Objective:To evaluate the value of serum protein electrophoresis in the diagnosis of periprosthetic joint infection (PJI) after hip and knee arthroplasty.Methods:The data of 171 patients who underwent one side hip or knee revision surgery in the affiliated Hospital of Qingdao University from August 2013 to June 2019 were analyzed retrospectively. According to the reasons for revision, 55 patients in PJI group, 29 males and 26 females, aged 67.38±9.60 years, 26 hips and 29 knees, were classified as Tsukayama type IV; Aseptic loosening (AL) group consisted of 116 patients, 67 males and 49 females, aged 69.69±9.20 years, 97 hips and 19 knees .The ratios of C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), D-dimer, fibrinogen, serum total protein, serum albumin, serum globulin and serum protein electrophoresis bands in the two groups were statistically analyzed. The sensitivity and specificity of each index were calculated according to the receiver operating characteristic (ROC) curve, and the diagnostic value was compared according to the area under the curve (AUC).Results:There was no significant difference in age, sex or body mass index (BMI) between PJI group and AL group ( P>0.05), but there was significant difference in joint type with 26 hips and 29 knees in PJI group, 97 hips and 19 knees in AL group (χ 2=24.41, P<0.001). The proportion of α1 globulin band was 6.40% (5.30%, 8.10%) in PJI group, which increased significantly compared to 4.20% (3.90%, 4.80%) in AL group ( H=453.50, P<0.001). Albumin band was 49.00% (44.00%, 52.20%) in PJI group, which decreased significantly compared to 54.35% (51.25%, 56.70%) in AL group ( H=4 954.00, P<0.001). The AUC of CRP, ESR, D-dimer, fibrinogen, albumin band and α1 globulin band were 0.87[95% CI (0.80, 0.93)], 0.88[95% CI (0.82, 0.94)], 0.67[95% CI (0.58, 0.76)], 0.87[95% CI (0.82, 0.93)], 0.78[95% CI (0.70, 0.85)] and 0.87[95% CI (0.81, 0.93)], respectively. Conclusion:Albumin bands and α1 globulin bands in serum protein electrophoresis had high diagnostic value for PJI, and the accuracy of α1 globulin bands was as good as that of routine inflammatory markers such as CRP and ESR.

OBJECTIVE: To explore the cause of abortion and strategy of prenatal diagnosis for pregnant women with high risk for chromosomal abnormalities by using copy number variation sequencing (CNV-seq) and short tandem repeats (STR) analysis. METHODS: A total of 36 samples were collected, including amniotic fluid, abortion tissue, whole blood, chorionic villi and umbilical cord blood. CNV-seq and STR analysis were carried out to detect microdeletions, microduplications, chromosomal aneuploidies, mosaicisms and triploidies. RESULTS: Among all samples, 1 was detected with 4p15.1p16.3 and 14q11.1q22.1 duplication, 1 was detected with 19p13.3 deletion, 8 were detected with chromosomal aneuploidies, 4 were detected with mosaicisms, two were detected with triploidies. No definite pathogenic CNVs were detected in 20 samples, which yielded a positive detection rate of 44.44%. CONCLUSION As a high-throughput detection method, CNV-seq has the advantages of rapidity, simplicity and high accuracy. It may suit prenatal diagnosis and analysis of abortion factors in combination with STR analysis.
Abortion, Spontaneous/genetics* ; DNA Copy Number Variations ; Female ; Humans ; Karyotyping ; Microsatellite Repeats ; Pregnancy ; Prenatal Diagnosis

Objective To evaluate the efficacy and safety of holmium laser in situ fenestration for aortic arch diseases during thoracic endovascular repair.Methods The clinical data of 12 patients with aortic dissection or aortic pseudoaneurysm was analyzed from Nov 2016 to Feb 2017.After thoracic aorta stenting the left common carotid artery and left subclavian artery were reconstructed using holmium laser in situ fenestration.Results The success rate of operation was 100％,no type Ⅰ or type Ⅱ endoleak occurred,1 case complicated with left retinal artery occlusion.All patients were followed up for 6 to 9 months,the mean time was 7.3 months.The location of the stent graft was good.The left carotid artery and left subclavian artery kept patent.Conclusions The laser in situ fenestration technique can provide the opportunity of stenting for patients with aortic arch lesion near the branch.Short term follow-up results were satisfactory.

Objective:To compare the expression levels of candidate genes before and after Shuganjieyu capsule treatment, to analyze their correlation with depression symptoms and cognitive function, and to find and clarify the biomarkers related to the efficacy of Shuganjieyu capsule.Methods:Among 27 patients with mild to moderate depression (MMD), 24 items Hamilton depression rating scale (HAMD-24) was used to assess the severity of depression, Chinese revised Wechsler adult intelligence scale(WAIS-RC) and Chinese revised Wechsler memory scale(WMS) were used to assess cognitive function, and qRT-PCR was used to detect the expression levels of candidate genes in peripheral blood of patients with depression before and after treatment with Shuganjieyu capsule.SPSS 25.0 software was used for statistical analysis, paired t-test, non-parametric test, Spearman correlation analysis and receiver operating characteristic curve were used for data statistics. Results:The symptoms of MMD patients were relieved after Shuganjieyu capsule treatment(HAMD scores: baseline 14.00(9.75, 18.25), 8-week 4.00(2.00, 7.25), Z=-4.462, P<0.01), and the verbal intelligence quotient(VIQ) of WMS was puomoved (VIQ scores: baseline (123.00±10.24), 8-week (128.00±6.77), t=4.372, P<0.01). The level of gene expression brain derived neurotrophic factor(BDNF) (baseline 1.68(0.92, 2.63), 8-week 2.30(1.47, 4.34), Z=-2.781, P=0.005), glial cell derived neurotrophic factor(GDNF) (baseline 0.74(0.31, 1.15), 8-week 0.97(0.50, 1.71), Z=-2.159, P=0.031), 5-hydroxytryptamine receptor 2A(HTR2A) (baseline 0.60(0.39, 1.60), 8-week 0.98(0.44, 2.29), Z=-1.994, P=0.046) and glutamate ionotropic receptor AMPA type subunit 1(GRIA1) (baseline 1.19(0.66, 2.40), 8-week 1.76(0.86, 4.13), Z=-2.756, P=0.006) was up-regulated after treatment.The change rate of BDNF expression were correlated with the score of HAMD-24 ( r=-0.35, P=0.038) and performance intelligence quotient of WMS ( r=0.40, P=0.022). Conclusions:BDNF may be used as a therapeutic marker of Shuganjieyu capsule in the treatment of clinical symptoms and cognitive function of MMD patients, which is used to evaluate the efficacy of antidepressants.

Geriatric depression in the elderly is becoming one of the most common psychiatric disorders affecting older people's mental and physical health.However, there is currently no systematic review on animal models for geriatric depression.Therefore, this paper analyzes and summarizes the animal models commonly used in geriatric depression studies and the application of antidepressants in geriatric depression models based on relevant national and international literature of recent years, aiming to provide insights on research approaches and considerations on study methods for geriatric depression.

Objective:To compare the clinical efficacy between robot-assisted and free-hand percutaneous cannulated screwing (PCS) in the treatment of femoral neck fractures in the middle-aged and young patients.Methods:A retrospective study was conducted to analyze the clinical data of 53 patients with femoral neck fracture who had been treated with PCS from May 2020 to May 2022 at Department of Traumatic Surgery, Maoming Hospital Affiliated to Southern Medical University. In the robot group of 25 patients subjected to robot-assisted PCS, there were 11 males and 14 females with an age of (48.2 ± 11.9) years; in the free-hand group of 28 patients subjected to free-hand PCS, there were 13 males and 15 females with an age of (48.5 ± 9.8) years. The 2 groups were compared in terms of operation time, intraoperative bleeding, intraoperative guide drills, intraoperative fluoroscopy frequency, fracture union time, Harris hip score at the last follow-up and postoperative complications. Postoperative imaging examination was performed to evaluate distribution accuracy of the cannulated screws in the femoral neck (deviation between the screws and the femoral neck axis, parallelism between the screws and distance between the screws and the neck cortex).Results:There was no statistically significant difference between the robot and free-hand groups in the general clinical data before operation, showing comparability ( P>0.05). The robot group showed significantly shorter operation time [(32.7 ± 4.8) min], significantly less intraoperative bleeding [(14.6 ± 4.8) mL], significantly less intraoperative guide drillings [(3.5 ± 0.7) times] and significantly less intraoperative fluoroscopy frequency [(7.9 ± 1.4) times] than the free-hand group [(56.9 ± 11.3) min, (27.0 ± 7.3) mL, (9.1 ± 1.8) times and (16.3 ± 6.0) times)] (all P<0.05). Postoperative imaging showed that the deviation between the screws and the femoral neck axis was 4.4° ± 1.1° on the anteroposterior X-ray film and 3.2° ± 0.8° on the lateral X-ray film, the parallelism between the screws 4.9° ± 0.8° on the anteroposterior X-ray film and 3.0° ± 0.7° on the lateral X-ray film, and the distance between the screws and the femoral neck cortex (10.4 ± 2.7) mm in the robot group, all significantly smaller than those in the free-hand group [10.5° ± 2.8°, 4.9° ± 1.1°, 12.1° ± 4.0°, 5.1° ± 1.3°, and (15.4 ± 3.2) mm] (all P<0.05). All the 53 patients were followed up for (22.2 ± 8.5) months. All fractures got united. The fracture union time in the robot group [(20.6 ± 4.6) weeks] was insignificantly shorter than that in the free-hand group [(23.7 ± 7.7) weeks] ( P>0.05). At the last follow-up, the Harris hip score in the robot group [(88.6 ± 5.6) points] was significantly higher than that in the free-hand group [(84.8 ± 6.3) points] ( P<0.05). Follow-ups revealed 2 cases of internal fixation loosening, 1 case of screw head cutting and 1 case of femoral head necrosis in the free-hand group but none of such complications in the robot group. Conclusion:In the treatment of femoral neck fractures in the middle-aged and young patients, compared with free-hand PCS, robot-assisted PCS shows advantages of shorter intraoperative time, less bleeding, less fluoroscopic radiation, higher accuracy of screw placement, a lower incidence of postoperative complications and better functional recovery of the hip joint.