BACKGROUND: Kienbock’s disease is aseptic necrosis of the lunate bone due to various causes, and its pathogenesis is unknown. Because the soft tissue around the wrist articular surface is small, so it leads to poor blood supply, and the progressive necrosis is irreversible. Early specificity is poor, clinical diagnosis rate is low, and late teratogenicity and disability rate is high. The clinical diagnosis and treatment are complicated, and there are many procedures, but there is no accurate guidance. OBJECTIVE: To review the current research status of mechanism, stage and clinical diagnosis of Kienbock’s disease, to summarize the clinical treatment of Kienbock’s disease in recent years, so as to discuss the clinical efficacy of various programs and provide guidance for clinical diagnosis and treatment. METHODS: A computer-based online search of PubMed and CNKI databases from 1970 to 2019 was conducted. Key words were “Kienbock’s disease, lunate bone, necrosis, mechanism, treatment” in English and Chinese, respectively. About 900 articles were retrieved, and 52 articles eligible for the inclusion and exclusion criteria were included for review. RESULTS AND CONCLUSION: (1) The pathogenesis of Kienbock’s disease is unknown, its etiology is complex, and researchers believe that anatomy and biomechanics, and individual factors are main causes, which still need further research. (2) The Lichtman stage is widely used in Kienbock’s disease classification. The latest breakthrough in arthroscopy is expected to form a new classification standard, which can be diagnosed by X-ray, CT or MRI combined with “triple sign”. It has poor early specificity, so the rate of misdiagnosis is high, and it should be identified with wrist diseases. (3) Early-stage Kienbock’s disease usually receive conservative treatment, and advanced stage tends to undergo surgical programs, including free vascularized bone graft, the lumate resection + tendon tamponade, radial wedge and shortening osteotomy, scaphotrapeziotrapezoid fusion, proximal row carpectomy, and bone cement prosthesis replacement, and the follow-up outcomes are different, so there is still no perfect treatment program.

Objective: To investigate the effect of fusion protein tick anticoagulant peptide (TAP)-staphylococcus aureus superantigen-like protein 5 (SSL5) on the formation of atherosclerotic plaque in ApoE knockout (ApoE-/-) mice.Methods: Totally 21 male 12-week-old ApoE-/-mice were randomly divided into three groups: TAP-SSL5 (3 mg·kg-1·d-1) group, SSL5 (2 mg·kg-1·d-1) group and the blank control group (pH 7.4 phosphate buffer), ip, qd, for 12 weeks.The changes of body mass were observed.The mice were fed with high cholesterol diet for 12 weeks, and then the levels of total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C) in plasma were detected.The aorta of mice was subjected to paraffin section and routine HE staining.The formation of atherosclerotic plaque in the aortic root was analyzed.The distribution of atherosclerotic plaques was observed by oil red O staining of the aorta.Results: Compared with that of the blank control group, the increasement of body weight of TAP-SSL5 group and the level of TC significantly decreased (P <0.001), while TG, HDL-C and LDL-C did not change significantly.The HE staining results showed that the plaque area of root slice in the aorta in TAP-SSL5 group was significantly lower than that in the blank control group (P<0.05).The red O staining of aorta showed that the formation of atherosclerotic plaque in TAP-SSL5 group was significantly smaller than that in the blank control group.Conclusion: TAP-SSL5 can significantly inhibit the formation of atherosclerotic plaques in the arteries of ApoE-/-mice.

Objective In order to improve the accuracy and efficiency of the measurement of range of motion (ROM) of human lower limbs and simplify process of ROM measurement,an automatic measurement of ROM of human lower limbs based on Kinect technique was proposed and tested in this study.Methods Fifty examinee were randomly divided into 5 groups,namely groups a,b,c,d and e,respectively,each group had 10 members.Using the human skeleton tracking technology from Kinect,the positions of the examinee's lower limbs were captured and tracked by processing the depth data of lower limbs' key joints.Then the information of ROM of hip and knee was output on human-computer interaction interface in real-time.By comparison with traditional manual measurement results,the accuracy of automatic measuring method could be verified.Meanwhile,with the aid of speech recognition and output technology,the mode of warning information transfer and the way of subject switch were optimized.Results According to the method of Grubbs-test and t-test,the ROM values | t | from the subjects' hip abduction (t =0.57,P =0.597),hip adduction (t =0.52,P =0.621),hip anteflexion (t =1.01,P =0.371),hip postextension (t =0.12,P =0.902),hip external rotation (t =0.00,P =1.000),hip internal rotation (t =0.34,P =0.753),knee flexion and extension (t =1.12,P =0.280) all were under the threshold value t0.025 (4) =2.776 on the premise of a level of significance α =0.05,which indicated that there was no significant difference between measured results and expected values(P ＞ 0.05).Conclusion The automatic measurement of ROM of lower limbs can be realized which can improve the measurement accuracy,simplify the measurement process and enhance the practicability of ROM of lower limbs measurement.

The application and advance of somatic sense interactive devices, such as EyeToy, Wii and Kinect, in the motor rehabilitation were introduced in this paper. The prospect of application of somatic sense interactive technology as an effective approach in rehabilitation is wide and bright.

Aim To study targeting capability of anti-CD19 (Fab)-LDMto CD19 +B lymphoma cells in vi-vo and in vitro.Methods Flow cytometry was em-ployed to determine the affinity of Cy5 labeled anti-CD19 (Fab)-LDP to human lymphoma Raji cells.And the optical imaging system was used to analyze the dis-tribution of Cy5-anti-CD19 (Fab )-LDP in lymphoma-transplanted xenograft nude mice in vivo.Results The results of flow cytometry demonstrated that Cy5-an-ti-CD19(Fab)-LDP had remarkable affinity with lym-phoma Raji cells;Raji lymphoma xenograft model was established successfully in nude mice and in vivo fluo-rescence imaging analysis indicated that the antibody-drug conjugates could specially be localized in the tar-get tumor.Conclusion The experiments in vivo and vitro confirm that anti-CD19 (Fab)-LDP has remarka-ble affinity to targeting CD19 +lymphoma cells,and the antibody drugs anti-CD19 (Fab )-LDP have the probability to be new drugs for the treatment of malig-nant lymphoma.

Objective To study the operational techniques and feasibility of superior rectal artery preserving laparoscopic resection of sigmoid colon carcinoma.Methods From Jan 2015 to Nov 2016,85 patients with sigmoid colon carcinoma were divided into artery preserving group (27 cases) and traditional surgical group (58 cases).Results The mean operation time was (283 ± 51) min,the mean lymph node dissection was (15 ± 8) and the mean blood loss was (62 ± 17) ml in the artery preserving group.The mean operation time was (179 ±e63) min,the mean lymph node dissection was (15 ±7) and the mean blood loss was (67 ± 17) ml in the traditional surgery group.The number of resected lymph nodes and blood loss had no statistical significance between these two groups (t =0.058,P ＞0.05).Longer operating time were observed in the retained vascular group as compared to the traditional surgical group (t =7.530,P ＜ 0.05).There was no anastomotic fistula in the retained vascular group,however,two anastomotic fistula cases occurred in the traditional surgical group (x2 =0.043,P ＞ 0.05).Conclusions Preservation of superior rectal artery was safe and feasible for laparoscopic resection of sigmoid colon carcinoma.

Objective:To investigate any effect of combining mirror visual feedback (MVF) training with robot-assisted gait training (RGT) in promoting the recovery of lower limb motor function among stroke survivors.Methods:Sixty stroke survivors were randomly divided into a combined treatment group, an RGT group and a control group, each of 20. In addition to traditional rehabilitation, the RGT group received 30min of RGT 5 days a week for 4 weeks, while the combined treatment group underwent 30min of RGT and also 20min of MVF training with the same frequency and duration. Before and after the treatment, the lower extremities motor functioning and walking ability of all of the patients were assessed using the Fugl-Meyer Assessment for the lower extremities (FMA-LE), the Berg Balance Scale (BBS) and Functional Ambulation Categories (FAC).Results:There were no systematic differences in any of the measurements before the treatment. After the 4 weeks, however, the average FMA-LE, BBS and FAC scores of the combined treatment and RGT groups were significantly better than the control group′s averages, and those of the combined treatment group were significantly superior to the RGT group′s. All of the groups had, however, improved significantly compared with before the treatment.Conclusions:Robot-assisted gait training is more effective in enhancing the motor functioning of the lower extremities and walking ability when it is combined with MVF.

Objective To investigate the consensus and controversies on the delineation of radiotherapy target volume for patients with locally advanced non-small cell lung cancer (LA-NSCLC).Methods Questionnaires including 15 questions on the delineation of radiotherapy target volume of NSCLC were sent to 12 radiation departments in China in November 2015.A patient with LA-NSCLC was selected by Fudan University Shanghai Cancer Center, and simulation CT images and medical history data were sent to the 12 radiation departments.Twelve radiation oncologists from the 12 radiation departments showed and explained the delineation of radiotherapy target volume of their own, and the patient was discussed by all experts in the sixth multidisciplinary summit forum of precise radiotherapy and chemotherapy for tumor and lung cancer.Results All receivers of the questionnaire answered the questions.The standard lung window width/level for the delineation of lung cancer was 800-1600/-600 to-750 HU, and the mediastinum window was 350-400/20-40 HU.Respiratory movement was measured by stimulator, 4D-CT, and stimulator+4D-CT with 2-5 mm expansion based on experience.The primary clinical target volume (CTV) was defined as gross target volume (GTV) plus 5-6 mm for squamous carcinoma/5-8 mm for adenocarcinoma.The metastatic lesion of mediastinal lymph nodes was delineated as 5 mm plus primary lesion in 6 departments and as primary lesion in another 6 departments.Of the 12 departments, 10 applied 5 mm of set-up error, 1 applied 3 mm, and 1 applied 4-6 mm.For V20 of the lungs, 10 departments defined it as<30%, 1 as<35%, and 1 as 28%.Nine departments defined the radiation dose of concurrent chemoradiotherapy (CCRT) for LA-NSCLC as 60 Gy in 30 fractions, 62.7 Gy in 33 fractions in 1 department, 50-60 Gy in 25-30 fractions in 1 department, and 60-70 Gy in 25-30 fractions in 1 department.For the delineation of target volume for the LA-NSCLC patient treated with CCRT, the primary planning target volume (PTV) was defined as GTV plus organ movement (IGTV) and set-up error (GTV→IGTV→PTV) in 3 departments, as CTV plus organ movement (ITV) and set-up error (GTV→CTV→ITV→PTV) in 8 departments, and as CTV plus set-up error/IGTV plus 5-6 mm for squamous carcinoma/5-8 mm for adenocarcinoma (CTV) and set-up error (GTV→CTV→PTV/GTV→IGTV→CTV→PTV) in 1 department.For the delineation of PTV in the mediastinal lymph node, GTV→IGTV→PTV was performed in 3 departments, GTV→CTV→ITV→PTV in 8 departments, and GTV→CTV→PTV in 1 department.For 10%-100% patients with LA-NSCLC, the radiation field needed to be replanned when 38-50 Gy was completed.There was no unified standard for the optimal standardized uptake value (SUV) of positron emission tomography (PET)-computed tomography (CT) simulation and delineation.Seven departments had applied magnetic resonance imaging (MRI) simulation and 10 departments had applied stereotactic body radiation therapy (SBRT) for the treatment of early-stage NSCLC.For the delineation of PTV for early-stage NSCLC (T1-2N0M0), GTV→IGTV→PTV was performed in 5 departments, IGTV→PTV in 3 departments, and GTV→CTV→ITV→PTV in 2 departments.In all the 12 departments, peripheral early-stage NSCLC was given 6.0-12.5 Gy/fraction, 3-12 fractions and central early-stage NSCLC was given 4.6-10.0 Gy/fraction, 5-10 fractions.The results of discussion on the delineation of target volume for the patient were as follows:respiratory movements should be measured by 4D-CT or simulator;the lung window width/level is 1600/-600 HU and the mediastinal window width/level is 400/20 HU;the primary controversy is whether the involved-field irradiation or elective nodal irradiation should be used for the delineation of CTVnd in the mediastinal lymph node.Conclusions Basic consensus is reached for the delineation of target volume in LANSCLC in these aspects:lung window width/level, respiratory movements and set-up error, primary lesion delineation, the radiation dose in CCRT, and the optimal time for replanning the radiation field.There are controversies on the optimal SUV in the delineation of target volume based on PET-CT simulation, the optimal dose fractionation in SBRT for early-stage NSCLC, and the delineation of CTVnd.

OBJECTIVETo study the role of outer membrane protein T (OmpT) in the pathogenesis of uropathogenic Escherichia.coli.

METHODSIn cultured human bladder epithelial cell line 5637, we examined the adhesion ability of wild-type (CFT073), ompT gene knockout (COTD), and revertant (pST) strains of E.coli to the cells and the extracellular matrix (ECM). The expressions of the adhesion gene iha and virulence gene iroN were detected by real-time PCR. Murine models of urinary tract infection with the 3 strains were established to evaluate the bacterial burden of the bladder and kidney tissue and bacterial counts in blood. We also detected the expressions of interleukin-6 (IL-6) and IL-8 in the bladder and kidney tissues of the mice.

RESULTThe COTD strain showed a significantly lower cell adhesion rate than CFT073 strain [(4.62∓0.39)% vs (8.81∓1.13)%, P<0.05] with also a lower ECM-adhesion rate [(4.95∓0.59)% vs (8.85∓0.79)%, P<0.05]. The mRNA expressions of iha and iroN in CFT073 strain were 2.1 and 3.8 times that of COTD strain. In the mouse model, the mean bacterial load of CFT073 strain in the bladder tissue was 6.36∓0.06, significantly greater than that of COTD (6.01∓0.07) and revertant (6.29∓0.06) strains (P<0.05); the bacterial load of CFT073 strain in the kidney tissue was also significantly higher than that of COTD strain (6.25∓0.05 vs 5.87∓0.06, P<0.05). In mice infected with the wild-type, knockout, and revertant strains, the detection rates of IL-6, which were identical to those of IL-8, in the inflammatory bladder and kidney tissues were 60%, 12.5%, and 50%, respectively.

CONCLUSIONSOmpT may regulate the expression of the adhesion gene iha and the transferrin gene iroN to affect the adhesion of uropathogenic E.coli to host cells.

Animals ; Bacterial Adhesion ; Bacterial Load ; Bacterial Outer Membrane Proteins ; metabolism ; Cell Line, Tumor ; Escherichia coli Infections ; pathology ; Escherichia coli Proteins ; metabolism ; Gene Knockout Techniques ; Humans ; Inflammation ; Interleukin-6 ; metabolism ; Interleukin-8 ; metabolism ; Kidney ; microbiology ; Mice ; Peptide Hydrolases ; metabolism ; Receptors, Cell Surface ; metabolism ; Urinary Bladder ; microbiology ; Urinary Tract Infections ; microbiology ; pathology ; Uropathogenic Escherichia coli ; pathogenicity

Objective:To study the safety and treatment outcomes of portal vein embolization (PVE) combined with lenvatinib plus an anti-programmed death-1(PD-1) antibody to treat patients with initially unreasectable hepatocellular carcinoma (uHCC).Methods:This study retrospectively analyzed the data of six patients with uHCC who received first-line combined systemic therapy with lenvatinib plus an anti-PD-1 antibody, and then underwent pre-hepatectomy PVE at the Department of Liver Surgery at Zhongshan Hospital, Fudan University from May 2019 to November 2020. All enrolled patients were males, aged (54.6±6.2) (ranged 46 to 63) years. Tumor response and liver volume were evaluated by medical imagings once every 2 months (±2 weeks) and evaluated using the Response Evaluation Criteria in Solid Tumours (version 1.1). Patients were followed-up by outpatient interviews or by phone calls to record their survival and tumor outcome status.Results:Three of the six enrolled patients had Barcelona Clinic Liver Cancer stage A and three had stage B disease. One patient achieved a partial response and five patients had stable diseases. The mean ± s. d. future liver remnant (FLR) percentage was (29.0±8.9) % before PVE and the combination therapy, and was (41.3±10.8) % before the last evaluation for liver surgery ( t=10.79, P<0.001). Hepatectomy was carried out in five patients, and one patient who failed to develop significant FLR hypertrophy did not undergo hepatectomy. Grade B post-hepatectomy liver failure and major postoperative complications (i.e. pleural effusion requiring additional percutaneous drainage) occurred in one patient. After a median post-operative follow-up of 4.5 (range: 1.0-12.3) months, all five patients were alive and were tumor free. Conclusion:PVE followed by hepatectomy is feasible in a uHCC patients receiving systemic therapy with lenvatinib and an anti-PD-1 antibody.