OBJECTIVE To investigate the ameliorative effect and mechanism of short-acting exenatide on diabetic cognitive dysfunction. METHODS Spontaneously diabetic db / db mice were randomly divided into model group （normal saline） and exenatide group （50 μg/kg）， with db / m mice as the normal control group （normal saline）， with 8 mice in each group. Mice in each group were subcutaneously injected with corresponding drugs or normal saline twice daily for 8 consecutive weeks. Body weight and fasting blood glucose were measured at a fixed time every week. Cognitive function was evaluated by Morris water maze test. The levels of oxidative st ress indicators [malondialdehyde （MDA）， superoxide dismutase （SOD）， glutathione （GSH） ] ， cyclic adenosine monophosphate （cAMP） and protein kinase A （PKA） were detected in hippocampus tissue of mice. The hippocampal neuronal HT22 cells of mice were divided into control group （25 mmol/L glucose）， high glucose group （125 mmol/L glucose）， high glucose+exenatide group （125 mmol/L glucose+20 nmol/L exenatide）， high glucose+exenatide+H89 （PKA inhibitor） group （125 mmol/L glucose+20 nmol/L exenatide+10 μmol/L H89）， and high glucose+H89 group （125 mmol/L glucose+10 μmol/L H89）. After 48 h of intervention with corresponding solutions/culture medium， the levels of oxidative stress indicators， cAMP and PKA， the activities of mitochondrial respiratory enzymes Ⅱ and Ⅳ， and the phosphorylation level of dynamin-related protein 1 （Drp1） were measured. RESULTS Animal experiments showed that compared with the normal control group， the model group exhibited significantly increased body weight， fasting blood glucose and MDA level in the hippocampus （ P ＜0.05）， as well as significantly prolonged escape latency （ P ＜0.05）； swimming speed significantly slowed down， the time spent in the target quadrant， the number of platform crossings， and the levels of SOD， GSH， cAMP and PKA in the hippocampus were significantly decreased （ P ＜0.05）. Compared with model group， all the above indicators （except for swimming speed） in the exenatide group were significantly reversed （ P ＜0.05）. Cell experiments showed that compared with high glucose group， the high glucose+exenatide group had significantly decreased MDA level （ P ＜0.05）， and significantly increased levels of SOD， GSH， cAMP and PKA， the activities of mitochondrial respiratory enzymes Ⅱ and Ⅳ， and phosphorylation level of Drp1 （ P ＜0.05）. Compared with high glucose+exenatide group， the above indicators in the high glucose+exenatide+H89 group were significantly reversed （ P ＜0.05）. CONCLUSIONS Short-acting exenatide can activate the cAMP/PKA pathway， promote Drp1 phosphorylation， and increase the activities of mitochondrial respiratory enzymes， thereby maintaining mitochondrial stability， reducing oxidative stress injury， and ultimately improving diabetic cognitive dysfunction.

Objective:To explore the effect of the combination of robot-assisted total knee arthroplasty and pressure sensor on early postoperative outcomes.Methods:Twenty patients who underwent YUANHUA robot-assisted TKA between September 2024 and December 2024 were prospectively enrolled. After randomization and exclusion of one patient lost to follow-up, 10 patients were included in the pressure-sensor group and 10 in the control (no-pressure) group. In the pressure-sensor group, surgeons used a pressure sensor to assist in soft tissue balancing after osteotomy, whereas in the control group, balancing was performed empirically. In both groups, medial and lateral compartment pressures of the knee at 10°, 45°, 90°, and 120° of flexion were recorded using a pressure sensor prior to component implantation. Clinical outcomes were evaluated preoperatively and at 1 day, 3 days, 1 week, 2 weeks, 6 weeks, and 3 months postoperatively using the visual analog scale (VAS), Knee Society Score (KSS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and Forgotten Joint Score (FJS).Results:All 20 procedures were completed successfully, and patients were followed for at least 3 months. At 10° of knee flexion, the difference between medial and lateral compartment pressures was significantly smaller in the pressure-sensor group (0.99±59.44 N) than in the control group (97.18±84.34 N; t=-2.948, P=0.009). At 45° of flexion, the corresponding differences were -12.99±36.20 N and 51.48±76.40 N, respectively ( t=-2.411, P=0.032). No significant differences in VAS, KSS, or WOMAC scores were observed between groups preoperatively ( P>0.05). At 3 months postoperatively, the KSS was significantly higher in the pressure-sensor group (174.40±16.39) compared with the control group (138.50±38.35, t=2.722, P=0.014). The WOMAC and VAS scores were significantly lower in the pressure-sensor group (12.70±11.00 and 1.20±0.92, respectively) than in the control group (27.30±18.54 and 2.70±2.00; t=-2.142, P=0.046; t=-2.153, P=0.045). At 2 weeks and 3 months postoperatively, the FJS scores in the pressure-sensor group [70.00±26.06 and 88.07(83.52, 95.83)] were significantly higher than those in the control group [37.92±32.42 and 50.00(32.50, 67.75); t=2.439, P=0.025; Z=-2.466, P=0.014]. Conclusion:The combination of precise osteotomy using robot-assisted TKA and soft tissue balancing guided by a pressure sensor provided more accurate medial-lateral compartment balance and significantly enhanced early postoperative clinical outcomes.

Objective:To explore the effect of the combination of robot-assisted total knee arthroplasty and pressure sensor on early postoperative outcomes.Methods:Twenty patients who underwent YUANHUA robot-assisted TKA between September 2024 and December 2024 were prospectively enrolled. After randomization and exclusion of one patient lost to follow-up, 10 patients were included in the pressure-sensor group and 10 in the control (no-pressure) group. In the pressure-sensor group, surgeons used a pressure sensor to assist in soft tissue balancing after osteotomy, whereas in the control group, balancing was performed empirically. In both groups, medial and lateral compartment pressures of the knee at 10°, 45°, 90°, and 120° of flexion were recorded using a pressure sensor prior to component implantation. Clinical outcomes were evaluated preoperatively and at 1 day, 3 days, 1 week, 2 weeks, 6 weeks, and 3 months postoperatively using the visual analog scale (VAS), Knee Society Score (KSS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and Forgotten Joint Score (FJS).Results:All 20 procedures were completed successfully, and patients were followed for at least 3 months. At 10° of knee flexion, the difference between medial and lateral compartment pressures was significantly smaller in the pressure-sensor group (0.99±59.44 N) than in the control group (97.18±84.34 N; t=-2.948, P=0.009). At 45° of flexion, the corresponding differences were -12.99±36.20 N and 51.48±76.40 N, respectively ( t=-2.411, P=0.032). No significant differences in VAS, KSS, or WOMAC scores were observed between groups preoperatively ( P>0.05). At 3 months postoperatively, the KSS was significantly higher in the pressure-sensor group (174.40±16.39) compared with the control group (138.50±38.35, t=2.722, P=0.014). The WOMAC and VAS scores were significantly lower in the pressure-sensor group (12.70±11.00 and 1.20±0.92, respectively) than in the control group (27.30±18.54 and 2.70±2.00; t=-2.142, P=0.046; t=-2.153, P=0.045). At 2 weeks and 3 months postoperatively, the FJS scores in the pressure-sensor group [70.00±26.06 and 88.07(83.52, 95.83)] were significantly higher than those in the control group [37.92±32.42 and 50.00(32.50, 67.75); t=2.439, P=0.025; Z=-2.466, P=0.014]. Conclusion:The combination of precise osteotomy using robot-assisted TKA and soft tissue balancing guided by a pressure sensor provided more accurate medial-lateral compartment balance and significantly enhanced early postoperative clinical outcomes.

Objective To explore the efficacy of endovascular treatment for closed articular artery injuries.Methods The clinical data of 13 patients from Jan 2010 to Dec 2014 treated for closed articular artery injuries were analyzed retrospectively.The location,severity and extent of arterial injury were confirmed by intraoperative arteriography.The diameter and length of the injured arteries were measured.The guidewire was sent to the lesion site and working wire pathway was established.When the guidewire was difficult to pass through the lesion site,femoral and posterior tibial or radial artery may be used to establish working wire pathway.The stent or stent-graft was implanted through the contralateral femoral artery or distal end of ipsilateral artery.Results Intraoperative angiography confirmed intimal injury (n =2),partial transection (n =5),complete transection (n =5) and arteriovenous fistula (n =1).Eighteen stents or stent-grafts were implanted.Treatment was successful in all patients without peiropeartive death and procedure-related complications.All were followed up for 15 to 48 months and the mean follow-up was (30 ± 11) months.Three patients with stent lumen stenosis less than 50％ as showed by angiography.There was no stent fracture,displacement,or deformation.Conclusions Endovascular treatment for closed articular artery injuries is of less invasion,shorter operative time and quick postoperative recovery.

OBJECTIVE: To evaluate the feasibility and effectiveness of endovascular repair for blunt popliteal arterial injuries. MATERIALS AND METHODS: A retrospective analysis of seven patients with clinical suspicion of popliteal arterial injuries that were confirmed by arteriography was performed from September 2009 to July 2014. Clinical data included demographics, mechanism of injury, type of injury, location of injury, concomitant injuries, time of endovascular procedures, time interval from trauma to blood flow restoration, instrument utilized, and follow-up. All patients were male (mean age of 35.9 ± 10.3 years). The type of lesion involved intimal injury (n = 1), partial transection (n = 2), complete transection (n = 2), arteriovenous fistula (n = 1), and pseudoaneurysm (n = 1). All patients underwent endovascular repair of blunt popliteal arterial injuries. RESULTS: Technical success rate was 100%. Intimal injury was treated with a bare-metal stent. Pseudoaneurysm and popliteal artery transections were treated with bare-metal stents. Arteriovenous fistula was treated with bare-metal stent and coils. No perioperative death and procedure-related complication occurred. The average follow-up was 20.9 ± 2.3 months (range 18-24 months). One patient underwent intra-arterial thrombolysis due to stent thrombosis at 18 months after the procedure. All limbs were salvaged. Stent migration, deformation, or fracture was not found during the follow-up. CONCLUSION: Endovascular repair seems to be a viable approach for patients with blunt popliteal arterial injuries, especially on an emergency basis. Endovascular repair may be effective in the short-term. Further studies are required to evaluate the long-term efficacy of endovascular repair.
Aneurysm, False ; Angiography ; Arteriovenous Fistula ; Demography ; Emergencies ; Endovascular Procedures ; Extremities ; Follow-Up Studies ; Humans ; Limb Salvage ; Male ; Popliteal Artery ; Radiology, Interventional ; Retrospective Studies ; Stents ; Thrombosis

The publisher and authors would like to draw the reader's attention to an error in the following article. Endovascular Repair of Blunt Popliteal Arterial Injuries. Korean J Radiol 2016;17(5):789-796.