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Distalfemur rotational alignment in knee osteoarthritis patients by three-dimensional computed tomography

Bo YANG ; Xianghui HUANG ; Xianghui DONG ; Hui QIANG ; Shizhang LIU ; Pengzhen LEI ; Ming CHEN

Journal of Xi'an Jiaotong University(Medical Sciences).2025;46(6):991-995. doi:10.7652/jdyxb202506015

Objective To explore the gender differences and the influence of varus and valgus deformities on distal femur rotational alignment in patients with knee osteoarthritis so as to provide reference for the distal femur rotational osteotomy in total knee arthroplasty(TKA).Methods CT data of 125 knees with osteoarthritis suitable for TKA(including 56 males and 69 females;78 varus knees and 47 valgus knees)were collected and received three-dimensional imaging reconstruction with Mimics software.We measured the posterior condylar angle(PCA),the angle between the anteroposterior axis and the surgical epicondylar axis(ASA),and the angle between the anteroposterior axis and the posterior condylar axis(APA).We also compared gender differences and the influences of varus-valgus deformities on distal femur rotational alignments.Results The PCA and ASA values of distal femur rotational alignments were(3.5±1.1)° vs.(2.8±1.2)°(P=0.001)and(90.6±3.4)° vs.(91.9±3.5)°(P=0.028)for males and females,with statistically differences between the genders.There was no statistically difference in APA between males and females(P=0.482).The PCA values of distal femur rotational alignment in varus and valgus knees were(3.6±1.1)° and(2.9±1.2)°,with a statistically difference between the two groups(P=0.001).There were no statistically differences in ASA or APA between varus and valgus knees(P＞0.05).Conclusion Gender and varus-valgus deformities of knee joint affect the distal femur rotational alignment.Distal femur rotational osteotomy angle should be determined according to the patient's CT imaging before TKA to reduce the errors caused by individual differences and improve the accuracy of the distal femur rotational alignment during TKA.

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Application of automated assessment software in optimizing thrombectomy workflow for stroke

Xiaolan YAN ; Ya SHAO ; Li XIAO ; Qiutong YUAN ; Baoyi GUO ; Yuping YOU ; Lijuan WANG ; Zhengzhou YUAN

Journal of Xi'an Jiaotong University(Medical Sciences).2025;46(6):910-915. doi:10.7652/jdyxb202506003

Objective To investigate whether the application of automated software for computed tomography angiography(CTA)and computed tomography perfusion imaging(CTP)can improve in-hospital workflow for endovascular treatment(EVT)in acute ischemic stroke patients.Methods We included patients with acute ischemic stroke who received CTA and CTP evaluation followed by EVT through the stroke emergency pathway at the Affiliated Hospital of Southwest Medical University between January 1,2020 and December 30,2022.The patients were divided into two groups:control group and artificial intelligence(Al)group based on whether automated software was used for assessment.The control group consisted of patients who underwent manual post-processing of multimodal imaging before June 2021,while the AI group was composed of patients whose imaging was processed with automated software from July 2021 onwards.The primary outcome was door-to-puncture time(DPT),and the secondary outcome was the 90-day modified Rankin Scale(mRS)score.Results A total of 312 patients were included,with 145 in the control group and 167 in the AI group.The median age of all the patients was 68 years(range:58-74 years),and 55.4％(173 patients)were male.The median National Institutes of Health Stroke Scale(NIHSS)score at presentation was 16 scores(range:12-19 scores).The median DPT was reduced from 110 min(range:80-150 min)before the use of automated software to 95 min(range:65-125 min)after its implementation(P＜0.001).However,there was no significant difference in the proportion of patients achieving functional independence(mRS score of 0-2)between the two groups(39.3％vs.41.3％,P=0.719).Conclusion The application of multimodal CT automated software improves the in-hospital workflow for acute ischemic stroke patients by reducing the time to EVT.However,the software did not significantly impact neurological functional outcomes as measured by the mRS.

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A retrospective study of the efficacy of endovascular therapy for acute symptoms of internal carotid artery occlusion

Pinyuan ZHANG ; Jiren ZHANG ; Dongman ZHAO ; Shilei QI ; Guoying DU ; Jian YANG

Journal of Xi'an Jiaotong University(Medical Sciences).2025;46(6):916-924. doi:10.7652/jdyxb202506004

Objective To explore the influencing factors of poor prognosis after successful recanalization of symptomatic acute internal carotid artery occlusion(AICAO)by applying endovascular therapy(EVT)technology.Methods We made a retrospective analysis of the clinical and imaging data of 62 symptomatic AICAO patients.After collateral evaluation and recanalization therapy,we obtained flat CT and DSA images,together with the findings of the collateral circulation assessment.At 24.0±6.0 hours after surgery,head plain CT scans were reexamined,and at 14 days after surgery or at discharge,neurological function was assessed using the NIHSS scale.Using the modified Rankin scale,we assessed neurological function and prognosis over a 90-day period.Results Each of the 62 patients had a TICI grade of 2b or 3 and was successfully recanalized.On average,it took 124.36±66.31 minutes from puncture to recanalization.Two instances involved iatrogenic dissection,while twelve cases had intraoperative distal thrombus escape episodes.Of all the patients,32 ones(51.6％)had a fair prognosis,whereas 30 patients(48.4％)had a bad prognosis.The two patient groups differed significantly in the ASPECT score,preoperative NIHSS score,intraoperative balloon catheter usage,postoperative 24 hour and 14 days NIHSS score,postoperative 14 days neurological function,and all-cause mortality within 90 days(all P＜0.05).The best intervention threshold for preoperative NIHSS score was 11.5 points,and both the preoperative NIHSS score and intraoperative BGC utilization were independent predictors influencing poor outcome.Conclusion The preoperative NIHSS score and intraoperative BGC usage are independent predictors of 90-day poor prognosis in AICAO patients with symptomatic AICAO who underwent successful recanalization via endovascular therapy.

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Trends in the disease burden of neonatal congenital birth defects in China and the globe,1990-2021

Huasheng LV ; Wei JI ; Fengyu SUN ; Haoliang SHEN ; BAHETI·LAZAIYI ; Teng YUAN ; You CHEN

Journal of Xi'an Jiaotong University(Medical Sciences).2025;46(6):1045-1052. doi:10.7652/jdyxb202506023

Objective To analyze the long-term trend in the disease burden of congenital birth defects(CBDs)among neonates in China from 1990 to 2021,compare the trend with global patterns,and identify key subtypes along with their association with socioeconomic status to provide evidence for public health interventions.Methods Utilizing data from the Global Burden of Disease Study 2021(GBD 2021),we extracted indicators including disability-adjusted life years(DALYs),mortality,and prevalence for the neonatal period(＜28 days)in China,encompassing ten major CBD subtypes.Joinpoint regression analysis was employed to calculate annual percent changes and estimate annual percent changes(EAPC),with comparisons of subtype composition between 1990 and 2021.Nonlinear regression was used to assess the relationship between DALYs rates and the Socio-demographic Index(SDI).Results From 1990 to 2021,DALYs rates for neonatal CBDs declined significantly both globally and in China,with China's EAPC at-4.67％[95％CI:(—5.06,—4.28)],substantially exceeding the global average of-1.70％[95％CI:(—1.75,—1.64)].Congenital heart anomalies remained the primary burden,while neural tube defects and orofacial clefts in China showed notable reductions(EAPCs of-7.25％and-11.22％,respectively).However,DALYs rates for congenital musculoskeletal and limb anomalies exceeded global expected levels.A resurgence in the prevalence was observed post-2015,with higher burdens in males.DALYs rates exhibited a negative correlation with SDI.Conclusion China has achieved significant reductions in the neonatal CBDs burden,surpassing global trends;yet challenges persist in managing congenital heart anomalies and musculoskeletal defects.Future efforts should focus on enhancing early screening,surgical interventions,and regional equity to align with global health objectives.

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Gut microbiota after kidney transplantation and its impact on patient prognosis

Pumeng FU ; Yaping LIU ; Mengru WANG ; Qingqing YAO ; Zhengyu REN ; Hongxia LI

Journal of Xi'an Jiaotong University(Medical Sciences).2025;46(6):900-909. doi:10.7652/jdyxb202506002

In recent years,with the advancement of microbial detection technologies,an increasing number of studies have revealed significant differences in the gut microbiota composition of kidney transplant recipients before and after surgery.These changes in the gut microbiota may influence graft function and the occurrence of post-transplant complications through a variety of factors.This article will review the research progress in the relationship between gut microbiota and kidney transplantation.It focuses on the changes in gut microbiota after kidney transplantation.The role of gut microbiota in immune regulation,drug metabolism,graft function protection,and post-transplant complications is also studied.At the same time,these effects may be of great significance in improving the short-term and long-term prognosis of kidney transplant recipients,thus providing a novel idea for further improving kidney transplant prognosis.

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Effectiveness of polyglycolicacid/hydroxypropyl methylcellulose composite materials for suturing after canine gastric tubular resection

Fenghua ZHANG ; Xueshuo WU ; Baozhi WANG ; Yuxiao XIA ; Noriyuki MATSUTANI ; Jubin FENG

Journal of Xi'an Jiaotong University(Medical Sciences).2025;46(6):953-959. doi:10.7652/jdyxb202506009

Objective To explore the effectiveness and safety of polyglycolic acid(PGA)and hydroxypropyl methylcellulose(HPMC)composite materials for suturing after canine sleeve gastrectomy.Methods A total of 36 healthy Beagle dogs were randomly divided into experimental group and control group in a 1∶1 male-to-female ratio.The experimental group underwent gastric sleeve resection with PGA+HPMC composite material for suture reinforcement,while the control group used NV-ET-M60E-2 suture material.Postoperative monitoring included survival status,food intake,and body temperature changes.Venous blood samples were collected before surgery,3 days after surgery,and before euthanasia for routine blood tests.At 2,4,and 8 weeks postoperatively,six dogs were euthanized at each time point for histological examination,hard tissue pathological evaluation,and safety assessment of the heart,liver,spleen,lungs,and kidneys.Results There were no significant differences in blood routine test results between the control group and the experimental group(P＞0.05).Before dissection,the percentage of basophils was significantly higher in the control group than in the experimental group(P=0.015).At 2 weeks after surgery,the severity of liver cell edema in the control group was higher than in the experimental group(P=0.036).However,the two groups did not significantly differ in the histological examination results of the heart,liver,spleen,lungs,or kidneys at other time points(P＞0.05).Hard tissue pathological slice results at 2,4,and 8 weeks after surgery showed no material residue in either group by the 8th week,and there were no significant differences in inflammation and necrosis scores or fibrosis/fat infiltration totals between the two groups(P＞0.05).Inflammation scores and fibrosis/fat infiltration totals at 8 weeks post-operation were significantly lower than those at 2 weeks post-operation(P＜0.05).During the experiment,no near-death phenomena occurred in either group,and no fever or refusal to eat was observed within 3 days after surgery.At dissection,the Beagle dogs appeared normal with glossy fur and no abnormal secretions.Conclusion PGA+HPMC composite materials can be effectively degraded and used as non-toxic suture fixation materials for wound suturing after sleeve gastrectomy,providing a theoretical basis for their clinical application.

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Endovascular therapy beyond 24 hours for middle cerebral artery atherosclerotic occlusion in acute ischemic stroke

Min GUAN ; Hongyu QIAO ; Bing YANG ; Xiufeng XIN ; Shengming HUANG ; Liang ZHANG ; Yingze LIN ; Jie LIANG

Journal of Xi'an Jiaotong University(Medical Sciences).2025;46(6):925-929. doi:10.7652/jdyxb202506005

Objective To assess the clinical and safety outcomes of endovascular therapy(EVT)administered beyond 24 h after the onset of symptoms in patients with acute ischemic stroke(AIS)resulting from middle cerebral artery atherosclerotic occlusion.Methods We enrolled consecutive AIS patients with middle cerebral artery atherosclerotic occlusion who received EVT in our hospital between January 2020 and June 2023 and divided them into two groups based on the time from AIS onset to EVT:EVT≤24 h group and EVT＞24 h group.The National Institutes of Health Stroke Scale(NIHSS)scores after surgery,90-day functional independence(defined as mRS 0-2),symptomatic ICH(sICH),postoperative acute thrombosis,as well as mortality,were analyzed in the two groups of patients.Results A total of 161 patients were recruited,with 106 cases in the EVT≤24 h group and 55 cases in the EVT＞24 h group.The NIHSS scores declined after EVT in both groups(P＜0.01).The NIHSS scores after surgery were lower in the EVT≤24 h group(median:4.5 vs.7.0,P＜0.05).90-day functional independence(45.3％vs.30.9％,95％CI:0.93-3.68),sICH(5.7％vs.9.1％,95％CI:0.18-2.06),postoperative acute thrombosis(6.6％vs.3.6％,95％CI:0.37-9.34),and mortality(3.8％vs.1.8％,95％CI:0.23-19.42)did not differ significantly between the groups(P＞0.05).Conclusion Our findings support EVT feasibility in selected patients with middle cerebral artery atherosclerotic occlusion beyond 24 h.Prospective studies are warranted for confirmation.

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Triptolide ameliorates renal interstitial fibrosis in mice with unilateral ureteral obstruction by inhibiting NLRP3-mediated pyroptosis

Linting WEI ; Pengbo GE ; Yan LI ; Ke LI ; Yinhong WANG ; Weihao ZHAO ; Chenkai CUI ; Rongguo FU

Journal of Xi'an Jiaotong University(Medical Sciences).2025;46(6):947-952. doi:10.7652/jdyxb202506008

Objective To investigate the effect of triptolide(TPL)on renal interstitial fibrosis in mice with unilateral ureteral obstruction(UUO)and its mechanism.Methods Six male C57BL/6J mice were randomly selected as the sham group,and 12 mice with UUO modeling were randomly divided into the model group(UUO)and the triptolide group(TPL).Changes in serum creatinine(SCr),blood urea nitrogen(BUN),and body weight were compared among the groups.Renal tissue specimens were collected at 14 d after UUO for HE and Masson staining.Immunohistochemistry staining was performed to observe the expression of α-smooth muscle actin(α-SMA)and fibronectin(Fn)in kidney tissues.Western blotting analysis was used to detect the protein expression levels of nucleotide combined with structure of oligomerization domain receptor protein 3(NLRP3),GSDMD,cGSDMD,IL-1β and IL-18.Results At week 1,the body weight of mice in the UUO and TPL groups significantly decreased compared with that in the sham group(P＜0.05).Body weight reduced in the TPL group compared with that in the Sham group at week 2(P＜0.01).There was no significant difference in body weight between the TPL and UUO groups.BUN levels did not differ significantly between the three groups.Compared with the sham group,the SCr level in the UUO group significantly increased[(15.680±1.508)μmol/L](P＜0.01).A reduction in SCr level was observed following TPL administration[(12.550±3.004)μmol/L](P＜0.05).HE staining showed that the renal tubules of mice in the UUO group were significantly dilated and atrophic,with interstitial edema and increased inflammatory cell infiltration,while the pathological damage of renal tissues was significantly alleviated after TPL treatment.Masson staining revealed that interstitial collagen deposition significantly increased in the UUO group(36.350±5.183)％(P＜0.01)and reduced after TPL administration(20.820±3.290)％(P＜0.01).Immunohistochemistry results demonstrated that the IOD levels of α-SMA(1.233±0.045)and Fn(1.337±0.045)were higher in UUO group mice than in the sham group,while the IOD levels of α-SMA(1.047±0.025)and Fn(1.113±0.021)were lower in the TPL group than in the UUO group(P＜0.05).Western blotting analysis indicated that the expression levels of NLRP3,cGSDMD,IL-1β and IL-18 in the UUO group mice were higher than those in the sham group,while the protein expression levels of the above-mentioned indicators significantly decreased after TPL treatment(P＜0.05).Conclusion TPL ameliorates renal interstitial fibrosis in mice with UUO by inhibiting NLRP3-mediated pyroptosis.

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Analysis of the current status of domestic medical drainage tube patents based on patent information mining

Feng MA ; Chuxin CHANG ; Yan LI ; Lengjianghai ZHENG ; Ruimin GONG ; Juntao DUAN ; Rongqian WU ; Yi LV ; Xiaoyun KANG

Journal of Xi'an Jiaotong University(Medical Sciences).2025;46(6):1013-1019. doi:10.7652/jdyxb202506019

Objective To analyze the current status and emerging technology trends in domestic medical drainage tube patents,so as to explore possible factors for low patent conversion rates.Methods Patents associated with"drainage tube","medical drainage tube","surgical drainage tube"and related terms were retrieved from the National Intellectual Property Administration Database and the Innojoy Patent Search Engine,covering the period from 2010 to 2020.Screening and visual analysis were conducted using Excel and SPSS 27.0.Results A total of 2 895 relevant patents were identified,comprising 2 489 utility model patents,367 invention patents and 39 design patents.The number of patent applications demonstrated a year-on-year growth trend,with a higher concentration in eastern coastal regions and provinces housing numerous top-tier hospitals and medical institutions.Approximately 49.26％of the patents filed by individuals were affiliated with hospitals,universities,or enterprises.Innovation hotspots included the design,functionality,performance,and safety aspects of drainage tubes and probes.Of the patents,72.61％were invalid,and 61.73％had a survival period of three years or less.Only 5.15％were commercially utilized through transfers,pledges,or licensing.Conclusion Domestic patent applications for medical drainage tubes have seen rapid growth,with a focus on enhancing tube structures such as sleeves,balloons,drainage holes,and threaded designs.However,the unsatisfactory situation of patent conversion and operation have been mainly limited by factors such as weak core technology of patents,insufficient awareness of achievements conversion,poor operation of patent conversion mechanism,insufficient market promotion,and insufficient integration of industry,academia,and research.To address this issue,enhancing intellectual property protection,revitalizing valid patents,and expanding transformation channels would benefit patients and facilitate hospitals'high-quality development,injecting new vitality into the health industry.

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The time-series association between carotid intima-media thickness and bone mineral density in a Chinese population:a cross-lagged analysis based on a cohort of people undergoing physical examination

Hua HAO ; Can ZHANG ; Peiying YANG ; Hui GENG ; Xiaohui LI ; Baosen MENG ; Jun WANG ; Baibing MI ; Mao MA

Journal of Xi'an Jiaotong University(Medical Sciences).2025;46(6):1037-1044. doi:10.7652/jdyxb202506022

Objective To explore the time cross-lagged effect between carotid intima-media thickness(CIMT)and bone mineral density(BMD)and to assess whether CIMT can be used as an early predictor of osteoporosis.Methods Based on the retrospective cohort study involved,people who underwent health checkups at The First Affiliated Hospital of Xi'an Jiaotong University from January 2019 to December 2023 were selected,and data related to CIMT and BMD were collected.The time-series relationship between CIMT and BMD was explored by cross-lagged modeling.Meanwhile,the effects of CIMT on BMD and its dose-response relationship were assessed using multiple linear regression and restricted cubic spline regression models.Results Analysis of 2 453 study subjects revealed a significant negative relationship between prior physical examination CIMT and subsequent BMD,and this relationship remained significant after controlling for confounders.For every 1-unit increase in CIMT,there was a mean decrease in second-stage BMD T-values of 0.113.Restricted cubic spline regression analysis showed a maximum decrease in BMD T-values of 0.121 for every 1.00 mm increase in CIMT.Conclusion The present study found that there was a significant negative cross-lag effect between CIMT and BMD,and that there was a dose-response between an increase in CIMT and a decrease in BMD.CIMT,as an easy-to-measure indicator,may be a potential marker for early prediction of osteoporosis,especially in the elderly population.

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