Objective To explore accuracy and clinical effect of robot-assisted implantation of sacroiliac penetrating screw in orthopedic surgery for posterior pelvic ring fracture.Methods The clinical data of 24 patients with posterior pelvic ring frac-ture treated with robot-assisted sacroiliac penetration screws from August 2022 to August 2023 were retrospectively analyzed,including 10 males and 14 females;aged from 21 to 73 years old with an average of(49.29±14.48)years old;according to Tile pelvic fractures,13 patients were type B and 11 were type C.The effect of screw placement was evaluated according to Gras criteria based on postoperative CT scan results.At the final follow-up,fracture healing was evaluated according to Matta score,and functional recovery was evaluated by Majeed score.Results All patients were followed up for 3 to 13 months with an aver-age of(6.00±3.28)months.Totally 36 sacroiliac penetrating screws,18 S1 penetrating screws,18 S2 penetrating screws were inserted,a total of 29 were excellent and 7 good according to Gras standard.Screw adjustment times was 0.00(0.00,0.75)times.At the final follow-up,Matta score was excellent in 18 patients,5 good and 1 moderate,and the maximum displacement distance was 2.55(0.00,5.65)mm.Majeed score was 84.37±8.38,15 patients were excellent,7 good and 2 moderate.Con-clusion Robot could accurately and safely assist in the placement of sacroiliac joint screws for the treatment of posterior pelvic ring fractures,and promote postoperative functional recovery of patients.

Objective To investigate the therapeutic effect of segmental decompression combined with corrective short-segment fusion surgery for the treatment of degenerative lumbar scoliosis.Methods In total,124 patients with degenerative lumbar scoliosis were selected and divided into short-and long-segment fusion groups using the random number table method,with 62 patients in each group.Posterior short-segment decompression,fixation,and fusion were performed in the short-segment fusion group;the fusion segment was the adjacent lumbar vertebra.Posterior long-segment decompression,fixation,and fusion were performed in the long-segment fusion group;the fusion segments included multiple adjacent lumbar vertebrae.At the 6th month after surgery,the coronal Cobb angle of lumbar convexity,sagittal Cobb angle of lumbar lordosis,intervertebral foramen height,intervertebral space height,intervertebral foramen area,spinal canal area,spinal canal diameter,Japanese Orthopedic Association(JOA)score,Oswestry Disability Index(ODI),degree of pain in the lower back and lower limbs,and postoperative complications were compared between the groups.Results The Cobb angle of the coronal lumbar scoliosis in the short-and long-segment fusion groups was significantly higher than that before surgery(P<0.05).At the 6th month after surgery,the intervertebral foramen height,intervertebral space height,intervertebral foramen area,spinal canal area,and spinal canal diameter in both groups increased,and those in the short-segment fusion group were higher than those in the long-segment fusion group(P<0.05);at the 6th month after the operation,the JOA scores of the short-segment and long-segment fusion groups were higher than those before surgery,and the JOA score of the short-segment fusion group was higher than that of the long-segment fusion group(P<0.05).The ODI score was lower than that before surgery in the short-and long-segment fusion groups,and the ODI score in the short-segment fusion group was lower than that in the long-segment fusion group(P<0.05).At the 6th month after surgery,the pain scores of the lower back and lower limbs in the short-and long-segment fusion groups were significantly higher than those before surgery(P<0.05).There were two cases of dural tears during decompression caused by lamina dura adhesion in the long-segment fusion group,and no serious complications were observed in the short-segment fusion group.Conclusions Both short-and long-segment decompression fixation fusion using a posterior approach can achieve good therapeutic effects for treating degenerative lumbar scoliosis.However,compared to the long-segment fusion group,the short-segment fusion group undergoing short-segment decompression fixation fusion through a posterior approach had a shorter surgical period,lower intraoperative blood loss,better recovery of lumbar function,and a lower risk of postoperative complications.

Objective This study aims to elucidate the structure-activity domain of LBP1C-2 targeting Kvβ.2 through an exploration of the structure-activity relationship.This study may also provide the scientific basis for the development of drug candidate with anti-early-onset dementia activity.Methods After partial acid hydrolysis,various structural fragments were obtained and subjected to monosaccharide composition and molecular weight analysis.Potential target proteins were selected using a protein chip,followed by validation of the targeting specificity of each structural fragment using surface plasmon resonance(SPR)technology.Results Through high-throughput screening using the HuProtTM human protein array,potential target protein Kvβ.2 was identified for LBP1C-2.SPR experiments revealed a strong binding affinity between LBP1C-2 and Kvβ.2 protein,with a binding constant(KD)of 1.9×10-7 M.The various structural fragments of LBP1C-2 exhibited different binding strengths with the target protein Kvβ.2.Among them,the segment LBP1C-2-1I(18.1 k Da)with a molar ratio of rhamose to galecturonic acid of 1:1 showed a binding strength to Kvβ.2 similar to that of the polysaccharide LBP1C-2,with a KD of approximately 3.3×10-7 M.Structural analysis indicates that the structure of LBP1C-2-1I contains 1,2-linked Rha and 1,4-linked GalA which are alternatively linked.The acid-hydrolyzed extracellular portion corresponding to this segment,LBP1C-2-1O may also bind to Kvβ.2.However,compared to other segments,it demonstrated a higher tendency to dissociate from the protein.Knockdown of the KCNAB2 gene(Kvβ.2)in BV2 cells inhibited the uptake of Aβ in BV2 cells,suggesting that protein Kvβ.2 may be a functional protein in the development of Alzheimer's disease.Conclusion LBP1C-2-1I has been identified as the primary active domain through which LBP1C-2 targets Kvβ.2.This suggests that the active domain of LBP1C-2 predominantly resides on the main chain rather than the side chain.This study provides crucial insights for a deeper understanding of the anti-early-onset dementia activity of LBP1C-2 and lays an experimental foundation for the design and development of targeted drugs for anti-early-onset dementia based on Lycium barbarum polysaccharides.

This study aimed to provide scientific evidence for predicting quality markers(Q-markers) of Elephantopus scaber by establishing UPLC fingerprint of E. scaber from different geographical origins and determining the content of 13 major components, as well as conducting in vitro anti-cancer activity investigation of the main components. The chromatographic column used was Waters CORTECS UPLC C_(18)(2.1 mm×150 mm, 1.6 μm), and the mobile phase consisted of acetonitrile and 0.1% formic acid solution(gradient elution). The column temperature was set at 30 ℃, and the flow rate was 0.2 mL·min~(-1). The injection volume was 1 μL, and the detection wavelength was 240 nm. The UPLC fingerprint of E. scaber was fitted using the Similarity Evaluation System for Chromatographic Fingerprint of Traditional Chinese Medicine(2012 edition) to determine common peaks, evaluate similarity, identify and determine the content of major components. The CCK-8 assay was used to explore the inhibitory effect of the main components on the proliferation of lung cancer cells. The results showed that in the established UPLC fingerprint of E. scaber, 35 common peaks were identified. Thirteen major components, including neochlorogenic acid(peak 1), chlorogenic acid(peak 2), cryptochlorogenic acid(peak 3), caffeic acid(peak 4), schaftoside(peak 6), galuteolin(peak 9), isochlorogenic acid B(peak 10), isochlorogenic acid A(peak 12), isochlorogenic acid C(peak 18), deoxyelephantopin(peak 28), isodeoxyelephantopin(peak 29), isoscabertopin(peak 31), and scabertopin(peak 32) were identified and quantified, and a quantitative analysis method was established. The results of the in vitro anti-cancer activity study showed that deoxyelephantopin, isodeoxyelephantopin, isoscabertopin, and scabertopin in E. scaber exhibited inhibition rates of lung cancer cell proliferation exceeding 80% at a concentration of 10 μmol·L~(-1), higher than the positive drug paclitaxel. These results indicate that the fingerprint of E. scaber is highly characteristic, and the quantitative analysis method is accurate and stable, providing references for the research on quality standards of E. scaber. Four sesquiterpene lactones in E. scaber show significant anti-cancer activity and can serve as Q-markers for E. scaber.
Humans ; Chromatography, High Pressure Liquid ; Drugs, Chinese Herbal/chemistry* ; Asteraceae/chemistry* ; Lung Neoplasms/drug therapy*

Professor
Acupuncture ; Acupuncture Therapy ; Angina, Stable ; Combined Modality Therapy ; Humans ; Moxibustion

【Objective】 To investigate the clinicopathological characteristics and prognosis of T2DM patients with renal involvement. 【Methods】 We conducted a retrospective analysis of clinical and pathologic data from T2DM patients who received renal biopsy(n = 120), and these patients were followed up. Renal outcome is defined as receiving renal replacement therapy or progression to ESRD. 【Results】 Among the 120 patients with T2DM, 57(47.5%) were diagnosed as DN, and 63(52.5%) as non diabetic renal disease(NDRD). The most common subtype of NDRD is membranous nephropathy. Compared with the NDRD group, the DN group had longer course of diabetes, worse renal function and higher proportion of diabetic retinopathy. Kaplan-Meier analysis showed that the renal survival rate in DN group was significantly lower than that in NDRD group. The 1-year, 5-year renal survival rate of DN group was only 81%, 41% Vs NDRD group 95, 84%. After multivariate adjustment, the risk of ESRD in DN patients was 3.81 times higher than that of NDRD patients(95%CI 1.61-9.01, P=0.002) . 【Conclusions】 There is a risk of misdiagnosis DN by clinical manifestations, and accurate diagnosis depends on renal biopsy. The prognosis of DN patients is significantly worse than NDRD, so it is of great clinical significance to distinguish the pathological types of diabetic patients with kidney disease.

【Objective】 To explore the main causes of death and the risk factors for death in maintenance hemodialysis (MHD) patients. 【Methods】 A retrospective study was carried out in 210 MHD patients in The Third Affiliated Hospital of Sun Yat-sen University. Of the 210 patients, 68 dead were designated as the experimental group and the other 142 survivals as the control. Single factor and binary logistic regression analyses were used to investigate the effects of clinical indicators on the prognosis of patients. We further performed subgroup analysis in experimental group, examined the patients died of cardiovascular diseases and those died of non-cardiovascular diseases, and then compared their results of color Doppler echocardiography. 【Results】 The age of the patients was(56.6±16.6) years and 125 of them were male. Compared with those in the control group, the patients in the death group had elder average age, higher rates of complications such as hypertension, diabetes, cardio-cerebro-vascular diseases, lower levels of hemoglobin, albumin, creatinine and uric acid and significantly elevated level of hypersensitive C-reactive protein(P < 0.05). The top three causes of death were cardiocerebro-vascular disease(33 cases, 48.5%), infection(16 cases, 23.5%), malnutrition(8 cases, 11.8%). Logistic regression analysis showed that age, cardio-cerebro-vascular diseases, diabetes mellitus, hypersensitive C-reactive protein and serum creatinine were independent risk factors for death in MHD patients. Subgroup analysis revealed the patients died of CVD diseases had higher incidences of left ventricular hypertrophy and cardiac valve calcification than those died of non-CVD diseases.【Conclusion】Cardio-cerebro-vascular diseases, infection and malnutrition are the main causes of death in MHD patients. Patients died of CVD diseases exhibit significantly higher incidences of left ventricular hypertrophy and cardiac valve calcification compared with those died of non-CVD diseases.

Background:Surgical treatment of both-column acetabular fractures is challenging because of the complex acetabular fracture patterns and the curved surface of the acetabulum.Seldom study has compared the application of three-dimensional (3D) printing technology and traditional methods of contouring plates intra-operatively for the surgical treatment of both-column acetabular fractures.We presented the use of both 3D printing technology and a virtual simulation in pre-operative planning for both-column acetabular fractures.We hypothesized that 3D printing technology will assist orthopedic surgeons in shortening the surgical time and improving the clinical outcomes.Methods:Forty patients with both-column acetabular fractures were recruited in the randomized prospective case-control study from September 2013 to September 2017 for this prospective study (No.ChiCTR1900028230).We allocated the patients to two groups using block randomization (3D printing group,n =20;conventional method group,n =20).For the 3D printing group,1:1 scaled pelvic models were created using 3D printing,and the plates were pre-contoured according to the pelvic models.The plates for the conventional method group were contoured during the operation without 3D printed pelvic models.The operation time,instrumentation time,time of intra-operative fluoroscopy,blood loss,number of times the approach was performed,blood transfusion,post-operative fracture reduction quality,hip joint function,and complications were recorded and compared between the two groups.Results:The operation and instrumentation times in the 3D printing group were significantly shorter (130.8 ± 29.2 min,t =-7.5,P ＜ 0.001 and 32.1 ± 9.5 min,t =-6.5,P ＜ 0.001,respectively) than those in the conventional method group.The amount of blood loss and blood transfusion in the 3D printing group were significandy lower (500 [400,800] mL,Mann-Whitney U=74.5,P ＜ 0.001 and 0 [0,400] mL,Mann-Whitney U =59.5,P ＜ 0.001,respectively) than those in the conventional method group.The number of the approach performed in the 3D printing group was significantly smaller than that in the conventional method group (pararectus + Kocher-Langenbeck [K-L] approach rate:35％ vs.85％;X2 =10.4,P ＜ 0.05).The time of intra-operative fluoroscopy in the 3D printing group was significantly shorter than that in the conventional method group (4.2 ± 1.8 vs.7.7 ± 2.6 s;t =-5.0,P ＜ 0.001).The post-operative fracture reduction quality in the 3D printing group was significantly better than that in the conventional method group (good reduction rate:80％ vs.30％;X2 =10.1,P ＜ 0.05).The hip joint function (based on the Harris score 1 year after the operation) in the 3D printing group was significantly better than that in the conventional method group (excellengood rate:75％ vs.30％;x2 =8.1,P ＜ 0.05).The complication was similar in both groups (5.0 ％ vs.25 ％;x2=3.1,P =0.182).Conclusions:The use of a pre-operative virtual simulation and 3D printing technology is a more effective method for treating bothcolumn acetabular fractures.This method can shorten the operation and instrumentation times,reduce Mood loss,blood transfusion and the time of intra-operative fluoroscopy,and improve the post-operative fracture reduction quality.

Adult ; Female ; Humans ; Hypertension, Pulmonary ; genetics ; Lupus Erythematosus, Systemic ; genetics ; Male ; Nerve Tissue Proteins ; genetics ; Polymorphism, Single Nucleotide

OBJECTIVETo evaluate the clinical outcomes between extreme lateral interbody fusion and conventional posterior operation in the treatment of upper lumbar disc herniation.

METHODSAmong 60 patients with upper lumbar disc herniation were treated with extreme lateral interbody fusion(XLIF) or conventional posterior operation from June 2010 to December 2014, 30 patients(19 males and 11 females) were treated with XLIF (XLIF group); and the other 30 patients(17 males and 13 females) were treated with conventional posterior operation (conventional group). In XLIF group, the lesions occurred at T₁₂L₁ segments in 2 patients, at L₁,₂ segments in 6 patients, at L₂,₃ segments in 10 patients, and at L₃,₄ segment in 12 patients. In conventional group, the lesions occurred at T₁₂L₁ segments in 1 patient, at L₁,₂ segments in 6 patients, at L₂,₃ segments in 8 patients, and at L₃,₄ segment in 15 patients. Operative incision lengths, time, blood loss, postoperative draining volume, hospital stays were recorded. Pre-and post-operative visual analogue score(VAS) and Japanese Orthopedic Association(JOA) were compared between two groups. According to the image data, the intervertebral fusion device was observed to be displaced and the rate of interbody fusion was analyzed.

RESULTSAll the patients were followed up, and the duration ranged from 12 to 48 months, with an average of 29 months. The complications included 2 femoral nerve damage in XLIF group (postoperative recovery within 3 months) and superficial incision infection in conventional group(cured by anti-infection). There were no patients with cerebrospinal fluid leakage(CSFL), cauda equina injuries or functional deterioration in the nerve root of lower limbs. In the XLIF group: the operative time was (65.6±20.5) minutes, blood loss was (48.8±15.3) ml, postoperative draining volume was 0 ml. In the conventional group: the operative time was (135.2±33.9) minutes, blood loss was (260.3±125.7) ml, postoperative draining volume was (207.1±50.2) ml. The operative time, blood loss, postoperative draining volume in XLIF group were less than those in the conventional group(<0.05). The JOA and VAS score were significantly improved in both groups during the follow-up period compared with those before operation(<0.05). But the difference of the JOA and VAS score between the two groups 1, 6, and 24 months after surgery had not significant differences(>0.05). There were no significant differences in the fusion rate between the two groups 6 and 12 months after operation(>0.05).

CONCLUSIONSThe XLIF fusion for the treatment of upper lumbar disc herniation has several advantages such as minimal invasive, stable vertebral plate, less complications and postoperative fusion rate, which has a better clinical effect.