Objective To explore the clinical efficacy of edaravone dexborneol combined with intravenous thrombolysis with alteplase,in the treatment of patients with acute ischemic stroke(AIS).Methods The patients with AIS undergoing intravenous thrombolysis with alteplase between January 7,2021 and December 31,2022 were enrolled and randomly divided into observation group and control group.The control group was treated with standard treatment according to the AIS guidelines,and the observation group was treated with edaravone dexborneol injection within 48 hours from thrombolysis to the onset of the disease on the basis of the treatment in the control group.7-day post-thrombolysis National Institutes of Health stroke scale(NIHSS),discharged NIHSS,difference between 7-day post-thrombolysis NIHSS and pre-thrombolysis NIHSS,and 3-month all-cause mortality and 3-month poor prognosis ratio were compared between the two groups.Results A total of 232 patients with AIS were randomly allocated to the observation group(n=1 16)and the control group(n=1 16).The differences between the two groups were not statistically significant for 7-day post-thrombolysis NIHSS and difference between 7-day post-thrombolysis NIHSS and pre-thrombolysis NIHSS(P＞0.05),and there were statistical differences in distribution of the discharged NIHSS score between the observation group and control group[2.0(0,3.0)vs.2.0(1.0,5.0),P＜0.05].The 3-month poor prognosis ratio was significantly lower in the observation group than in the control group(12.1％vs.28.4％;OR=0.252,95％CI 0.105 to 0.602,P=0.002).Conclusion Edaravone dexborneol enhances the efficacy of AIS undergoing intravenous thrombolysis with alteplase and improves the 3-month outcome of patients.

Objective:To investigate the role of serum CX3CR1 in the diagnosis of coronary artery stenosis and in the evaluation of prognosis after percutaneous coronary intervention.Methods:A total of 101 patients with coronary artery stenosis (≥ 50% stenosis) confirmed with coronary angiography (CAG) in Haiyang People's Hospital from January 2018 to May 2019 who were followed up till May 2021 were included in the observation group. Thirty-four healthy individuals who underwent physical examination during the same period were included in the control group. Patients in the observation group were divided into an in-stent restenosis group (ISR group, n = 28) and a non-ISR group ( n = 73). The expression of CX3CR1 was detected. The incidence of adverse cardiac events was calculated. The sensitivity, specificity, and area under the curve (AUC) plotted for the use of CX3CR1 to diagnose coronary artery stenosis and predict adverse cardiac events were evaluated. Results:The expression of CX3CR1 in the observation group was (3.95 ± 1.05) μg/L, which was significantly higher than (2.30 ± 0.65) μg/L in the control group ( t = 2.87, P < 0.05). The receiver operating characteristic curve analysis showed that the AUC, sensitivity, and specificity of the use of CX3CR1 in diagnosing coronary artery stenosis were 0.892, 75.2%, and 88.2%. The incidence of non-fatal myocardial infarction, angina pectoris, heart failure, and cardiac death in the ISR group was significantly higher compared with the non-ISR group ( χ2 = 8.06, 7.17, 8.06, 7.17, all P < 0.05). The receiver operating characteristic curve analysis results showed that the AUC value of CX3CR1 in predicting non-fatal myocardial infarction, angina pectoris, heart failure, and cardiac death were 0.786, 0.895, 0.997, and 0.887, respectively. Conclusion:CX3CR1 is highly expressed in coronary artery stenosis, which can provide a reference for the diagnosis and prognostic evaluation of coronary artery stenosis.

Objective:To explore the clinical value of quantitative parameters on spectral CT in predicting the invasiveness of lung adenocarcinoma manifesting as ground-glass nodules (GGN).Methods:The clinical and imaging data of 129 patients with pathologically confirmed lung adenocarcinoma who were surgically resected in the First Affiliated Hospital of Zhengzhou University from March to October 2022 were retrospectively analyzed, including 45 males and 84 females, aged from 33 to 81. According to the pathological results, they were divided into the minimally invasive adenocarcinoma (MIA) group ( n=64) and the invasive adenocarcinoma (IAC) group ( n=65). All patients underwent enhanced spectral CT within two weeks before surgery. The iodine density map, Z-Effective (Z eff) map, and electron density (ED) map were reconstructed on the post-processing workstation, and the spectral parameters, including normalized iodine concentration (NIC), arterial enhancement fraction (AEF), Z eff, and ED were measured and calculated. Conventional CT features were analyzed, including maximum diameter, CT value, nodule types, margin, lobulation sign, spiculation sign, bubble sign, pleural retraction sign, abnormal vascular sign, and air bronchial sign. The clinical features, conventional CT characteristics and spectral CT parameters of two groups were compared using the independent sample t test, the Mann-Whitney U test, and the χ 2 test. Multivariate logistic regression analysis was used to evaluate the independent risk factors of lung adenocarcinoma invasiveness, and the model was constructed. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the performance of parameters and models in predicting the invasiveness of lung adenocarcinoma. Results:There were significant differences between the MIA group and IAC group in maximum diameter, CT value, nodule type, margin, spiculation sign, pleural retraction sign, air bronchial sign, venous phase NIC, AEF, venous phase Z eff, arterial phase ED, venous phase ED ( P<0.05). Multivariate logistic regression analysis showed that the maximum diameter (OR=1.183, 95%CI 1.062-1.318), CT value (OR=1.004, 95%CI 1.001-1.007), venous phase NIC (OR=1.185, 95%CI 1.083-1.298), AEF(OR=0.975, 95%CI 0.957-0.994), venous phase Z eff (OR=0.031, 95%CI 0.005-0.196) were independent influence factors for the invasiveness of lung adenocarcinoma. The conventional CT model was established with the maximum diameter and CT value, and the spectral CT model was established with venous phase NIC, AEF, and venous phase Z eff. The combined model was established with all the parameters above. Areas under the ROC curve of the conventional CT model, the spectral CT model, and the combined model for predicting the invasiveness of lung adenocarcinoma were 0.828, 0.854, and 0.902, respectively. Conclusion:The quantitative parameters of double-layer detector spectral CT can be used as an indicator to predict the invasiveness of lung adenocarcinoma manifesting as GGN, and AEF has the highest diagnostic efficacy. Spectral CT combined with conventional CT features can further improve the diagnostic efficiency.

AIM: To explore the possible mechanism of Xiaokeshu recipe in the treatment of type 2 diabetes mellitus (T2DM) by observing the effects of Xiaokeshu Recipe on serum inflammatory factors. METHODS: Male SPF-grade SD rats were fed with high-fat and high-sugar fodder combined with intraperitoneal injection of streptozotocin (STZ) to prepare the model of T2DM. The model rats were randomly divided into a model group,a metformin group, low and high-dose Xiaokeshu recipe groups, and a normal group was set up. After successful modeling, the metformin group and the Xiaokeshu recipe groups were treated with metformin and Xiaokeshu recipe by gavage respectively, normal saline was given by gavage in the normal group and the model group. The general living status of rats before and after treatment was observed. After 4 weeks of drug intervention, serum samples and ileum tissue of rats were collected for biochemical and Western blot. RESULTS: As compaed with the model group,the polydipsia and polyuria in the low and high-dose Xiaokeshu recipe and the metformin groups could be improved. As compaed with the model group, the levels of fasting blood glucose (FBG), fasting insulin (FINS) and interleukin-1β (IL-1β) of rats in the low-dose Xiaokeshu recipe group were decreased, but the differences were statistically insignificant (P0.05), the levels of FBG, FINS and IL-1β of rats in the high-dose Xiaokeshu recipe and the metformin groups were significantly decreased as compared with the the model group (P 0.05 or P0.01). As compaed with the model group, the levels of Lipopolysaccharide (LPS), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) in the high-dose Xiaokeshu recipe and the metformin groups were decreased (P<0.05 or P<0.01). As compared with the model group, the expressions of toll-like receptor 4 (TLR4) and nuclear transcription factor (NF-κB) protein in ileal tissue were down-regulated in the low and high-dose Xiaokeshu Recipe and the metformin groups (P<0.05 or P<0.01). CONCLUSION: Xiaokeshu recipe may reduce the level of serum LPS, inhibit the TLR4/NF-κB signaling pathway, and reduce the release of inflammatory factors, thus improving insulin resistance and reducing the blood sugar of the body.

OBJECTIVE: To investigate the effectiveness of arthroscopic multi-point fixation with anchor and suture in the treatment of tibial insertion avulsion fracture of anterior cruciate ligament (ACL) involving the anterior root of lateral meniscus (LM). METHODS: A retrospective analysis was conducted on the clinical data of 28 patients with tibial insertion avulsion fracture of ACL involving the anterior root of LM who were treated with arthroscopic multi-point fixation with anchor and suture between October 2017 and January 2023. There were 12 males and 16 females with the mean age of 26 years (range, 13-57 years). There were 20 cases of sports injury and 8 cases of traffic accident injury. In 2 cases of old fracture, the time from injury to operation was 45 days and 90 days, respectively; in 26 cases of fresh fracture, the time from injury to operation was 3-20 days (mean, 6.7 days). According to the Meyers-McKeever classification, there were 4 cases of type Ⅱ, 11 cases of type Ⅲ, and 13 cases of type Ⅳ. The preoperative Lysholm knee function score was 42.1±9.0, the International Knee Documentation Committee (IKDC) score was 40.0±7.3, and the Tegner score was 0.7±0.7. RESULTS: All operations were successfully completed, and the incisions healed by first intention. All the 28 patients were followed up 5-60 months (mean, 20.4 months). During the follow-up, there was nocomplication such as infection, vascular or nerve injury, loosening or breakage of internal fixator, or stiffness of knee joint. Postoperative X-ray films showed satisfactory fracture reduction and firm fixation. All fractures healed clinically, and the healing time was 8-16 weeks (mean, 10.3 weeks). At last follow-up, Lachman test and anterior drawer test were negative. At last follow-up, Lysholm knee function score was 92.4±5.5, IKDC score was 91.6±4.4, and Tegner score was 5.2±1.1, which significantly improved when compared with preoperative scores ( t=-22.899, P<0.001; t=-29.870, P<0.001; t=-19.979, P<0.001). CONCLUSION Multi-point fixation with anchor and suture in the treatment of tibial insertion avulsion fracture of ACL involving the anterior root of LM can not only fix the LM, but also effectively reduce and fix the avulsion fracture, which can obtain good effectiveness.
Male ; Female ; Humans ; Adult ; Anterior Cruciate Ligament/surgery* ; Menisci, Tibial/surgery* ; Fractures, Avulsion/surgery* ; Retrospective Studies ; Anterior Cruciate Ligament Injuries/surgery* ; Treatment Outcome ; Arthroscopy ; Tibial Fractures/surgery* ; Knee Joint/surgery* ; Sutures ; Suture Techniques

OBJECTIVE: To summarize the research progress of anterior cutaneous nerve injury and repair in knee arthroplasty. METHODS: The relevant literature at home and abroad in recent years was reviewed and summarized from the anatomy of anterior cutaneous nerve, nerve injury grade, clinical manifestations, prevention and treatment of anterior cutaneous nerve. RESULTS: The anterior cutaneous nerve injury is a common complication of knee arthroplasty. Because the anterior cutaneous nerve branches are many and thin, and mainly run between the first and second layers of fascia, this level is often ignored during surgical exposure. In addition, the knee arthroplasty does not routinely perform the exploration and repair of the cutaneous nerve. So the anterior cutaneous nerve injury is difficult to avoid, and can lead to postoperative skin numbness and knee pain. At present, studies have explored the feasibility of preventing its occurrence from the aspects of improved incision and intraoperative separation of protective nerve. There is no effective prevention and treatment measures for this complication. For patients with skin numbness after knee arthroplasty, the effectiveness of drug treatment is not clear. Local nerve block or nerve excision can be used to treat patients with painful symptoms after knee arthroplasty considering cutaneous pseudoneuroma. CONCLUSION Knee arthroplasty is widely used and anterior cutaneous nerve injury is common in clinic. In the future, more high-quality clinical studies are needed to further explore the prevention and treatment measures of this complication and evaluate the clinical benefits obtained.
Humans ; Arthroplasty, Replacement, Knee/adverse effects* ; Hypesthesia/etiology* ; Skin ; Pain/etiology* ; Knee Joint ; Pain, Postoperative

OBJECTIVE: To investigate the repair method of type Ⅱc injury in the lateral meniscus popliteal tendon area based on the porcine knee joint. METHODS: Eighteen commercially available fresh porcine knee joints were randomly divided into 3 groups ( n=6). After preparing a type Ⅱc injury in the lateral meniscus popliteal tendon area, and the anterior (group A), posterior (group B), or anterior and posterior (group C) of the popliteal hiatus (PH) was sutured by vertical mattress. The tension meter was used to apply gradient tensions of 2, 4, 6, 8, and 10 N along the tibial plateau horizontally, respectively, to pull the midpoint of the lateral meniscus popliteal tendon area. The displacement values before modeling, after modeling, and after suture were recorded. The reduction value of lateral meniscus displacement and reduction rate after suture were calculated and compared between groups. RESULTS: There was no significant difference between groups ( P>0.05) in the displacement values before modeling, after modeling, and after suture under different tensions. There was no significant difference between groups A and C ( P>0.05) in the reduction value of lateral meniscus displacement and reduction rate after suture under different tensions. The reduction value of lateral meniscus displacement and reduction rate after suture in group B were lower than those in groups A and C. The reduction value of lateral meniscus displacement under tension of 2 N and the reduction rates under tensions of 2, 4, and 6 N between groups A and B showed significant differences ( P<0.05). The reduction value of lateral meniscus displacement and the reduction rate under tensions of 2, 4, and 6 N between groups B and C showed significant differences ( P<0.05). CONCLUSION Suturing the anterior area of PH is the key to repairing type Ⅱc injury of lateral meniscus popliteal tendon area.
Animals ; Humans ; Knee ; Knee Joint ; Menisci, Tibial/surgery* ; Swine ; Tendons ; Tibia

ObjectiveTo investigate the demand, supply and satisfaction of the Chinese people on assistive technology. MethodsBased on the data from the World Health Organization rapid Assistive Technology Assessment (rATA) questionnaire in six provinces and cities in China, the assistive technology of the whole population in China was described from three aspects of demand, supply and satisfaction. ResultsA total of 15 234 valid questionnaires were obtained. In terms of demand, the proportion of visual impairment was the highest in all the functional impairment categories, the highest demands in the list were glasses (low-vision, short/long distance etc.) and walking sticks (canes/sticks, tripod and quadripod), while the highest demand outside the list was anti-skid pad. In terms of supply, the private sector was the main one, followed by government facility and public hospital, and most users took "paid out-of-pocket (self)" to obtain assistive technology, the distance to access the assistive technology was concentrated at "less than five kilometers", and the biggest obstacle to obtain assistive technology was lack of knowledge about assistive technology. Overall satisfaction with assistive technology was optimistic, the adaptation degree and service quality of assistive technology were the most unsatisfactory factors for users. ConclusionIn China, the satisfaction of assistive technology is optimistic, and there is a few amount of unmet assistive technology. It is necessary to propagandize assistive technology, and its manual should be readable, the assistive technical service team should be multidisciplinary, enterprises should promote independent innovation, and the professionals should be regulated.

This paper reports a case of multiple myeloma complicated with Primary systemic light chain amyloidosis peripheral neuropathy.Patient was a male,60 years old with subacute onset of peripheral neuropathy.Patient had previous history of hypertension,coronary heart disease and stable angina pectoris.His urine routine examination 2 months ago showed urine protein(+++).The first clinical symptom with peripheral neuropathy characterized by progressive numbness and weakness of both lower limbs.The diagnosis was made after completing electromyography,lumbar puncture,renal puncture,bone puncture and other related examinations,and relevant treatment was given.As a rare disease of nervous system,the incidence rate is low.Early diagnosis is an important step to reduce mortality and improve prognosis.However,the disease is easily misdiagnosed as diabetic peripheral neuropathy and chronic inflammatory demyelinating polyradiculoneuropathy,thereby delaying diagnosis and treatment.

Objective:To improve clinicians' understanding of Multisystem Inflammatory Syndrome in Children (MIS-C) and to reduce missed and misdiagnosis.Methods:The clinical data of a patient with Multisystem inflammatory syndrome in children admitted to Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology in January 2023 were analyzed retrospectively, together with literature review.Results:A 10-year-old male patient was admitted to hospital with a fever for 5 days. This patient had a history of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection 1 month prior to admission; after admission, he continued to have recurring high fevers, accompanied by abdominal pain and Kawasaki disease like manifestations, shock, multiple organ function impairment, and a significant increase in inflammatory indicators. Finally, the patient was diagnosed with MIS-C, treated with intravenous immunoglobulin, glucocorticoids and aspirin, and discharged with clinical improvement.Conclusion:MIS-C was a novel syndrome with Kawasaki-like manifestations.Currently, the overall prognosis for MIS-C is good, but its pathogenesis is unclear and the therapeutic consensus remains limited. More studies are needed to clarify the best diagnosis and treatment methods and true prognosis.