BACKGROUND:Developmental dysplasia of hip refers to the deformity of acetabulum and proximal femur,which can lead to hip instability and hip osteoarthritis. Periacetabular osteotomy is the main treatment for non-terminal developmental dysplasia of hip in adolescents and adults. Pelvic inclination plays an important role in biomechanics of hip joint,which determines the stress direction of hip joint. In hip joint diseases,pelvic compensatory tilt can occur to minimize the abnormal stress of hip joint.OBJECTIVE:To observe whether periacetabular osteotomy changes pelvic sagittal tilt in patients with developmental dysplasia of hip,and to investigate the effect of acetabular covering on pelvic sagittal tilt.METHODS:A retrospective analysis was performed on 29 patients who underwent periacetabular osteotomy due to developmental dysplasia of hip in West China Hospital of Sichuan University from August 2019 to June 2022. Anteroposterior X-rays of the standing pelvis were collected before and 6 months after surgery. The pelvic tilt parameters,including the lateral center-edge angle,pubic symphysis to sacroiliac joint distance,pubic symphysis to sacroiliac joint midline distance,sacrofemoral-pubic angle,and pelvic tilt,were measured. Hip functions of all patients were assessed by hip disability and osteoarthritis score and Harris score before and 6 months after surgery.RESULTS AND CONCLUSION:(1) The lateral center-edge angle,pubic symphysis to sacroiliac joint midline distance,and sacrofemoral-pubic angle were significantly increased 6 months postoperatively compared to preoperative values (P<0.05). Tonnis angle and pelvic tilt were significantly decreased (P<0.05). There was no significant difference in pubic symphysis to sacroiliac joint distance between preoperative and postoperative measurements (P>0.05). (2) The hip disability and osteoarthritis scores and Harris scores were significantly increased 6 months after operation (P<0.01). (3) It is indicated that periacetabular osteotomy surgery can significantly improve acetabular coverage and the pelvis showed significant anteversion changes in patients with developmental dysplasia of hip.

BACKGROUND:Patients with chronic ankle instability tend to overpronate when walking,which increases the risk of ankle sprain during the stance phase of the walking cycle.Clinicians often use Kinesio taping or athletic taping for ankle taping.Since Kinesio taping is elastic and athletic taping cannot be stretched,there are differences in technical applications and physiological mechanisms between them,which may result in different rehabilitation effects.OBJECTIVE:To compare the effects of Kinesio taping and athletic taping on the frontal plane of the foot motion and the horizontal plane of the tibia motion in patients with chronic ankle instability during the stance phase of walking.METHODS:Forty patients with chronic ankle instability were randomly divided into Kinesio taping group and athletic taping group.In the Kinesio taping group,two patches were pasted from the inside to the outside of the hind foot to generate pulling tension that facilitates foot eversion;in the athletic taping group,ankle locking basket taping was used.Walking tests were conducted on an electric treadmill before and after taping.A three-dimensional motion analysis system was used to obtain the kinematic parameters of the subjects'foot and tibia.RESULTS AND CONCLUSION:After taping,in the Kinesio taping group,the foot valgus angle increased in the early stance phase(P<0.05),but there was no effect on foot position in the late stance phase(P>0.05).After taping,in the athletic taping group,internal rotation of the tibia increased in the late stance phase(P<0.05);however,there was no significant change in tibial position in the early stance phase(P>0.05).To conclude,compared with athletic taping,Kinesio taping can provide a flexible pulling force that is beneficial for foot eversion in the early stance phase of the gait cycle,while not restricting normal foot inversion in the late stance phase.Therefore,Kinesio taping may be a practical rehabilitation therapy for patients with chronic ankle instability,correcting abnormal motion of the ankle joint without restricting its natural motion.

Objective:To compare the mid-term efficacy of one anastomosis gastric bypass (OAGB) and sleeve gastrectomy (SG) in the treatment of obesity and metabolic syndrome, and related postoperative complications.Method:Clinical data of patients undergoing indirect OAGB or SG from Jan to Dec 2022 was enrolled. Firty-eight patients were included in the OAGB group and 178 patients were included in the SG group. Propensity matching scores was performed with matching ratio of 1∶1. Eighty-four patients (42 in each group) were included in the analysis finally. We compared the differences in weight loss, metabolic syndrome remission, and postoperative complications among different groups.Result:The 2-year follow-up results show that the OAGB group and SG group showed similar improvements in weight, BMI, percentage of total weight loss, percentage of excess weight loss [(71.60±11.47)kg vs. (72.90±11.21)kg, t=0.529, P>0.05;(26.13±4.16)kg/m 2vs. (26.86±4.12)kg/m 2, t=0.805, P>0.05; (30.89%±9.68%) vs. (27.59%±7.74%), t=1.726, P>0.05; (99.25%± 36.35%) vs. (97.02%±40.97%), t=0.264, P>0.05]. In terms of metabolic complications, the OAGB group had a higher remission rate. The OAGB group showed more significant improvements in fasting plasma glucose, glycated Hemoglobin A1c, triglycerides, uric acid [(5.11±0.36)mmol/L vs. (5.40±0.63)mmol/L, t=2.593, P<0.05; (5.13%±0.4%) vs. (5.38%±0.36%), t=2.889, P<0.05; (0.94±0.35)mmol/L vs. (1.12±0.41)mmol/L, t=2.145, P<0.05; (330.60±73.73)μmol/L vs. (394.30±111.43)μmol/L, t=3.089, P<0.05]. There was no statistically significant difference in hemoglobin and albumin, but the serum iron in the OAGB group was lower than SG group, and the difference was statistically significant [(14.45±7.75)μmol/L vs.(17.78±6.58)μmol/L, t=2.118, P<0.05]. There was no difference between the two groups in terms of postoperative complications. Conclusion:OAGB has similar weight loss effects and postoperative complication rates compared to SG, and effectively improves metabolic symptoms.

The Kirsten rat sarcoma viral oncogene homolog ( KRAS ) mutation is one of the most prevalent activating alterations in cancer. It indicates a poor overall prognosis due to its highly invasive nature. Although several KRAS inhibitors have been developed in recent years, a significant clinical challenge has emerged as a substantial proportion of patients eventually develop resistance to these therapies. Therefore, identifying determinants of drug resistance is critical for guiding treatment strategies. This review provides a comprehensive overview of the mutation landscape and molecular mechanisms of KRAS activity in various cancers. Meanwhile, it summaries the progress and prospects of small molecule KRAS inhibitors undergoing clinical trials. Furthemore, this review explores potential strategies to overcome drug resistance, with the ultimate goal of steering toward patient-centric precision oncology in the foreseeable future.
Humans ; Drug Resistance, Neoplasm/drug effects* ; Proto-Oncogene Proteins p21(ras)/metabolism* ; Mutation/genetics* ; Neoplasms/genetics* ; Antineoplastic Agents/therapeutic use*

Juvenile idiopathic arthritis (JIA) is the most common condition of chronic rheumatic disease in children. JIA is an autoimmune or autoinflammatory disease, with unclear mechanism and limited treatment efficacy. Recent studies have found a number of alterations in gut microbiota and its metabolites in children with JIA, which are related to the development and progression of JIA. This review focuses on the influence of the gut microbiota and its metabolites on immune function and the intestinal mucosal barrier and discuss the key role of the gut-joint axis in the pathogenesis of JIA and emerging treatment methods based on gut microbiota and its metabolites. This review could help elucidate the pathogenesis of JIA and identify the potential therapeutic targets for the prevention and treatment of JIA.
Humans ; Arthritis, Juvenile/physiopathology* ; Gastrointestinal Microbiome/physiology* ; Child ; Intestinal Mucosa

Objective To establish a stable,reliable,and clinically relevant porcine model of endotoxin-induced acute respiratory distress syndrome(ARDS).Methods Ten 8-month-old male Bama minipigs were deeply sedated,followed by invasive mechanical ventilation and electrocardiographic monitoring.Lipopolysaccharide(LPS)was intravenously pumped at 600 μg/(kg·h)for 3 hours,then maintained at 15 μg/(kg·h)thereafter.Dynamic monitoring was performed at five time points after LPS injection(LPS 0,1,3,5,and 8 h),including arterial blood gas analysis and chest computed tomography(CT)scans.Pathological examination of lung tissues obtained via bronchoscopic biopsy(HE staining and transmission electron microscopy)was conducted.These indicators were comprehensively used to evaluate the success of the animal model.Results At 5 hours after LPS administration,8 minipigs developed symptoms such as skin cyanosis,elevated body temperature,and respiratory distress.The oxygenation index decreased to<300 mmHg.Chest CT scans showed diffuse pulmonary infiltrates.Histopathology revealed alveolar edema and hyaline membrane formation.Transmission electron microscopy demonstrated disruption of pulmonary blood-air barrier,depletion of lamellar bodies in type Ⅱ pneumocytes,inflammatory cell infiltration,and exudation of plasma proteins and fibrin.Compared with LPS 0 h,at LPS 8 h,the oxygenation index and arterial blood pH were significantly decreased(P<0.001),while blood lactic acid and serum potassium were significantly increased(P<0.05);serum calcium and base excess were significantly decreased(P<0.05),and the lung injury score based on HE-stained lung sections was significantly increased(P<0.01).Conclusion The porcine ARDS model established by continuous LPS injection can dynamically simulate the pathophysiological characteristics and typical pathological manifestations of clinical septic ARDS,making it an effective tool to study the pathogenesis,prevention,and treatment strategies of septic ARDS.

BACKGROUND:Developmental dysplasia of hip refers to the deformity of acetabulum and proximal femur,which can lead to hip instability and hip osteoarthritis. Periacetabular osteotomy is the main treatment for non-terminal developmental dysplasia of hip in adolescents and adults. Pelvic inclination plays an important role in biomechanics of hip joint,which determines the stress direction of hip joint. In hip joint diseases,pelvic compensatory tilt can occur to minimize the abnormal stress of hip joint.OBJECTIVE:To observe whether periacetabular osteotomy changes pelvic sagittal tilt in patients with developmental dysplasia of hip,and to investigate the effect of acetabular covering on pelvic sagittal tilt.METHODS:A retrospective analysis was performed on 29 patients who underwent periacetabular osteotomy due to developmental dysplasia of hip in West China Hospital of Sichuan University from August 2019 to June 2022. Anteroposterior X-rays of the standing pelvis were collected before and 6 months after surgery. The pelvic tilt parameters,including the lateral center-edge angle,pubic symphysis to sacroiliac joint distance,pubic symphysis to sacroiliac joint midline distance,sacrofemoral-pubic angle,and pelvic tilt,were measured. Hip functions of all patients were assessed by hip disability and osteoarthritis score and Harris score before and 6 months after surgery.RESULTS AND CONCLUSION:(1) The lateral center-edge angle,pubic symphysis to sacroiliac joint midline distance,and sacrofemoral-pubic angle were significantly increased 6 months postoperatively compared to preoperative values (P<0.05). Tonnis angle and pelvic tilt were significantly decreased (P<0.05). There was no significant difference in pubic symphysis to sacroiliac joint distance between preoperative and postoperative measurements (P>0.05). (2) The hip disability and osteoarthritis scores and Harris scores were significantly increased 6 months after operation (P<0.01). (3) It is indicated that periacetabular osteotomy surgery can significantly improve acetabular coverage and the pelvis showed significant anteversion changes in patients with developmental dysplasia of hip.

Objective:To investigate the alterations in the topological properties of gray matter and white matter dynamic and static functional brain networks in patients with major depressive disorder (MDD) and bipolar depression (BDD) using graph theory analysis, and to evaluate the potential of their combination as biomarkers for differential diagnosis between unipolar and bipolar depression.Methods:From March 2021 to April 2024, inpatients were recruited from the Department of Psychosomatic Medicine, Zhongda Hospital, Southeast University, including 132 patients with MDD, 84 patients with BDD, and 91 healthy controls (HCs). Resting-state structural and functional MRI data were collected, and dynamic and static functional brain networks of gray matter and white matter were constructed. Graph theory analysis was applied to calculate global and nodal network properties, differences in topological attributes among the three groups were compared by One-way analysis of covariance, and Turkey′s post hoc test was used for further pairwise comparison. The network topology attribute indicators with statistically significant inter-group differences were selected using the Least Absolute Shrinkage and Selection Operator regression (LASSO) for feature classification. The diagnostic performance of combined gray and white matter network features for distinguishing MDD from BDD was assessed using receiver operating characteristic (ROC) curves and a random forest model.Results:In the analysis of the static gray matter functional network, both MDD and BDD patients showed abnormal local topological properties. Compared with HCs, the MDD group exhibited abnormal betweenness centrality (BC) in the left inferior frontal gyrus, left precuneus, left ventromedial occipital cortex, right ventromedial occipital cortex, and right anterior thalamus ( t=-3.95-3.62, all P<0.05). The degree centrality (DC) of the left and right anterior thalamus was also abnormal in the MDD group ( t=3.78,4.14, both P<0.001), as was the nodal efficiency (Ne) of the left precuneus and bilateral anterior thalamus ( t=2.37, 3.61, 3.82, all P<0.05). Compared with HCs, the BDD group showed abnormalities in DC and Ne of the left precuneus ( t=-2.76, P=0.014; t=-3.01, P=0.007). In the analysis of the dynamic white matter functional network, both MDD and BDD patients demonstrated abnormal temporal variability of local topological properties. Compared with HCs, the MDD and BDD groups showed reduced BC temporal variability in the left superior corona radiata ( t=-2.39, P=0.047; t=-4.28, P<0.001), and there were significant differences in DC temporal variability in the right posterior limb of the internal capsule and lentiform nucleus ( t=2.65, P=0.021; t=3.49, P=0.001) in MDD group compared with HCs and BBD. The differential diagnosis model combining gray and white matter dynamic and static network topological features achieved an area under the ROC curve of 0.80. Conclusion:Both MDD and BDD exhibit altered topological properties in static gray matter functional networks and dynamic white matter functional networks. The combination of these features may aid in the differential diagnosis of MDD and BDD.

BACKGROUND:Patients with chronic ankle instability tend to overpronate when walking,which increases the risk of ankle sprain during the stance phase of the walking cycle.Clinicians often use Kinesio taping or athletic taping for ankle taping.Since Kinesio taping is elastic and athletic taping cannot be stretched,there are differences in technical applications and physiological mechanisms between them,which may result in different rehabilitation effects.OBJECTIVE:To compare the effects of Kinesio taping and athletic taping on the frontal plane of the foot motion and the horizontal plane of the tibia motion in patients with chronic ankle instability during the stance phase of walking.METHODS:Forty patients with chronic ankle instability were randomly divided into Kinesio taping group and athletic taping group.In the Kinesio taping group,two patches were pasted from the inside to the outside of the hind foot to generate pulling tension that facilitates foot eversion;in the athletic taping group,ankle locking basket taping was used.Walking tests were conducted on an electric treadmill before and after taping.A three-dimensional motion analysis system was used to obtain the kinematic parameters of the subjects'foot and tibia.RESULTS AND CONCLUSION:After taping,in the Kinesio taping group,the foot valgus angle increased in the early stance phase(P<0.05),but there was no effect on foot position in the late stance phase(P>0.05).After taping,in the athletic taping group,internal rotation of the tibia increased in the late stance phase(P<0.05);however,there was no significant change in tibial position in the early stance phase(P>0.05).To conclude,compared with athletic taping,Kinesio taping can provide a flexible pulling force that is beneficial for foot eversion in the early stance phase of the gait cycle,while not restricting normal foot inversion in the late stance phase.Therefore,Kinesio taping may be a practical rehabilitation therapy for patients with chronic ankle instability,correcting abnormal motion of the ankle joint without restricting its natural motion.

Objective:To investigate the alterations in the topological properties of gray matter and white matter dynamic and static functional brain networks in patients with major depressive disorder (MDD) and bipolar depression (BDD) using graph theory analysis, and to evaluate the potential of their combination as biomarkers for differential diagnosis between unipolar and bipolar depression.Methods:From March 2021 to April 2024, inpatients were recruited from the Department of Psychosomatic Medicine, Zhongda Hospital, Southeast University, including 132 patients with MDD, 84 patients with BDD, and 91 healthy controls (HCs). Resting-state structural and functional MRI data were collected, and dynamic and static functional brain networks of gray matter and white matter were constructed. Graph theory analysis was applied to calculate global and nodal network properties, differences in topological attributes among the three groups were compared by One-way analysis of covariance, and Turkey′s post hoc test was used for further pairwise comparison. The network topology attribute indicators with statistically significant inter-group differences were selected using the Least Absolute Shrinkage and Selection Operator regression (LASSO) for feature classification. The diagnostic performance of combined gray and white matter network features for distinguishing MDD from BDD was assessed using receiver operating characteristic (ROC) curves and a random forest model.Results:In the analysis of the static gray matter functional network, both MDD and BDD patients showed abnormal local topological properties. Compared with HCs, the MDD group exhibited abnormal betweenness centrality (BC) in the left inferior frontal gyrus, left precuneus, left ventromedial occipital cortex, right ventromedial occipital cortex, and right anterior thalamus ( t=-3.95-3.62, all P<0.05). The degree centrality (DC) of the left and right anterior thalamus was also abnormal in the MDD group ( t=3.78,4.14, both P<0.001), as was the nodal efficiency (Ne) of the left precuneus and bilateral anterior thalamus ( t=2.37, 3.61, 3.82, all P<0.05). Compared with HCs, the BDD group showed abnormalities in DC and Ne of the left precuneus ( t=-2.76, P=0.014; t=-3.01, P=0.007). In the analysis of the dynamic white matter functional network, both MDD and BDD patients demonstrated abnormal temporal variability of local topological properties. Compared with HCs, the MDD and BDD groups showed reduced BC temporal variability in the left superior corona radiata ( t=-2.39, P=0.047; t=-4.28, P<0.001), and there were significant differences in DC temporal variability in the right posterior limb of the internal capsule and lentiform nucleus ( t=2.65, P=0.021; t=3.49, P=0.001) in MDD group compared with HCs and BBD. The differential diagnosis model combining gray and white matter dynamic and static network topological features achieved an area under the ROC curve of 0.80. Conclusion:Both MDD and BDD exhibit altered topological properties in static gray matter functional networks and dynamic white matter functional networks. The combination of these features may aid in the differential diagnosis of MDD and BDD.