OBJECTIVE: To review the research progress on correction of severe foot and ankle deformities with digital hexapod external fixators. METHODS: The relevant research literature on digital hexapod external fixators at home and abroad in recent years was reviewed and analyzed. Taking Taylor spatial frame (TSF) as a representative, this article elaborates on the research progress of this technology in the treatment of severe foot and ankle deformities from aspects such as device principle, technical characteristics, clinical application, complication management, and controversial perspectives, aiming to provide theoretical references for clinical application. RESULTS: The treatment of severe foot and ankle deformities is a complex challenge in orthopedics, often involving multiple plane alignment abnormalities, muscle weakness, soft tissue contractures, and joint dysfunction. The digital hexapod external fixators (such as TSF), based on the principle of six degrees of freedom motion and combined with computer-assisted technology, enables precise correction of multi-dimensional deformities. CONCLUSION The digital hexapod external fixators provides a minimally invasive and efficient option for the treatment of severe foot and ankle deformities, and shows significant advantages in the treatment of complex post-traumatic deformities, neuromuscular deformities, diabetes Charcot arthropathy, and other diseases.
Humans ; External Fixators ; Foot Deformities/surgery* ; Ankle Joint/abnormalities* ; Ankle/abnormalities* ; Equipment Design

OBJECTIVE: To summarize the research and clinical application progress of foot lengthening surgery. METHODS: Relevant research literature on foot lengthening surgery in recent years at home and abroad was reviewed, and a summary was made from aspects such as the types of lengthening surgery, the types of foot diseases treated by clinical application, effectiveness, and complications. RESULTS: Bone defects and shortening deformities of the foot are relatively common clinically. As an innovative treatment method, foot lengthening surgery has gradually attracted attention, mainly including the Ilizarov technique and one-stage bone grafting lengthening surgery. The former promotes bone regeneration based on the tension-stress principle and is widely used in the treatment of calcaneal defects and congenital metatarsal brachymetatarsia, achieving good curative effects. However, there are also complications such as pin-tract infection, joint stiffness and contracture, non-union and delayed union of bone, re-fracture, and alignment deviation. The latter has a short treatment cycle, but the lengthening length is limited. Bone graft resorption and soft tissue complications are its main complications. CONCLUSION Foot lengthening surgery will develop towards the direction of personalization, intelligence, and precision. With the help of multi-center research, biological materials, and intelligent technologies, the effectiveness and safety will be further improved to better restore the function and appearance of the foot.
Humans ; Bone Transplantation/methods* ; Bone Lengthening/methods* ; Ilizarov Technique ; Osteogenesis, Distraction/methods* ; Foot Deformities/surgery* ; Postoperative Complications ; Treatment Outcome ; Foot/surgery*

Objective:To investigate the incidence of venous thromboembolism (VTE) in patients with esophageal cancer (EC).Methods:The retrospective cohort study was conducted. The clinicopathological data of 8 458 EC patients who were admitted to Sichuan Cancer Hospital from January 2017 to December 2021 were collected. There were 6 923 males and 1 535 females, aged (64±9)years. There were 3 187 patients undergoing surgical treatment, and 5 271 cases undergoing non-surgical treatment. Observation indicators: (1) incidence of VTE in EC patients; (2) treatment and outcomes of patients with VTE. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was analyzed using the t test. Measurement data with skewed distribution were represented as M(range), and comparison between groups was analyzed using the nonparameter rank sum test. Count data were expressed as absolute numbers or percentages, and comparison between groups was analyzed using the chi-square test or Fisher exact probability. Comparison of ordinal data was analyzed using the nonparameter rank sum test. Results:(1) Incidence of VTE in EC patients. Of 8 458 EC patients, 175 cases developed VTE, with an incidence rate of 2.069%(175/8 458). Among 175 VTE patients, there were 164 cases of deep venous thrombosis (DVT), 4 cases of pulmonary embolism (PE), 7 cases of DVT and PE. There were 59 surgical patients and 116 non-surgical patients. There was no significant difference in thrombus type between surgical and non-surgical EC patients with VTE ( χ2=1.95, P>0.05). Of 3 187 surgical patients, the incidence of VTE was 1.851%(59/3 187), including an incidence of 0.157%(5/3 187) of PE. PE accounted for 8.475%(5/59) of surgical patients with VTE. Of 5 271 non-surgical patients, the incidence of VTE was 2.201%(116/5 271), including an incidence of 0.114%(6/5 271) of PE. PE accounted for 5.172%(6/116) of non-surgical patients with VTE. There was no significant difference in the incidence of VTE or PE between surgical patients and non-surgical patients ( χ2=1.20, 0.05, P>0.05). (2) Treatment and outcomes of patients with VTE. Among 175 EC patients with VTE, 163 cases underwent drug treatment, and 12 cases did not receive treatment. Among 163 cases with drug therapy, 158 cases underwent anticoagulant therapy, 5 cases were treated with thrombolysis. All the 163 patients were improved and discharged from hospital. Conclusions:The incidence of VTE in patients with EC is relatively low, as 2.069%. There is no significant difference in the incidence of VTE or thrombus type between surgical EC patients and non-surgical EC patients.

Objective To investigate the technique and dosage selection of indocyanine green(ICG)fluorescence staining in laparoscopic anatomical hemihepatectomy.Methods A retrospective cross-sectional study was conducted.The clinical date of the patients who underwent laparoscopic anatomical hemihepatectomy in the Cancer Hospital of the Chinese Academy of Medical Sciences from October 2020 to October 2023 was collected and analyzed,and the management of the Glissonean pedicle,the method and effect of ICG fluorescence staining during the operation,the dose of ICG injection,and the postoperative recovery were analyzed.Results A total of 91 laparoscopic anatomical hemihepatectomies were enrolled in this study,including 28 right hemihepatectomies and 63 left hemihepatectomies.The Glissonean pedicle was dissected intra-sheath in 9 cases and extra-sheath in 82 cases.ICG fluorescence staining was all performed using the negative staining method,of which 69 cases(75.8%)were successfully stained.The success rate of staining in the extra-sheath dissection and low-dose ICG group was higher than that in the intra-sheath dissection and high-dose ICG group.The average operation time was(168.5±32.2)minutes,the intraoperative bleeding volume was(152.4±56.3)ml,and the intraoperative blood transfusion rate was 6.6%(6/91),the average postoperative hospital stay was(8.5±2.6)days.One case was converted to laparotomy due to exophytic growth of the tumor compressing the Glissonean pedicle.Four cases had Clavien-Dindo Ⅰ-Ⅱ complications,all of which improved after treatment.There were 3 cases of grade Ⅲa complications,all of which were caused by bile leakage and abdominal cavity infection.They were cured by puncture and drainage.And there were no serious complications above grade Ⅲb.Conclusions In laparoscopic anatomical hemihepatectomy,the ICG fluorescence staining method was recommended to use the negative staining method of the extra-sheath dissection of the Glissonean pedicle,and a lower dose of ICG could help to increase the success rate of fluorescence staining.

ObjectiveTo investigate the relationship among spontaneous turning direction, balance ability and fall risk in patients with stroke during walking. MethodsFrom December, 2021 to November, 2022, 94 patients with stroke were recruited from Beijing Bo'ai Hospital. They were assessed with simple Timed 'Up and Go' Test (TUGT, TUGT1), TUGT with a cup in hand (TUGT2), and TUGT with calculation task (TUGT3). The spontaneous turning directions at the turn point were recorded, and the patients were divided into no-same group (n = 34) and same group, and the same group was further divided into affected group (n = 33) and unaffected group (n = 27), according to the spontaneous turning direction. After a spontaneous turning of each TUGT, the patients were asked to finish another TUGT turning to the opposite direction. And then, they were assessed with single leg standing test, Functional Reach Test (FRT), 360° turning test and the Morse Fall Scale (MFS). ResultsThere were the most patients with left hemiplegia in the affected group (χ² = 7.995, P < 0.05). The time of TUGT1, TUGT2 and TUGT3 was the most in the affected group and the least in the unaffected group (F > 4.009, P < 0.05), and it was more in the affected group than in the unaffected group as post-hoc test (P < 0.05). The one leg standing time (H = 9.403, P = 0.009) and FRT distance (F = 4.300, P = 0.016) were the least in the affected group and the most in the unaffected group, and it was less in the affected group than in the unaffected group as post-hoc test (P < 0.05). The turning time (F = 4.134, P = 0.019) and turning steps (F = 5.611, P = 0.003) were the most in the affected group and the least in the unaffected group, and it was more in the affected group than in the unaffected group as post-hoc test (P < 0.05). The score of MFS was the most in the affected group and the least in the unaffected group (H = 8.192, P = 0.017), and it was more in the affected group than in the unaffected group as post-hoc test (P < 0.05). ConclusionThe stroke patients spontaneously turning to the affected side during walking usually are poorer in balance function, and in a risk of fall.

OBJECTIVE: To prepare vitamin E polyethylene glycol 1000 succinate (TPGS)-modified insulin-loaded liposomes (T-LPs/INS) and evaluate its safety, corneal permeability, ocular surface retention and pharmacokinetics in rabbit eyes. METHODS: The safety of the preparation was investigated in human corneal endothelial cells (HCECs) using CCK8 assay and live/dead cell staining. In the ocular surface retention study, 6 rabbits were randomized into 2 equal groups for application of fluorescein sodium dilution or T-LPs/INS labeled with fluorescein in both eyes, which were photographed under cobalt blue light at different time points. In the cornea penetration test, another 6 rabbits divided into 2 groups for application of Nile red diluent or T-LPs/INS labeled with Nile red in both eyes, after which the corneas were harvested for microscopic observation. In the pharmacokinetic study, 2 groups of rabbits (n=24) were treated with eye drops of T-LPs/INS or insulin, and the aqueous humor and cornea were collected at different time points for measurement of insulin concentrations using enzyme linked immunosorbent assay. DAS2 software was used to analyze the pharmacokinetic parameters. RESULTS: The prepared T-LPs/INS showed good safety in cultured HCECs. Corneal permeability assay and fluorescence tracer ocular surface retention assay demonstrated a significantly higher corneal permeability of T-LPs/INS with a prolonged drug residence in the cornea. In the pharmacokinetic study, insulin concentrations in the cornea at 6, 15, 45, 60, and 120 min (P < 0.01) and in the aqueous humor at 15, 45, 60, and 120 min after dosing were significantly higher in T-LPs/INS group. The changes in insulin concentrations in the cornea and aqueous humor were consistent with a two-compartment model in T-LPs/INS group and with the one-compartment model in the insulin group. CONCLUSION The prepared T-LPs/INS shows an improved corneal permeability, ocular surface retention capacity and eye tissue concentration of insulin in rabbits.
Humans ; Animals ; Rabbits ; Insulin ; Liposomes ; Endothelial Cells ; Lipopolysaccharides ; Vitamin E ; Cornea ; Fluorescein

Enzalutamide (ENZ) is a second-generation androgen receptor (AR) antagonist used for the treatment of castration-resistant prostate cancer (CRPC) and reportedly prolongs survival time within a year of starting therapy. However, CRPC patients can develop ENZ resistance (ENZR), mainly driven by abnormal reactivation of AR signaling, involving increased expression of the full-length AR (ARfl) or dominantly active androgen receptor splice variant 7 (ARv7) and ARfl/ARv7 heterodimers. There is currently no efficient treatment for ENZR in CRPC. Herein, a small molecule LLU-206 was rationally designed based on the ENZ structure and exhibited potent inhibition of both ARfl and constitutively active ARv7 to inhibit PCa proliferation and suppress ENZR in CRPC. Mechanically, LLU-206 promoted ARfl/ARv7 protein degradation and decreased ARfl/ARv7 heterodimers through mouse double minute 2-mediated ubiquitination. Finally, LLU-206 exhibited favorable pharmacokinetic properties with poor permeability across the blood-brain barrier, leading to a lower prevalence of adverse effects, including seizure and neurotoxicity, than ENZ-based therapies. In a nutshell, our findings demonstrated that LLU-206 could effectively inhibit ARfl/ARv7-driven CRPC by dual-targeting of ARfl/ARv7 heterodimers and protein degradation, providing new insights for the design of new-generation AR inhibitors to overcome ARfl/ARv7-driven CRPC.

The widespread application of next generation sequencing (NGS) in clinical settings has enabled testing, diagnosis, treatment and prevention of genetic diseases. However, many issues have arisen in the meanwhile. One of the most pressing issues is the lack of standards for reporting genetic test results across different service providers. The First Forum on Standards and Specifications for Clinical Genetic Testing was held to address the issue in Shenzhen, China, on October 28, 2017. Participants, including geneticists, clinicians, and representatives of genetic testing service providers, discussed problems of clinical genetic testing services across in China and shared opinions on principles, challenges, and standards for reporting clinical genetic test results. Here we summarize expert opinions presented at the seminar and report the consensus, which will serve as a basis for the development of standards and guidelines for reporting of clinical genetic testing results, in order to promote the standardization and regulation of genetic testing services in China.

Objective To investigate the utility behavior of dietary supplement in middle school students from Shenyang and Shanghai .Methods The survey questionnaires were handed out to the middle school students from different grades of 11 schools in Shenyang and Shanghai .The characteristics of population statistic and behavior on the understanding and attitude of dietary supplement were collected .Results 1210 survey questionnaires were handed out and 916 were taken back effectively . The utility rate of dietary supplement was 24 .56％ in this survey .50 .89％ of the user considered that taking the dietary sup-plement reached the expected effect .The probability of the dietary supplement utility in students was different in different grade and city .The utility rate of the dietary supplement from the students whose parents had medical related occupations was higher than others .The main objective of taking dietary supplement was supplement vitamin and microelement .The pharmacy was the primary channel to get the dietary supplement .The information and recommendations of the dietary supplement was mainly coming from experts in medicine and nutrition .78 .93％ of the responders made no difference of the category and trade-mark of dietary supplement .But the responders from Shenyang and family which had medicine related parents took more atten-tion on the category and trademark of dietary supplement than that from Shanghai and family which had not medicine related parents .(P<0 .01) The effectiveness of dietary supplement from the responders was related to gender and administer habit . (P<0 .01) Conclusion A quarter of the survey students were taken dietary supplement .The safety education of dietary sup-plement utility should be carried out during middle school .Family from different city had differences in the utility of dietary supplement .Family with medicine related parents preferred to take dietary supplement .The channel of supply and recommen-dation was rational in the middle school student′s family .

Background Laser in situ keratomileusis (LASIK) is widely applicated to correct the refractive error in ophthalmology nowadays.However,the morphology and structure changes of anterior eye segment caused by the ablation of corneal stroma and suction of negative pressure during surgery should be concerned.Objective This study was to assess the changes of the anterior eye segment parameters and the factors influencing these parameters after LASIK.Methods The clinical data of 59 eyes of 31 patients who received LASIK in Chongqing Medal Eye Institute during May 2012 to July 2013 were retrospectively analyzed.The mean age of the patients was (24.52±8.41) years and the spherical equivalent was (-5.96±3.75) D.The central anterior chamber angle (ACA),anterior chamber volume (ACV),anterior chamber depth (ACD) were measured with Sirius Scheimpflug tomography,and lens thickness (LT) was measured by A-scan before operation and 1,3,6 months after operation.The anterior chamber was divided into anterior and posterior parts by the plane of cornea 4 mm radius area.The ACD of cornea 4 mm radius area sagittal height section (Sag4mm ACD) (the height from posterior corneal vertex to corneal radius of 4 mm plane) and residual ACD (RACD) (the height from corneal radius of 4 mm plane to the anterior lens surface) were computed.The association between ACD and RACD or LT were assessed by Pearson correlation analysis.Results The ACA,ACV,ACD,RACD and LT were significantly different among various time points before and after LASIK (F =8.319,P＜0.05;F =11.596,P＜0.05;F =24.045,P＜0.01;F =16.087,P＜0.05;F =15.333,P＜0.01),and the ACA,ACV,ACD and RACD were significantly decreased 1-6 months after LASIK than those before LASIK (all at P＜0.05).There were no significant differences in the Sag4 mm ACD between pre-and postLASIK (all at P＞0.05).The LT was significantly increased after surgery in comparison with that before surgery (P＜0.01).The positive correlations were found between RACD and ACD before LASIK and in 1,3,6 months after LASIK (r =0.976,0.824,0.724,0.938,all at P＜0.05) and negative correlation between LT and ACD in 3 and 6 months after LASIK (r=-0.344,P＜0.01;r =-0.363,P＜0.01).Conclusions The ACD decrease following LASIK mainly in the sector from the plane of cornea 4 mm radius area to lens surface.The change of ACD might be associated with forward shifting of anterior lens surface caused by enhanced accommodation.