Objective To evaluate graft isometry after anatomic single bundle reconstruction of anterior cruciate ligament (ACL) using dynamic computed tomography (CT).Methods A retrospective study was conducted of the 14 patients who had undergone single bundle ACL reconstruction from June to August 2015.They were all men,with an average age of 28.6 years (range,from 18 to 39 years).At 6 months after operation,they received dynamic CT scanning during a cycle of knee extension to flexion.3D bone models representing the knee at different flexion positions (0°,30°,60°,90°,and 120°) in each patient were reconstructed from the CT images.The grid method was used to locate the positions of the central footprints of the tibial and femoral tunnels.The lengths between the entries of the femoral and tibial tunnels were measured from each tunnel entry to reflect the graft length change.Furthermore,we measured the isometry at the over-the-top position of the femur and at the anatomic tibial position.Results All the tunnel entries were located at the central area of the ACL anatomic attachment.The reconstructed ACL was the longest when the knee was in full extension.The length was gradually shortened between the femoral and tibial tunnels during flexion of the knee from 0° to 90°.The anatomic position showed an average of 4.82 mm shortening and the over-the-top position an average of 3.28 mm shortening.The length excursion increased in early flexion from 0° to 30° (2.91 ±0.91 mm on average) and reduced in later flexion from 90° to 120° (2.98 ± 1.41 mm on average).Conclusions None of the reconstructed ACL was isometric.A graft length may be the longest when the knee is in full extension and decrease gradually during the flexion from 0° to 90° and increase gradually during the flexion of 90° to 120°.The graft should be fixed when the knee is in the flexion of 30°.

Objective To study the relationship between the dose indicator of computed radiography (CR) and the entrance surface dose (ESD),and to build a model for estimating ESD based on this relationship.Methods Taking Kodak CR system as the research object,a theoretical model for estimating the ESD was established according to theoretical derivations,and the key parameters in the model were determined through experiments in a CR system.Further experiments in another CR system were also conducted to verify the model.Results The ESDs were not only dependent on the dose indicator provided by the CR system,but also influenced by other factors,such as tube potential,patient's body thickness and energy response of the imaging plate.The estimation results of the model agreed well with the experiment results,and the relative deviation was confirmed within 20％.Conclusions The dose indicator based model can provide a relatively fast and easy way for evaluating the doses of patients undergoing X-ray diagnoses with the CR system.

OBJECTIVETo explore the association of fish intake with the risk of renal cancer.

METHODSPubMed, Embase, CNKI and CA databases were searched for case-control studies or cohort studies examining the relationship between fish or fish products intake and renal cancer. Heterogeneity among the selected studies was assessed using I2 score, and the publication bias was assessed using funnel plots.

RESULTSSeventeen articles were included in the analysis with a heterogeneity across the studies (P=0.003, I(2)=52.3%). A random-effects model was used to generate the pooled risk ratio (RR) and 95% confidence interval (CI), and no statistically significant association was found between the risk of renal cancer and fish intake (RR=0.90; 95% CI, 0.78-1.02). In subgroup analysis, no evidence was found that the study design, study region or publication date influenced the results; but in the gender subgroup analysis, fish intake we found to decrease the risk of renal cancer in men but not in women.

CONCLUSIONThe results of meta-analysis do not support an association between fish intake and a lowered risk of renal cancer.

Carcinoma, Renal Cell ; etiology ; Diet ; Female ; Fish Products ; Humans ; Kidney Neoplasms ; etiology ; Male ; Odds Ratio ; Risk Factors

Objective To investigate the relationship between serum markers β amyloid (Aβ), tau and thyroid hormone levels and post-stroke cognitive impairment (PSCI) in the acute phase of cerebral infarction. Methods A total of 214 patients with acute cerebral infarction were enrolled. The baseline data and serological indicators were collected and the cognitive function of patients was evaluated. All patients were divided into cognitive impairment group and normal group based on follow-up results. The differences of Aβ1-42, tau protein and thyroxine levels between the two groups and their relationship with disease progression were analyzed. The Cox regression analysis and ROC curve were used to compare the above parameters to predict the development of PSCI. Results The total protein level of Tau (210.6 ±98.9 pg/mL) was higher and Aβ1-42 (426.1 ±123.5 pg/mL) and triiodothyronine (T3) (1.43 ±0.57 nmol/L), free thyroxine (FT4) (13.15±2.23 pmol/L) was significantly lower in the cognitive impairment group than in the normal group (P<0.05). Tau protein (r=-0.457), Aβ1-42 (r=0.348), T3 (r=0.211), and FT4 (r=0.306) were all associated with disease progression (P<0.05). Cox regression analysis showed that Aβ1-42 and T3 were important influencing factors in the occurrence of PSCI. The area under the curve of Aβ1-42 combined with T3 was 0.841. The specificity and the sensitivity were 74.8% and 85.3%, respectively, with a diagnostic cutoff value of 0.572. Conclusion Aβ1-42 and T3 levels in the acute phase of cerebral infarction may predict the progression of PSCI.

Objective:To explore the effect of continuous feeding on the growth and development of premature infants.Methods:A total of 82 cases of premature infants in our hospital were selected as the research objects, whose birth time was from March 2018 to March 2019. According to different feeding methods, they were divided into control group and observation group, 41 cases in each group. The control group was fed intermittently and the observation group was fed continuously. Before and after 6 months of feeding, the levels of serum growth hormone and insulin-like growth factor-1, the mental development index(MDI) and physical development index(PDI), body mass, head circumference and height, and adverse reactions were compared.Results:The time of jaundice regression and hospitalization time in the observation group were (8.01±1.52) d, (28.41±3.57) d, shorter than (10.28±2.29) d, (36.19±6.47) d in the control group, the difference was statistically significant ( t value was 5.288, 6.741, P<0.05). There was no significant difference between the control group and the observation group in the levels of serum growth hormone and insulin-like growth factor-1 before feeding ( t value was 0.160, 0.075, P>0.05). After feeding for 6 months, the levels of serum growth hormone and insulin-like growth factor-1 in the experimental group were higher than those in the control group ( t value was 6.895, 19.537, P<0.05). Six months after feeding, the MDI and PDI of the observation group were 115.2±67.93 and 107.6±48.66 respectively, higher than 96.17±13.57, 94.52±10.89 in the control group ( t value was 7.777, 6.038, P<0.05). After feeding for 6 months,the growth level of body weight,head circumference and height in the observation group was higher than that in the control group ( t value was 7.590,10.124,15.661, P<0.05). The adverse reactions of premature infants in hospital infection, multiple apnea, gastric retention and neonatal necrotizing enterocolitis were lower than those in the control group ( χ2 value was 5.399-21.006, P<0.05). Conclusions:Continuous feeding can significantly improve the level of growth hormone and insulin-like growth factor-1 in premature infants, which is conducive to their growth and development, reduce the occurrence of adverse reactions and shorten the hospitalization time of premature infants, which has a certain clinical application value.

Tocilizumab has been reported to attenuate the "cytokine storm" in COVID-19 patients. We attempted to verify the effectiveness and safety of tocilizumab therapy in COVID-19 and identify patients most likely to benefit from this treatment. We conducted a randomized, controlled, open-label multicenter trial among COVID-19 patients. The patients were randomly assigned in a 1:1 ratio to receive either tocilizumab in addition to standard care or standard care alone. The cure rate, changes of oxygen saturation and interference, and inflammation biomarkers were observed. Thirty-three patients were randomized to the tocilizumab group, and 32 patients to the control group. The cure rate in the tocilizumab group was higher than that in the control group, but the difference was not statistically significant (94.12% vs. 87.10%, rate difference 95% CI-7.19%-21.23%, P = 0.4133). The improvement in hypoxia for the tocilizumab group was higher from day 4 onward and statistically significant from day 12 (P = 0.0359). In moderate disease patients with bilateral pulmonary lesions, the hypoxia ameliorated earlier after tocilizumab treatment, and less patients (1/12, 8.33%) needed an increase of inhaled oxygen concentration compared with the controls (4/6, 66.67%; rate difference 95% CI-99.17% to-17.50%, P = 0.0217). No severe adverse events occurred. More mild temporary adverse events were recorded in tocilizumab recipients (20/34, 58.82%) than the controls (4/31, 12.90%). Tocilizumab can improve hypoxia without unacceptable side effect profile and significant influences on the time virus load becomes negative. For patients with bilateral pulmonary lesions and elevated IL-6 levels, tocilizumab could be recommended to improve outcome.
Antibodies, Monoclonal, Humanized ; COVID-19/drug therapy* ; Humans ; SARS-CoV-2 ; Treatment Outcome