Objective To investigate the effects of different use methods of tourniquet on hidden blood loss and knee joint swelling in total knee arthroplasty(TKA),and to explore its potential benefits for postoperative rehabilitation.Methods A prospective study was conducted from March 2018 to March 2023 in Xuzhou Municipal Hospital Affiliated to Xuzhou Medical University,involving 131 patients who underwent TKA.The patients were divided into three groups based on the method of tourniquet use:44 patients routinely used a tourniquet in group A,48 patients only used a tourniquet during the application of bone cement in group B,and 39 patients did not use tourniquet in group C.Operation time,dressing changes,intraoperative blood loss,total blood loss,explicit blood loss,hidden blood loss,percentage of hidden blood loss,postoperative blood transfusion,hemoglobin(Hb),hematocrit(HCT),C-reactive protein(CRP),and creatine kinase(CK)were compared among groups.The pain and functional recovery were evaluated by visual analogue scale(VAS)and knee society clinical rating system(KSS)before surgery,and 3 days,1 month,and 3 months after surgery.The degree of limb swelling and the range of motion of the knee were also compared among groups.Results Group A had shorter operation time and less frequency of postoperative dressing changes than the other two groups(P<0.05).The hidden blood loss and total blood loss in group A were significantly less than those in group C(P<0.05),and the hidden blood loss and total blood loss volume in the three groups from low to high was group A

Ferroptosis is closely related to iron metabolism,lipid metabolism,and amino acid metabolism,which contribute to the production of reactive oxygen species,mitochondrial damage,and cell death.Ferroptosis has recently been recognized as a key regulatory mechanism during tumor development,including in acute leukemia.This review considers the inhibitory effects of drugs on the occurrence and development of acute leukemia,by regulating key proteins or factors involved in the above three metabolic pathways of ferroptosis and by interfering with the production of lipid peroxides.We also point out the deficiencies in current research and describe the role of ferroptosis in acute leukemia.The application of these findings in clinical trials will provide new ideas for future research and the treatment of leukemia.

Objective To investigate the clinical outcome differences between robotic-assisted intramedullary nailing and traditional manual surgery,and to analyze the advantages and feasibility of robotic-assisted intramedullary nail fixation in the treatment of intertrochanteric fractures in elderly patients.Methods From December 2023 to December 2024,elderly patients with intertrochanteric fractures who underwent surgery at Department of Trauma Orthopedics,Beijing Luhe Hospital,Capital Medical University were included.Patients were divided into two groups based on the surgical method.The robotic-assisted group underwent robotic-assisted intramedullary nail fixation,while the traditional group received manual intramedullary nail fixation.Baseline data and observation indicators were collected and compared between the two groups to assess any differences.Results There were no statistically significant differences in baseline data between the two groups(P>0.05).The intraoperative blood loss in the robotic-assisted group was(94.28±9.43)mL,compared to(143.00±11.11)mL in the traditional group(P<0.001).The operative time in the robotic-assisted group was(53.06±9.89)min,while in the traditional group,it was(66.74±10.18)min(P<0.001).The skin incision length for the main nail in the robotic-assisted group was(3.23±0.64)cm,whereas in the traditional group,it was(4.03±0.79)cm(P<0.01).Postoperative hemoglobin levels in the robotic-assisted group decreased by(12.63±4.27)g/L,compared to(17.29±4.32)g/L in the traditional group(P=0.018).At 6 months postoperatively,the Harris hip scores in the robotic-assisted group showed 30 cases of excellent,10 good,and 3 poor outcomes,while in the traditional group,there were 22 excellent,15 good,and 6 poor cases(P=0.198).Conclusion Robotic-assisted intramedullary nailing for intertrochanteric fractures offers advantages such as minimally invasive and precise procedures,shorter operative times,and reduced blood loss.Compared to traditional surgical methods,it demonstrates certain benefits in reducing postoperative complications in elderly patients.

Objective To investigate the clinical outcome differences between robotic-assisted intramedullary nailing and traditional manual surgery,and to analyze the advantages and feasibility of robotic-assisted intramedullary nail fixation in the treatment of intertrochanteric fractures in elderly patients.Methods From December 2023 to December 2024,elderly patients with intertrochanteric fractures who underwent surgery at Department of Trauma Orthopedics,Beijing Luhe Hospital,Capital Medical University were included.Patients were divided into two groups based on the surgical method.The robotic-assisted group underwent robotic-assisted intramedullary nail fixation,while the traditional group received manual intramedullary nail fixation.Baseline data and observation indicators were collected and compared between the two groups to assess any differences.Results There were no statistically significant differences in baseline data between the two groups(P>0.05).The intraoperative blood loss in the robotic-assisted group was(94.28±9.43)mL,compared to(143.00±11.11)mL in the traditional group(P<0.001).The operative time in the robotic-assisted group was(53.06±9.89)min,while in the traditional group,it was(66.74±10.18)min(P<0.001).The skin incision length for the main nail in the robotic-assisted group was(3.23±0.64)cm,whereas in the traditional group,it was(4.03±0.79)cm(P<0.01).Postoperative hemoglobin levels in the robotic-assisted group decreased by(12.63±4.27)g/L,compared to(17.29±4.32)g/L in the traditional group(P=0.018).At 6 months postoperatively,the Harris hip scores in the robotic-assisted group showed 30 cases of excellent,10 good,and 3 poor outcomes,while in the traditional group,there were 22 excellent,15 good,and 6 poor cases(P=0.198).Conclusion Robotic-assisted intramedullary nailing for intertrochanteric fractures offers advantages such as minimally invasive and precise procedures,shorter operative times,and reduced blood loss.Compared to traditional surgical methods,it demonstrates certain benefits in reducing postoperative complications in elderly patients.

BACKGROUND:Sinomenine hydrochloride has anti-tumor effects,but it is rarely reported in T-cell acute lymphoblastic leukemia.OBJECTIVE:To investigate the inhibitory effect of sinomenine hydrochloride on CEM cells in acute T lymphoblastic leukemia.METHODS:Different concentrations(0.5,1,2 and 4 mmol/L)of sinomenine hydrochloride were used to act on CEM cells.CCK-8 assay was used to detect the inhibition rate of cell proliferation and calculate the IC50.Inverted microscope and Giemsa staining were used to observe the changes of CEM cells.The RNA sequencing was performed to analyze the differential gene expression and biological information.Combined with transcriptome sequencing analysis results,flow cytometry was used to detect the apoptosis rate of CEM cells after treatment with of different concentrations(1,2,and 4 mmol/L)of sinomenine hydrochloride.Western blot assay was used to detect the expression of Bcl-2,Bax,and Caspase-9 proteins in CEM cells after treatment with of different concentrations(1,2,and 4 mmol/L)of sinomenine hydrochloride.RESULTS AND CONCLUSION:(1)Sinomenine hydrochloride inhibited the growth of CEM cells in dose and time-dependent manner.(2)After dosing,the number of CEM cells decreased and pyknosis appeared.(3)RNA sequencing revealed 53 differential expressed genes.Gene Ontology was significantly enriched in cellular process,cellular anatomical entities,and binding.Signaling pathway analysis related to tumor was apoptosis.(4)Sinomenine hydrochloride induced the apoptosis of CEM cell in a concentration-dependent manner.(5)Sinomenine hydrochloride could promote the expressions of Bax and Caspase-9,but restrain the expression of Bcl-2 in CEM cells.Therefore,sinomenine hydrochloride can induce apoptosis in CEM cells and suppress cell proliferation,maybe via up-regulation of the protein levels of Bax and caspase-9 and down-regulation of the protein level of Bcl-2.

Ferroptosis is closely related to iron metabolism,lipid metabolism,and amino acid metabolism,which contribute to the production of reactive oxygen species,mitochondrial damage,and cell death.Ferroptosis has recently been recognized as a key regulatory mechanism during tumor development,including in acute leukemia.This review considers the inhibitory effects of drugs on the occurrence and development of acute leukemia,by regulating key proteins or factors involved in the above three metabolic pathways of ferroptosis and by interfering with the production of lipid peroxides.We also point out the deficiencies in current research and describe the role of ferroptosis in acute leukemia.The application of these findings in clinical trials will provide new ideas for future research and the treatment of leukemia.

BACKGROUND:Sinomenine hydrochloride has anti-tumor effects,but it is rarely reported in T-cell acute lymphoblastic leukemia.OBJECTIVE:To investigate the inhibitory effect of sinomenine hydrochloride on CEM cells in acute T lymphoblastic leukemia.METHODS:Different concentrations(0.5,1,2 and 4 mmol/L)of sinomenine hydrochloride were used to act on CEM cells.CCK-8 assay was used to detect the inhibition rate of cell proliferation and calculate the IC50.Inverted microscope and Giemsa staining were used to observe the changes of CEM cells.The RNA sequencing was performed to analyze the differential gene expression and biological information.Combined with transcriptome sequencing analysis results,flow cytometry was used to detect the apoptosis rate of CEM cells after treatment with of different concentrations(1,2,and 4 mmol/L)of sinomenine hydrochloride.Western blot assay was used to detect the expression of Bcl-2,Bax,and Caspase-9 proteins in CEM cells after treatment with of different concentrations(1,2,and 4 mmol/L)of sinomenine hydrochloride.RESULTS AND CONCLUSION:(1)Sinomenine hydrochloride inhibited the growth of CEM cells in dose and time-dependent manner.(2)After dosing,the number of CEM cells decreased and pyknosis appeared.(3)RNA sequencing revealed 53 differential expressed genes.Gene Ontology was significantly enriched in cellular process,cellular anatomical entities,and binding.Signaling pathway analysis related to tumor was apoptosis.(4)Sinomenine hydrochloride induced the apoptosis of CEM cell in a concentration-dependent manner.(5)Sinomenine hydrochloride could promote the expressions of Bax and Caspase-9,but restrain the expression of Bcl-2 in CEM cells.Therefore,sinomenine hydrochloride can induce apoptosis in CEM cells and suppress cell proliferation,maybe via up-regulation of the protein levels of Bax and caspase-9 and down-regulation of the protein level of Bcl-2.

With the progress of information technology and intelligent technology,the intelligent development of urine testing instruments is facing new opportunities.Using the disease cybernetics theory model to analyze the business process and current urine testing instruments of clinical urine analyzer,a generational theoretical model of urine testing instruments has been constructed,which is conducive to guiding the intelligent development direction of urine testing instruments.The study divides urine testing instruments into one to four generations of products,with the first-generation of products being operated by doctors.The second-generation products are currently available for laboratory technicians to use various urine analyzers.The third-generation products further optimize the testing process and intelligence,without the need for inspectors to operate.The fourth-generation products are unmanned and do not require sampling.It can be seen that with the development of technology,urine analysis has indeed become more convenient,but after all,various instruments have their limitations.Therefore,the establishment of a theoretical model for the generation of urine testing instruments should be applied in clinical urine testing,which can not only improve the efficiency of urine analysis but also improve its quality.

Objective:To explore the correlation between cervical curve and ossification of ligaments in cranio-cervical junction and cervical spine in patients with cervical degenerative diseases.Methods:A retrospective study was conducted among 458 patients with cervical degenerative disease who underwent cervical spine X-ray and CT examinations at the Orthopedics Department of Beijing Tiantan Hospital, Capital Medical University between January 2016 and July 2020. There were 265 males and 193 females, with an average age of 57.02±10.41 years (range, 22-87 years). Patients were divided into 5 types (lordosis, straight, S-type degenerative kyphosis, R-type degenerative kyphosis and C-type degenerative kyphosis). Cervical lordosis was defined as C 2-C 7 curve <-4°, cervical kyphosis was defined as >4°, cervical straight was defined as -4° to 4°. C 2-C 7 curve, C 0-C 2 curve were measured respectively, and correlations among these imaging parameters were analyzed. CT images were used to assess the presence of ossification of ligaments in cranio-cervical and cervical spine, including ossification of the posterior longitudinal ligament, nuchal ligament, ligamentum flavum, transverse ligament, apical ligament, diffuse idiopathic skeletal hyperostosis (DISH), as well as capped dens sign (CDS), and correlations between these cervical curve and presence of ossification of ligaments were analyzed. The different grades were based on the length of the ossification of interest with respect to the distance from the posterosuperior rim of the anterior arch of the atlas to the inferior margin of the foramen magnum on mid-sagittal cervical spine CT images, Grade 3 CDS was determined when the length was more than two-thirds. Results:There were 245 patients with cervical lordosis, 114 patients with straight, 53 patients with S-type degenerative cervical kyphosis, 36 patients with R-type degenerative cervical kyphosis and 10 patients with C-type degenerative cervical kyphosis. C 0-C 2 curve showed a negative correlation with C 2-C 7 curve in all enrolled patients ( r=-0.45, P<0.001) and R-type degenerative kyphosis group ( r=-0.58, P<0.001); C 0-C 2 curve showed no correlation with C 2-C 7 curve in lordosis ( r=-0.10, P=0.124), straight ( r=-0.11, P=0.233), S-type degenerative kyphosis ( r=-0.01, P=0.943) or C-type degenerative kyphosis groups ( r=0.03, P=0.946). CDS was detected in 38.4% (176/458) of patients, and Grade 3 was detected in 17.9% (82/458) of patients. The prevalence of CDS was correlated with R-type degenerative cervical kyphosis ( r=0.10, P=0.030). Cervical kyphosis, S-type degenerative kyphosis, C-type degenerative kyphosis, C 2-C 7 curve and C 0-C 2 curve showed no correlation with ossification of the posterior longitudinal ligament, nuchal ligament, ligamentum flavum, transverse ligament, apical ligament, diffuse idiopathic skeletal hyperostosis (DISH) or different grades CDS ( P>0.05). Conclusion:R-type degenerative cervical kyphosis are more likely to correlate with the cranio-cervical curve and CDS, which is an ossification of ligament in cranio-cervical junction.

Objective:This work developed a novel and convenient detection method which realized rapid and sensitive detection of the viral nucleic acid.Methods:Here we established a novel nucleic acid detection method based on a graphene field effect transistor (g-FET). By anchoring a chemical molecule on the sensing interface and then modifying with the highly sensitive DNA tetrahedral probes, it realized accomplish highly sensitive detection of the viral nucleic acid. By measuring the transfer curve of the devices, it can make the biological signal of the hybridization for the probe molecule and the target RNA converted into an electrical signal of the g-FET devices. Then through the signal amplification of the field effect transistor (FET) device, it realized a high-sensitive detection of the viral RNA.Results:The DNA tetrahedron probe we designed was targeted at the ORF1 ab gene region of the 2019 novel coronavirus (2019-nCoV) RNA. The target RNA was hybridized and bound by the principle of base-pair complementation. Then we tested the 2019-nCoV simulative RNA samples with different concentrations in saliva, when the concentration of target RNA increased, the Dirac point of the devices presented a regular leftward offset. The limited of detection concentration of this sensor can reach 0.05 copy/μl, and the response time was shorter than 5 minutes in 100 μl volume of tested liquid. Conclusions:In this work, we developed a novel g-FET sensor based on DNA tetrahedral probes, which realized a rapid and sensitive detection of viral nucleic acid.