BACKGROUND:Traditional assessment methods for knee osteoarthritis rely on clinical symptoms,physical examinations,and imaging findings of patients.However,these methods fail to reflect the dynamic changes in knee joint kinetics and do not comprehensively depict the objective status of the knee joint.The emergence of the 6 degree of freedom gait analysis system provides a more objective and practical dynamic assessment method for the severity of knee osteoarthritis.This system serves as a basis for more precise treatment strategies for different patients,thereby optimizing patient treatment approaches.OBJECTIVE:To review relevant assessment systems for knee osteoarthritis,compare the 6 degree of freedom gait analysis with traditional methods for assessing knee osteoarthritis severity,and explore the application of 6 degree of freedom gait analysis in guiding knee osteoarthritis treatment strategies.METHODS:A computer search was conducted using Google Scholar and PubMed databases for relevant articles published from January 2002 to June 2023.English search terms included"knee osteoarthritis,knee osteoarthritis severity,6DOF gait analysis,evaluation methods,WOMAC,KOOS."Chinese search terms were"knee osteoarthritis,osteoarthritis evaluation system,6 degree of freedom gait analysis."Based on inclusion and exclusion criteria,a total of 65 articles were selected for synthesis and summarization.RESULTS AND CONCLUSION:(1)The 6 degree of freedom gait analysis improves the accuracy of knee osteoarthritis severity assessment.Treatment plans based on this method significantly improved patient prognosis.(2)Current research findings suggest standardizing the integration of 6 degree of freedom gait analysis and traditional assessment methods in clinical practice for an objective and accurate evaluation of knee osteoarthritis.This enables better selection of treatment plansand evaluation of the long-term effectiveness of individualized treatment strategies.

Objective To investigate the imaging features of post-transplant lymphoproliferative disorder(PTLD)after allogeneic hematopoietic stem cell transplantation(allo-HSCT).Methods The imaging findings of EB virus-associated PTLD(EBV-PTLD)after allo-HSCT in 8 patients with hematological diseases were retrospectively analyzed,including 1 case with acute lymphoblastic leukemia(ALL),3 cases with acute myeloid leukemia(AML),1 case with myelodysplastic syndrome(MDS)and 3 cases with aplas-tic anemia(AA).All patients were positive for EB virus(EBV)after transplantation.MRI,CT plain scan and enhanced scan were performed to analyze the imaging features of all lesions.Results Central nervous system(CNS)was involved in 5 cases,pharyngeal lymphatic ring and left lacrimal sac was involved in 1 case,liver was involved in 1 case,intraperitoneal and retroperitoneal lymph nodes was involved in 1 case.All patients were pathologically confirmed with PTLD.Conclusion PTLD may involve multiple organs and tissues after hematopoietic stem cell transplantation with different onset time.Timely MRI and CT examination,combined with PTLD screening and EBV detection,can detect and diagnose PTLD lesions in early stage,providing important clinical value.

Objective To investigate the imaging features of post-transplant lymphoproliferative disorder(PTLD)after allogeneic hematopoietic stem cell transplantation(allo-HSCT).Methods The imaging findings of EB virus-associated PTLD(EBV-PTLD)after allo-HSCT in 8 patients with hematological diseases were retrospectively analyzed,including 1 case with acute lymphoblastic leukemia(ALL),3 cases with acute myeloid leukemia(AML),1 case with myelodysplastic syndrome(MDS)and 3 cases with aplas-tic anemia(AA).All patients were positive for EB virus(EBV)after transplantation.MRI,CT plain scan and enhanced scan were performed to analyze the imaging features of all lesions.Results Central nervous system(CNS)was involved in 5 cases,pharyngeal lymphatic ring and left lacrimal sac was involved in 1 case,liver was involved in 1 case,intraperitoneal and retroperitoneal lymph nodes was involved in 1 case.All patients were pathologically confirmed with PTLD.Conclusion PTLD may involve multiple organs and tissues after hematopoietic stem cell transplantation with different onset time.Timely MRI and CT examination,combined with PTLD screening and EBV detection,can detect and diagnose PTLD lesions in early stage,providing important clinical value.

BACKGROUND:Traditional assessment methods for knee osteoarthritis rely on clinical symptoms,physical examinations,and imaging findings of patients.However,these methods fail to reflect the dynamic changes in knee joint kinetics and do not comprehensively depict the objective status of the knee joint.The emergence of the 6 degree of freedom gait analysis system provides a more objective and practical dynamic assessment method for the severity of knee osteoarthritis.This system serves as a basis for more precise treatment strategies for different patients,thereby optimizing patient treatment approaches.OBJECTIVE:To review relevant assessment systems for knee osteoarthritis,compare the 6 degree of freedom gait analysis with traditional methods for assessing knee osteoarthritis severity,and explore the application of 6 degree of freedom gait analysis in guiding knee osteoarthritis treatment strategies.METHODS:A computer search was conducted using Google Scholar and PubMed databases for relevant articles published from January 2002 to June 2023.English search terms included"knee osteoarthritis,knee osteoarthritis severity,6DOF gait analysis,evaluation methods,WOMAC,KOOS."Chinese search terms were"knee osteoarthritis,osteoarthritis evaluation system,6 degree of freedom gait analysis."Based on inclusion and exclusion criteria,a total of 65 articles were selected for synthesis and summarization.RESULTS AND CONCLUSION:(1)The 6 degree of freedom gait analysis improves the accuracy of knee osteoarthritis severity assessment.Treatment plans based on this method significantly improved patient prognosis.(2)Current research findings suggest standardizing the integration of 6 degree of freedom gait analysis and traditional assessment methods in clinical practice for an objective and accurate evaluation of knee osteoarthritis.This enables better selection of treatment plansand evaluation of the long-term effectiveness of individualized treatment strategies.

Objective To investigate CT manifestations of pulmonary graft-versus-host disease(GVHD)after allogeneic hematopoietic stem cell transplantation(allo-HSCT)in children.Methods A total of 311 children with pulmonary GVHD who underwent allo-HSCT were retrospectively analyzed.According to the onset time of pulmonary GVHD within 100 days after allo-HSCT or not,the patients were divided into acute group(n=82)and chronic group(n=229).Chest CT manifestations were observed and compared between groups,and children survival after treatments were recorded an d compared between groups.Results The main CT manifestations of pulmonary GVHD after allo-HSCT in children included ground glass opacity(GGO)(82/311,26.37％),air trapping(78/311,25.08％),thickening bronchial wall(32/311,10.29％),bronchiectasis(28/311,9.00％),pleural effusion(43/311,13.83％),thickening interlobular septum(43/311,13.83％),thickening pleura(41/311,13.18％)and thoracic air leak syndrome(41/311,13.18％).The proportion of localized GGO,diffuse GGO,pleural effusion and thickening interlobular septum in acute group were all higher,while of air trapping and bronchiectasis were both lower than those in chronic group(all P＜0.05).No significant difference of other menifeatations was found between groups(all P＞0.05).After treatments,85 cases died,and the mortality rate was 27.33％(85/311),which in acute group(30/82,36.59％)was higher than in chronic group(55/229,24.02％)(x2=4.802,P=0.031).Conclusion CT manifestations of pulmonary GVHD after allo-HSCT in children had certain characteristics.

Objective:To discuss the improvement effect of Shenshuai Yingyang Capsule in the renal osteodystrophy model rats and its effect on the bone morphogenetic protein(BMP)-7/Smads signaling pathway,and to clarify the relationship between renal function and bone metabolism in the renal osteodystrophy model rats.Methods:Fifty SPF SD rats were selected,and 10 of which were randomly chosen as control group,and the remaining 40 rats were used to establish the renal osteodystrophy model.Thirty successful modeling rats were divided into model group,positive control group,and Shenshuai Yingyang Capsule group,and there were 10 rats in various groups.The rats in control and model groups were given saline,the rats in positive control group were given 0.01 mg·kg-1 calcitriol,and the rats in Shenshuai Yingyang Capsule group were given 1.2 g·kg-1 Shenshuai Yingyang Capsule,all the rats were treated for 12 weeks.HE staining was used to observe the pathomorphology of femur tissue of the rats in various groups;automatic biochemical analyzer and chemiluminescence were used to detect the kidney function and calcium-phosphorus metabolism indicators in serum of the rats in various groups;real-time fluorescence quantitative PCR(RT-qPCR)method was used to detect the expression levels of BMP-7 and Smad1/5/8 mRNA in femur tissue of the rats in various groups;Western blotting method was used to detect the expression levels of BMP-7,phosphorylated BMP-7(p-BMP-7),Smad1/5/8,and phosphorylated-Smad1/5/8(p-Smad1/5/8)proteins in femur tissue of the rats in various groups.Results:The HE staining results showed that there was normal trabecular arrangement in control group with unchanged osteoblasts and osteoid area.In model group,the trabecular width and average osteoid area were increased,while the number of osteoblasts was decreased.In positive control and Shenshuai Yingyang Capsule groups,the trabecular width and average osteoid area were decreased,and the number of osteoblasts was increased.Compared with control group,the levels of blood urea nitrogen(BUN)and serum creatinine(Scr)of the rats in model group were increased(P<0.05);compared with model group,the levels of BUN and Scr of the rats in positive control and Shenshuai Yingyang Capsule groups were decreased(P<0.05);compared with positive control group,the levels of BUN and Scr of the rats in Shenshuai Yingyang Capsule group were decreased(P<0.05).Compared with control group,the level of calcium ion(Ca2+)in serum of the rats in model group was decreased(P<0.05),and the levels of phosphorus ion(P3-),parathyroid hormone(PTH),and alkaline phosphatase(ALP)were increased(P<0.05);compared with model group,the levels of Ca2+in serum of the rats in positive control and Shenshuai Yingyang Capsule groups were increased(P<0.05),and the levels of P3-,PTH,and ALP were decreased(P<0.05);compared with positive control group,the level of Ca2+in serum of the rats in Shenshuai Yingyang Capsule group was increased,and the levels of P3-,PTH,and ALP were decreased(P<0.05).The RT-qPCR results showed that compared with control group,the expression levels of BMP-7 and Smad1/5/8 mRNA in femur tissue of the rats in model group were decreased(P<0.05);compared with model group,the expression levels of BMP-7 and Smad1/5/8 mRNA of the rats in positive control drug group and Shenshuai Yingyang Capsule group were increased(P<0.05);compared with positive control group,the expression levels of BMP-7 and Smad1/5/8 mRNA in femur tissue of the rats in Shenshuai Yingyang Capsule group were increased(P<0.05).The Western blotting results showed that compared with control group,the expression levels of BMP-7,p-BMP-7,Smad1/5/8,and p-Smad1/5/8 proteins in femur tissue of the rats in model group were decreased(P<0.05);compared with model group,the expression levels of BMP-7,p-BMP-7,Smad1/5/8,and p-Smad1/5/8 proteins in femur tissue of the rats in positive control group and Shenshuai Yingyang Capsule group were increased(P<0.05);compared with positive control group,the expression levels of BMP-7,p-BMP-7,Smad1/5/8,and p-Smad1/5/8 proteins in femur tissue of the rats in Shenshuai Yingyang Capsule group were increased(P<0.05).Conclusion:Shenshuai Yingyang Capsule can improve the kidney function and calcium-phosphorus metabolism disorders in the renal osteodystrophy model rats,promote the proliferation of the bone marrow stromal cells,and enhances the bone metabolism;its mechanism may be related to the activation of BMP-7/Smads signaling pathway.

Objective To investigate CT manifestations of pulmonary graft-versus-host disease(GVHD)after allogeneic hematopoietic stem cell transplantation(allo-HSCT)in children.Methods A total of 311 children with pulmonary GVHD who underwent allo-HSCT were retrospectively analyzed.According to the onset time of pulmonary GVHD within 100 days after allo-HSCT or not,the patients were divided into acute group(n=82)and chronic group(n=229).Chest CT manifestations were observed and compared between groups,and children survival after treatments were recorded an d compared between groups.Results The main CT manifestations of pulmonary GVHD after allo-HSCT in children included ground glass opacity(GGO)(82/311,26.37％),air trapping(78/311,25.08％),thickening bronchial wall(32/311,10.29％),bronchiectasis(28/311,9.00％),pleural effusion(43/311,13.83％),thickening interlobular septum(43/311,13.83％),thickening pleura(41/311,13.18％)and thoracic air leak syndrome(41/311,13.18％).The proportion of localized GGO,diffuse GGO,pleural effusion and thickening interlobular septum in acute group were all higher,while of air trapping and bronchiectasis were both lower than those in chronic group(all P＜0.05).No significant difference of other menifeatations was found between groups(all P＞0.05).After treatments,85 cases died,and the mortality rate was 27.33％(85/311),which in acute group(30/82,36.59％)was higher than in chronic group(55/229,24.02％)(x2=4.802,P=0.031).Conclusion CT manifestations of pulmonary GVHD after allo-HSCT in children had certain characteristics.

OBJECTIVETo evaluate the effect and safety of acupuncture combined with Jiawei Mojie tablet for the prevention of endometriosis recurrence after surgery.

METHODSOne hundred and six patients after the conservative surgery against endometriosis were randomly divided into a western medication group and an acupuncture and medication group(a combination group), 53 cases in each one. In the western medication group, gestrinone was applied orally. In the combination group, acupuncture and Jiawei Mojie tablet with oral administration were adopted. Xuehai (SP 10), Sanyinjiao (SP 6) and Guanyuan (CV 4) were mainly used, and acupoints based on syndrome differentiation were combined. After the surgery and when the menstruation was end, 3 to 5 days later the preventive treatment was used successively for 6 months. Patients were followed up after treatment and in 3 months, 6 months, and 18 months (two years after surgery) after treatment. The recurrence [Abdominal/perineal ultrasonic examination, serum cancer antigen 125 (CA125) test], menstruation score, endometriosis health profile-5 (EHP-5) and the safety index of serum alanine aminotransferase (ALT) were compared between the two groups.

RESULTSEight patients (five cases in the western medication group and three cases in the combination group) were rejected because of dropping, and six ones (two cases in the western medication group and four cases in the combination group) discontinued. When patients were followed up in 18 months after treatment, the suspected recurrence rate through ultrasonic examination was 2.0% (1/50), and the unusual rate of serum CA125 text was 4.0% (2/50) in the combination group, which were apparently lower than 18.8% (9/48) and 25.0% (12/48) in the western medication group (both P < 0.01). After treatment and 3-month, 6-month, and 18-month following up, the menstruation scores of the combination group were obviously lower than those of the western medication group (P < 0.01, P < 0.05). After 18 months, the positive rate of EHP-5 in the combination group was 0 (0/50), which was markedly lower than 18.8% (9/48) in the western medication group (P < 0.01). After treatment and 3-month, 6-month, and 18-month following up, the unusual rates of serum ALT text in the combination group were lower than those in the western medication group (P < 0.01, P < 0.05). After treatment, the unusual rate of serum ALT text was not significantly different in the combination group compared with that before treatment (P > 0.05), and after treatment and 3-month, 6-month following up, the unusual rates of serum ALT text in the western medication group were remarkablely higher than those before treatment (P < 0.01, P < 0.05). After 18-month following up, the unusual rate of serum ALT text in the western medication group was not statistically significant compared with that before treatment (P > 0.05).

CONCLUSIONAcupuncture combined with Jiawei Mojie tablet can effectively prevent endometriosis recurrence after surgery, and improve menstruation condition and life quality, which are less injurious for liver than gestrinone.

Acupuncture Points ; Acupuncture Therapy ; Administration, Oral ; Adult ; CA-125 Antigen ; blood ; Combined Modality Therapy ; Drugs, Chinese Herbal ; administration & dosage ; Endometriosis ; blood ; drug therapy ; prevention & control ; surgery ; Female ; Humans ; Male ; Recurrence ; Young Adult

Objective To explore the expression and clinical significance of microRNA (miR)-155 and miR -222 in plasma of patients with ventricular septal defect(VSD),and to analyze the possible mechanism.Methods A total of 20 children with VSD who received treatment at the Department of Cardiovascular Surgery from August 2012 to June 2013 were enrolled (the VSD group)and 15 patients with fracture (the control group).The plasma miR -155 and miR -222 expression levels were measured by real -time quantitative reverse transcription -polymerase chain reaction (RT -qPCR).The potential target genes of miR -155 and miR -222 were predicted by using 3 current-ly available prediction programs,including TargetScan,mirbase and Miranda,and the signaling pathway of miRNA was predicted by Pathway -express analysis.Results Compared with the control group,the expression levels of miR -155 (P =0.033)and miR -222(P <0.001)in the VSD group decreased significantly;miR -155 and miR -222 predic-ted target genes included 74 and 50,respectively.The Pathway -express analysis indicated that 7 signaling pathways played important roles in the occurrence of fetal VSD,including signaling pathways for heart development,such as:mito-gen -activated protein kinase(MAPK)signaling pathway.Conclusions The expression levels of plasma miR -155 and miR -222 in VSD were significantly decreased.The target genes were related to signaling pathways for heart deve-lopment (MAPK signaling pathway),which indicates that miR -155 and miR -222 may be involved in the pathological process of VSD,and may serve as an independent evaluation indicator for the diagnosis of VSD.

Objective To observe the clinical efficacy of electroacupuncture plus oral administration ofZeling Guanjie Xiaozhong Heji in treating rheumatoid arthritis (RA) due to liver-kidney yin deficiency.Method Totally 126 patients with active RA due to liver-kidney yin deficiency were randomized into a treatment group and a control group, 63 cases in each group. The control group was prescribed with orally taking Methotrexate tablets and Leflunomide tablets, while the treatment group was intervened by electroacupuncture plus oral administration ofZeling Guanjie Xiaozhong Heji in addition to the medications given to the control group. The Disease Activity Score 28 (DAS28) was evaluated before and after intervention, and the therapeutic efficacies were compared based on the criteria of the American College of Rheumatoid (ACR) and syndrome of traditional Chinese medicine (TCM).Result The ACR total effective rate was 87.3% in the treatment group versus 65.1% in the control group, and the difference was statistically significant (P<0.01). The total effective rate based on TCM syndrome was 87.3% in the treatment group versus 73.0% in the control group, and the difference was statistically significant (P<0.05). There was a significant difference in comparing the DAS28 score between the two groups after intervention (P<0.01).Conclusion Electroacupuncture plus oral administration of Chinese medication and western medication is an effective approach in treating RA due to liver-kidney yin deficiency, and it can significantly enhance the therapeutic efficacy based on ACR20 and TCM syndrome.