Objective·To verify the accuracy and clinical feasibility of fluoroscopic stereophotogrammetric analysis(FSA)technology based on two dimension(2D)-three dimension(3D)registration for early migration detection of aseptic loosening of joint prostheses.Methods·2D-3D registration algorithms centering on the light source and projected object respectively in FSA technology were verified under various working conditions through image synthesis experiments,and the feasibility of clinical application was verified through real model experiments.The image synthesis experiment established a perspective projection environment with the same parameters as the real environment in a virtual environment,the 2D perspective images of the 3D model(bone or prosthesis)during the six degrees of freedom transformation were recorded,and the six degrees of freedom transformation of the 3D model was restored by using different 2D-3D registration algorithms.The error of each registration algorithm was calculated.For real model validation,the migration between bone and prosthesis after joint replacement surgery was simulated with a high precision bone prosthesis migration simulator.The 3D model of the bone or prosthesis was reconstructed by using computed tomograph(CT)images and optical scanning,and the 2D perspective images before and after prosthesis migration were captured by using a fluoroscopy device.The migration of the prosthesis was restored by using FSA technology based on 2D-3D registration,and the error of FSA technology was calculated.Results·The accuracy of the 2D-3D registration algorithm centering on the light source was higher than that of the algorithm centering on the projected object under different working conditions.When the initial registration conditions were favorable,the algorithm centering on the light source reduced the rotation error compared to the algorithm centering on the projected object,with a statistical difference(P=0.021),and the displacement error decreases,with a significant statistical difference(P=0.000).Moreover,algorithms centering on the light sources required lower similarity and fewer registration times to meet clinical application requirements.Conclusion·The accuracy of FSA technology based on 2D-3D registration in early migration detection of artificial joint prostheses meets clinical application requirements.This technology can warn of late aseptic loosening of prostheses by detecting early migration of prostheses after joint replacement surgery,and is expected to be applied to clinical practice through further research.

Objective:To investigate whether the prophylactic use of a dose of sensitive antibiotics before revision for periprosthetic joint infection (PJI) may affect the positive rate of intraoperative specimen culture.Methods:This prospective study recruited the patients who underwent revision due to PJI from July 1, 2017 to February 1, 2019 at Department of Orthopaedics, The First Affiliated Hospital to Fujian Medical University. After use of antibiotics was stopped in all patients for 2 weeks before operation, synovial fluid was extracted for culture to confirm pathogenic bacteria and drug sensitivity and some/all of the prostheses were removed during operation. According to their sequence number of admission, the patients were randomly divided into group A and group B. Samples were taken in group A after a dose of sensitive antibiotics was administered 30 to 60 minutes before revision while a dose of sensitive antibiotics was given in group B after all samples were taken. Intra-operatively, synovial fluid, tissue grinding fluid (TGF) and ultrasonic prosthesis lysate (UPL) were taken for aerobic and anaerobic culture. According to whether there was a positive culture of at least one microbiological specimen, the preoperative and intraoperative culture results were analyzed and compared between the 2 groups.Results:A total of 32 PJI patients were included in this study due to positive culture of synovial fluid before operation, with 16 cases in group A and 16 in group B. The most common infection bacteria were staphylococci (59.3%, 19/32). There was no significant difference in age, gender, mode of operation, Tsukayama classification, prosthesis removal, preoperative ESR, CRP, synovial fluid white blood cell count (SF-WBC) or polymorphonuclear cell percentage (PMN) between the 2 groups. The positive rates of synovial fluid, tissue, TGF and UPL were 81.3% (13/16), 62.5% (10/16), 93.8% (15/16) and 93.8% (15/16) for group A, and 87.5% (14/16), 68.8% (11/16), 93.8% (15/16) and 100.0% (16/16) for group B, showing insignificant differences between the 2 groups ( P>0.05). The positive rates of TGF and UPL culture showed no significant difference between them in group A or in group B ( P>0.05), but they were significantly higher than those of traditional tissue culture ( P<0.05). Conclusions:As prophylactic use of antibiotics before PJI revision may not affect the positive rate of intraoperative specimen culture, it is not necessary to postpone use of prophylactic antibiotics before PJI revision. Furthermore, as positive rates of TGF and UPL culture are similar but significantly higher than those of traditional tissue culture, tissue grinding can be used to improve the positive rate of tissue culture.

Objective: To examine the prevalence of allergic diseases in schoolaged children from Shanghai and to explore related factors so as to produce epidemiological data regarding allergic diseases in children. Methods: Multistage cluster sampling was used to carry out the study in Shanghai from April to June 2019. A total of 10 686 children aged 7-12 years from 17 primary schools participated in the survey. The International Study of Asthma and Allergies in Childhood (ISAAC)Scale was used to evaluate allergic diseases. Multivariate Logistic regression analysis was performed to analyze the related factors. Results: The overall prevalence of allergic diseases among schoolaged children in Shanghai was 47.0%. A higher prevalence was observed among boys (50.4% vs 43.3% in girls, χ2=54.44, P<0.01). Common allergic diseases included asthma (13.9%), allergic rhinitis (18.2%), and atopic dermatitis (34.3%). The Logistic regression analysis showed that the common risk factors of asthma, allergic rhinitis and atopic dermatitis included the following:male gender (OR=1.52,1.44,1.22); mother has a bachelors degree or above (OR=1.26,1.77,1.84); family history of allergic diseases (OR=2.87,4.24,2.57); only child (OR=1.16,1.28,1.22); curtain cleaning frequency <1 time/month (OR=1.41,1.79,1.77); room not cleaned daily (OR=1.14,1.18,1.20); and dust exposure frequency ≥1 time/month (OR=1.45,1.56,1.42), all P<0.05. These three types of allergic diseases were also associated with unique risk factors that dependent on socialenvironmentalbehavioral factors. Conclusion Compared with previous data, the prevalence of allergic diseases among schoolaged children in Shanghai increased significantly in 2019. The related influencing factors involve multiple variables including demographics, environmental exposure and behavior, which warrant further exploration.

The incidence of tinnitus is very high, which can affect the patient's attention, emotion and sleep, and even cause serious psychological distress and suicidal tendency. Currently, there is no uniform and objective method for tinnitus detection and therapy, and the mechanism of tinnitus is still unclear. In this study, we first collected the resting state electroencephalogram (EEG) data of tinnitus patients and healthy subjects. Then the power spectrum topology diagrams were compared of in the band of δ (0.5-3 Hz), θ (4-7 Hz), α (8-13 Hz), β (14-30 Hz) and γ (31-50 Hz) to explore the central mechanism of tinnitus. A total of 16 tinnitus patients and 16 healthy subjects were recruited to participate in the experiment. The results of resting state EEG experiments found that the spectrum power value of tinnitus patients was higher than that of healthy subjects in all concerned frequency bands. The
Attention ; Brain ; Electroencephalography ; Humans ; Parietal Lobe ; Tinnitus

Objective:To investigate the effect of pyrroloquinoline quinone (PQQ) on age-related skin aging in mice and its mechanisms.Methods:Thirty Kunming mice were fed in specific pathogen-free condition, and equally divided into 3 groups: young group was fed with a normal diet for 8 months, old group was fed with a normal diet for 20 months to establish a mouse model of natural aging, and PQQ group was fed with PQQ-containing forages (4 milligrams of PQQ per kilogram of normal forages) for 20 months. After feeding, the mouse dorsal skin tissues were obtained, hematoxylin and eosin (HE) staining was performed to measure the epidermal and dermal thickness, Masson staining to detect changes in total skin collagen, immunohistochemical study to detect changes in expression of the proliferation marker Ki67, transmission electron microscopy to detect changes in autophagosomes in the mouse skin, and Western blot analysis to determine the expression of autophagy-related proteins Beclin1, LC3Ⅱ/LC3Ⅰ, and p62. Statistical analysis was carried out by using one-way analysis of variance for intergroup comparisons followed by least significant difference (LSD) - t test for multiple comparisons. Results:HE and Masson staining showed that the epidermal and dermal thickness and the percentage of area of dermis stained positive for collagen among the total area of dermis in the tested region were significantly lower in the old group (15.67 ± 0.36 μm, 87.95 ± 11.86 μm, 22.12% ± 1.72%, respectively) than in the young group (29.37 ± 0.25 μm, 264.93 ± 10.34 μm, 45.03% ± 1.54%, respectively, all P<0.05) , and significantly higher in the PQQ group (25.53 ±0.47 μm, 145.01 ± 9.71 μm, 31.17% ± 1.20%, respectively) than in the old group (all P<0.05) . Immunohistochemical study revealed that the expression of Ki67 was significantly lower in the old group (13.74% ± 3.06%) than in the young group (29.07% ± 2.79%, P<0.05) and PQQ group (21.20% ± 1.47%, P<0.05) . Transmission electron microscopy showed that the number of autophagosomes in the skin was significantly higher in the old group than in the young group ( P<0.05) , but significantly lower in the PQQ group than in the old group ( P<0.05) . As Western blot analysis revealed, the old group showed significantly decreased Beclin1 expression and LC3 Ⅱ/LC3 Ⅰ ratio, but significantly increased p62 expression compared with the young group (all P<0.05) ; compared with the old group, the PQQ group showed significantly increased Beclin1 expression and LC3Ⅱ/LC3Ⅰratio, but significantly decreased p62 expression (all P<0.05) . Conclusion:PQQ can delay the age-related skin aging in mice, likely by increasing the proliferative capacity of mouse skin cells and promoting skin autophagy.

OBJECTIVE：To systematically evaluate the efficacy and saf ety of sacubitril-valsartan in the treatment of heart failure without reduced ejection fraction （non-HFrEF）patients，and to provide evidence-based reference for its clinical treatment. METHODS：Retrieved from Cochrane Library ，PubMed，Embase，CNKI，VIP and Wanfang data ，during the inception to Feb. 29th，2020，randomized controlled trials （RCTs）about sacubitril-valsartan （trial group ）versus routine medicine as renin- angio- tensin converting enzyme inhibitors/angiotensin Ⅱ receptor antagonists （control group ） in the treatment of non-HFrEF were collected. After literature screening and data extraction ，the quality of included literatures were evaluated with Cochrane bias risk evaluation tool 5.3.0. Meta-analysis was conducted with Stata 14.0 software，and the publication bias analysis and sensitivity analysis were performed. RESULTS ：Totally 6 RCTs were included ，involving 5 502 patients. Results of Meta-analysis showed that the HF re-hospitalization rate [RR ＝0.84，95％CI（0.77，0.91），P＜0.001] and the serum creatinine elevation rate [RR ＝0.78，95％ CI（0.67，0.91），P＝0.001] in trial group were significantly lower than control group. NYHA classification improvement rate [RR ＝ 1.25，95％CI（1.10，1.43），P＝0.001] and the hypotension rate [RR ＝1.43，95％CI（1.24，1.65），P＜0.001] were significantly higher than control group. There was no statistical significance in the cardiovascular mortality [RR ＝0.94，95％CI（0.79，1.12）， P＝0.481]，all-cause mortality [RR ＝0.95，95％CI（0.83，1.08），P＝0.417]，the levels of NT-proBNP [WMD ＝－301.16，95％CI （－602.77，0.44），P＝0.050] and LVEF [WMD ＝1.49，95％CI（－1.33，4.32），P＝0.300] after treatment ，and the hyperkalaemia rate [RR ＝0.88，95％CI（0.77，1.01），P＝0.070] between 2 groups. The results of publication bias analysis and sensitivity analysis showed there was a high possibility of publication bias ，and the results of several indexes were not stable. CONCLUSIONS ： Sacubitril-valsartan may effectively reduce HF re-hospitalization rate and the risk of elevated serum creatinine in non-HFrEFpatients，improve the heart function but the risk of hypotension is high. The results should be interpreted carefully.

Objective:To determine the equilibrium solubility and n-octanol/water partition coefficients (Papp)of cinnamon acid and cinnamaldehyde. Methods:The equilibrium solubility of cinnamon acid and cinnamaldehyde in different solutions was determined by HPLC,and their n-octanol/water partition coefficients were determined by a shaking flask method combined with HPLC-DAD. Results:When the pH of solution was 7.8,the equilibrium solubility of cinnamon acid was the largest,while that of cinnamaldehyde was the largest in pH 6.8 solution. The scopes of lgPappof cinnamon acid and cinnamaldehyde in different buffer solutions(pH 1.2-7.8) were -1.04-2.27 and 0.29-1.67, respectively, while those in n-octanol/water solvent were 0.85 and 1.26, respectively. Conclusion:The method is simple,accurate and fast to predicate the absorption of chemical components. In gastrointestinal physiological environment,cinnamaldehyde has good absorption, while cinnamon acid is with poor absorption in stomach and with better absorption in intestinal.

Visual fixation is an item in the visual function subscale of the Coma Recovery Scale-Revised (CRS-R). Sometimes clinicians using the behavioral scales find it difficult to detect because of the motor impairment in patients with disorders of consciousness (DOCs). Brain-computer interface (BCI) can be used to improve clinical assessment because it directly detects the brain response to an external stimulus in the absence of behavioral expression. In this study, we designed a BCI system to assist the visual fixation assessment of DOC patients. The results from 15 patients indicated that three showed visual fixation in both CRS-R and BCI assessments and one did not show such behavior in the CRS-R assessment but achieved significant online accuracy in the BCI assessment. The results revealed that electroencephalography-based BCI can detect the brain response for visual fixation. Therefore, the proposed BCI may provide a promising method for assisting behavioral assessment using the CRS-R.
Adolescent ; Adult ; Aged ; Brain ; physiopathology ; Brain-Computer Interfaces ; Consciousness Disorders ; diagnosis ; physiopathology ; Diagnosis, Computer-Assisted ; methods ; Electroencephalography ; methods ; Evoked Potentials ; Female ; Fixation, Ocular ; physiology ; Humans ; Male ; Middle Aged ; Neurologic Examination ; Pilot Projects ; Severity of Illness Index ; User-Computer Interface

Objective To compare the clinical effects of mini phalangeal external fixation and mini plate in the treatment of intraarticular fractures of the metacarpal bone head,and to provide a theoretical basis for clinical selection of surgical plan. Methods Seventy?four cases of metacarpal bone head intraarticular fractures treated in Huizhou People′s Central Hospital from March 2014 to March 2016 were selected as the research object. All cases were closed fractures and were randomly divided into the external fixation group and the mini plate group,37 cases in each group and treated respectively with the mini phalangeal external fixator and mini AO plate. The patients were followed up for 6 months to 1 year,the function of the metacarpophalangeal joint,the union of the fracture and the incidence of side effects were compared between the two groups. Results The excellent rates of the external fixation group at 6 months and I year after operation were 91. 9% ( 34/37) and 97. 3%( 36/37) respectively,which were significantly higher than those of the mini plate group ( 73. 0%( 27/37) ,81. 2%( 30/37 ) ) , the difference was statistically significant (χ2 = 7. 120, 7. 062, P<0. 05 ) . The complication rate of the external fixation group was 2. 7%( 1/37) ,which was significantly lower than that of the mini plate group ( 24. 3% ( 9/37 ) ) , the difference was statistically significant ( P=0. 014 ) . The average fracture healing time in the external fixator group was (2. 6±0. 4) months,which was significantly lower than that in the mini plate group (3. 1±0. 7) months,the difference was statistically significant (t=2. 40,P<0. 001) . Conclusion In the treatment of metacarpal bone head fracture,the external fixation has small trauma,can do cross joint fixation,and maintain a good fixation strength,and promote the healing of fracture and the recovery of metacarpophalangeal joint function. It is worthy of clinical application.

Objective To investigate the treatment effects and mechanisms of pyrroloquinoline quinine(PQQ) on defective teeth and mandible in Bmi-1 knockout mice.Methods Male and female Bmil+/-mice were paired with each other from the same nest.At the age of 7 weeks,the mice were divided into three groups,the wild type mice received normal diet(10 mice,WT group),Bmil-/-mice received normal diet (10 mice,BKO group),and the Bmi1+/-mice received normal diet and PQQ diet(10 mice,BKO+PQQ group).X-ray and micro-CT were used to detect mandible and dental size and bone mineral density.HE staining,histochemical and immunohistochemical methods were respectively used to detect alveolar bone thickness of cortical bone,predentin thickness of mandibular first molar,mandibular osteoblast number and osteoclast number.Flow cytometry was used to detect reactive oxygen species(ROS) levels of various organs(femur,thymus and liver).The data were statistically analyzed with one-way ANOVA and t test.Results Compared with BKO mice,BKO+PQQ mice partially rescued total body phenotype,increased body weight and prolonged survival time.X-ray and micro-CT showed the size of the mandible and teeth and bone mineral density of PQQ+BKO mice increased compared with BKO mice.In PQQ+BKO mice,mandibular alveolar bone cortical thickness[(68.65±0.25) μm] was significantly different from that in BKO mice[(42.45±0.35) μm] (P＜0.01).There was significant difference in predentin thickness of mandibular first molar between PQQ + BKO mice[(4.25 ± 0.15) μm] and BKO mice[(31.55 ± 0.35) μm] (P＜0.001).The number of osteoblasts in the mandible of BKO+PQQ mice[(38.45±0.25) cell/mm3] was significantly higher than that in the BKO mice[(18.15±0.55) cell/mm3] (P＜0.01).However,the number of osteoclasts in the BKO+PQQ mice [(9.45±0.25) cell/mm3] was significantly lower than that in the BKO group[(14.25±0.35) cell/mm3] (P＜0.01).Compared with the BKO group,ROS levels of the femur,thymus and liver in the BKO + PQQ mice were significantly decreased(P＜0.01).Conclusions The results indicate that PQQ may have treatment effects on defective teeth and mandible through promoting osteoblast bone formation and reducing osteoclast bone resorption,scavenging ROS and reducing DNA damage.