BACKGROUND: With the increasing number of patients undergoing knee arthroplasty in China, the complications caused by the mismatch of prosthesis with anatomical parameters arouse extensive attentions.OBJECTIVE: To measure the anatomical parameters of the knee joints in healthy Zhuang ethnic group from Guangxi Zhuang Autonomous Region, China, using three-dimensional (3D) reconstruction technology, thus providing reference for the design and placement of the hip prosthesis.METHODS: Sixty-eight individuals, including 30 females and 38 males, were selected from 217 healthy people undergoing CT examination. All data were imported into Mimics 15.0 software used for 3D reconstruction, and then the knee parameters were then measured and analyzed.RESULTS AND CONCLUSION: There was no significant difference in the parameters of the bilateral femur and tibia (P > 0.05). The femoral parameters had significant differences between genders (P < 0.05). The width of tibial platform, sagittal length of lateral tibial platform, distance between medial tibial plateau and fibular head, and posterior slope of tibial plateau showed no significant differences between genders (P > 0.05), while there were significant differences in the width of medial/lateral tibial platform, and sagittal length of medial tibial platform between genders (P < 0.05). The sagittal length of medial femoral condyle was negatively correlated with age, and all femoral parameters were positively correlated with height; while only the width of medial and lateral tibial platform were positively correlated with height. To conclude, 3D reconstruction technology is available for research on the morphology of the knee joint in the Zhuang ethnic group from Guangxi Zhuang Autonomous Region, which provides references for prosthesis design and research appropriate for the Zhuang ethnic group.

Objective To investigate the expression of PD-1 on CD4 +and CD8 + T cells in patients with HBeAg-positive chronic hepatitis B(CHB)treated with telbivudine.Methods Fifty-six HBeAg-positive CHB patients admitted in the First Affiliated Hospital of Zhengzhou University during January 201 3 and June 201 4 were enrolled in this study.The expression of PD-1 on CD4 +and CD8 + T cells was detected with flow cytometry at baseline,24,48 and 72 wks after telbivudine treatment.The relationship of PD-1 expression with alanine aminotransferase (ALT)level,HBeAg seroconversion and HBV DNA loads was analyzed.t test and completely random variance analysis were used to analyze the data.Results The PD-1 expression on CD4 + and CD8 + T cells at baseline was higher in patients with low ALT levels compared to those with high ALT levels(t =1 2.20 and 9.69,both P <0.01 ),while higher levels of PD-1 expression was also observed in patients with high HBV DNA load (≥5 lgIU /mL)compared to those with low HBV DNA load (t =4.39 and 4.85,both P <0.01 ).PD-1 levels on CD4 + and CD8 + T cells presented a declining trend after telbivudine treatment(F =6.98 and 8.97,both P <0.01 ),PD-1 expression in patients with HBeAg seroconversion showed lower levels compared with baseline values (t =1 8.45 and 1 8.01 ,both P <0.01 ). Conclusion In HBeAg-positive CHB patients,the expression of PD-1 on CD4 + and CD8 + T lymphocytes shows a decreasing trend during the treatment with telbivudine,indicating that antiviral therapy may alleviate the immunosuppression in these patients.

Objective To evaluate reference range for fasting venous blood cells in the healthy 51 584 elderly people from Shuyang,China.Methods Totally 1000 non-old people and 51 584 elderly people were involved in this study.Fasting venous blood cells were collected from each group of subjects using standard procedures.The collected aliquots were processed according to standard operating procedures to determine participants' complete blood counts.Non-parametric methods were employed to calculate the reference intervals and 95 ％ confidence intervals for complete blood counts by Sysmex XE-2100 blood cell analyzer.Results The reference ranges of fasting venous blood cells in elderly subjects (male,female) were [(3.25-9.45) × 109/L and (3.35-9.39) × 109/L,WBC];[(3.87-5.55) × 1012/L and (3.71-5.19) × 1012/L,RBC] ; [(116.2-169.5)g/L and(107.4-153.6)g/L,Hb] ; [(37.2-52.4) ％ and(35.2-48.6) ％,HCT] ; [(86.3-104.8)fl and (85.2-103.5) fl,MCV] ; [(27.0-33.4) pgand(26.4-32.5)pg,MCH]; [(297.1-335.4)g/L and(293.3-330.5)g/L,MCHC];[[(38.4-54.2) and (38.6-52.9),RDW-SD]; [(11.3-15.4)％ and(11.4-15.3)％,RDW-CV];[(98.8-303.8) × 109/L and (109.9-334.8) × 109/L,PLT] ; [(1.10-3.42) and (1.20-3.78) ml/L,PCT];[(11.2-15.6) fl and(11.3-15.5)fl,MPV]; [[(8.89-16.7)％ and(9.48 17.1)％,PDW];[(20.3-49.1) ％ and (20.5-48.6) ％,PLCR],respectively.13 parameters of fasting venous blood samples in elderly people had statistically significant differences compared with non-old people (all P ＜0.05).Conclusions The reference range of fasting venous blood samples in elderly people are significantly different from non-old people.It is necessary to scientifically and reasonably establish the reference ranges for fasting venous blood cells in local elderly people.

Objective:To investigate the application value of Overlap guiding tube (OGT) in Overlap esophagojejunostomy of laparoscopic total gastrectomy.Methods:The retrospective and descriptive study was conducted. The clinicopathological data of 5 patients with gastric cancer who were admitted to Nanfang Hospital of Southern Medical University from June to July in 2021 were collected. There were 3 males and 2 females, aged from 48 to 61 years, with a median age of 54 years. Patients underwent laparoscopic total gastrectomy combined with OGT-assisted Overlap esophagojejunostomy. Observation indicators: (1) surgical situations; (2) postoperative situations; (3) follow-up. Follow-up was conducted by outpatient examination and telephone interview to detect postoperative anastomotic stenosis and esophageal reflux up to September 2021. Measurement data with normal distribution were represented as Mean± SD, and measurement data with skewed distribution were represented as M(IQR) or M(range). Count data were represented as absolute numbers. Results:(1) Surgical situations: 5 patients underwent laparoscopic total gastrectomy combined with OGT-assisted Overlap esophagojejunostomy and D 2 lymph node dissection success-fully, achieving R 0 resection. There was no combined organ resection, intraoperative conversion to laparotomy or combined thoracotomy. There was no intraoperative conversion to other esophagoje-junostomy method either. The tumor diameter, length of surgical incision, the number of lymph nodes dissected, time of esophagojejunal anastomosis, time of digestive reconstruction, operation time, volume of intraoperative blood loss of 5 patients were 3.0(2.8)cm, 5.0(2.0)cm, 47.0(21.0), 21.0(5.0)minutes, 62.0(23.0)minutes, 295.0(75.0)minutes, and 50.0(60.0)mL, respectively. The anvil fork of linear stapler was successfully inserted into esophageal lumen by once operation in 4 cases of 5 patients and by twice operation in 1 case to complete the esophagojejunostomy. (2) Post-operative situations: the time to first out-of-bed activities, time to postoperative first anal flatus, time to postoperative initial liquid diet intake, time to postoperative initial semi-liquid diet intake, time to abdominal drainage tube removal, duration of postoperative hospital stay of 5 patients were 2.0(1.0)days, 3.0(2.0)days, 4.0(3.0)days, 6.0(3.0)days, 7.0(4.0)days, and 9.0(6.0)days, respectively. Results of postoperative pathological examination of 5 patients showed gastric adenocar-cinoma in all the 5 patients, with the TNM staging as stage pT2-4aN0M0. The esophageal surgical margin was negative in all cases, and the length of proximal margin from esophagus was 5.0(4.0)cm. None of the 5 patients developed anastomotic leakage, anastomotic bleeding or anastomotic stenosis. Two cases with mild pneumonia (Clavien-Dindo grade Ⅱ) were cured by conservative treatment such as anti-infection and expectoration promotion. There was no unplanned secondary surgery or perioperative death occurred to the 5 patients. (3) Follow-up: 5 patients were followed up for 3 months. None of the 5 patients developed anastomotic stenosis or esophageal reflux during the follow-up. Conclusion:OGT-assisted Overlap esophagojejunostomy of laparoscopic total gas-trectomy is safe and feasible, with good short-term effects.

Objective: To explore the value and disadvantage of micro-mirror in the intracranial aneurysm surgery. Methods: Micro-mirror was used to assist microsurgical clipping to 36 intracranial aneurysms in 31 cases, of which 3 were carotid-ophthalmic artery aneurysms, 3 anterior choroidal artery aneurysm, 11 were posterior communicating artery aneurysms, 7 were middle cerebral artery aneurysms, 10 anterior communicating artery or anterior cerebral artery aneurysms, and the others were a posterior cerebral artery aneurysm and a posterior inferior cerebellar artery aneurysm. The micro-mirror was used before and after clipping to observe the anatomic features of necks hidden behind and medial to aneurysms, to visualize surrounding neurovascular structures, and to verify the optimal clipping position. Intraoperative indocyanine green fluorescein angiography confirmed the success of sufficient clipping. Results: All aneurysms were clipped successfully. The parent arteries were occluded temporarily in 26 cases, and 9 aneurysms ruptured during the operation. Postoperative follow-up lasted from 2 weeks to 1 year. After operations digital subtraction angiography (DSA) were repeated in 10 cases, computed tomography angiography(CTA) in 21 cases, and no insufficient clipping or occlusion of parent arteries were revealed. Conclusions Micro-mirror assisting microsurgical clipping to the intracranial aneurysm is conducive to accurate clipping, and is a convenient and practical operation.

We conducted a prospective study to assess the non-inferiority of adjuvant chemotherapy alone versus adjuvant concurrent chemoradiotherapy (CCRT) as an alternative strategy for patients with early-stage (FIGO 2009 stage IB-IIA) cervical cancer having risk factors after surgery. The condition was assessed in terms of prognosis, adverse effects, and quality of life. This randomized trial involved nine centers across China. Eligible patients were randomized to receive adjuvant chemotherapy or CCRT after surgery. The primary end-point was progression-free survival (PFS). From December 2012 to December 2014, 337 patients were subjected to randomization. Final analysis included 329 patients, including 165 in the adjuvant chemotherapy group and 164 in the adjuvant CCRT group. The median follow-up was 72.1 months. The three-year PFS rates were both 91.9%, and the five-year OS was 90.6% versus 90.0% in adjuvant chemotherapy and CCRT groups, respectively. No significant differences were observed in the PFS or OS between groups. The adjusted HR for PFS was 0.854 (95% confidence interval 0.415-1.757; P = 0.667) favoring adjuvant chemotherapy, excluding the predefined non-inferiority boundary of 1.9. The chemotherapy group showed a tendency toward good quality of life. In comparison with post-operative adjuvant CCRT, adjuvant chemotherapy treatment showed non-inferior efficacy in patients with early-stage cervical cancer having pathological risk factors. Adjuvant chemotherapy alone is a favorable alternative post-operative treatment.
Female ; Humans ; Uterine Cervical Neoplasms/drug therapy* ; Prospective Studies ; Quality of Life ; Neoplasm Staging ; Chemoradiotherapy ; Chemotherapy, Adjuvant/adverse effects* ; Adjuvants, Immunologic ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use* ; Retrospective Studies