OBJECTIVE: To investigate the effectiveness of Youngswick-Akin osteotomy in the treatment of moderate hallux valgus combined with mild to moderate hallux rigidus. METHODS: The clinical data of 43 patients with moderate hallux valgus combined with mild to moderate hallux rigidus who were admitted between August 2019 and August 2022 and met the selection criteria were retrospectively analyzed. There were 8 males and 35 females. The age ranged from 28 to 77 years, with an average age of 59.0 years. The disease duration ranged from 10 to 35 months, with an average of 20 months. The degree of hallux rigidus included 2 cases of CoughlinⅠ degree, 29 cases of Ⅱ degree, 12 cases of Ⅲ degree. The preoperative hallux valgus angle ranged from 25° to 40°, with an average of 32°. All patients were treated with Youngswick-Akin osteotomy. The first metatarsophalangeal joint space was compared before operation and at 6 months after operation. The American Orthopaedic Foot and Ankle Society (AOFAS) score and visual analogue scale (VAS) score were used to evaluate the functional recovery and pain relief of the patients before operation and at 6 and 24 months after operation. According to the severity of hallux rigidus, the patients were divided into mild group (Ⅰ, Ⅱ degree) and moderate group (Ⅲ degree) to compare the prognosis, including the changes of AOFAS score, VAS score, and the first metatarsophalangeal joint space. RESULTS: The operation time was 60-75 minutes (mean, 65 minutes). The intraoperative blood loss was 10-30 mL (mean, 20 mL). Two cases had superficial infection of the incision margin after operation, and healed well after dressing change and antibiotic treatment. The incisions of the other patients healed by first intention, and no medial cutaneous nerve injury of the great toe occurred. All patients were followed up 24-31 months, with an average of 25.8 months. The patient's hallux valgus deformity was corrected without recurrence; no complication such as osteomyelitis and hallux varus occurred. The AOFAS score, VAS score, and the first metatarsophalangeal joint space after operation significantly improved when compared with those before operation, the AOFAS score and VAS score at 24 months after operation further improved when compared with those at 6 months after operation, and the differences were significant ( P<0.05). The change of VAS score in mild group was significantly better than that in moderate group ( P<0.05); but there was no significant difference in the changes of AOFAS score and the first metatarsophalangeal joint space between the two groups ( P>0.05). CONCLUSION Youngswick-Akin osteotomy for moderate valgus deformity with mild to moderate hallux rigidus can achieve good functional recovery, pain relief, and joint space improvement.
Humans ; Osteotomy/methods* ; Hallux Valgus/diagnostic imaging* ; Male ; Female ; Middle Aged ; Hallux Rigidus/diagnostic imaging* ; Retrospective Studies ; Adult ; Aged ; Treatment Outcome ; Metatarsophalangeal Joint/surgery*

High-voltage pulsed electric field(HV-PEF)ablation technology has demonstrated promising applications in the clinical treatment of chronic obstructive pulmonary disease(COPD).However,its use has been limited to exploratory applications in a small number of cases,and the underlying mechanisms remain largely undefined.To facilitate broader clinical implementation,comprehensive molecular mechanism studies via extensive animal experimentation are essential.Rats,due to their ease of modeling COPD and the availability of comprehensive molecular reagents,serve as an optimal model for such studies.Consequently,the development of electrodes specifically designed for HV-PEF respiratory ablation in SD rats is of significant importance.In this study,we meticulously examined the anatomical structure of rat airways and investigated various equipment parameters,including material composition,rigidity,diameter,electrode ring dimensions,spacing between positive and negative poles,insulation coating for the catheters,welding techniques between the guidewire and electrode ring,and the design of vent holes in the catheter.Based on these considerations,we fabricated PVC ablation electrode catheters with integrated ventilation functionality.Subsequently,we employed finite element simulation to estimate the field strengths that could be applied by these electrodes.The simulation results were then validated in normal rats to assess the electrical safety and efficacy of the electrodes.These findings laid the groundwork for further investigation into the mechanisms of HV-PEF treatment for COPD.

Objective:To investigate the protective role of extracellular signal-regulated kinase (ERK) signaling pathway in the process that vasonatrin peptide (VNP) reduces hepatic ischemia-reperfusion injury in rats.Methods:Twenty SD rats, weighting 200-250 g, were randomly divided into four groups and each group has five rats. The four groups were sham operation group (S group), ischemia-reperfusion group (I/R group), VNP group (V group) and PD98059+ VNP group (P+ V group). In the rat model of hepatic warm ischemia and reperfusion, the hepatic artery and portal vein of the left lobe and middle lobe of the liver were clamped with arterial clamp for 45 min followed by reperfusion for 120 min. In the V group, VNP (50 μg/kg) was injected 10 minutes before ischemia. In the P+ V group, PD98059 (2 mg/kg) was injected 20 min before VNP injection followed by VNP administration and I/R treatment. The serum levels of alanine amino transaminase (ALT), aspartate amino transferase (AST), tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β) and the superoxide dismutase (SOD) in liver tissue homogenate and malondialdehyde (MDA) were measured. The histopathology of liver tissue was observed. The contents of p-ERK1/2 were detected by Western blot.Results:Compared with S group, in I/R group and P+ V group the serum levels of ALT [(489.65±11.22), (333.05±24.77) vs. (33.78±4.88) U/L], AST [(651.43±14.99), (503.18±21.48) vs. (154.84±12.32) U/L], TNF-α [(12.83±1.09), (9.64±0.57) vs. (2.11±0.11) ng/L], IL-1β [(7.19±0.62), (5.12±0.22) vs. (1.10±0.49) ng/L], MDA [(8.00±0.88), (5.60±1.01) vs. (2.76±1.29) μmol/mg] increased, while SOD [(54.89±10.60), (68.85±8.33) vs. (126.10±15.63) nmol/mg]decreased (all P<0.05). The histopathology of liver tissue revealed that liver structure damaged more seriously in I/R group and P+ V group. Western blot analysis showed that p-ERK1/2 decreased significantly in I/R group and P+ V group. Compared with I/R group, ALT, AST, MDA, TNF-α and IL-1β decreased significantly and SOD increased significantly in V group (all P<0.05). The histopathology of liver tissue revealed that liver structure was damaged slightly, and p-ERK1/2 increased significantly in V group compared with I/R group ( P<0.05). Conclusion:VNP can significantly reduce hepatic ischemia-reperfusion injury through activation of p-ERK1/2 signaling pathway and inhibition of hepatocyte inflammatory response.

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

Objective:To observe the clinical efficacy of secukinumab in the treatment of active psoriatic arthritis (PsA).Methods:Thirty active PsA patients in the out-patient clinic of the First Affiliated Hospital of the PLA Air Force Military Medical University between July 2020 to December 2021 were included in this study. Patients were categorized into one group with axial involvement ( n=17, 57%) and the other group with peripheral joint involvement ( n=13, 43%) according to arthritis subtypes. Patients in both groups received a subcutaneous injection of 300 mg of secukinumab at 0, 1, 2, 3, and 4 weeks, and then every 4 weeks. The CRP, ESR, VAS pain score (VAS-pain, 0~10 cm), physician comprehensive assessment of disease activity by VAS score (VAS-gh, 0~10 cm), psoriasis involvement area and severity index (PASI), skin quality of life index (DLQI), psoriatic arthritis disease activity index (DAPSA), psoriatic arthritis activity score (PASDAS), Bath ankylosing spondylitis activity index (BASDAI) were recorded at week 0, week 12, and week 24. DAP-SA response (score ≤4) and minimum disease activity (MDA) were also used to assess the proportion of overall patients who responded to secukinumab treatment. The measurement data with normal distribution were analyzed by repeated measure analysis of variance. Non-normally distributed data were expressed as median (IQR). Count data were expressed as frequency and percentage (%) and analyzed by Fisher exact probability method. Results:The mean duration of skin disease in both axial involvement and peripheral joint involvement groups was (14±8)years and (12±7)years ( t=0.70, P=0.256), respectively. The mean duration of arthritis symptoms in both groups was (3.2±3.7)years and (1.8±2.1)years ( t=1.17, P=0.125), respectively. All patients completed 24 weeks of secukinumab treatment. At 24 weeks, VAS-pain, VAS-gh, PASI, DLQI, DAPSA, PASDAS and BASDAI were all decreased significantly ( P<0.05). Patients with axial involvement seemed more likely to benefit in CRP [2.4 (1.7, 3.5) mg/L vs 8.0 (5.3, 14.0) mg/L, Z=-2.69, P=0.007] and VAS-pain[1.0 (0, 2.0) vs (5.0, 6.0), Z=-3.47, P<0.001]improvement ( P<0.005). Both groups achieved PASI 100, which meant achieving clearance of skin dis-ease. The DAPSA remission rate and MDA of the patients with axial involvement were 88% and 82%, re-spectively, and the DAPSA remission rate and MDA were 92% and 92%, respectively. Secukinumab was found to be safe and well tolerated with no adverse event reported or observed during 24-week treatment. Conclusion:In real-world observations, secukinumab is proven to be safe and effective for the treatment of PsA, with rapid relieving of skin and joint symptoms and reduction of disease activity. Patients with axial involvement may benefit more notably than patients with peripheral arthritis subtype.

OBJECTIVE: In the context of coronavirus disease 2019 (COVID-19) pandemic, the subject was designed to develop a new tracheal intubation device based on magnetic navigation technology to improve the success rate of tracheal intubation and reduce the risk of occupational exposure of medical staff. METHODS: The new tracheal intubation device was designed with the uniqueness of the magnetic field environment and magnetic steering of magnetic navigation technology. And preliminary magnetic navigation tracheal intubation experiments were performed on the tracheal intubation simulator. RESULTS: Magnetic navigation tracheal intubation can successfully implement tracheal intubation, and the time required is lower than that of traditional laryngoscopy. CONCLUSIONS The tracheal intubation based on magnetic navigation technology is feasible, with high efficiency and easy operation. That is expected to be widely used for tracheal intubation during treatment of patients outside the hospital in the future. At the same time, magnetic navigation endotracheal intubation technology will be the key technology for the development of endotracheal intubation robots.
COVID-19/therapy* ; Equipment Design ; Feasibility Studies ; Humans ; Intubation, Intratracheal ; Magnetic Phenomena ; SARS-CoV-2 ; Technology

Objective:To investigate the clinical efficacy of endoscopic magnetic compression bilio-enteric anastomosis for the treatment of biliary obstruction after complex abdominal surgery.Methods:The retrospective and descriptive study was conducted. The clinical data of 3 patients with biliary obstruction after complex abdominal surgery who were admitted to the First Affiliated Hospital of Xi′an Jiaotong University between January 2012 and December 2019 were collected. There were 2 males and 1 female, aged from 27 to 57 years, with a median age of 56 years. The 3 patients underwent endoscopic magnetic compression bilio-enteric anastomosis to complete internal drainage of bile ducts after several unsuccessful endoscopic or interventional therapy. Observation indicators: (1) surgical situations; (2) postoperative situations; (3) follow-up. Follow up using outpatient examination was performed to detect the biliary stent, liver function and patency of anastomotic stoma up to December 2019.Results:(1) Surgical situations: all the 3 patients underwent successful endoscopic magnetic compression bilio-enteric anastomosis, including 2 cases with magnetic compression choledochoduodenal anastomosis and 1 case with magnetic compression choledochojejunostomy. The length of biliary stricture, length and width of magnetic device subsidiary magnet/patent magnet, time of magnetic compression for the 3 patients were 7.1 mm, 3.0 mm, 2.0 mm, 7 mm/8 mm, 6 mm/6 mm, 5 mm/5 mm, 130 minutes, 90 minutes, 75 minutes, respectively. (2) Postoperative situations: the time to biliary tract recanalization after operation for the 3 patients were 15 days, 8 days, 9 days, respectively. None of the patients encountered gastrointestinal perforation, hemorrhage or infection. (3) Follow-up: the biliary stents were inserted into the anastomotic stoma for the 3 patients after biliary tract recanalization, including a catheter of percutaneous transhepatic cholangiodrainage (PTCD) with 12 Fr size, a biliary plastic stent with 7 Fr size, a catheter of PTCD with 14 Fr size, respectively. The biliary stents were removed after 17 months, 2 months, and 6 months from the 3 patients, respectively. The 3 patients were followed up for 40 months, 20 months, and 5 months respectively after removing biliary stents, and the concentration of total bilirubin, concentration of aspartate aminotransferase, concentration of alanine aminotransferase for the 3 patients were 5-19 μmol/L, 25-40 U/L, and 20-35 U/L, respectively. The results of ultrasonic examination or magnetic resonance cholangiopancreatography examination showed that no intra-hepatic bile duct dilation or stricture of choledochojejunostomy was found within the 3 patients. One of the 3 patients was hospitalized for biliary tract infection after 37 months from removing biliary stents, and the results of ultrasonic examination or magnetic resonance cholangiopancreatography examination showed intrahepatic cholelithiasis. The cholelithiasis was removed under endoscopy and stricture of choledochojejunostomy was not found within patient by the endoscopic examination or cholangiography examination.Conclusion:The endoscopic magnetic compression bilio-enteric anastomosis is a safe and feasible technique for the treatment of biliary obstruction after complex abdominal surgery with good long-term effects.

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 health status of occupational mercury workers and reveal the effects of mercury exposure on the cardiovascular system. Methods: In June 2019, a total of 2651 mercury workers participated in the occupational health examination between 2016-2018 from a thermometer manufacturing plant and a fluorescent lamp manufacturing plant were included in this study. Then, they were divided into a high-level mercury exposure group (425 workers whose urine mercury concentration >35 μg/g creatinine) and a low-mercury mercury exposure group (2226 workers whose urinary mercury concentration <35 μg/g creatinine) . Mercury concentration in the workplace was also detected. Finally, the results of electrocardiogram (ECG) , blood routine, blood biochemistry and other physical examinations were analyzed. The measurement data of age and exposure years were analyzed by test. Urinary mercury and blood parameters were analyzed by Mann-Whitney nonparametric test. Chi-square test was used for the analyses of gender, ECG abnormality rate and other categorical data. Results: The 8-hour weighted average allowable concentration (CTWA) of mercury in the workplace of high-exposure group was 0.002 2-0.152 mg/m³. The abnormal rate of ECG in the high-exposed group (29.6%) was higher than that in the low-exposure group (10.1%) in 2018 (P<0.01) . Compared with the low-exposure group, the WBC of the high-exposure group from 2016 to 2018 was increased, with statistically significance (P<0.05) ; the RBC of the high-exposure group in 2016 and 2017 was decreased, with statistically significance (P<0.01) ; the total bilirubin concentration in the high-exposure group was decreased from 2016 to 2018, with statistically significance (P<0.05) . Conclusion Long-term exposure to high concentration of mercury in the workplace may influence cardiovascular system. Therefore, engineering protection and individual protection should be implemented well.

Objective To investigate the relationship between Toxoplasma gondii (T.gondii) infection and metabolic syndrome (MS).Methods A total of 20 577 patients who received serum test of anti-T.gondii IgG antibody in the National Health and Nutrition Examination Survey ( NHANES) of the United States from 2009 to 2014 were collected to analyze the clinical features of anti-T.gondii IgG antibody positive patients , and to compare metabolic related indicators in the antibody IgG positive and negative groups .The independent sample t-test, chi-square test, and logistic regression analysis were used to explore the risk factors of MS . Results A total of 2 746 participants were positive for the T.gondii antibody (13.34%), with a higher prevalence of male (14.44%vs 12.27%, χ2 ＝15.99, P＜0.01).Meanwhile, the prevalence of T.gondii increased with age and body mass index (BMI) (χ2 ＝979.98 and 50.85,respectively, both P＜0.01).Among the 2 191 patients with MS, 449 (20.49%) patients were positive for T.gondii.While 2 297 (12.49%) patients were anti-T.gondii positive in 18 386 non-MS patients.The difference was statistically significant (χ2 ＝78.504, P＜0.01).Age (t＝-37.37), BMI (t＝-4.28), glycosylated hemoglobin (t＝-11.81), fasting blood glucose (t＝-9.38), triacylglycerol (t＝-6.32), cholesterol (t＝-7.16), serum uric acid (t＝-5.25) and serum creatinine (t＝-7.69) in the seropositive group were all higher than those in the seronegative group (all P＜0.01).After adjusting for age and gender , the prevalence of T.gondii was an independent risk factor for MS (odds ratio [OR]＝1.147,P＝0.023).Conclusions BMI, blood lipids, blood uric acid and blood glucose are significantly increased in patients with T.gondii infection.T.gondii infection is an independent risk factor for MS.