OBJECTIVE: To explore the feasibility and effectiveness of suture anchor double-pulley technique combined with suture three-dimensional binding via bone tunnel technique for avulsion fractures of the inferior pole of the patella. METHODS: A clinical data of 38 patients with avulsion fractures of the inferior pole of the patella, who met the selective criteria and were admitted between September 2021 and April 2023, was retrospectively analyzed. The fractures were treated with suture anchor double-pulley technique combined with suture three-dimensional binding via bone tunnel technique in 18 cases (group A) and steel wire tension-band fixation in 20 cases (group B). There was no significant difference in terms of age, gender, cause of fracture, side of fracture, and disease duration between the two groups ( P>0.05). The length of incision, operation time, occurrence of complications, the range of motion of knee joint, and Böstman score of knee joint at last follow-up were recorded. The fracture healing was evaluated through X-ray films and the time of fracture healing was recorded. RESULTS: All incisions healed by first intention. The length of incision was significantly shorter in group A than in group B ( P<0.05). There was no significant difference in the operation time between the two groups ( P>0.05). All patients were followed up 12-24 months (mean, 16.1 months). X-ray films showed that all fractures healed and there was no significant difference in the healing time between the two groups ( P>0.05). At last follow-up, the range of motion and Böstman score of the knee joint in group A were significantly better than those in group B ( P<0.05). During follow-up, 1 patient (5.6%) in group A had one anchor mild prolapse and 3 patients (15.0%) occured internal fixation irritation in group B. But there was no significant difference in the incidence of complications between the two groups ( P>0.05). CONCLUSION For the avulsion fractures of the inferior pole of the patella, the suture anchor double-pulley technique combined with suture three-dimensional binding via bone tunnel technique has advantages of reliable fixation, small incision, avoidance of secondary operation to remove internal fixator, and fewer complications, with definite effectiveness.
Humans ; Male ; Female ; Patella/surgery* ; Suture Anchors ; Fracture Fixation, Internal/instrumentation* ; Adult ; Retrospective Studies ; Middle Aged ; Fractures, Avulsion/surgery* ; Treatment Outcome ; Young Adult ; Range of Motion, Articular ; Fracture Healing ; Adolescent ; Suture Techniques ; Knee Joint/physiopathology*

OBJECTIVE: To compare the effectiveness of using a composite loop plate to reconstruct the coracoclavicular ligament around the coracoid process and using a clavicular hook plate for fixation in treatment of Rockwood type Ⅲ acute acromioclavicular joint dislocation. METHODS: A retrospective analysis was conducted on the clinical data of 60 patients with Rockwood type Ⅲ acute acromioclavicular joint dislocation who were admitted between June 2022 and September 2023 and met the selection criteria. Among them, 30 patients were treated with the composite loop plate to reconstruct the coracoclavicular ligament around the coracoid process (loop plate group) and 30 with clavicular hook plate fixation (hook plate group). There was no significant difference in baseline data between the two groups ( P>0.05), including gender, age, injured side, cause of injury, disease duration, preoperative visual analogue scale (VAS) score for pain, and Constant-Murley score. The incision length, operation time, length of hospital stay, and the occurrence of complications during follow-up were recorded. The Constant-Murley score and VAS score were used to evaluate shoulder joint function and pain, and the differences (change values) of the indicators between before operation and at 6 months after operation were calculated for inter-group comparison. In the loop plate group, the coracoclavicular distance (CCD) on the anteroposterior X-ray films of the acromioclavicular joint was measured at 1 day and 6 months after operation to assess the loss of acromioclavicular joint reduction. RESULTS: The incision length of the loop plate group was significantly shorter than that of the hook plate group ( P<0.05). There was no significant difference in the operation time and the length of hospital stay between the two groups ( P>0.05). All incisions healed by first intention after operation. All patients were followed up 12-18 months (mean, 16.3 months). There was no significant difference in the follow-up time between groups ( P>0.05). The Constant-Murley scores and VAS scores of both groups significantly improved at 6 months after operation when compared with those before operation ( P<0.05); the differences in the change values of the two indicators between groups were significant ( P<0.05). The CCD of the loop plate group were (10.40±0.83) mm at 1 day and (10.70±0.68) mm at 6 months and no repositioning loss was observed. Three cases in the hook plate group had residual shoulder joint pain after operation. The difference in the accidence of complications between groups was not significant ( P>0.05). CONCLUSION For Rockwood type Ⅲ acute acromioclavicular joint dislocation, compared with the clavicular hook plate fixation, the composite loop plate for reconstructing the coracoclavicular ligament around the coracoid process has the advantages of simple operation, safety, minimally invasive, good functional recovery, and fewer complications. Moreover, it avoids the need for a second surgery to remove the internal fixation device, and the patient acceptance and satisfaction are higher.
Humans ; Acromioclavicular Joint/surgery* ; Bone Plates ; Male ; Retrospective Studies ; Female ; Adult ; Ligaments, Articular/injuries* ; Joint Dislocations/surgery* ; Coracoid Process/injuries* ; Treatment Outcome ; Middle Aged ; Plastic Surgery Procedures/instrumentation* ; Fracture Fixation, Internal/instrumentation* ; Young Adult ; Clavicle/surgery*

Objective:To analyze the implementation and effectiveness of standardized training for medical aesthetic practitioners in Guangdong province from 2015 to 2023.Methods:Training data from 2015 to 2023 were retrospectively collected from programs organized by the Guangdong Medical Association, including sessions in aesthetic surgery, dermatology, dentistry, traditional Chinese medicine, laser aesthetics, and injectable aesthetics. The training implementation was summarized. A random sample of 120 trainees was selected to complete a questionnaire to assess training outcomes.Results:A total of 45 offline standardized training sessions were held, covering both theoretical and practical instruction. The total training duration reached 180 days, involving 6 776 participant attendances. Aesthetic surgery accounted for the highest number (1 701 attendances), followed by aesthetic dermatology (1 197 attendances). Among specialized technical programs, laser aesthetics (1 708 attendances) and injectable aesthetics (1 578 attendances) had the most participants. Most trainees (5 705 attendances) were physicians from tertiary public general hospitals. A total of 116 questionnaires were collected, with 115 participants expressing satisfaction with the course content, teaching arrangement, and training materials. All trainees passed the skills assessment and received training certificates.Conclusions:The standardized training for medical aesthetic practitioners in Guangdong province from 2015 to 2023 has been well implemented and shows favorable outcomes. It contributes to improving the technical competence of professionals in the medical aesthetics field.

Objective:To analyze the implementation and effectiveness of standardized training for medical aesthetic practitioners in Guangdong province from 2015 to 2023.Methods:Training data from 2015 to 2023 were retrospectively collected from programs organized by the Guangdong Medical Association, including sessions in aesthetic surgery, dermatology, dentistry, traditional Chinese medicine, laser aesthetics, and injectable aesthetics. The training implementation was summarized. A random sample of 120 trainees was selected to complete a questionnaire to assess training outcomes.Results:A total of 45 offline standardized training sessions were held, covering both theoretical and practical instruction. The total training duration reached 180 days, involving 6 776 participant attendances. Aesthetic surgery accounted for the highest number (1 701 attendances), followed by aesthetic dermatology (1 197 attendances). Among specialized technical programs, laser aesthetics (1 708 attendances) and injectable aesthetics (1 578 attendances) had the most participants. Most trainees (5 705 attendances) were physicians from tertiary public general hospitals. A total of 116 questionnaires were collected, with 115 participants expressing satisfaction with the course content, teaching arrangement, and training materials. All trainees passed the skills assessment and received training certificates.Conclusions:The standardized training for medical aesthetic practitioners in Guangdong province from 2015 to 2023 has been well implemented and shows favorable outcomes. It contributes to improving the technical competence of professionals in the medical aesthetics field.

Objective:To investigate the prognosis of patients with initially resectable gastric cancer liver metastasis (GCLM) who were treated by different modalities, and analyze the influencing factors for prognosis of patients.Methods:The retrospective cohort study was conducted. The clinicopathological data of 327 patients with initially resectable GCLM who were included in the database of a nationwide multicenter retrospective cohort study on GCLM based on real-world data from January 2010 to December 2019 were collected. There were 267 males and 60 females, aged 61(54,68)years. According to the specific situations of patients, treatment modalities included radical surgery combined with systemic treatment, palliative surgery combined with systemic treatment, and systemic treatment alone. Observation indicators: (1) clinical characteristics of patients who were treated by different modalities; (2) prognostic outcomes of patients who were treated by different modalities; (3) analysis of influencing factors for prognosis of patients with initially resectable GCLM; (4) screening of potential beneficiaries in patients who were treated by radical surgery plus systemic treatment and patients who were treated by palliative surgery plus systemic treatment. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the independent sample t test. Measurement data with skewed distribution were represented as M( Q1, Q3), and comparison between groups was conducted using the rank sum test. Count data were described as absolute numbers or percentages, and comparison between groups was conducted using the chi-square test. The Kaplan-Meier method was used to calculate survival rate and draw survival curve, and Log-Rank test was used for survival analysis. Univariate and multivariate analyses were conducted using the COX proportional hazard regression model. The propensity score matching was employed by the 1:1 nearest neighbor matching method with a caliper value of 0.1. The forest plots were utilized to evaluate potential benefits of diverse surgical combined with systemic treatments within the population. Results:(1) Clinical characteristics of patients who were treated by different modalities. Of 327 patients, there were 118 cases undergoing radical surgery plus systemic treatment, 164 cases undergoing palliative surgery plus systemic treatment, and 45 cases undergoing systemic treatment alone. There were significant differences in smoking, drinking, site of primary gastric tumor, diameter of primary gastric tumor, site of liver metastasis, and metastatic interval among the three groups of patients ( P<0.05). (2) Prognostic outcomes of patients who were treated by different modalities. The median overall survival time of the 327 pati-ents was 19.9 months (95% confidence interval as 14.9-24.9 months), with 1-, 3-year overall survival rate of 61.3%, 32.7%, respectively. The 1-year overall survival rates of patients undergoing radical surgery plus systemic treatment, palliative surgery plus systemic treatment and systemic treatment alone were 68.3%, 63.1%, 30.6%, and the 3-year overall survival rates were 41.1%, 29.9%, 11.9%, showing a significant difference in overall survival rate among the three groups of patients ( χ2=19.46, P<0.05). Results of further analysis showed that there was a significant difference in overall survival rate between patients undergoing radical surgery plus systemic treatment and patients undergoing systemic treatment alone ( hazard ratio=0.40, 95% confidence interval as 0.26-0.61, P<0.05), between patients undergoing palliative surgery plus systemic treatment and patients under-going systemic treatment alone ( hazard ratio=0.47, 95% confidence interval as 0.32-0.71, P<0.05). (3) Analysis of influencing factors for prognosis of patients with initially resectable GCLM. Results of multivariate analysis showed that the larger primary gastric tumor, poorly differentiated tumor, larger liver metastasis, multiple hepatic metastases were independent risk factors for prognosis of patients with initially resectable GCLM ( hazard ratio=1.20, 1.70, 1.20, 2.06, 95% confidence interval as 1.14-1.27, 1.25-2.31, 1.04-1.42, 1.45-2.92, P<0.05) and immunotherapy or targeted therapy, the treatment modality of radical or palliative surgery plus systemic therapy were independent protective factors for prognosis of patients with initially resectable GCLM ( hazard ratio=0.60, 0.39, 0.46, 95% confidence interval as 0.42-0.87, 0.25-0.60, 0.30-0.70, P<0.05). (4) Screening of potentinal beneficiaries in patients who were treated by radical surgery plus systemic treatment and patients who were treated by palliative surgery plus systemic treatment. Results of forest plots analysis showed that for patients with high-moderate differentiated GCLM and patients with liver metastasis located in the left liver, the overall survival rate of patients undergoing radical surgery plus systemic treatment was better than patients undergoing palliative surgery plus systemic treatment ( hazard ratio=0.21, 0.42, 95% confidence interval as 0.09-0.48, 0.23-0.78, P<0.05). Conclusions:Compared to systemic therapy alone, both radical and palliative surgery plus systemic therapy can improve the pro-gnosis of patients with initially resectable GCLM. The larger primary gastric tumor, poorly differen-tiated tumor, larger liver metastasis, multiple hepatic metastases are independent risk factors for prognosis of patients with initial resectable GCLM and immunotherapy or targeted therapy, the treatment modality of radical or palliative surgery plus systemic therapy are independent protective factors for prognosis of patients with initially resectable GCLM.

OBJECTIVE To optimize the extraction process and to primarily evaluate the anti-anxiety and anti-depression efficacy of polysaccharide from Baihe dihuang decoction. METHODS Based on Plackett-Burman experimental design， using the comprehensive score of yield and content of polysaccharide as indicators， with extraction time， water amount， alcohol precipitation concentration as factors， Box-Behnken response surface methodology was used to optimize the extraction process of polysaccharide from Baihe dihuang decoction； and the validation test was conducted. Forty ICR mice were divided into control group， venlafaxine group [positive control， 13.5 mg/（kg·d）]， Baihe dihuang polysaccharide high-dose and low-dose groups [5.28， 2.64 g/（kg·d），by raw material]， with 10 mice in each group （half male and half female）. Administration groups were given corresponding drug solution intragastrically， and control group was given water 10 mL/kg intragastrically， once a day， for 7 test， forced swimming test and tail suspension test were used to evaluate the effects of the extract prepared by the optimal process on the anxiety-like and depression-like behavior of mice； enzyme-linked immunosorbent assay was used to detect the effects of the extract on the levels of neurotransmitter in cerebral tissue of mice. RESULTS The optimal extraction process of Baihe dihuang decoction was： the water amount of 25 times， extract time of 1.5 hours， and alcohol precipitation concentration of 70%. In 3 times of validation test， the average yield and content of polysaccharide were 33.10% and 0.62 mg/mg， the relative deviations of which from the predicted values （36.14% and 0.65 mg/mg） were 8.40% and 4.62% respectively （RSD＜2%， n＝3）. The polysaccharide extract of Baihe dihuang decoction could effectively increase the percentages of open-arms entry， the percentages of open-arms time， the total distance of voluntary activities and the activity distance in central area， and significantly shortened the immobility time of forced swimming test and tail suspension test （P＜0.05 or P＜0.01）. The polysaccharide extract could significantly increase the levels of 5-hydroxytryptamine， norepinephrine （except for the Baihe dihuang polysaccharide low-dose group） and gamma-aminobutyric acid in cerebral tissue of mice， while significantly decrease the levels of glutamic acid （except for the Baihe dihuang polysaccharide low-dose group） （P＜0.05 or P＜ 0.01）. CONCLUSIONS The optimized extraction process of polysaccharide from Baihe dihuang decoction is stable and feasible， and the obtained polysaccharide extract has obvious anti-anxiety and anti-depression effect in vivo.

OBJECTIVE To investigate the mechanism of Fuke duanhongyin capsule in improving dysfunctional uterine bleeding （DUB） in rats. METHODS Pregnant SD rats were randomly divided into blank control group （distilled water）， model control group （distilled water） and Fuke duanghongyin capsule group （1.296 g/kg）， with 6 rats in each group. Except for blank control group， DUB model was established in other groups. After modeling， they were given relevant medicine/distilled water 10 mL/kg intragastrically， once a day， for consecutive 14 d. After medication， uterine index， ovary index and hemorheology indexes （whole blood high shear relative index， whole blood low shear relative index， erythrocyte aggregation index， Carson viscosity） of rats were all determined. The pathological changes of uterus and ovary tissues were observed； mRNA relative expression levels of epidermal growth factor （EGF）， hypoxia-inducible factor 1α （HIF-1α）， epidermal growth factor receptor （EGFR） and serine/ threonine-protein kinase 1（AKT1）， and protein relative expression levels of EGF and EGFR in uterine tissue were all measured. RESULTS Compared with model control group， the uterine index， ovary index， erythrocyte aggregation index were all decreased significantly in Fuke duanghongyin capsule group （P＜0.05 or P＜0.01）； whole blood high shear relative indexes， mRNA relative expression levels of EGF， HIF-1α and EGFR and protein relative expression levels of EGF and EGFR in uterine tissue were all increased significantly （P＜0.05 or P＜0.01）. The pathological changes of ovary and uterus were improved. CONCLUSIONS Fuke duanhongyin capsule can improve DUB in rat， the mechanism of which may be related to the activation of EGF-EGFR signaling pathway.

Objective:To analyze the prognosis-related factors of patients with surgical treatment of lung cancer brain metastases.Methods:From January 2016 to November 2018, the clinical data of the patients with lung cancer brain metastases received surgical treatment in Department of Neurosurgery, Cancer Hospital of Chinese Academy of Medical Sciences and Peking Union Medical College were retrospectively collected, and completed data of 83 patients were obtained. The single factor analysis was based on the log-rank method, and the multi-factor analysis was used by the Cox proportional hazard model, and the R software was used to map the influencing factors into the nomogram and verify them.Results:The median overall survival (OS) of 83 patients was 27.0 months. The median OS of patients with surgery alone was 15.7 months, the median OS of patients with surgery combined with radiotherapy, chemotherapy or targeted therapy was 27.7 months, and the difference was statistically significant ( χ2=8.735, P=0.003). The results of single factor analysis showed that gender ( χ2=4.652, P=0.031), smoking history ( χ2=8.239, P=0.004), postoperative targeted treatment ( χ2=13.697, P<0.001), postoperative adjuvant therapy ( χ2=8.735, P=0.003), pathology of metastatic tumor ( χ2=11.799, P=0.001), and lung cancer molecular graded prognostic assessment (Lung-molGPA) sore ( χ2=11.333, P=0.004) affected patients′ OS. The results of multivariate analysis showed that smoking history ( HR=0.311, 95% CI: 0.107-0.901, P=0.031), postoperative targeted therapy ( HR=3.563, 95% CI: 1.286-9.868, P=0.015), pathology of metastatic tumor ( HR=0.364, 95% CI: 0.137-0.965, P=0.042), Lung-molGPA score ( HR=0.595, 95% CI: 0.374-0.946, P=0.028) were independent prognostic factors for OS of patients with lung cancer brain metastases. In order to further evaluate the prognosis of patients, nomogram was drawn using these four independent prognostic factors. The model had high accuracy and could better evaluate the prognosis of patients. Conclusion:Lung cancer brain metastases patients with operative indication can benefit from surgery, and active adjuvant therapy after operation can further prolong the OS of patients. The nomogram constructed by smoking, targeted therapy, pathology of metastatic tumor and Lung-molGPA score can be used to evaluate individual patient outcomes and guide clinical treatment.

Objective To explore the CT and MR features of malignant peripheral nerve sheath tumor (MPNST) of adults.Methods The CT and MRI findings of 20 patients of MPNST confirmed by pathology were analyzed retrospectively.Results Among 20 cases,the lesions were located in the lower extremities (n=4),shoulder and spine (n=4),abdomen (n=3),chest wall (n=2),mediastinum (n=2),breast (n=1),prostate (n=1),scrotum (n=1),scalp (n=1),left maxillary sinus and orbital bottom (n=1).Nineteen cases appeared as solid masses and 1 case appeared as diffuse lesion.The maximum cross section of the lesions were about 1.41 cm× 1.42 cm-17.10 cm× 18.08 cm.Sixteen cases were ill defined margin and 4 cases were well-defined margin.CT scan showed 14 cases were lower density or isodensity and with patchy inhomogeneous density.Multiple calcification were found in 2 cases and osteolytic destruction were found in 7 cases.Enhanced CT of 10 cases showed solid component and gradually delayed enhancement,while cystic lesion and necrosis were not enhancement.The tortuous arteries were displayed in 7 cases.Seven cases were performed MRI and the lesions appeared as hypo-intensity on T1WI and hypo-intensity on T2WI with obviously high intensity of cystic component.Enhanced MRI of 3 cases showed significantly heterogeneous enhancement,cyst and necrosis had no enhancement.MR dynamic enhancement of 1 case showed time-signal intensity curve was platform type.DWI showed high signal.Conclusion MPNST has certain CT and MR characteristics which are helpful to improve the diagnostic accuracy.

Objective Sodium-bile acid cotransporter plays an important role in the development of Echinococcus.The present study aimed to clone sodium bile acid cotransporter gene in Echinococcus multilocularis (EmSBACT5) and to analyze the bioinformatics of its coding protein.Methods EmSBACT5 gene was amplified by reverse transcription RCR (RT-PCR) technology and its nucleotide sequence was sequenced.Bioinformatics softwares were used to predict and analyze the physical and chemical properties, hydrophilicity/hydrophobicity, transmembrane domain, post-translational modification sites, structural domain, secondary structure, tertiary structure, subcellular localization and biological functions of the coding protein.Results The complete open reading frame was amplified with 654 bp in length, encoding 217 amino acids.The homology of the nucleic acid sequence and amino acid sequence of EmSBACT5 gene were 98% and 96% with the published SBACT5 in Echinococcus granulosus (EgSBACT5) respectively.Protein analysis results showed that the molecular formula of EmSBACT5 protein was C1141H1797N273O284S11.Its relative molecular mass was 24240 and isoelectric point was 8.99.There were 9 post-translational modification sites and 4 typical domains.Alpha helical, β-sheet, β-turn and random coil accounted for 29.95%, 31.80%, 7.83% and 30.41%, respectively.This protein was a hydrophobic membrane protein and was mainly located in the cytoplasmic membrane, and it might play a role in the processes of material transport and signal transmission.Conclusion The EmSBACT5 gene was cloned successfully and the informatics characteristics of its coding protein were obtained, which provides basic information for prevention and control of echinococcosis.