OBJECTIVE: To investigate the midterm clinical efficacy of medial patellofemoral complex (MPFC) reconstruction for recurrent patellar dislocation with high-grade trochlear dysplasia. METHODS: A retrospective analysis was carried out among adult patients who underwent arthroscopically assisted MPFC reconstruction between January 2014 and December 2020. Dejour classification was evaluated to grade trochlear dysplasia; tibial tubercle-trochlear groove (TT-TG) distance and Insall-Salvati index were measured. Preoperative and postoperative patient-reported outcome measures (PROMs) were compared, including International Knee Documentation Committee (IKDC) score, Kujala score, Lysholm score and Tegner score. Information regarding returning-to-sport rate, re-instability events and complications was collected. Patellar tilt (PT), lateral patellar displacement (LPD) and bisect offset (BSO) ratio were measured based on axial computed tomography before and after surgery to assess the patellofemoral congruence. RESULTS: A total of 46 MPFC reconstructions in 43 patients were enrolled, including 16 male and 27 female. Mean age at surgery was (22.2±7.6) years (range: 14-44 years). Mean follow-up was (49.9±22.6) months (range: 18-102 months). The percentages of Dejour B, C and D dysplasia were 37.0% (17/46), 43.5% (20/46), and 19.6% (9/46), respectively. Mean Insall-Salvati index was 1.2±0.2 (range: 0.85-1.44), and mean TT-TG distance was (19.6±3.5) mm (range: 10.6-28.7 mm). At latest follow-up, there were significant improvements in all PROMs (P < 0.001): IKDC score, from 56.3±15.1 to 86.2±8.1; Kujala score, from 58.9±15.6 to 92.6±5.4; Lysholm score, from 63.7±15.0 to 94.0±5.7; Tegner score, from 3.1±1.4 to 4.7±1.4, and there were no significant differences in the improvements of the scores between the patients with Dejour B, C and D dysplasia. Overall, ninety percent of the patients returned to their preoperative sports level. One patient reported a postoperative subluxation, while no cases of infection, limited range of motion or patella fracture were observed. PT, LPD and BSO ratio were all significant altered (P < 0.001) after MPFC reconstruction. CONCLUSION Arthroscopically assisted MPFC reconstruction yielded satisfactory midterm clinical results for recurrent patellar dislocation with high-grade trochlear dysplasia. No significant differences of improvements in knee function were observed among the three types of high-grade trochlear dysplasia.
Humans ; Patellar Dislocation/surgery* ; Male ; Female ; Adult ; Arthroscopy/methods* ; Retrospective Studies ; Adolescent ; Young Adult ; Patellofemoral Joint/surgery* ; Recurrence ; Plastic Surgery Procedures/methods* ; Patella/surgery* ; Treatment Outcome

Objective To explore the value of MRI radiomics in the differential diagnosis of cerebral alveolar echinococcosis(CAE)and brain metastases(BM).Methods The clinical and imaging data of 30 patients with CAE confirmed by postoperative pathology in the First Affiliated Hospital of Xinjiang Medical University and 38 patients with BM in the Affiliated Hospital of Traditional Chi-nese Medicine of Xinjiang Medical University during the same period were retrospectively analyzed.Preoperative T1-enhanced axial images using 3D Slicer software were used to delineate the volume of interest(VOI)of the lesions,and Python was used to extract 18 radiomics features including the 10th and 90th percentile and median of the lesions.The radiomics parameters of the two groups were compared and statistically analyzed,respectively.The efficacy of each parameter in the differential diagnosis of CAE and BM was explored.Results There was no significant difference in age and body mass index(BMI)between CAE and BM.There was sig-nificantly more males in CAE than that in BM(P<0.001).Previous history of primary tumor and life history in epidemic area were the key to the differential diagnosis of CAE and BM.High correlation features were filtered from 18 radiomics,and statistical differ-ences were found in 7 features such as 90th percentile and entropy(P<0.05).The combined analysis of these seven features had the best diagnostic performance,with area under the curve(AUC)of 0.732,sensitivity of 79.5%,specificity of 61.1%,and accuracy of 72.3%,respectively.Logistic regression analysis showed that kurtosis odds ratio(OR)value was 0.10,95%confidence interval was 0.01,0.83(P<0.05).Conclusion For CAE and BM with very similar conventional imaging findings,clinical history combined with radiomics can provide better differential diagnosis basis.

Objective To delineate the current research landscape,emerging hotspots,and frontiers re-garding the relationship between the oral microbiome and digestive system diseases.Methods We retrieved publications from the Web of Science Core Collection database using topic-specific queries on"oral microbi-ome"and"digestive diseases."Bibliometric analysis was performed using VOSviewer,CiteSpace,and the"bibliometrix"package in R for data mining and visualization.Results A total of 1228 eligible articles were included.Analysis revealed that research on the correlation between oral microbiota and digestive system diseases will remain a global hotspot.Academic institutions dominated the publications,with centralized institutional distribution and team-based collaboration,though overall collaboration networks remained fragmented.Geo-graphically,the United States emerged as the leading contributor,followed by China and the United Kingdom.While China-U.S.collaborations were prominent,China's engagement with other regions remained limited.Current research hotspots focus on the interplay between oral microbiota and gut microbiota,inflam-matory bowel disease(IBD),and digestive system tumors.Conclusions Research in this field demonstrates high activity and diversity.Studies on the associations of oral microbiota with gut microbiota,IBD,and diges-tive system tumors(particularly esophageal,gastric,pancreatic,and colorectal cancers)remain prominent.Future studies should prioritize elucidating underlying mechanisms and innovating in biomarker discovery and application.However,insufficient collaboration and resource-sharing among institutions currently hinder pro-gress in this field.

OBJECTIVE To evaluate the efficacy， safety and cost-effectiveness of toripalimab （Tor） combined with chemotherapy （CT） in the treatment of locally advanced or metastatic non-small cell lung cancer （NSCLC）. METHODS PubMed， the Cochrane Library， Embase， Web of Science， CBM， CNKI， Wanfang Data， and Health Technology Assessment （HTA） related websites were searched to collect the HTA reports， systematic reviews/meta-analyses and pharmacoeconomic studies of Tor+CT in the treatment of locally advanced or metastatic NSCLC from database/website inception to March 31， 2025. After data extraction and quality evaluation， the results of the included studies were analyzed descriptively. RESULTS A total of eleven studies were included， involving five systematic reviews/meta-analyses， and six pharmacoeconomic studies. Among the five systematic reviews/ meta-analyses， two were of high quality， while there was one each of moderate， low， and very low quality. All six pharmacoeconomic studies were of good quality. In terms of efficacy， compared with CT， Tor+CT significantly improved patients’ progression-free survival （PFS） and overall survival （P＜0.05）. In addition， compared with ipilimumab+CT， durvalumab， durvalumab+tremelimumab and sugemalimab+CT， Tor+CT could also improve the PFS （P＜0.05）. In terms of safety， there was no significant difference in the incidence of grade≥3 adverse events between patients receiving Tor+CT and CT （P＞0.05）； while Tor+CT had a lower incidence of grade≥3 adverse E-mail： events， compared with camrelizumab+CT， pembrolizumab+ 3233255290@qq.com ipilimumab， nivolumab+CT and atezolizumab+CT （P＜0.05）.In terms of cost-effectiveness， Tor+CT treatment had certain cost-effectiveness advantages， compared with CT. CONCLUSIONS Compared with CT， other programmed death-1/programmed death-ligand 1 inhibitors alone， or their combination with CT， Tor+CT for the treatment of locally advanced or metastatic NSCLC has good efficacy， safety and cost-effectiveness.

In this work, starting from 4-hydroxycoumarin, three series of 22 coumarin derivatives, among which 8 have not been reported in the literature, were synthesized and their in vitro anti-inflammatory activities and mechanisms of action were preliminarily investigated using mouse macrophage model. The results showed that most of the derivatives could significantly inhibit the production of pro-inflammatory factor NO, with compounds 2e, 2f, 2g, 2h, 2i, 2j, 4e, and 4f showing better anti-inflammatory activity than the positive control drug dexamethasone. Further experiments showed that compounds 2h and 4f significantly inhibited the production of pro-inflammatory factors IL-6, TNF-α and IL-1β in RAW264.7 macrophages, and could, therefore, be used as lead compounds for further studies.

Objective To evaluate the therapeutic effects of different intracranial pressure lower-ing regimens in patients with acute large-area cerebral infarction based on electrical impedance tomo-graphy(EIT)technology.Methods A total of 75 patients with acute large-area cerebral infarction were selected as the study subjects and randomly divided into study group(n=40,using mannitol combined with albumin to decrease intracranial pressure)and control group(n=35,using mannitol alone to decrease intracranial pressure).EIT technology was used to continuously monitor the changes in intracranial pressure within 48 hours in the patients.Clinical data of the two groups were collected,and the 24-hour intracranial pressure change rate,48-hour intracranial pressure change rate,ICU stay duration,hospitalization duration,antibiotic use duration,and National Institutes of Health Stroke Scale(NIHSS)score at discharge were observed and compared between the two groups.A 90-day sur-vival follow-up was also conducted.Results There was no statistically significant difference in the 24-hour intracranial pressure change rate between the two groups(P＞0.05).The 48-hour intracrani-al pressure change rate in the study group was higher than that in the control group,and the difference was statistically significant(P＜0.05).The ICU stay duration,hospitalization duration,and antibiotic use duration in the study group were all shorter than those in the control group,and the NIHSS score at discharge in the study group was lower than that in the control group,with statistically significant differences(P＜0.05).The follow-up results showed that the survival duration in the study group was longer than that in the control group,and the 90-day cumulative survival rate in the study group was higher than that in the control group,but the differences were not statistically significant(P＞0.05).The modified Rankin Scale score in the study group was lower than that in the control group,and the difference was statistically significant(P＜0.05).Conclusion Compared with the use of mannitol alone,early use of mannitol combined with albumin can effectively decrease the in-tracranial pressure within 48 hours,shorten the hospitalization duration,and improve neurological function in patients with acute large-area cerebral infarction.

Objective To delineate the current research landscape,emerging hotspots,and frontiers re-garding the relationship between the oral microbiome and digestive system diseases.Methods We retrieved publications from the Web of Science Core Collection database using topic-specific queries on"oral microbi-ome"and"digestive diseases."Bibliometric analysis was performed using VOSviewer,CiteSpace,and the"bibliometrix"package in R for data mining and visualization.Results A total of 1228 eligible articles were included.Analysis revealed that research on the correlation between oral microbiota and digestive system diseases will remain a global hotspot.Academic institutions dominated the publications,with centralized institutional distribution and team-based collaboration,though overall collaboration networks remained fragmented.Geo-graphically,the United States emerged as the leading contributor,followed by China and the United Kingdom.While China-U.S.collaborations were prominent,China's engagement with other regions remained limited.Current research hotspots focus on the interplay between oral microbiota and gut microbiota,inflam-matory bowel disease(IBD),and digestive system tumors.Conclusions Research in this field demonstrates high activity and diversity.Studies on the associations of oral microbiota with gut microbiota,IBD,and diges-tive system tumors(particularly esophageal,gastric,pancreatic,and colorectal cancers)remain prominent.Future studies should prioritize elucidating underlying mechanisms and innovating in biomarker discovery and application.However,insufficient collaboration and resource-sharing among institutions currently hinder pro-gress in this field.

As a physical treatment technique, modified electro-convulsive therapy (MECT) is used to treat mental and certain neurological disorders by causing seizures with short, suitable electrical currents applied to the brain while the patient is under general anesthesia and muscle relaxants. MECT is recognized for its therapeutic efficacy and clinical safety, rendering it one of the most prevalent interventions in psychiatric care. To enhance clinical outcomes and minimize adverse effects, this consensus document delineates the indications, therapeutic parameters, therapeutic procedures, potential adverse effects, and associated management strategies for MECT. These guidelines are informed by the latest clinical research and expert consensus, integrating evidence-based medicine methodologies. The objective is to furnish clinicians with precise operational guidelines and to advance the standardization of MECT practices in clinical settings.

Objective To explore the value of MRI radiomics in the differential diagnosis of cerebral alveolar echinococcosis(CAE)and brain metastases(BM).Methods The clinical and imaging data of 30 patients with CAE confirmed by postoperative pathology in the First Affiliated Hospital of Xinjiang Medical University and 38 patients with BM in the Affiliated Hospital of Traditional Chi-nese Medicine of Xinjiang Medical University during the same period were retrospectively analyzed.Preoperative T1-enhanced axial images using 3D Slicer software were used to delineate the volume of interest(VOI)of the lesions,and Python was used to extract 18 radiomics features including the 10th and 90th percentile and median of the lesions.The radiomics parameters of the two groups were compared and statistically analyzed,respectively.The efficacy of each parameter in the differential diagnosis of CAE and BM was explored.Results There was no significant difference in age and body mass index(BMI)between CAE and BM.There was sig-nificantly more males in CAE than that in BM(P<0.001).Previous history of primary tumor and life history in epidemic area were the key to the differential diagnosis of CAE and BM.High correlation features were filtered from 18 radiomics,and statistical differ-ences were found in 7 features such as 90th percentile and entropy(P<0.05).The combined analysis of these seven features had the best diagnostic performance,with area under the curve(AUC)of 0.732,sensitivity of 79.5%,specificity of 61.1%,and accuracy of 72.3%,respectively.Logistic regression analysis showed that kurtosis odds ratio(OR)value was 0.10,95%confidence interval was 0.01,0.83(P<0.05).Conclusion For CAE and BM with very similar conventional imaging findings,clinical history combined with radiomics can provide better differential diagnosis basis.

As a physical treatment technique, modified electro-convulsive therapy (MECT) is used to treat mental and certain neurological disorders by causing seizures with short, suitable electrical currents applied to the brain while the patient is under general anesthesia and muscle relaxants. MECT is recognized for its therapeutic efficacy and clinical safety, rendering it one of the most prevalent interventions in psychiatric care. To enhance clinical outcomes and minimize adverse effects, this consensus document delineates the indications, therapeutic parameters, therapeutic procedures, potential adverse effects, and associated management strategies for MECT. These guidelines are informed by the latest clinical research and expert consensus, integrating evidence-based medicine methodologies. The objective is to furnish clinicians with precise operational guidelines and to advance the standardization of MECT practices in clinical settings.