BACKGROUND:Total knee arthroplasty is an effective treatment for late-stage osteoarthritis,but postoperative pain and joint function recovery are the main challenges.Nerve block and mixed drug injection are two common pain relief methods,but the effect of their combined use is still unclear. OBJECTIVE:To investigate the effects of ultrasound-guided continuous adductor canal block+single sciatic nerve block+"cocktail"mixed drug analgesia on postoperative pain relief and joint function recovery in total knee arthroplasty. METHODS:120 patients with osteoarthritis admitted to Hebei Province Cangzhou Hospital of Integrated Traditional and Western Medicine from January to May 2022 were randomly divided into two groups(n=60).The observation group received ultrasound-guided continuous adductor canal block+single sciatic nerve block+"cocktail"mixed drug analgesia.The control group received ultrasound-guided continuous adductor canal block+single sciatic nerve block.The differences in visual analog scale score,hospital for special surgery score,pain mediators,expression levels of inflammatory factors,the occurrence of adverse reactions,and postoperative barehanded muscle strength test were compared between the two groups. RESULTS AND CONCLUSION:(1)The visual analog scale scores at rest and exercise were lower in the observation group than those in the control group at 6,8,12,24,48,and 72 hours postoperatively(P<0.05).(2)Hospital for special surgery scores at 1 and 3 months postoperatively were significantly higher in the observation group than those in the control group(P<0.05).(3)In terms of pain mediators and inflammatory factors,the expression levels were significantly lower in the observation group than those in the control group(P<0.05).(4)There was no statistically significant difference in terms of adverse effects and postoperative barehanded muscle strength examination between the two groups(P>0.05).(5)In total knee arthroplasty,ultrasound-guided continuous adductor canal block and single sciatic nerve block,together with a"cocktail"mixed drug analgesia injected into the joint cavity,can provide excellent analgesia,facilitate the recovery of joint function,and relieve postoperative pain and inflammation with a high degree of safety.

Peripheral T-cell lymphoma(PTCL)is a group of hematological malignant tumors with high heterogeneity.At present,CHOP(cyclophosphamide,vincristine,prednisone,doxorubicin)or CHOP-like regimens are usually used for first-line treatment,but the remission rate is low,and the prognosis is poor.It is urgent to improve the traditional chemotherapy regimens to improve the efficacy onthe basis of tradtional che-motherapeutic regimen.Recent studies have found that the epigenetic alterations are crucial in the pathogene-sis of PTCL,and more and more new epigenetic targeted drugs have shown good effects and safety in the monotherapy and combination therapy of PTCL,which provide a new strategy for the precise diagnosis and treatment of PTCL.This article reviews the latest progress in epigenetic changes of PTCL and the prospects of targeted drug therapy applications,in order to provide reference for improving the clinical prognosis of the patients with PTCL.

Objective:To investigate the efficacy and safety of chidamide in the maintenance therapy for patients with T-cell lymphoma (TCL).Methods:A prospective, single-arm clinical study was conducted. A total of 53 TCL patients who achieved partial remission (PR) and above after first-line induction chemotherapy in the Second Affiliated Hospital of Army Military Medical University from May 2018 to July 2020 were included, among which 28 cases underwent autologous hematopoietic stem cell transplantation after induction chemotherapy, and then received maintenance therapy with chidamide initiating 30 to 45 days after transplantation (the transplantation group); 25 cases began to receive maintenance therapy with chidamide about 30 days after 6 to 8 courses of first-line induction chemotherapy (non-transplantation group). Chidamide usage was listed as follows: oral, 20-30 mg per time, 2 times per week, at intervals of not less than 3 d and the therapy was maintained for 2 years or until disease progression or intolerance. The main study endpoint was the 2-year recurrence rate, and the secondary study endpoints included the 1-year recurrence rate, the 1- and 2-year progression free survival (PFS) rate, the 1- and 2-year overall survival (OS) rate, and the safety of maintenance therapy.Results:The median follow-up was 13.5 months (range 5 to 51 months). After 6 to 8 courses of first-line induction chemotherapy in 53 patients with TCL, complete remission (CR) was achieved in 29 (54.7%) cases and PR in 24 (45.3%) cases. The proportion of patients aged ≤ 60 years and those achieving CR before maintenance treatment in the transplantation group was higher than that in non-transplantation group (both P < 0.05). During maintenance therapy, the best remission reached CR in 84.9% (45/53) of patients; CR rates during maintenance therapy were 89.3% (25/28) and 80.0% (20/25), respectively in the transplantation and non-transplantation groups; and PR rates were 10.7% (3/28), and 20.0% (5/25) ( χ2 = 0.31, P = 0.577). Among the 53 patients with TCL, 21 cases had recurrence with a 1-year recurrence rate of 26.4% (14/53) and a 2-year recurrence rate of 39.6% (21/53). The 2-year recurrence rates were 42.9% (12/28) and 36.0% (9/25), respectively in the transplantation and non-transplantation groups, and the difference was not statistically significant ( χ2 = 0.26, P = 0.610). The 1-year recurrence rates of patients receiving chidamide maintenance therapy with different international prognostic index (IPI) scores and whether achieving CR before maintenance therapy or not showed statistically significant differences (all P < 0.05); the 2-year recurrence rates of patients receiving chidamide maintenance therapy with different IPI scores, bone involvement or not and whether achieving CR before maintenance therapy or not showed statistically significant differences (all P < 0.05). The 1-year PFS and OS rates were 80.7% and 88.6%, and the 2-year PFS and OS rates were 61.1% and 71.9% in 53 patients. The 1-year PFS rates of patients in the transplantation and non-transplantation groups were 81.1% and 80.2% ( P = 0.774), and the 1-year OS rates were 89.3% and 87.4%, respectively ( P = 0.736). The 2-year PFS rates were 60.4% and 61.3% ( P = 0.440), and the 2-year OS rates were 72.7% and 70.6% ( P = 0.510). No patient discontinued chidamide maintenance therapy due to adverse drug reactions during maintenance therapy; ≥ grade 3 adverse drug reactions included neutropenia (9 cases, 23.1%), anemia (7 cases, 17.9%), thrombocytopenia (6 cases, 16.2%) and electhrolyte disturbance (1 case, 5.3%). The chidamide dosage was adjusted to 20 mg per time due to leucopenia in 7 patients and thrombocytopenia in 3 patients. Conclusions:Maintenance therapy with chidamide can reduce recurrence rate and prolong survival time of TCL patients, and it has a favorable safety.

Objective:We aimed to develop a novel visualized model based on nomogram to predict postoperative overall survival.Methods:This was a multicenter, retrospective, observational cohort study, including participants with histologically confirmed gastric and colorectal cancer who underwent radical surgery from 11 medical centers in China from August 1, 2015 to June 30, 2018. Baseline characteristics, histopathological data and nutritional status, as assessed using Nutrition Risk Screening 2002 (NRS 2002) score and the scored Patient-Generated Subjective Global Assessment, were collected. The least absolute shrinkage and selection operator regression and Cox regression were used to identify variables to be included in the predictive model. Internal and external validations were performed.Results:There were 681 and 127 patients in the training and validation cohorts, respectively. A total of 188 deaths were observed over a median follow-up period of 59 (range: 58 to 60) months. Two independent predictors of NRS 2002 and Tumor-Node-Metastasis (TNM) stage were identified and incorporated into the prediction nomogram model together with the factor of age. The model's concordance index for 1-, 3- and 5-year overall survival was 0.696, 0.724, and 0.738 in the training cohort and 0.801, 0.812, and 0.793 in the validation cohort, respectively.Conclusions:In this study, a new nomogram prediction model based on NRS 2002 score was developed and validated for predicting the overall postoperative survival of patients with gastric colorectal cancer. This model has good differentiation, calibration and clinical practicability in predicting the long-term survival rate of patients with gastrointestinal cancer after radical surgery.

Objective To explore the lipid-lowering effect of Qige Decoction before and after compatibility through the combination of pharmacodynamics and liver metabolomics,and to provide new research strategies for exploring the scientific notation of traditional Chinese medicine compatibility.Methods According to the pharmacodynamic strategy,three groups of drug administration were set up as Qige Decoction group,Astragali Radix-Puerariae Radix group,and Pericarpium Citri Tangerinae group.Four indices of blood lipids,serum biochemical indicators,and liver morphology and pathology were used to evaluate the intervention effect of Qige Decoction on hyperlipidemic rats.Liver metabolomics technology was used to analyze the effects of Qige Decoction on metabolites before and after compatibility,and multivariate statistical analysis was used to evaluate the differences between groups in terms of differential metabolites and metabolic pathways.Results Compared with the model group,the callback abilities of four indices of blood lipid in the Qige Decoction group were higher than those in Astragali Radix-Puerariae Radix group and Pericarpium Citri Tangerinae group,among which the total cholesterol(TC)and triglyceride(TG)levels in the Qige Decoction group decreased(P＜0.05).A total of 86 potential biomarkers were identified by liver metabolomics,with 23,13,and 7 metabolites being significantly different in the Qige Decoction group,Astragali Radix-Puerariae Radix group,and Pericarpium Citri Tangerinae group,respectively(P＜0.05).Metabolic pathway analysis of 29 specific biomarkers with significant callback effects showed that they were related to glycerophospholipid metabolism,linoleic acid metabolism,α-linolenic acid metabolism,sphingolipid metabolism,arachidonic acid metabolism,and unsaturated fatty acid biosynthesis.Qige Decoction mainly regulates glycerophospholipid and linoleic acid metabolism,and uniquely acts on sphingolipid metabolism.Conclusion Qige Decoction has more lipid-lowering targets after compatibility,with better lipid-lowering effects than the Astragali Radix-Puerariae Radix group and Pericarpium Citri Tangerinae group.This study provides experimental evidence and research strategies for further revealing the scientific notation of traditional Chinese medicine compatibility.

OBJECTIVE: To investigate the early effectiveness of transiliac-transsacral screws internal fixation assisted by augmented reality navigation system HoloSight (hereinafter referred to as "computer navigation system") in the treatment of posterior pelvic ring injuries. METHODS: A retrospective analysis was made in the 41 patients with posterior pelvic ring injuries who had been treated surgically with transiliac-transsacral screws between June 2022 and June 2023. The patients were divided into navigation group (18 cases, using computer navigation system to assist screw implantation) and freehand group (23 cases, using C-arm X-ray fluoroscopy to guide screw implantation) according to the different methods of transiliac-transsacral screws placement. There was no significant difference in gender, age, body mass index, causes of injuries, Tile classification of pelvic fracture, days from injury to operation, usage of unlocking closed reduction technique between the two groups ( P>0.05). The time of screw implantation, the fluoroscopy times, the guide wire adjustment times of each screw, and the incidence of complications were recorded and compared between the two groups. The position of the transiliac-transsacral screw was scanned by CT within 2 days after operation, and the position of the screw was classified according to Gras standard. RESULTS: The operation was successfully completed in both groups. The time of screw implantation, the fluoroscopy times, and the guide wire adjustment times of each screw in the navigation group were significantly less than those in the freehand group ( P<0.05). There were 2 cases of incision infection in the freehand group, and the incision healed by first intention after active dressing change; there was no screw-related complication in the navigation group during operation and early period after operation; the difference in incidence of complications between the two groups (8.7% vs. 0) was not significant ( P=0.495). According to the Gras standard, the screw position of the navigation group was significantly better than that of the freehand group ( P<0.05). CONCLUSION Compared with the traditional freehand method, the computer navigation system assisted transiliac-transsacral screws internal fixation in the treatment of posterior pelvic ring injuries has advantages of improving the accuracy of screw implantation and reducing radiation damage and the time of screw implantation.
Humans ; Retrospective Studies ; Surgical Wound Infection ; Replantation ; Body Mass Index

The accurate annotation of transcription start sites(TSSs)and their usage are critical for the mechanistic understanding of gene regulation in different biological contexts.To fulfill this,specific high-throughput experimental technologies have been developed to capture TSSs in a genome-wide manner,and various computational tools have also been developed for in silico pre-diction of TSSs solely based on genomic sequences.Most of these computational tools cast the problem as a binary classification task on a balanced dataset,thus resulting in drastic false positive predictions when applied on the genome scale.Here,we present DeeReCT-TSS,a deep learning-based method that is capable of identifying TSSs across the whole genome based on both DNA sequence and conventional RNA sequencing data.We show that by effectively incorporating these two sources of information,DeeReCT-TSS significantly outperforms other solely sequence-based methods on the precise annotation of TSSs used in different cell types.Furthermore,we develop a meta-learning-based extension for simultaneous TSS annotations on 10 cell types,which enables the identification of cell type-specific TSSs.Finally,we demonstrate the high precision of DeeReCT-TSS on two independent datasets by correlating our predicted TSSs with experimentally defined TSS chromatin states.The source code for DeeReCT-TSS is available at https://github.-com/JoshuaChou2018/DeeReCT-TSS_release and https://ngdc.cncb.ac.cn/biocode/tools/BT007316.

Background: Long non-coding RNA (lncRNA) has been regarded as a new tumor biomarker in recent years, but studies on effect of lncRNA in the pathogenesis of colorectal cancer is limited. Aims: To investigate the relationship between the changes of lncRNA and clinicopathologic features, prognosis of colorectal cancer. Methods: LncRNA related to the prognosis of colorectal cancer patients collected from TCGA data were screened by Cox analysis, and the correlation between lncRNA and clinicopathologic features was analyzed. Colorectal cancer cell line stably low-expressed with LINC00327 was constructed. Real-time quantitative PCR was used to detect gene expression, cell proliferation was measured by CCK-8 assay, and cell invasion was determined by Transwell experiment. Results: There were 94 lncRNA that varied in frequency between 5% and 31%, 7 of which with mRNA expression changes (DSCR4A, DSCR8, FAM138F, LINC00161, LINC00303, LINC00313, LINC00315) were associated with low overall survival rate; 6 of which with copy number alteration (LINC00327, LINC00352, LINC00362, LINC00424, LINC00566, LINC00621) were related to tumor recurrence. The above mentioned mRNA expression change was significantly correlated with age and lymph node metastasis. Copy number alteration was closely correlated with clinical stage and vascular infiltration. The down-regulation of LINC00327 could inhibit the proliferation and invasion of tumor cells. Conclusions: LncRNA that related to the prognosis and clinicopathologic features of colorectal cancer patients can be used for early diagnosis, prediction of progression and analysis of prognosis of colorectal cancer. LINC00327 may be considered as a potential oncogene.

Objective To investigate the effect of lumboperitoneal (L-P) shunt and ventriculoperitoneal(V-P) shunt for trea-ting the patients with communicating hydrocephalus .Methods The databases of PubMed ,Web of Science ,Scopuss ,Karge , EBSCO+MEDLINE ,OVID ,EMBASE ,CNKI ,CBM disc databases ,Wanfang databases ,Weipu databases were retrieved by com-puter .The relevant literatures about L-P shunt and V-P shunt for treating communicating hydrocephalus included in these databases during 1990-2016 were collected and performed the meta analysis by using the STATA 12 .0 software .Results The success rate of L-P shunt in treating communicating hydrocephalus was apparently higher than that of V-P shunt(P<0 .05) .Moreover ,postopera-tive infection rate ,obstruction rate of shunt system and total postoperative complications rate in L-P shunt were apparently lower than those of V-P shunt(P<0 .05) ,However ,there was no statistical difference in shunt poor rate between L-P shunt and V-P shunt(P>0 .05) .Conclusion L-P shunt is worth recommending .But due to lower quality of the evidences ,it is needed more high quality primary studies to remedy the insufficiency of the study .

The purpose of this study was to compare the pharmacokinetic profiles of tetramethylpyrazine phosphate (TMPP) in plasma and extracellular fluid of the cerebral cortex of rats via three delivery routes: intranasal (i.n.), intragastric (i.g.) and intravenous (i.v.) administration. After i.n., i.g. and i.v. administration of a single-dose at 10 mg/kg, cerebral cortex dialysates and plasma samples drawn from the carotid artery were collected at timed intervals. The concentration of TMPP in the samples was analyzed by HPLC. The area under the concentration-time curve (AUC) and the ratio of the AUCbrain to the AUCplasma (drug targeting efficiency, DTE) was calculated to evaluate the brain targeting efficiency of the drug via these different routes of administration. After i.n. administration, TMPP was rapidly absorbed to reach its peak plasma concentration within 5 min and showed a delayed uptake into cerebral cortex (t max=15 min). The ratio of the AUCbrain dialysates value between i.n. route and i.v. injection was 0.68, which was greater than that obtained after i.g. administration (0.43). The systemic bioavailability obtained with i.n. administration was greater than that obtained by the i.g. route (86.33% vs. 50.39%), whereas the DTE of the nasal route was 78.89%, close to that of oral administration (85.69%). These results indicate that TMPP is rapidly absorbed from the nasal mucosa into the systemic circulation, and then crosses the blood-brain barrier (BBB) to reach the cerebral cortex. Intranasal administration of TMPP could be a promising alternative to intravenous and oral approaches.