 groups: one received traditional Chinese medicine treatment, one western medicine treatment, one combination therapy and one as the control group. Traditional Chinese medicine group was treated with Jiangzhipailuan decoction treatment for 3 months, western medicine group was treated with up to Diane-35 ( ethinyl cyproterone tablets) for three cycles, while the combination therapy group was treated with traditional Chinese medicine ,western medicine as well as combined treatment for 3 courses. Results In the combination therapy group the PPARα, PGC-1α and decreased SREBP-1c, SCAP copy number was significantly improved ,and body mass index was significantly lowered. The total improvement rate of menstrual in three groups were 71.42% ,75.00% ,92.86% respectively. Conclusion Jiangzhipailuan decoction played a prominent role in regulating PPARα,PGC-1α and SREBP-1c,SCAP related to lipid metabolism in the treatment of polycystic ovarian syndrome.

BACKGROUND: The articular surface of interphalangeal joint and metacarpophalangeal joint is destroyed or defected, that would remain serious sequela in many patients and affect patient's routine work and living. Therefore, therapeutic efficacy of finger joint damage determines the functional recovery of hands. Tissue engineering provides a novel pathway for finger joint damage. OBJECTIVE: To summarize the research progress on the repair and reconstruction of finger joint damage. RETRIEVAL STRATEGY: The researcher of this article used the computer to retrieve literatures of Pubmed database with docuterms of "Interphalangeal joints fractures, Metacarpophalangeal joints fractures, Finger osteoarticular, Reconstruct", and the language was defined to English. Meanwhile China Academic Journals Full-Text Database from 2000 to 2007 was also retrieved with docuterms of "Interphalangeal joints, Metacarpophalangeal joints, Fractures, Repair and reconstruct", and the language was defined to Chinese. Totally 106 correlated articles were screened out and the data were firstly checked. Inclusion standard: ①closely correlated to the repair and reconstruction of finger joint damage; ②those published in the near future or authorized journal in the same field were preferred. Exclusion standard: repetitive investigation. LITERATURE EVALUATION: The resource of literatures was the clinic empirical studies of the repair and reconstruction of finger joint damage. Among 32 included articles, 3 of them were reviews and the others were clinic or empirical studies. DATA SYNTHESIS: The homogeneity variant bone-joint transplantation has got some successes in clinic, but how to prolong the survival time of transplanting joints would be a new research topic. Autoallergic joint transplantation is a good method to treat the defects of finger joints, but how to make handling conveniently, diminish secondary damage and search new donor site, all deserve to research. The ideal therapeutic efficacy of the finger joint damage is anatomical reset of the joint profile, that can reduce traumatic arthritis and anchylosis at the minimal level. But it is still a tough problem in the fingers joint's repairs, because of the multiple structure of bone-joint in hands and trauma factors. Open reduction and internal fixation, skeletal traction, arthroplasty, fusion of joint, prosthetic replacement of joint, articular transplantation and bone-joint tissue engineering have all obtained success, but none can fully succeed or be generally adopted. CONCLUSION: There are many treatments of the finger joint damage, but their results are not very well. With the research of homogeneity variant bone-joint transplantation, autoallergic joint transplantation and tissue engineering development, bone-joint transplantation will have a wide prospect in treatment of finger joints damage.

0.01). CONCLUSION: The 5th CMC joint of the hamatum can be considered to be a new and well joint donor site, and it can be used to repair and reconstruct the base joints of the proximal phalanx.

Objective: To explore the characteristics of clinical pathology, diagnosis, and prognosis of primary renal lymphoma (PRL).Methods: The clinical features, pathological features, immune phenotypes, treatment, and prognosis of 22 patients were retrospectively analyzed. Results: The PRL patients' ages ranged from 2 to 72 years (mean, 54.3 years), of which 13 patients were older than 50 years (59.1%). All of the 22 patients were diagnosed with non-Hodgkin's lymphoma (NHL), including 20 cases of B-cell lymphoma and 2 cases of T-cell lymphoma. Seven patients were still alive and survived for 6-50 months, but the other 15 were dead and survived for only 5-35 months. Conclusion: PRL is uncommon. Clinical manifestations and imaging performance specificity are not obvious. and easily misdiagnosed. Histopathology is still the golden standard for the final diagnosis of this entity. The kidney is most easily involved followed by the bladder. B-cell NHL is the common subtype, and the most common type is the diffuse large B-cell lymphoma. Up to now,no standard regime could be performed for PRL patients. At present, comprehensive therapy, including surgery and chemotherapy, is recommended. For patients with locally advanced or highly aggressive status, therapeutic effect with chemotherapy alone is usually satisfied.

Objective:To study the clinicopathologic and genetic features of Waldeyer′s ring peripheral T-cell lymphoma with follicular helper T cell immunophenotypes (wPTCL-TFH), with comparison to the nodal peripheral T-cell lymphoma with TFH immunophenotypes (nPTCL-TFH) and angioimmunoblastic T-cell lymphoma (AITL), as to know this rare tumor better.Methods:The clinical data, histopathology features, EBV positivity, T cell clonality and IDH2 R172 gene mutation in 8 cases of wPTCL-TFH were collected at the First Affiliated Hospital of Zhengzhou University from December 2015 to April 2019, and analyzed by immunohistochemistry, in situ hybridization, TCR gene rearrangement (BIOMED-2) and Sanger sequencing.Follow-up data were obtained by telephone. Results:There were 6 males and 2 females with a median age of 62.5 years (age ranging from 30 to 75 years). All patients had neither fever nor skin manifestations, but were all found mucosa thickened or mass of waldeyer′s ring with multiple lymph nodes enlarged by PET-CT/CT scans. Five of the 7 patients were at advanced stages (Ⅲ/Ⅳ stage). Microscopically, the mucosa was infiltrated diffusely and characteristically by numerous small-medium sized lymphocytes, lacking polymorphous inflammatory background and extra-follicular expansion of follicular dendritic cell networks (FDC networks). The clear T cells presented in 5 cases. Ulcers on mucosal surfaces (6 cases) and local-extensive loss of intramucosal glands (7 cases) were commonly noted. Granulomas composed of epithelioid histiocytes were observed in 2 cases. Immunohistochemically, all the tumor cells expressed CD4 and at least 2 types of follicular helper of T cell (TFH) markers: PD-1 (8/8), bcl-6 (8/8), CXCL13 (7/8) and CD10 (1/8). Most of the cases (6 cases) expressed CD30. EBV positive appeared in 4 cases. All 8 cases were T cell monoclonal. IDH2 R172 were wild-type in 6 cases. One patient died at the follow-up time on 18 months; the other 7 survived (the follow-up time varied from 3 to 10 months). Conclusions:wPTCL-TFH is rare, and its clinicopathological features are similar to nPTCL-TFH which may be the manifestation of the same disease at different stage, and partly overlapped with AITL. The differential diagnosis from PTCL-NOS is necessary and comprehensive analyses of clinical, morphological, immunohistochemical and genetic features can help make a correct diagnosis.

Freezing of gait is a common gait disorder in Parkinson disease (PD), which is highly disabling, situational and therapeutically challenging. At present, there is no clear and effective intervention method. In recent ten years, exercise training based on cognitive-motor dual tasks has been more and more used in the intervention treatment of freezing of gait of PD patients, and achieved certain clinical results. The muscle-brain crosstalk effect of exercise training promoting muscle secretory factors is crucial for freezing of gait rehabilitation of PD. There are differences in the effects of cognitive-motor dual tasks of different types and loads on gait, but the specific training types and loads and mechanism of action still need to be further elucidated. This paper focuses on the research progress of muscle-brain crosstalk mechanism in cognitive-motor interference effect of freezing of gait in PD patients, aiming to providing a new theoretical perspective for clinical cognitive-motor training intervention of freezing of gait in PD patients.

Objective:To study the clinicopathological features and prognosis of nodal lymphoplasmacytic lymphoma/Waldenstrom′s macroglobulinemia (n-LPL/WM).Methods:A total of 19 cases of n-LPL/WM were collected from May 2009 to January 2020 at First Affiliated Hospital of Zhengzhou University. The clinicopathologic features, immunophenotype, Ig gene rearrangement (BIOMED-2), MYD88 L265P mutation status (by Sanger sequencing) and follow-up data (by telephone) were analyzed.Results:There were 15 males and 4 females with a median age of 61 years (range 43 to 82 years). There were 14 WM and five LPL. The most common symptoms were weakness, fatigue (9/19) and B symptoms (11/19). Majority of the patients (16/18) presented with systemic multiple lymphadenopathies. Eighteen patients presented at advanced stages (Ⅲ/Ⅳ stage). Serum M protein status was IgM (15 cases), IgG (1 case), IgA (1 case) and no-secretory type (2 cases). Seventeen patients had bone marrow involvement. Morphologically, all 19 cases were divided into two groups: typical group (9 cases) or atypical group (10 cases). In the typical group, the structures of the lymph nodes were preserved; the neoplastic cells were predominantly plasmacytoid lymphocytes or mixed small lymphocytes, plasmacytoid lymphocytes and plasma cells, without proliferation of FDC network and follicular implantation. In the atypical group, the tumor showed effaced nodal architecture (5 cases), mainly proliferation of small lymphocytes (6 cases), FDC proliferation and/or follicular implantation (6 cases), marginal zone B cell differentiation (4 cases) and diffuse amyloidosis (1 case). Hemosiderin deposition (19 cases), infiltration of fatty tissue (19 cases) and interstitial sclerosis (9 cases) were commonly seen in both groups. Immunohistochemically, the neoplastic B cells expressed CD20 and CD79α, and the neoplastic plasma cells were positive for CD38, CD138 and MUM-1; eight cases showed light chain restriction; of the seven detected cases, five expressed IgM and the other two expressed IgG and IgA respectively; four cases expressed CD23 weakly, Ki-67 index was 10%-30%. MYD88 L265P mutation was seen in 18/18 cases. There was no significant difference in clinicopathologic features and prognosis between the two groups ( P>0.05). The median follow-up time was 61 months, 11 patients were alive, while eight died; the 5-year survival rate was 21.1%. Conclusions:n-LPL/WM is rare, but patients usually present in advanced stages. It is easily confused with other small B-cell lymphomas with plasma cell differentiation, especially basing on morphologic features alone; thus the accurate diagnosis of n-LPL/WM requires a combination of clinical features, serum M protein, immunohistochemistry, bone marrow morphology,flow cytometry and MYD88 L265P mutation status etc. The prognosis of n-LPL/WM may be not very good, and further studies with more cases are needed.

Objective:To evaluate the diagnostic efficiency of hypersensitivity quantitative fecal immunochemical test (hs-qFIT) in colorectal cancer (CRC) and advanced adenoma.Methods:From July to December 2020, consecutive patients aged 50 to 75 years who underwent colonoscopy in Qilu Hospital of Shandong University, and had the Asia-Pacific colorectal screening score of medium or high risk were enrolled. All patients were requested to complete two hs-qFIT before colonoscopy. The diagnostic efficacy of hs-qFIT for CRC and advanced adenoma were assessed. Receiver operating characteristic curve of hs-qFIT in CRC diagnosis was drawn and the area under the curve (AUC) was calculated.Results:A total of 811 patients including 20 (2.5%) cases of CRC, 47 (5.8%) cases of advanced adenoma, 206 (25.4%) cases of non-advanced adenoma, 219 (27.0%) cases of non-adenomatous polyp, 76 (9.4%) cases of other colorectal lesions and 243 (30.0%) cases of non-colorectal lesions were involved. When the fecal hemoglobin cut-off values were 10, 30, 50, 75 and 100 ng/mL, the positive rates of hs-qFIT detection were 17.9% (145/811), 10.9% (88/811), 8.3% (67/811), 7.4% (60/811) and 5.8% (47/811), respectively. When the cut-off value of fecal hemoglobin decreased from 100 ng/mL to 10 ng/mL, the sensitivity of hs-qFIT for CRC diagnosis increased from 90.0% to 100.0%, and the specificity decreased from 96.3% to 84.2%; and the sensitivity of hs-qFIT for the diagnosis of advanced adenoma increased from 19.1% to 66.0%, and the specificity decreased from 95.0% to 85.1%. The AUC of hs-qFIT for the diagnosis of CRC and advanced adenoma were 0.981 (95% confidence interval ( CI) 0.970 to 0.992) and 0.846 (95% CI 0.807 to 0.886), respectively. When the optimal cut-off values were taken, the sensitivity and specificity were 100.0% and 91.2% for the diagnosis of CRC, and 66.0% and 85.3% for the diagnosis of advanced adenoma, respectively. Conclusion:Hs-qFIT can help the early screening of CRC and advanced adenoma.