Objective:To evaluate the efficacy and safety of mitoxantrone hydrochloride liposome injection in the treatment of peripheral T-cell lymphoma (PTCL) in a real-world setting.Methods:This was a real-world ambispective cohort study (MOMENT study) (Chinese clinical trial registry number: ChiCTR2200062067). Clinical data were collected from 198 patients who received mitoxantrone hydrochloride liposome injection as monotherapy or combination therapy at 37 hospitals from January 2022 to January 2023, including 166 patients in the retrospective cohort and 32 patients in the prospective cohort; 10 patients in the treatment-na?ve group and 188 patients in the relapsed/refractory group. Clinical characteristics, efficacy and adverse events were summarized, and the overall survival (OS) and progression-free survival (PFS) were analyzed.Results:All 198 patients were treated with mitoxantrone hydrochloride liposome injection for a median of 3 cycles (range 1-7 cycles); 28 cases were treated with mitoxantrone hydrochloride liposome injection as monotherapy, and 170 cases were treated with the combination regimen. Among 188 relapsed/refractory patients, 45 cases (23.9%) were in complete remission (CR), 82 cases (43.6%) were in partial remission (PR), and 28 cases (14.9%) were in disease stabilization (SD), and 33 cases (17.6%) were in disease progression (PD), with an objective remission rate (ORR) of 67.6% (127/188). Among 10 treatment-na?ve patients, 4 cases (40.0%) were in CR, 5 cases (50.0%) were in PR, and 1 case (10.0%) was in PD, with an ORR of 90.0% (9/10). The median follow-up time was 2.9 months (95% CI 2.4-3.7 months), and the median PFS and OS of patients in relapsed/refractory and treatment-na?ve groups were not reached. In relapsed/refractory patients, the difference in ORR between patients with different number of treatment lines of mitoxantrone hydrochloride liposome injection [ORR of the second-line, the third-line and ≥the forth-line treatment was 74.4% (67/90), 73.9% (34/46) and 50.0% (26/52)] was statistically significant ( P = 0.008). Of the 198 PTCL patients, 182 cases (91.9%) experienced at least 1 time of treatment-related adverse events, and the incidence rate of ≥grade 3 adverse events was 66.7% (132/198), which was mainly characterized by hematologic adverse events. The ≥ grade 3 hematologic adverse events mainly included decreased lymphocyte count, decreased neutrophil count, decreased white blood cell count, and anemia; non-hematologic adverse events were mostly grade 1-2, mainly including pigmentation disorders and upper respiratory tract infection. Conclusions:The use of mitoxantrone hydrochloride liposome injection-containing regimen in the treatment of PTCL has definite efficacy and is well tolerated, and it is a new therapeutic option for PTCL patients.

Osteoporotic thoracolumbar fracture in the elderly will seriously reduce their quality of life and life expectancy. For osteoporotic thoracolumbar fracture in the elderly, spinal reconstruction is necessary, which should comprehensively consider factors such as the physical condition, fracture type, clinical characteristics and osteoporosis degree. While there lacks relevant clinical norms or guidelines on selection of spinal reconstruction strategies. In order to standardize the concept of spinal reconstruction for osteoporotic thoracolumbar fracture in the elderly, based on the principles of scientificity, practicality and progressiveness, the authors formulated the Clinical guideline for spinal reconstruction of osteoporotic thoracolumbar fracture in elderly patients ( version 2022), in which suggestions based on evidence of evidence-based medicine were put forward upon 10 important issues related to the fracture classification, non-operative treatment strategies and surgical treatment strategies in spinal reconstruction after osteoporosis thoracolumbar fracture in the elderly, hoping to provide a reference for clinical treatment.

Objective To evaluate the Thompson procedure in the treatment of chronic mallet finger with tendon defect.Methods From July 2014 to October 2016,9 cases of chronic mallet finger with tendon defect were treated by Thompson procedure at Department of Hand Surgery,Wuhan Puai Hospital.They were 4 males and 5 females,aged from 25 to 56 years (average,36 years).Their disorder was on the left side in 3 cases and on the right side in 6 ones,involving 2 index fingers,3 middle fingers,3 ring fingers and one little finger.The ranges of motion (ROM) for distal and proximal interphalangeal joints were measured after operation.Operative complications were observed and recorded.Dargan functional assessment was used to evaluate the outcomes at the final follow-up.Results All the 9 patients were followed up for 5 to 36 months (average,16.5months).The wounds healed primarily without such complications as infection,skin breakage,abnormal fingertip sensation or nail deformity.All cases of mallet finger malformation were corrected.About 10 weeks after operation,one case presented with mild mallet finger malformation which was completely corrected after active fixation for 8 weeks.The Dargan assessment at the final follow-up showed 8 excellent and one good cases.Conclusion Thompson procedure can lead to satisfactory outcomes and limited complications in the treatment of chronic mallet finger with tendon defect.

Objective: To investigate the expression of lncRNA LINC00886 in human esophageal squamous cell carcinoma (ESCC) tissues and cell lines, and its effects on proliferation, migration and invasion of Eca109 cells. Methods: The cancer tissues and corresponding para-cancerous tissues of 69 ESCC patients were collected in the biological specimen bank of the Fourth Hospital of Hebei Medical University from June 2014 to December 2016; the ESCC cell lines Eca109, TE13, TE1, Kyse150, Yes-2 and Kyse170 were also collected. LINC00886 gene expression in ESCC tissues and cell lines was detected by qPCR. Eca109 cells were transfected with pIRES2-LINC00886 and pIRES2-NC, respectively, and the overexpression efficiency of LINC00886 gene in Eca109 cells was detected by qPCR; MTS, clone formation assay, wound-healing assay and Transwell invasion assay were respectively used to detect the effect of LINC00886 over-expression on proliferation, migration and invasion ability of Eca109 cells. Results: The expression of LINC00886 gene in ESCC tissues was significantly lower than that in para-cancerous tissues (P<0.01), and its expression level was associated with tumor TNM stage and lymph node metastasis (both P<0.05). The expression level of LINC00886 gene in ESCC cell lines was also lower than that of the control group (all P<0.01). Compared with control group, the expression level of LINC00886 gene was significantly higher in Eca109 cells transfected with pIRES2-LINC00886 (both P<0.05). Compared with the control group, LINC00886 overexpression significantly inhibited the proliferation, migration and invasion abilities of Eca109 cells (all P<0.01). Conclusion: The decreased expression of LINC00886 gene may be related to the occurrence and development of ESCC. Over-expression of LINC00886 gene inhibits the proliferation, migration and invasion abilities of ESCC cells.

Objective: To analyze factors affecting stability after fixed orthodontic treatment. Methods: Five hundred and forty-four patients who had finished fixed orthodontic treatment more than two years in First Department of Orthodontics, China Medical University from January, 2000 to December, 2017 were investigated and the rate of regular revisit was counted. The data of 288 patients were successfully collected by calling or sending text messages and the rate of standard use of retainers as prescribed (patients wore retainers for 24 months or longer) was counted. According to the variation of peer assessment rating (PAR) index at the start of retention and the time the data collected, the patients were divided into relapse group (variation of PAR index >5) and non-relapse group (variation of PAR index ≤5). Difference significance analysis and multiple-factor logistic regression analysis were used. Sixty patients wearing retainers well were collected and the curative effects of Hawley retainer and vacuum formed retainer (VFR) were compared, which included overbite, overjet, maxillary irregularity index, mandibular irregularity index, width betwenn canine and width between first molar. Results: The rate of regular revisit was 41.0% (223/544). Two hundred and one of 288 patients (69.8%) who were visited successfully had regular revisit, and 60.4%(174/288) of the patients wore retainers well; 30.2% (87/288) of the patients who were visited successfully didn't have regular revisit, and 10.4% (30/288) of the patients wore retainers well. Difference significance analysis showed that there was highly significant difference between relapse group and non-relapse group in the type of retainer and duration of retention (P<0.01). One hundred and forty of 224 patients (62.5%) in non-relapse group and 37.5% (24/64) of the patients in relapse group used VFR, and the duration of retention in non-relapse group was significantly longer than that in relapse group (P<0.01). Multiple-factor Logistic regression analysis showed that wearing Hawley retainers (OR=3.067, P<0.05) was the risk factor influencing relapse. The duration of retention (OR=0.832, P<0.01) was the protective factor influencing relapse. Independent-sample t test indicated that the variations of maxillary [(0.82±0.36) mm] and mandibular [(1.05±0.22) mm] irregularity index in Hawley retainer group were larger than maxillary [(0.64±0.29) mm] and mandibular [(0.72±0.35) mm)] irregularity index in VFR group, respectively. The differences between the two groups were significant (P<0.05). Conclusions Duration of retention was implicated in stability after orthodontic treatment. VFR had better effect in the aspects of irregularity index than Hawley retainer.

Objective To evaluate the outcomes of the free bone flap of medial femoral condyle for treatment of old scaphoid fracture with bone necrosis and review the utility of this procedure.Methods Eleven cases of old scaphoid fracture with bone necrosis were treated with the free medical femoral condyle bone grafting between Feburay,2013 and May,2015(9 males and 2 females).The average age was 34 years ranged from 27 to 55 years.Six cases were in left wrist,and other 5 cases were in right.Six cases were in waist area,and the other 5 cases were proximal pole nonunion.All cases were evaluated with 3D-CT scan,while humpback deformity were occurred in 6 cases,and avascular necrosis at the proximal pole were occurred in 3 cases.After refreshing the fracture,the free medical femoral condyle bone was transferred to the scaphoid,reduct the scaphoid and fix with the Kirschner wire.An endto-side anastomosis was performed with the bone flap artery and the radial artery,accompanied by the end to end anastomosis of the flap vein and the vein with the radial artery.The plaster was used for 8 weeks.Bone healing was evaluated with X-ray and 3D CT scan.A functional review was performed after the operation and a Mayo wrist scoring test was taken 6 months after the treatment.Results The average followed-up period was 13.1 months(ranged from 9 to 24 months).Bone union were demonstrated in all cases at 13.4 weeks after the operation (ranged from 11 to 18 weeks).Mayo wrist scoring testing showed excellent in 5 cases,good in 4 cases,and fair in 2 cases.Conclusion Free bone flap of medial femoral condyle is constant in vascular anatomy,and is easy to perform with plenty bone graft and less morbidity at donor site.Medial femoral condyle bone flap transplantation based on the descending gennicular vessels is an effective method for treatment of old scaphoid fracture with bone necrosis.

Objective To explore the procedure method and treatment outcome for the dual intersecting trapezoid flaps for repairing flexion contractures of fingers.Methods From February 2013 to April 2015,data of 26 fingers in 11 patients with flexion contractures who were treated with dual intersecting trapezoid flaps and followed up for more than 1 year were retrospectively analyzed.There were 7 males (16 fingers) and 4 females (10 fingers) with an average age of 38.2 years old (ranged from 28 to 60 years old).17 cases of right finger,and 9 cases of the left.There were 8 fingers of mild contracture,14 fingers of moderate contracture,and 4 fingers of severe contracture.Take the scar wrinkle tension line as the central axis,the distance was from 0.5cm to 0.Scm,and decompose the medial axis evenly,form several symmetrical trapezoid skin flaps on the radial side and ulnar side of the fingers.The direction of the double arm of the trapezoid flap is relative to the angle of the central axis from 60° to 70°,and the double skin flap is interlaced.Incisions were designed in a dual intersecting trapezoid flap over the contracture.Coverd the wound with excess skin and scar folds on the dorsal side of the lateral and interphalangeal joints,and full thickness skin graft was utilized to repair skin defect.Results All 24 flaps survived without blood circulation disorders and infections.Only 2 cases appeared flap tip necrosis,delayed healing.The mean active extension and flexion of DIP joints in mild contracture patients were-3° (ranged from-8° to 0°) and 45° (range from 30° to 60°),respectively;and PIP joints were-5° (ranged from-10° to 0°)and 90° (ranged from 70° to 110°),respectively.Contracture scars were extended by an average of 150％.The mean active extension and flexion of DIP joints in moderate contracture in patients were-5° (ranged from-9° to 0°) and 35° (ranged from 20° to 50°),respectively;and PIP joints were-5° (ranged from-10° to 0°) and 85° (ranged from 75° to 120°),respectively.Contracture scars were extended by an average of 130％.The mean active extension and flexion of DIP joints in severe contracture patients were-8° (ranged from-15° to-5°) and 17° (ranged from 10° to 25°),respectively;and PIP joints were-8° (ranged from-10° to-5°) and 78° (ranged from 70° to 90°),respectively.Contracture scars were extended by an average of 220％.According to the upper extremity functional evaluation standard by Hand Surgery Branch of Chinese Medical Association,mild contracture:the results were rated as excellent in 6 cases,good in 1 case and fair in 1 case.The overall satisfactory rate was 87.5％;moderate contracture:the results were rated as excellent in 12 cases,good in 1 case and fair in 1 case.The overall satisfactory rate was 92.9％;severe contracture:the results were rated as excellent in 2 cases,good in 1 case and fair in 1 case.The overall satisfactory rate was 75％.Conclusion The dual intersecting trapezoid flap plasty is easy to use,which has rich vascularity and mobility,and it is a good way to correct the cross-joint scar contracture flexion deformity with less complications.

OBJECTIVE: To determine the incidence of surgical site infection (SSI) after abdominal surgery and to further evaluate the related risk factors of SSI in China. METHODS: The multicenter cross-sectional study collected clinical data of all adult patients who underwent abdominal surgery from May 1, 2018 to May 31, 2018 in 30 domestic hospitals, including basic information, perioperative parameters, and incisional microbial culture results. The primary outcome was the incidence of SSI within postoperative 30 days. SSI was classified into superficial incision infection, deep incision infection, and organ/gap infection according to the US Centers for Disease Control and Prevention (CDC) criteria. The secondary outcome variables were ICU stay, postoperative hospital stay, total hospital stay, 30-day mortality and treatment costs. Multivariate logistic regression was used to analyze the risk factors of SSI. RESULTS: A total of 1666 patients were enrolled in the study, including 263 cases of East War Zone Hospital of PLA, 140 cases of Affiliated Hospital of Qingdao University, 108 cases of The First Affiliated Hospital of Nanchang University, 87 cases of Central War Zone Hospital of PLA, 77 cases of West China Hospital, 74 cases of Guangdong General Hospital, 71 cases of Chenzhou First People's Hospital, 71 cases of Zigong First People's Hospital, 64 cases of Zhangjiagang First People's Hospital, 56 cases of Nanyang City Central Hospital, 56 cases of Lanzhou General Hospital of Lanzhou Military Command, 56 cases of Shandong Provincial Hospital, 52 cases of Shangqiu First People's Hospital, 52 cases of People's Hospital of Xinjiang Uygur Autonomous Region, 48 cases of The Second Xiangya Hospital of Central South University, 48 cases of Chinese PLA General Hospital, 44 cases of Affiliated Hospital of Xuzhou Medical University, 38 cases of Hunan Province People's Hospital, 36 cases of Dongguan Kanghua Hospital, 30 cases of Shaoxing Central Hospital, 30 cases of Northern Jiangsu People's Hospital, 29 vases of The First Affiliated Hospital of Zhengzhou University, 27 cases of General Hospital of Tianjin Medical University, 22 cases of Zigong Fourth People's Hospital, 21 cases of The Second Hospital of University of South China, 18 cases of Tongji Hospital, 15 cases of Nanchong Central Hospital, 12 cases of The 901th Hospital of PLA, 11 cases of Hunan Cancer Hospital, 10 cases of Lanzhou University Second Hospital. There were 1019 males and 647 females with mean age of (56.5±15.3) years old. SSI occurred in 80 patients (4.8%) after operation, including 39 cases of superficial incision infection, 16 cases of deep incision infection, and 25 cases of organ/interstitial infection. Escherichia coli was the main pathogen of SSI, and the positive rate was 32.5% (26/80). Compared with patients without SSI, those with SSI had significantly higher ICU occupancy rate [38.8%(31/80) vs. 13.9%(220/1586), P<0.001], postoperative hospital stay (median 17 days vs. 7 days, P<0.001) and total hospital stay (median 22 days vs. 13 days, P<0.001), and significantly higher cost of treatment (median 75 000 yuan vs. 44 000 yuan, P<0.001). Multivariate analysis showed that male rise(OR=2.110, 95%CI:1.175-3.791, P=0.012), preoperative blood glucose level rise(OR=1.100, 95%CI: 1.012-1.197, P=0.026), operative time (OR=1.006, 95%CI:1.003-1.009, P<0.001) and surgical incision grade (clean-contaminated incision:OR=10.207, 95%CI:1.369-76.120, P=0.023; contaminated incision: OR=10.617, 95%CI:1.298-86.865, P=0.028; infection incision: OR=20.173, 95%CI:1.768-230.121, P=0.016) were risk factors for SSI; and laparoscopic surgery (OR=0.348, 95%CI:0.192-0.631, P=0.001) and mechanical bowel preparation(OR=0.441,95%CI:0.221-0.879, P=0.020) were protective factors for SSI. CONCLUSIONS The incidence of postoperative SSI in patients with abdominal surgery in China is 4.8%. SSI can significantly increase the medical burden of patients. Preoperative control of blood glucose and mechanical bowel preparation are important measures to prevent SSI.
Abdomen ; surgery ; Adult ; Aged ; China ; Cross-Sectional Studies ; Female ; General Surgery ; statistics & numerical data ; Humans ; Male ; Middle Aged ; Operative Time ; Postoperative Complications ; prevention & control ; Preoperative Period ; Retrospective Studies ; Risk Factors ; Surgical Wound Infection ; prevention & control

Objective: To investigate the expression of long non-coding RNA NUP50-AS1 (lncRNA NUP50-AS1) in esophageal squamous cell carcinomas (ESCC) tissues and cell lines, and to explore its effect on proliferation, migration and invasion of human esophageal cancer Eca109 cells. Methods: 49 pairs of ESCC tissues and corresponding para-cancerous tissues obtained from the Biological Specimen Base of the Fourth Hospital of Hebei Medical University during Jan. 2015 to Jan. 2016 were used in this study. qRT-PCR method was applied to detect the expression of NUP50-AS1 in collected tissues samples and five esophageal cancer cell lines (TE1, TE13, Eca109, Kyse150 and Kyse170). ShRNAs were transiently transfected into Eca109 cells to interfere the expression of NUP50AS1 gene, and finally, sh2-NUP50-AS1 was used for the following experiments. The effect of NUP50-AS1 gene knockdown on the proliferation of Eca109 cells was detected by MTS and colony formation assay; the effect of NUP50-AS1 gene knockdown on the migration of Eca109 cells was detected by scratch test, and the effect on cell invasion was detected by Transwell assay. Results: The expression of NUP50-AS1 in ESCC was correlated with the lymphnode metastasis and TNM stage (all P<0.01). The expression of NUP50AS1 in ESCC tissues was significantly higher than that in corresponding normal tissues (2.003±0.870 vs 1.000±0.000, P<0.05). The expression of NUP50-AS1 in five esophageal cancer cell lines was significantly up-regulated (P<0.05), and it had the highest expression in Eca109 cell line. After transfection, sh2-NUP50-AS1 had the highest transfection efficiency, and knocking down NUP50-AS1 gene significantly inhibited the proliferation, invasion and migration of the Eca109 cells. Conclusion: The expression of lncRNA NUP50AS1 in ESCC tissues was significantly higher than that in the para-cancerous tissues, and correlated with the TNM stage and lymphnode metastasis. The down-regulation of NUP50-AS1 inhibited the proliferation, invasion and migration of esophageal cancer cells. The high expression of NUP50-AS1 gene may be closely related to the occurrence and development of ESCC.

Objective To determine the angles of trochlear line(TL), antero-posterior line (APL) and posterior condylar line (PCL) with clinical epicondylar axis (CEA), analyze the variability difference in 3 axes relative to CEA. Methods The right knees in 36 patients with knee osteoarthritis (gradeⅣ) and who had underwent total knee arthroplasty were enrolled in this study, 11 male patients aged 60-81 (69.1 ± 6.3) years and 25 female patients aged 33- 85(67.7 ± 12.2) years. All of right knees were scanned using computed tomography. The angles between the CEA and each of the 3 axes (TL, PCL, APL) were measured using software. Results The angles of TL-CEA, APL-CEA and PCL-CEA was (6.10 ± 3.22)°, (85.80 ± 2.86)°and (2.70 ± 1.80)°. The F tests showed that the angel invariability between the TL and CEA the APL axis (α=0.58) or the PCL (α=0.28) for referencing the CEA had no significant differences. Conclusions The TL can be a relatively reliable reference axis to determine rotational alignment of the femoral component similar to PCL and APL.