Objective To explore clinical effect of arthroscopic circumpatellar denervation in anterior knee pain of patellofemoral osteoarthritis and its correlation with cartilage degeneration.Methods Totally 104 patients with anterior knee pain of patellofemoral osteoarthritis were randomly divided into two groups.Patients in control group(n =52) were treated with arthroscopic debridement,and those in combined group(n =52) were treated with arthroscopic debridement plus circumpatellar denervation.All the patients were followed-up for 6 months.The WOMAC scores,knee function recovery were compared between two groups,and the changes of WOMAC score among different degrees of cartilage degeneration were analyzed.Results The WOMAC score of pain,morning stiffness and joint function were significantly improved in combined group than those in control group at 6 months after surgery(P ＜ 0.05).At 6 months after surgery,the score of range of activity and walking distance in both groups were all increased,and combined group had more remarkable increase than that of control group(P ＜ 0.05).Compared with before surgery,the total WOMAC score in patients with grade Ⅰ-m at 6 months after surgery significantly decreased (P ＜ 0.05),while there was no significant difference in patients with grade Ⅳ level between before surgery and 6 months after surgery (P ＞ 0.05).Conclusion Arthroscopic debridement plus circumpatellar denervation for anterior knee pain of patellofemoral osteoarthritis can effectively relieve pain symptom,promote the recovery of knee joint function,especially suitable for patients with cartilage degeneration of Ⅰ ～ Ⅲ.

Objective To investigate the influence of hydroxyethyl starch solution on exogenous coagulation and active protein C (APC) in the patients with septic shock.Methods A single-center prospective study was conducted.Eighty-four consecutive patients with septic shock admitted to intensive care unit (ICU) of Peking University People's Hospital from November 2009 to October 2014 were enrolled.The patients were randomized into two study groups by random digits table:Ringer lactate solution group (RL group,n =40) and hydroxyethyl starch group (HES group,n =44),and Ringer lactate solution or hydroxyethl starch 130/0.4 was used for resuscitation respectively.Peripheral blood was collected at four time points:before resuscitation,6,12,and 24 hours after resuscitation.The prothrombin time (PT),tissue factor (TF),tissue factor pathway inhibitor (TFPI) and APC were determined,and the length of ICU stay and the mortality were recorded.Results There were no significant differences in PT,TF,TFPI,and APC before and after resuscitation in RL group.No change in PT was found after resuscitation in HES group,and no significant difference was found as compared with RL group.TF after resuscitation in HES group was decreased gradually,and the level at the 24 hours after resuscitation was significantly lower than that before resuscitation (U/L:15.80±7.32 vs.31.40±2.75,P ＜ 0.05); but there was no significant difference at all time points when compared with that of RL group (all P ＞ 0.05).TFPI at 12 hours and 24 hours after resuscitation in HES group was increased when compared with before resuscitation (μg/L:1.32±0.22,1.14±0.09 vs.0.63±0.54).TFPI in HES group was significantly higher than that in RL group (μg/L:0.84 ± 0.69,0.95 ± 0.30),but there was no significant differences between two groups (both P ＞ 0.05).APC after resuscitation in HES group was decreased gradually,which was significantly lower than that in RL group at 6,12,24 hours after resuscitation (mg/L:3.38±3.00 vs.5.98±4.12,3.31 ± 1.94 vs.5.33 ± 3.71,3.42 ± 2.64 vs.7.53 ± 4.67,P ＜ 0.05 or P ＜ 0.01).The length of ICU stay in HES group was significantly shorter than that in RL group (days:12.50 ± 8.83 vs.17.10± 16.60,t =9.037,P ＜ 0.001),but there was no significant difference in mortality between HES group and RL group [40.9％ (18/44) vs.60.0％ (24/40),x 2=2.339,P =0.126].Conclusions Both RL and hydroxyethyl starch fluid resuscitation did not affect the PT of the patients.The use of hydroxyethyl starch probably inhibits excessive activation of the exogenous coagulation and hyper-coagulation in the early stage of sepsis,and inhibits activation of protein C as well.

Objective To explore the methods to reduce the occlusion of perforating arteries after intracranial stenting of the vertebral artery. Methods Clinical data of 32 cases of Gateway-Wingspan stent implantation for intracranial branch of vertebral artery were retrospectively analyzed. The postoperative stricture and perfusion improvement situation were evaluated, the reason of perforating artery occlusion was analyzed. Results Thirty-two patients were implanted with 33 pieces of Wingspan stent and 1 piece of Apollo bracket. The operation success rate were 100%, and the stenosis rate reduced from (76.6±6.1)%to (27.9±5.2)%. After three months, the transcranial doppler sonography (TCD) and CT angiography were checked, showing no in-stent restenosis in all patients. Two patients occurred the perforating artery occlusion within 24 hours after operation. The possible reason was the change of stability of atherosclerotic plaque at the stenosis and the plaque displacement caused by the mechanical action of the balloon or stent, which may lead to medulla oblongata artery block. After drug and rehabilitation treatment, the symptoms in patients were improved significantly. Conclusion The perforating artery occlusion after stent implantation in intracranial branch of vertebral artery can be prevented by strict evaluation and preoperative preparation, the right selection of intraoperative balloon and stent, which still needs larger sample data to prove.

ObjectiveTo study the efficacy of using multileaf collimators with different position and different degree in the treatment of nasopharyngeal carcinoma (NPC) using intensity-modulated radiotherapy techniques.Methods Ten patients withNPC were administered andanalyzed.Thepenumbra characteristics, dose of target, and radiation conformal indexes (CI) of mode T1 and mode T2 were measured and compared using dose volume histogram generated by Varian Eclipse three-dimensional planning computer system. Mode T1 :The angles of seven coplanar beams were 0°, 52°, 106°, 160°, 212°, 258°and 308°,respectively. There were no restriction on the position and degree of multileaf collimators. Parameters were set and optimized. Mode T2 :The beam angles and the parameters were as same as mode T1. According to the actual situations, the position and the degree of the multileaf collimators were changed. Then thedose optimization was performed. Results Target dose coverage in both mode T1 and T2 could be clinically accepted, and the CI were 0. 82 and 0. 83(t = -0. 25, P =0. 815). The maximum dose reductions in the lens, eyes, optic nerves and corneas were 28. 7% (t = 4. 80, P = 0. 000), 2. 7% (t = 2. 99, P = 0. 021),1.4%(t= 1.05,P=0.032), and 30.5% (t=2.99,P=0. 020), respectively. However, the mean dose and V35 of the parotid were increased by 0. 6% (t = - 2. 82, P = 0. 043) and 9.9% (t = - 2. 05, P =0. 038). ConclusionsOpimization of multileaf collimators can reduce the scattering and leaking rays. Compared with mode T1 ,controlling the position and degree of multileaf collimators could reduce the radiation dose to the eyes and optic-nerves, especially to the lens.

Carcinoma, Non-Small-Cell Lung ; genetics ; metabolism ; pathology ; DNA Mutational Analysis ; DNA, Neoplasm ; genetics ; isolation & purification ; Genes, erbB-1 ; Humans ; Lung Neoplasms ; genetics ; metabolism ; pathology ; Mutation ; Paraffin Embedding ; methods ; Polymerase Chain Reaction ; methods ; Real-Time Polymerase Chain Reaction ; methods ; Receptor, Epidermal Growth Factor ; genetics

Adult ; Critical Illness ; Extracorporeal Membrane Oxygenation ; methods ; Female ; Humans ; Myocarditis ; therapy

Objective: To give a retrospective bibliometric analysis of documents about the breast cancer stem cell (BCSC) and reveal the hotspots and trends of global output. Methods: Articles about the research of BCSC between 2014 and 2019 were retrieved in PubMed and Scopus databases, and SciVal was used to evaluate the global scholarly output and identify the most active factors, such as publications, countries, institutions, and top journal percentile, from the indicators of Field-Weighted Citation Impact (FWCI), CiteScore (CS), keywords and topic prominence percentile. Research hotspots and trends were discussed in detail. Results: A total of 4 700 publications on the research of BCSC from 2014 to 2019 were retrieved in this study with FWCI 1.73. The USA was the top country with a total of 1 742 publications and National Institutes of Health was the top institution both in total citation and FWCI. Non-coding RNA (ncRNA), mesenchymal stem cells, and immunotherapy were the most frequently used topics in BCSC. Conclusion: Researches on the correlation of BCSC and ncRNA, tumor microenvironment, and immunotherapy are the hotspots and trends in BCSC.

Objective • To give a retrospective bibliometric analysis of documents about precision medicine and to reveal the characteristics and hotspots of global research output. Methods • Articles about the research of precision medicine between 2013 and 2017 were retrieved in PubMed and bibliometric methods were used to evaluate global scientific output and to identify the most active factors, such as countries, journals, highly cited papers, etc. Co-word analysis was also used to show the research hotspots and trends. Results • A total of 23 284 publications on the research of precision medicine from 2013 to 2017 were retrieved in this study. "Molecular targeted therapy" and "antineoplastic agents" were the most frequently used co-words in precision medicine. Conclusion • Molecular targeted therapy for cancer treatment is the hotspot in the precision medicine research, in which the study of antineoplastic agents is the main topic.

Objective To evaluate the implication and necessity of deepithelialization in mastopexy.Methods A total of 124 patients with mastoptosis were randomly divided into 2 groups:group Ⅰ and group Ⅱ,62 cases each.A double-circle incision technique was used for all the patients.In group Ⅰ,full thickness skin around nipple-areola was resected.While in group Ⅱ,deepithelialization was performed and the peri nipple-areola dermis was preserved.Results The average full skin resection time was 4.5 minute per side in group Ⅰ and the skin deepithelialization time was 15.8 minute per side in group Ⅱ.Postoperative follow-up was carried out for all the 124 patients with duration of 2 weeks to 4 years.In group Ⅱ,sebaceous cysts,epidermal inclusion cyst and suture knot exclusion were found at the incision site in 8 patients (12.9 ％) at 3 weeks to 1.5 years after operation.Conclusions The blood supply to the nipple-areola complex is not affected by full-thickness skin removal during mastopexy,while the incidence of complication at the incision site decreases significantly.We conclude that deepithelialization has not much clinical significance in mastopexy.

Objective To screen thyroid function among planned pregnant women in Chongqing, to guide prenatal and postnatal care. Methods Proportional multi-stage stratified cluster random sampling method was adopted to enroll 11 953 planned pregnant women for questionnaire, physical examination, and serum samples collection. Results The median TSH was 2. 04 mIU/ L, P25 = 1. 36 mIU/ L,P75 = 2. 99 mIU/ L. TSH levels being normal, higher, and lower than the reference were 91. 47% , 6. 20% , and 2. 33% , respectively. In Northeast Chongqing, the proportions of median TSH level and TSH level above the upper limit were higher than those in other regions(P<0. 05). With improved education, proportions of TSH above the upper limit and below the lower limit declined(P<0. 05). With the increase in body mass index, the proportion of those whose TSH was above the upper limit showed elevated trend(P<0. 05). In women with history of adverse pregnancy outcomes, their median TSH was higher than that in the control group, and those, whose TSH level exceeded the upper limit, yield higher results than those in the control group(P<0. 05). In women with higher fasting blood glucose The median TSH level was lower than that in normal blood glucose group( P<0. 05), with the fasting plasma glucose concentration and TSH negatively correlated(P<0. 05). Conclusion The abnormal rate of TSH level in planned pregnant women was 8. 53% in Chongqing. The abnormal rate varies by different regions, education levels, body mass indexes, and blood glucose levels. Previous history of adverse pregnancy outcomes was related to elevated TSH levels. It is necessary to take pre-pregnancy thyroid function screening investigation.