Objective To study the feasibility of using fluorescent immunofiltration test based on quantum dots (QDs)for rapid and quantitative detection of C-reactive protein.Methods Based on homemade QDs and QDs-antibody bioconjugates,an immune de-tection method was established via the double antibodies sandwich technique on the immunochromatography card.The test results could be read under the irradiation of UV light,and quantitative results could be measured through the combination of a laser and fluorescent spectroscopy.Results Under UV light irradiation,the minimum detection concentration of CRP was 0.156 mg/L.U-sing the quantitative detection method,the fluorescent intensities on the cards could be established a linear relationship with the con-centration of CRP,and the linear equation was that log(Y )=0.563 log(X)+4.570,r2 =0.958.Conclusion The fluorescent quan-tum dot immunofiltration assay can be used for quantitative detection of CRP;The quantum dots immuno-labels have the potential to develop new type of immune-diagnostic reagents.

Objective To compare the efficacy of tibial tuberosity osteotomy (TTO) combined with medial patellofemoral ligament reconstruction (MPFLR) with simple TTO in treatment of recurrent patella dislocation associated with patella alta.Methods From July 2010 to December 2015,50 patients with recurrent patella dislocation and patella alta were included in this study.There were 15 males and 35 females with an average age of 20.6 years.These patients received surgical treatment and their clinical data were collected and retrospectively analyzed by case-control study.According to surgical methods,patients were divided into TTO group (32 cases) and MPFLR + TTO group (18 cases).The differences between preoperative status and postoperative status were evaluated by knee function scores including Tegner,international knee documentation committee (IKDC),Kujala scores,knee injury and osteoarthritis outcome score (KOOS).Patellar stability was checked at the last follow-up visit.Results The TTO group and MPFLR + TTO group were followed up for (50.9 ± 17.8) months and (22.3± 10.1)months,respectively.Two patients occurred recurrent dislocation in TTO group,who showed positive in both extrapolation test and extrapolation apprehension test at 0°flexions of knee.All patients in MPFLR + TTO group did not occur recurrent dislocation,who showed negative in both extrapolation test and extrapolation apprehension test at 0° flexions of knee.There was no significant difference between preoperative and postoperative results in TTO group in Tegner score (P ＞ 0.05),KOOS scores in pain and daily life activities subdomains (P ＞ 0.05),while differences in the rest of scores were statistically significant (P ＜ 0.05).Compared with TFO group,the differences of all scores were statistically significant (P ＜ 0.05) and KOOS scores in the pain and daily life activities subdomains were significantly improved postoperatively in MPFLR + TTO group P ＜0.05).Conclusions For patients with recurrent patellar dislocation associated with patella alta,both surgical methods are found to be effective.Postoperative improvements in pain and daily life activities are less obvious in TTO.While postoperative improvements in pain and daily life activities in MPFLR + TTO are superior to those of TTO.

Objective:To investigate the clinical efficacy of 3D printed metal augment or tibial prosthesis for reconstruction of large bone defects in total knee arthroplasty (TKA) and knee revision surgery.Methods:A total of 7 patients (7 knees) with TKA or knee revision who were admitted to the Department of Orthopaedics of the Second Affiliated Hospital of Zhejiang University School of Medicine with large bone defects from July 2018 to December 2023 were retrospectively analyzed, including 4 patients with TKA and 3 patients with knee revision. There were 3 males and 4 females, aged 58.7±7.6 years (range, 54-68 years), 3 patients with left knee and 4 patients with right knee. All the patients had bone defects in the knee joint (AORI type III), 2 cases had bone defects only in the femur, 4 cases had bone defects only in the tibia, and 1 case had bone defects in both the tibia and femur, which were treated with personalized reconstruction using 3D printing. Hip-knee-ankle angles, American Knee Society score (KSS) before and after surgery were compared, and postoperative complications were observed.Results:All patients successfully completed the operation, and the operation time was 189.3±35.5 min (range, 125-240 min). Complex TKA was performed in 4 cases with surgical times of 175, 195, 210, and 240 min, and revision surgery was performed in 3 cases with surgical times of 125, 180, and 200 min, respectively. Intraoperative blood loss was 114±24.4 ml (range, 100-150 ml). Five cases used 3D printed metal augment, and two used 3D printed one-piece tibial components. All patients were followed up for 2, 2, 5, 6, 7, 20, 57 months, respectively. The KSS of the five patients at 3 months postoperatively were 56, 61, 66, 56, and 56 points, respectively, greater than the preoperative scores of 35, 44, 36, 27, and 41 points. The KSS functional scores of the five patients at 3 months postoperatively were 45, 45, 45, 30, and 45 points, respectively, which were greater than the preoperative scores of 30, 30, 15, 20, and 20 points. The hip-knee-ankle angle was 181.8°±3.4° (range, 177.9° to 188.0°) at the final follow-up and 175.8°±12.4° (range, 153.3° to 192.1°) before surgery, with no significant difference ( t=-1.230, P=0.242). At the final follow-up, the 3D printed component was well integrated with the bone surface, the prosthesis was securely positioned, and the force lines of the lower limbs were normal. There were no postoperative complications such as poor wound healing, infection, fat liquefaction, nerve injury, deep vein thrombosis of lower limbs, knee joint stiffness, periprosthesis infection and loosening. Conclusion:Using 3D printed metal augment or tibial prosthesis to reconstruct the huge bone defect in TKA and revision has a satisfactory early clinical effect, satisfactory joint function and good surgical safety.

Total knee arthroplasty (TKA) is an effective treatment for end-stage knee disease, with the postoperative alignment, component position, soft tissue balance, and prosthesis matching being key factors for the success of TKA. In order to achieve more accurate postoperative alignment and component position, better soft tissue balance and prosthesis matching for longer prosthesis longevity, better postoperative function and higher patient satisfaction, various intelligent accuracy technological aids such as computer assisted navigation (CAN), patient specific instrumentation (PSI), surgical robots, microsensors, customized implants (CI) and personalized 3D preoperative planning have emerged and are given high expectation. In this paper, the authors review the application and research progress of the above technological aids mainly from aspects of alignment, component position, clinical outcomes and cost analysis, so as to provide a reference for the application of related technological aids in TKA.

The distal femoral fracture, tibial plateau fracture and patellar fracture may all develop into traumatic knee arthritis, which is probably associated with knee dysfunction problems. Total knee arthroplasty (TKA) is an effective treatment for end-stage knee arthritis. The distal femoral valgus cut angle (VCA) is an important reference for distal femoral resection in TKA and significantly affects postoperative prosthesis position and lower extremity alignment after TKA. For VCA, the specific methods for definition, measurement methods, clinical application and influencing factors are currently controversial. Hence, the authors review the research progress in the role of VCA in TKA from the above-mentioned four aspects, hoping to provide a reference for accurate preoperative planning and intraoperative performance of TKA.

To evaluate the efficacy and safety of left atrial appendage occlusion (LAAO) in patients with atrial fibrillation (AF) over 75 years. A total of 82 patients with AF who underwent LAAO successfully in Beijing Anzhen Hospital from March 2014 to March 2019 were divided into two groups according to age: the elderly group (aged>75 years) and the young group (aged ≤75 years). Risk of perioperative complications and incidence of ischemic stroke and major bleeding during follow-up were retrospectively analyzed. The results showed that there were no significant differences in procedure-related ischemic stroke(0 vs.1.6%, P=0.768) and major bleeding (0 vs.1.6%, P=0.768) during perioperative period between the two groups. No complications as death or pericardial tamponade occurred in the two group. During a (25.9±15.9) months period of followed up, ischemic stroke event rate was 3.6/100 person-years in the elderly group and 4.9/100 person-years in the young group, respectively. Major bleeding event rate was 2.5/100 person-years in the elderly group and 0/100 person-years in the young group, respectively. Compared with the expected ones, the relative risk reduction (RRR) of stroke in the elderly group was more profound than that in the young group (32.0% vs. 25.0%), while the risk of major bleeding in the young group was significantly lower than that in the elderly group (RRR 100% vs. 56.9%). Therefore, LAAO might be suitable for stroke prevention in the elderly AF patients.

Anti-Bacterial Agents/pharmacology* ; Biofilms ; Microbial Sensitivity Tests ; Peptides ; Plankton ; Staphylococcus epidermidis

Objective    To analyze and compare the perioperative efficacy difference between full-port Da Vinci robotic surgery and thoracoscopic surgery in patients with mediastinal tumor resection. Methods    The data of 232 patients with mediastinal tumors treated by the same operator in the Department of Thoracic Surgery of the Second Affiliated Hospital of Harbin Medical University were included. There were 103 (44.4%) males and 129 (55.6%) females, with an average age of 49.7 years. According to the surgical methods, they were divided into a robot-assisted thoracic surgery (RATS) group (n=113) and a video-assisted thoracoscopic surgery (VATS) group (n=119). After 1 : 1 propensity score matching, 57 patients in the RATS group and 57 patients in the VATS group were obtained. Results    The RATS group was better than the VATS group in the visual analogue scale pain score on the first day after the surgery [3.0 (2.0, 4.0) points vs. 4.0 (3.0, 5.0) points], postoperative hospital stay time [4.0 (3.0, 5.5) d vs. 6.0 (5.0, 7.0) d] and postoperative catheterization time [2.0 (2.0, 3.0) d vs. 3.0 (3.0, 4.0) d] (all P<0.05). There was no statistical difference between the two groups in terms of intraoperative blood loss, postoperative complications, postoperative thoracic closed drainage catheter placement rate or postoperative total drainage volume (all P>0.05). The total hospitalization costs [51 271.0 (44 166.0, 57 152.0) yuan vs. 35 814.0 (33 418.0, 39 312.0) yuan], operation costs [37 659.0 (32 217.0, 41 511.0) yuan vs. 19 640.0 (17 008.0, 21 421.0) yuan], anesthesia costs [3 307.0 (2 530.0, 3 823.0) yuan vs. 2 059.0 (1 577.0, 2 887.0) yuan] and drug and examination costs [9 241.0 (7 987.0, 12 332.0) yuan vs. 14 143.0 (11 620.0, 16 750.0) yuan] in the RATS group was higher than those in the VATS group (all P<0.05). Conclusion    Robotic surgery and thoracoscopic surgery can be done safely and effectively. Compared with thoracoscopic surgery, robotic surgery has less postoperative pain, shorter tube-carrying time, and less postoperative hospital stay, which can significantly speed up the postoperative recovery of patients. However, the cost of robotic surgery is higher than that of thoracoscopic surgery, which increases the economic burden of patients and is also one of the main reasons for preventing the popularization of robotic surgery.

The artificial neural network has the ability of the information processing and storage, good adaptability, strong learning function, association function and fault tolerance function. The research on the artificial neural network is mostly focused on the dynamic properties due to fact that the applications of artificial neural networks are related to its dynamic properties. At present, the researches on the neural network are based on the hierarchical network which can not simulate the real neural network. As a high level of abstraction of real complex systems, the small world network has the properties of biological neural networks. In the study, the small world network was constructed and the optimal parameter of the small word network was chosen based on the complex network theory firstly. And then based on the regulation mechanism of the synaptic plasticity and the topology of the small world network, the small world neural network was constructed and dynamic properties of the neural network were analyzed from the three aspects of the firing properties, dynamic properties of synaptic weights and complex network properties. The experimental results showed that with the increase of the time, the firing patterns of excitatory and inhibitory neurons in the small world neural network didn't change and the firing time of the neurons tended to synchronize; the synaptic weights between the neurons decreased sharply and eventually tended to be steady; the connections in the neural network were weakened and the efficiency of the information transmission was reduced, but the small world attribute was stable. The dynamic properties of the small world neural network vary with time, and the dynamic properties can also interact with each other: the firing synchronization of the neural network can affect the distribution of synaptic weights to the minimum, and then the dynamic changes of the synaptic weights can affect the complex network properties of the small world neural network.