Objective: To study changes of ultrastructure of atrial endothelial cells during acute atrial fibrillation (AF) in canines, and explore the possible mechanism of AF left atrial thrombosis. Methods: A total of 16 healthy adult mongrel canines were randomly and equally divided into blank control group (only received thoracotomy without pacing) and rapid atrial pacing (RAP) group (established acute AF model). Myocardial tissue of left and right appendage were taken from two groups and received hematoxylin eosin (HE) staining, then myocardial cell morphological changes was observed under ordinary light microscope; morphological changes of appendage endothelial cells was observed under electron microscope. Results: (1) Paroxysmal AF was successfully induced in all canines of RAP group; (2) There were no significant difference in morphology of appendage and endocardial tissue under ordinary light microscope between two groups; 3. Under transmission electron microscope, endothelium cell of appendage tissue presented defect of different extent, and some shedding in RAP group; while endothelial cell layer was complete with absence of necrosis and shedding in blank control group. Compared with blank control group, there was significant rise in endothelial cell incompleteness (12.5% vs. 75.0%) in RAP group, P=0.041. Conclusion: When acute atrial fibrillation occurs, endothelial cell ultrastructure has already changed, which may be related to thrombosis adhered to wall during atrial fibrillation.

Retrospective analysis was performed for the clinical data of 15 chronic insertion achilles tendinitis patients undergoing platelet-rich plasma (PRP) trigger point injection.The scores of Validated Victorian Institute of Sports Assessment-Achilles (VAS-A) and foot function index (FFI) improved greatly versus pre-treatment (all P ＜ 0.05).Tendon insertion structure inflammation decreased significantly on magnetic resonance imaging.At the last follow-up,all patients recovered normal gait and daily activity.The trigger point injection of PRP is efficacious for chronic insertion achilles tendinopathy.

A total of 52 patients with chronic lateral epicondylitis were randomly assigned into platelet-rich plasma (PRP) (n =28) or corticosteroid (n =24) group.The visual analog pain scale (VAS) and Mayo elbow score had no significant difference between two groups within 1 week post-treatment.However,VAS and Mayo elbow score improved more significantly in PRP group versus corticosteroid group at Month 1 and 6 post-treatment (P ＜ 0.05).The PRP trigger point injection treatment of elbow lateral epicondylitis achieved clinical outcomes and it was superior to glucocorticoid treatment.

Objective To observe the effects of platelet-rich plasma (PRP) gel in the treatment of [Ⅳ stage pressure ulcers.Methods A total of 12 patients with stage Ⅳ pressure ulcers were treated with PRP gel from December 2012 to December 2013 in our department.The PRP gel was formed by autologous PRP mixed with thrombin and calcium chloride.The PRP gel was applied to the wound after dressing.Time intervals between dressing were 4 days.Overall pressure ulcer improvement was assessed every week until complete wound healing.Results All stage Ⅳ pressure ulcer wound infection was controlled and fresh granulation tissue was found after 2 times of PRP gel covering.The time of ulcer wound healing were 6-10 weeks (mean 8 weeks).The times of changing the PRP gel were 16.No patients experienced adverse reactions during treatment.Conclusions PRP gel can effectively control the pressure ulcer infection and promote ulcer wound healing.

Objective: To evaluate the outcomes of splenectomy in the treatment of relapsed/refractory autoimmune hemolytic anemia (AIHA). Methods: Retrospective analysis was performed in 30 cases with relapsed/refractory AIHA who were treated with splenectomy in our hospital. The pre- and post-operative blood routine indexes and responses were followed up. Results: Among the 30 relapsed/refractory AIHA patients, 20 were pure AIHA (including 13 patients with warm antibody AIHA, 2 with warm-cold double antibody AIHA and 5 with Coombs negative AIHA) and 10 were Evans syndrome. The short-term response was evaluated 10-14 days after operation, and the overall response rate (ORR) of short-term response was 90% [12 cases in complete response (CR), 6 cases in partial response (PR)] in 20 therapeutic evaluable cases. Among 13 patients with long-term follow-up data, except 3 patients with Evans syndrome died (2 cases were refractory to splenectomy, 1 case relapsed after surgery), the ORR of 10 patients with relapsed/refractory pure AIHA at 6 months and 12 months were 90% (9/10) and 70% (7/10), respectively, with a median follow-up of 14 (4-156) months. At the end of follow-up, 3 cases had maintained CR for more than 3 years. Conclusion The short-term response of splenectomy as a second-line treatment for relapsed/refractory AIHA is satisfactory, and long-term outcome of splenectomy is up to 70% at 1 year. Approximately one-third of patients could maintain sustained remission.

Objective:To observe the effect of taping on the kinematic characteristics of the ankle joint during forward and lateral jumps by male basketball players with chronic ankle instability (CAI).Methods:A Vicon 3D motion capture system and a Kistler 3D ergometer were used to collect data describing the landing data with or without taping from forward and lateral jumps of 29 male basketball players with CAI. The landing data included the dorsiflexion and plantarflexion angles, valgus and inversion angles and external and internal rotation angles. Dorsiflexion or plantarflexion angular velocity was also recorded along with valgus or inversion angular velocity and external or internal rotation angular velocity 200ms, 150ms, 100ms and 50ms before and after touchdown. The data obtained were modeled using three-dimensional motion analysis software, and then analyzed.Results:Taping reduced the ankle plantarflexion in landing from a forward jump by 3.27° 50ms before landing and by 2.70° at touchdown. The ankle inversion angle was reduced 2.13° 50ms before touchdown, while the angle of external rotation decreased by 2.59° 200ms before touchdown and 2.17° 150ms before. Moreover, the angle of external rotation 100ms after landing was reduced by a significant 1.59° compared with that without taping. In lateral jumps taping reduced the average ankle plantarflexion angle by 1.94° 50ms before landing and 3.23° at touchdown compared with no taping. Ankle inversion was reduced significantly by 2.86° 50ms before landing and by 2.87° at touchdown. External rotation was a significant 0.93° less 200ms before landing and 2.36° smaller 150ms before touchdown. In the forward jump landing, taping reduced the average angular velocity of ankle dorsiflexion on landing by a significant 58.5°/s and by 28.39°/s 100ms later. In the lateral jump landings the average ankle dorsiflexion velocity decreased by significant 20.5°/s with taping, but the valgus velocity increased by 49.7°/s compared with no taping. However, 50ms after touchdown the speed of external rotation with taping was 30.3°/s slower than without taping.Conclusions:Ankle taping can modify ankle rotation angles and angular velocities during landing from jumps. This is particularly helpful for basketball players with CAI.

Objective To discuss rationality of the three-link model used in analysis on interactive dynamics of deep squatting, and clarify the source of differences in calculation of joint torque by three-link model and Visual 3D. Methods Eight subjects were selected to obtain kinematic data of the squat motion through Vicon. The second Lagrangian equation was used to establish the three-link dynamic equation. The joint torque was calculated based on the Mathematica programming. The results were compared with the calculation results of lower limb chain segment model by Visual 3D, and the similarity between the two results was evaluated by the coefficient of complex correlation (CMC). Results The CMC of hip joint and knee joint from 8 subjects was larger than 0.85, and the CMC of ankle joint was between 0.50-0.85. The joint torque calculated by three-link dynamic equation and Visual 3D was highly similar in hip joint and knee joint, and there was only a moderate similarity in ankle joint. Conclusions The three-link model can be used in further analysis on interactive dynamics of deep squatting, but the influence of interactive moment caused by ground reaction force (external moment) on ankle torque should be considered.

Objective To investigate the characteristics of knee kinematics and ground reaction force (GRF), as well as the stress state of cartilage and meniscus in the process of lateral incisions at different cutting angles under expected conditions. Methods Kinematics and GRF data of 14 subjects at 45°, 90° and 135° cutting angle respectively under expected conditions were collected. The knee joint reaction force was obtained through the inverse dynamics calculation of Visual 3D. Based on three-dimensional (3D) finite element model of the knee joint, the contact process at 3 lateral cutting angles was simulated. ResultsUnder expected conditions, there were significant differences in knee joint kinematics characteristics at 3 cutting angles during contact process(P＜0.001), and the knee flexion increased with the cutting angle increasing; the vertical GRF decreased significantly with the cutting angle increasing (P＜0.001), while the horizontal GRF showed the opposite trend; for 3 cutting angles, the peak contact stress of patellar cartilage and femoral cartilage was larger at 90° cutting angle, the peak principal stress at anterior cruciate ligament (ACL) contact point was also larger at 90° cutting angle, and the following was at 135° and 45° cutting angle, respectively; the peak contact stress of lateral femoral cartilage was larger than that of medial femoral cartilage at 3 cutting angles. Conclusions The risk of knee joint injury is higher at 90° cutting angle, and the stress state of knee joint at 135° cutting angles is better than that at 90° cutting angle, and the risk of knee joint injury does not increase with the increase of cutting angle under expected conditions.

Objective:To investigate the efficacy of the biopsy strategy combining 6-core systematic and 3-core MRI-targeted biopsy on prostate cancer (PCa) detection in biopsy-na?ve patients.Methods:The clinical data of 121 biopsy-na?ve patients who underwent transperineal prostate biopsy in West China Hospital of Sichuan University from July 2018 to January 2020 were retrospectively analyzed. The average age was (64.7±9.1) years old. Pre-biopsy prostate-specific antigen (PSA) was (12.4±7.5)ng/ml, f/t PSA was 0.13±0.05. Prostate volume was (43.1±26.1) ml and PASD was (0.35±0.27) ng/ml 2. The prostate-imaging and data system (PI-RADS) score of MRI before biopsy was reported to be 3 for 29 patients (24.0%), 4 for 54 patients (44.6%) and 5 for 38 patients (31.8%). All 121 patients underwent 12-core systematic biopsy combined with a 3-core or 5-core MRI-targeted biopsy, of which 61 patients underwent 3-core targeted biopsy and 60 underwent 5-core targeted biopsy. There was no significant difference in the pre-biopsy clinical data between the two groups ( P>0.05). A 6-core systematic biopsy was redefined as the results of 6 cores among the 12-core systematic biopsy. We compared the detection rates among the single 12-core systematic biopsy, 6-core systematic biopsy, MRI-targeted biopsy (3-core or 5-core), and different systematic biopsy combing with targeted biopsy for any PCa and clinically significant PCa, and we also analyzed the cumulative cancer detection rates for MRI-targeted biopsy of different cores. Results:Of the 121 patients in this study, the biopsy results were negative for 43 patients (35.5%) and positive for 78 (64.5%). The detection rate of clinically significant PCa was 55.4% (67/121). The detection rate of the 6-core systematic biopsy combined with MRI-targeted biopsy was 62.0% (75/121) for PCa and 55.4% (67/121) for clinically significant PCa, which was of no difference compared with that for the 12-core systematic biopsy combined with MRI-targeted biopsy ( P>0.05), but the 6-core systematic biopsy combined with MRI-targeted biopsy avoided the overdiagnosis of 3 patients with Gleason score 3+ 3. The detection rate of PCa for MRI-targeted biopsy was 57.9% (70/121), including 42.1% (51/121) for the first core, 55.4% (67/121) for the first two cores, and 57.9% (70/121) for the first three cores. Compared with the single-core targeted biopsy for suspicious lesions, the first 2-core targeted biopsy ( OR=1.7, 95% CI 1.0-2.8) and 3-core targeted biopsy ( OR=1.9, 95% CI 1.1-3.1) can significantly increase the detection rate of PCa, while the fourth or fifth core of targeted biopsy can not increase the detection rate additionally (60%, 36/60). Conclusion:For patients with suspected PCa, the prostate biopsy strategy combing 6-core systematic and 3-core MRI-targeted biopsy performs no inferior than the current 12-core systematic biopsy combined with MRI-targeted biopsy.

Objective:To evaluate the effect of the improved team-based learning (TBL) teaching method in the undergraduate probation course of ophthalmology based on the goal of cultivating excellent doctors.Methods:The undergraduates of clinical medicine were randomly divided into experimental group and control group. The control group ( n=50) was given conventional ophthalmology probation teaching, while the experimental group ( n=50) was given ophthalmology probation teaching of improved TBL teaching method. The theoretical examination performance and skill assessment results of students in the two groups were compared, and the subjective evaluation of the students on the teaching was also compared. SPSS 23.0 was used to conduct t-test and Wilcoxon's rank sum test. Results:The theoretical examination performance of experimental group (29.68±4.52) was better than that of control group (27.84±4.33), with significant differences ( P<0.05); the skill assessment results of experimental group (32.88±5.05) were also better than those of the control group (30.88±6.99), with significant differences ( P<0.05); the subjective evaluation of teaching effect in each item of experimental group was better than that of control group ( P<0.05). Conclusion:The improved TBL teaching method can not only improve students' theoretical knowledge and experimental skills, but also improve students' self-study and teamwork ability, which will provide a feasible educational reform plan for achieving the goal of cultivating excellent doctors.