The recombinant human thyroid-stimulating hormone (rhTSH) can be used for differentiated thyroid cancer (DTC) preparation before ¹³¹I therapy, and follow-up. Since its approval by the American Food and Drug Administration (FDA) in 1998, rhTSH has been clinically used in European countries, the United States, and other countries for nearly 30 years. In April 2024, China’s first independently developed rhTSH agent was approved. Based on clinical experience and evidence from domestic and international studies, an expert consensus on the application of rhTSH has been developed following thorough consultations among experts. The consensus offers evidence-based recommendations to guide the appropriate use of rhTSH in clinical practice.

BACKGROUND:The application of robot-assisted technology for total knee arthroplasty is one of the current research hotspots.Since the 1980s,robot-assisted technology has been introduced into total knee arthroplasty outside China to achieve accurate osteotomy and good recovery of lower limb alignment.After decades of use,the robot has continuously improved its performance with new iterations,but has been criticized for increasing perioperative time and surgical trauma. OBJECTIVE:To summarize the advantages and disadvantages of current orthopedic surgical robots in total knee arthroplasty. METHODS:PubMed database and CNKI were searched to analyze the advantages and disadvantages of robot-assisted total knee arthroplasty in surgical trauma.English search terms were"arthroplasty,replacement,knee,knee replacement arthroplasty,procedure,robotic surgical,total knee arthroplasty,arthroplasty,replacement,knee,robotic-assisted".The Chinese search terms were"robot-assisted,robotic arm,knee osteoarthritis,arthritis".After the initial screening of all articles according to the inclusion and exclusion criteria,62 articles with high quality and relevance were reviewed. RESULTS AND CONCLUSION:(1)Robot-assisted total knee arthroplasty did not increase the degree of surgical trauma in patients,and showed a lower trauma effect than conventional manual total knee arthroplasty.(2)Robot-assisted total knee arthroplasty has the advantages of accurate auxiliary osteotomy,individualized prosthesis implantation,better protection of soft tissue around the knee joint,reduction of analgesic drug use,reduction of postoperative inflammatory index changes,and shortening of hospital stay.However,there are also shortcomings such as prolonged operation time,increased complications,and increased medical costs.(3)It is concluded that preliminary clinical application studies have shown that robot-assisted total knee arthroplasty can reduce surgical trauma,but it is necessary to be alert to potential risks.Simultaneously,its exact advantages compared with conventional manual total knee arthroplasty need to be verified by large-sample randomized controlled studies and long-term follow-up.

Objective:To compare the early clinical outcomes between domestic robot-assisted total knee arthroplasty (RA-TKA) and conventional manual total knee arthroplasty (CM-TKA) for patients with primary knee osteoarthritis.Methods:Embase, Pubmed, Web of Science, Zhi.com and Wanfang databases from January 2015 to April 2023 were searched for clinical controlled trials (RCTs) comparing the clinical outcomes between RA-TKA and CM-TKA. After literature screening, quality evaluation and data extraction according to the criteria required, Revman 5.3 software was applied to perform a Meta-analysis of the literature data. The operation time, intraoperative bleeding, hip-knee-ankle angle (HKA), HKA bias value, frontal femoral component (FFC), frontal tibia component (FTC), lateral femoral component (LFC), lateral tibia component (LTC), Knee Society Score (KSS), visual analogue scale (VAS), Western Ontario and McMaster University Osteoarthritis Index (WOMAC), knee mobility, Hospital for Specialty Surgery (HSS) knee score, length of hospital stay, and rate of complications were compared between the RA-TKA and CM-TKA patients.Results:Eight RCTs and 449 patients were included, with 221 patients in the RA-TKA group and 228 ones in the CM-TKA group. The Meta-analysis showed that the RA-TKA group had significantly longer operation time ( MD=18.41, 95% CI: 11.28 to 25.23, P<0.001), significantly better HKA ( MD=0.41, 95% CI: 0.06 to 0.76, P=0.020), significantly better HKA bias value ( MD=-0.92, 95% CI: -1.25 to -0.60, P<0.001), significantly better FTC ( MD=0.38, 95% CI: 0.08 to 0.67, P=0.010), significantly better LTC ( MD=1.71, 95% CI: 0.94 to 2.48, P<0.001), and significantly better knee mobility ( MD=-2.23, 95% CI: -4.18~-0.27, P=0.030) than the CM-TKA group. However, the differences were not statistically significant between the 2 groups in the intraoperative bleeding, FFC, LFC, KSS, VAS, WOMAC, HSS, length of hospital stay, or rate of complications ( P>0.05). Conclusion:Use of a domestic robot to assist conventional manual TKA can significantly improve the accuracy of prosthesis fixation and reconstruct the alignment of lower limb better, showing potential advantages in promoting functional recovery of the knee for the patients.

ObjectiveTo explore the role of aryl hydrocarbon receptor/suppressor of cytokine signaling 2/nuclear transcription factor-κB (AHR/SOCS2/NF-κB) signaling in the reduction of spinal cord injury (SCI) inflammation with every-other-day fasting (EODF). MethodsA total of 36 healthy male Sprague-Dawley rats were randomly divided into sham group (n = 12), model group (n = 12) and EODF group (n = 12). The latter two groups were established C₅ spinal cord hemi-clamp model. The EODF group received EODF, namely fasting and feeding per 24 hours (water free), for two weeks after operation. They were assessed with Grooming Test before operation, and one, seven and 14 days after operationt, respectively. Pathological injury of spinal cord was observed with HE staining 14 days after operation, while the expression of AHR, SOCS2 and NF-κB proteins were detected with Western blotting, and the mRNA of AHR, SOCS2, inhibitor α of NF-κB (IκBα), NF-κB and tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) were measured with reverse transcription real-time quantitative polymerase chain reaction. ResultsCompared with the sham group, the Grooming Test score decreased in the other two groups (P < 0.05), and cavity, edema and structural disorder appeared in the spinal cord. Compared with the model group, the pathology of EODF group improved, and the Grooming Test score increased (P < 0.05). The mRNA and protein expression of AHR and SOCS2 increased (P < 0.05), the mRNA and protein expression of NF-κB decreased (P < 0.05), the mRNA expression of IκBα increased (P < 0.05), and the mRNA expression of TNF-α and IL-6 decreased (P < 0.05). ConclusionEODF may promote the recovery of motor function of forelimb in rats with SCI, and relieve damage and inflammation, which may associate with the activation of AHR/SOCS2/NF-κB signaling pathway.

ObjectiveTo systematically review the efficacy and safety of exosomes derived from bone marrow mesenchymal stem cells (BMSC) on animal models of spinal cord injury. MethodsAnimal studies about BMSC-derived exosomes for spinal cord injury were retrieved from databases of PubMed, Cochrane Library, Web of Science, CNKI and Wangfang Data, from establishment to October, 2021. Two researchers independently screened and extracted the data, and evaluated the risk of bias. The studies were qualitatively analyzed. ResultsA total of 21 studies were included, involving 1 342 animals. Male or female Sprague-Dawley rats were selected for 18 studies, and the body mass of the rats was (200±50) g in 19 studies. The injury nodes focused on T_9-11 spinal cord, with various methods. The types, medication time, frequency, concentration and dose of the exosomes were heterogeneous. ConclusionsThe BMSC-derived exosomes can improve the motor function after spinal cord injury, reduce the damage of spinal cord, resist apoptosis and inflammation, reduce the permeability of blood-spinal cord barrier, and promote the growth of axons and blood vessels. More high-quality studies are needed for further verification.

OBJECTIVETo compare the effects of "paraplegic triple needling" and conventional needling on psychological and daily living ability of patients with spinal cord injury.

METHODSA total of 50 patients with spinal cord injury were randomized into an observation group and a control group, 25 cases in each one. Rehabilitation training was applied in the two groups. In the observation group, on the basis of rehabilitation training, "paraplegic triple needling" was added, namely, puncturing the governor vessel (GV) and back- points respectively in the upper and lower segments of the injury plane and locating the key muscle movement points of the lower extremities by the peripheral nerve electrical stimulation device. Electroacupuncture (EA) was given at the points up and down the two sections of the GV points, back- points, the key muscle movement points. In the control group, conventional needling was applied at the points of GV, back- points, Huantiao (GB 30), Zusanli (ST 36), Xuanzhong (GB 39) and Yanglingquan (GB 34). The treatment was given once a day, the treatment for a month as one course and a total of 2 course were required. In addition, 25 health checkers were selected at the physical examination center of General Hospital of Chengdu Military Region as a normal control group. The content of peripheral serum 5-hydroxy tryptamine (5-HT) was tested before treatment, 1 course and 2 courses of treatment, The modified Barthel index (MBI) was used to observe the daily living activities, the Hamilton depression scale (HAMD) and Hamilton anxiety scale (HAMA) were used to evaluate the psychological status.

RESULTSIn the two groups, the content of serum 5-HT was lower than that in the normal control group before treatment (both <0.05). After one course of treatment, the MBI score and content of serum 5-HT were all increase in the two groups; the HAMA score and HAMD score were all reduced (all <0.05); the results in the observation were better than those in the control group (all <0.05). After 2 courses of treatment, the MBI score and content of serum 5-HT were all increased in the two groups, and the HAMA score and HAMD score were all reduced (all <0.05), but the difference was not significant statistically between the two groups (all >0.05). Pearson correlation analysis showed that the content of serum 5-HT in patients with spinal cord injury was negatively correlated with disease course, HAMA and HAMD score (all <0.05), and positively correlated with MBI score (<0.05).

CONCLUSIONThere are differences in the content of serum 5-HT between the normal person and the patients with pinal cord injury. The content of serum 5-HT can early predict the depression and anxiety in patients with spinal cord injury. Compared with the conventional needling, "paraplegic triple needling" can improve depression and anxiety in the early stage and improve the daily living ability of patients with spinal cord injury.

Activities of Daily Living ; Acupuncture Points ; Anxiety ; Electroacupuncture ; methods ; Humans ; Spinal Cord Injuries ; rehabilitation ; therapy

OBJECTIVETo observe the neurological protection effects of "paraplegia-triple-needling method" on rats with incomplete spinal cord injury (SCI), so as to make a preliminary exploration on its mechanism.

METHODSA total of 45 SD rats were randomly divided into a paraplegia-triple-needling method group (group A), a regular acupuncture group (group B) and a model group (group C), 15 rats in each one. The rats model of incomplete spinal cord injury was established by modified Allen's method. The acupoints of governor vessel and back-shu points next to the vertebras of upper end and lower end of injured segment as well as motor points in key muscle of lower extremities were treated with acupuncture in the group A; the acupoints of governor vessel and back-shu points next to the vertebras of upper end and lower end of injured segment as well as "Huantiao" (GB 30), "Housanli" (ST 36), "Yanglingquan" (GB 34) and "Genduan"(Extra) were treated with acupuncture in the group B; rats in the group C received no treatment after model establishment but grabbing and immobilization. The needles were retained for 15 min in the group A and group B, once a day for 14 times. 1 d, 7 d and 14 d after model establishment, Basso Beattie Bresnahan (BBB) scores were observed in each group; the morphologic change of injured spinal cord and expression of positive cells of calcitonin gene-related peptide (CGRP) were observed. Results (1) One day after SCI, there was no significant difference of BBB scores among three groups (P> 0. 05); 7 days and 14 days after SCI, BBB scores in the group A and group B were significantly superior to those in the group C (all P<0. 05), and the BBB scores in the group A were superior to those in the group B ( both P<0. 05). (2) There was expression of CGRP positive cells in all three groups, and that in the group A and group B was significantly higher than that in group C (both P<0. 05); 14 days after treatment, the expression in the group A was higher than that in the group B (P<0. 05).

CONCLUSIONThe "paraplegia-triple-needling method" could obviously! improve the motor function of rats with SCI, especially the expression of neuroprotective factor CGRP, which is likely to be one of the mechanisms of neurological protection effect.

Acupuncture Points ; Acupuncture Therapy ; instrumentation ; methods ; Animals ; Calcitonin Gene-Related Peptide ; genetics ; metabolism ; Disease Models, Animal ; Humans ; Male ; Rats ; Rats, Sprague-Dawley ; Spinal Cord Injuries ; genetics ; metabolism ; therapy

Objective The article described the design and building of a virtual reality technology-based rehabilitation system for patients with cognitive deficits, including overall idea, design and structure of the system, the key technology, such as formal description of the training data, man-machine interactive control, controlling simulation of the training process and virtual environment module development to achieve system implementation. The system is suitable for our country and military. It will create a new way for the cognitive rehabilitation and help to promote the application of virtual reality technology in rehabilitation

BACKGROUND:Intensity-time (I/T) curve examination is a monitoring technology used for diagnosis of nerve damage,muscle disease and prognostic evaluation using current stimulation and qualitative or quantitative analysis.It also has significance to the diagnosis of lumbar disc herniation (LDH).Whether it can be used in LDH prognostic evaluation is poorly understood.OBJECTIVE:To explore the effectiveness of I/T curve in diagnosis and prognostic evaluation of LDH.METHODS:I/T curves of 113 LDH patients were measured by CX-3 electrodiagnostic equipment,and the results were compared with their unaffected sides and analyzed after physiotherapy.A total of 253 curves were measured,including 107 biceps femoris,101 gastrocnemius and 45 tibialis anterior muscle curves.All patients were sequential treated by traction,medium frequency,ultrashort wave,electric acupuncture as well as infrared radiation following I/T diagnosis,once a day,10 days for a course,with 10 days interval in 3 courses,I/T curves were performed after 3 courses.The therapeutic effect was evaluated by using I/T results combined with clinical symptom and physical signs.RESULTS AND CONCLUSION:The first estimated percentage by I/T curved line were 36.36% (controlled by normal nerve),62.85% (controlled by part of the denervated),0.79% (controlled by the completely denervated) and 63.64% (controlled by total abnormal nerve).After the physiotherapy,the effectiveness of the complete recovery was 92.86% by the normal nerve as well as 58.82% by the abnormal nerve.Above all,the practical value could be concluded from the diagnosis,evaluation and effectiveness of LDH used by I/T curve line.The therapeutic effectiveness controlled by the normal nerve is much better than that controlled by the abnormal.

Objective To evaluate the clinical efficacy and outcomes of percutaneous cholecystostomy(PC) under type-B ultrasonic guide as an alternative treatment option for critically ill patients of acute cholecystitis.Methods The clinical data of 53 high-risk patients of acute cholecystitis were retrospectively analyzed,who received PC from January 1999 to August 2005.Results All cases were successfully punctured and intubated,and 4 received reoperation because of blocked tube or fall-off.Fifty-two(97.3%) gained bile drainage effectively.No complications occurred due to the procedures in the cholecystostomy and intubation.One patient required emergency cholecystectomy on day 1 after the procedures because of deteriorating conditions.Forty-one accepted selective cholecystectomy in 2 weeks to 3 months after cholecystostomy.The follow-up period was 6 months to 3 years.Conclusion PC is an effective,convenient and safe method in managing acute cholecystitis in high-risk patients,with high achievement ratio and less complications.