1.Staged Characteristics of Mitochondrial Energy Metabolism in Chronic Heart Failure with Heart-Yang Deficiency Syndrome and Prescription Intervention from Theory of Reinforcing Yang
Zizheng WU ; Xing CHEN ; Lichong MENG ; Yao ZHANG ; Peng LUO ; Jiahao YE ; Kun LIAN ; Siyuan HU ; Zhixi HU
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(5):129-138
Chronic heart failure (CHF) is a complex clinical syndrome caused by ventricular dysfunction, with mitochondrial energy metabolism disorder being a critical factor in disease progression. Heart-Yang deficiency syndrome, as the core pathogenesis of CHF, persists throughout the disease course. Insufficiency of heart-Yang leads to weakened warming and propelling functions, resulting in the accumulation of phlegm-fluid, blood stasis, and dampness. This eventually causes Qi stagnation with phlegm obstruction and blood stasis with water retention, forming a vicious cycle that exacerbates disease progression. According to the theory of reinforcing Yang, the clinical experience of the traditional Chinese medicine (TCM) master Tang Zuxuan in treating CHF with heart-Yang deficiency syndrome, and achievements from molecular biological studies, this study innovatively proposes an integrated research framework of "TCM syndrome differentiation and staging-mitochondrial metabolism mechanisms-intervention with Yang-reinforcing prescriptions" which is characterized by the integration of traditional Chinese and Western medicine. Heart-Yang deficiency syndrome is classified into mild (Stage Ⅰ-Ⅱ), severe (Stage Ⅲ), and critical (Stage Ⅳ) stages. The study elucidates the precise correlations between the pathogenesis of each stage and mitochondrial metabolism disorders from theoretical, pathophysiological, and therapeutic perspectives. The mild stage is characterized by impaired biogenesis and substrate-utilization imbalance, corresponding to heart-Yang deficiency and phlegm-fluid aggregation. Linggui Zhugantang and similar prescriptions can significantly improve the expression of peroxisome proliferator-activated receptor gamma co-activator-1α(PGC-1α)/silent information regulator 2 homolog 1 (SIRT1) and ATPase activity. The severe stage centers on oxidative stress and structural damage, reflecting Yang deficiency with water overflow and phlegm-blood stasis intermingling. At this stage, Zhenwu Tang and Qiangxin Tang can effectively mitigate oxidative stress damage, increase adenosine triphosphate (ATP) content, and repair mitochondrial structure. The critical stage arises from calcium overload and mitochondrial disintegration, leading to the collapse of Yin-Yang equilibrium. At this stage, Yang-restoring and crisis-resolving prescriptions such as Fuling Sini Tang and Qili Qiangxin capsules can inhibit abnormal opening of the mitochondrial permeability transition pore (MPTP), reduce cardiomyocyte apoptosis rate, and protect mitochondrial function. By summarizing the characteristics of mitochondrial energy metabolism disorders at different stages of CHF, this study explores the application of the theory of reinforcing Yang in treating heart-Yang deficiency syndrome and provides new insights for the clinical diagnosis and treatment of CHF.
2.Danhong Injection Regulates Ventricular Remodeling in Rat Model of Chronic Heart Failure with Heart-Blood Stasis Syndrome via p38 MAPK/NF-κB Signaling Pathway
Zizheng WU ; Xing CHEN ; Jiahao YE ; Lichong MENG ; Yao ZHANG ; Junyu ZHANG ; Zhixi HU
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(5):149-159
ObjectiveTo explore the mechanism of ventricular remodeling mediated by the p38 mitogen-activated protein kinase (MAPK)/nuclear factor kappa B (NF-κB) signaling pathway in the rat model of chronic heart failure (CHF) with heart-blood stasis syndrome, as well as the intervention effect of Danhong injection. MethodsIn vivo experiment: SPF-grade male SD rats were assigned via the random number table method into 4 groups: Sham operation, model, captopril (8.8 mg·kg-1), and Danhong injection (6.0 mL·kg-1). The model of CHF with heart-blood stasis syndrome was established by abdominal aortic constriction, and the sham operation group only underwent laparotomy without constriction. All the groups were treated continuously for 15 days. The tongue color of rats was observed. Echocardiography, hemorheology, heart mass index (HMI), and left ventricular mass index (LVMI) were measured. Hematoxylin-eosin (HE) staining and Masson staining were performed to observe the pathological and fibrotic changes of the myocardial tissue. Enzyme-linked immunosorbent assay (ELISA) was employed to quantify the levels of N-terminal pro-B-type natriuretic peptide (NT-proBNP), interleukin-6 (IL-6), angiotensin Ⅱ (AngⅡ), tumor necrosis factor-α (TNF-α), and Creactive protein (CRP) in the serum, as well as the levels of matrix metalloproteinase-2 (MMP-2) and matrix metalloproteinase-9 (MMP-9) in the myocardial tissue. Western blot was used to quantify the protein levels of p-p38 MAPK/p38 MAPK and p-NF-κB p65/NF-κB p65 in the myocardial tissue. In vitro experiment: H9C2 cardiomyocytes were treated with 1×10-6 mol·L-1 AngⅡ to establish a model of myocardial hypertrophy. H9C2 cardiomyocytes were allocated into normal, model, inhibitor + Danhong injection, Danhong injection (20 mL·L-1), and inhibitor (SB203580, 5 μmol·L-1) groups. CCK-8 assay was used to detect the viability of H9C2 cardiomyocytes. Rhodamine-labeled phalloidin staining was used to reveal the area of cardiomyocytes. Real-time PCR was performed to determine the mRNA levels of atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP). Western blot was used to assess the protein levels of p-p38 MAPK/p38 MAPK and p-NF-κB p65/NF-κB p65. ResultsIn vivo experiment: Compared with the sham operation group, the model group showed purplish-dark tongue with decreased R, G, B values of the tongue surface (P<0.01), increased whole blood viscosity (at low, medium, and high shear rates) (P<0.01), decreased left ventricular ejection fraction (LVEF) and left ventricular fractional shortening (LVFS) (P<0.01), increased left ventricular end-diastolic diameter (LVIDd), left ventricular end-systolic diameter (LVIDs), and left ventricular posterior wall thickness at end-diastole (LVPWd) (P<0.01), raised LVMI and HMI (P<0.01), and elevated levels of NT-proBNP, TNF-α, IL-6, and CRP in the serum and MMP-2 and MMP-9 in the myocardial tissue (P<0.01). The HE and Masson staining of the myocardial tissue showed compensatory myocardial hypertrophy, fibrosis, and massive inflammatory cell infiltration in the model group. Additionally, the model group presented up-regulated protein levels of p-p38 MAPK/p38 MAPK and p-NF-κB p65/NF-κB p65 in the myocardial tissue (P<0.01). Compared with the model group, each administration group showed increased R, G, B values of the tongue surface (P<0.05, P<0.01), decreased whole blood viscosity (at low, medium, and high shear rates) (P<0.05, P<0.01), increased LVEF and LVFS (P<0.01), decreased LVIDd, LVIDs, and LVPWd (P<0.05, P<0.01), declined LVMI and HMI (P<0.05, P<0.01), and lowered levels of NT-proBNP, TNF-α, IL-6, and CRP in the serum and MMP-2 and MMP-9 in the myocardial tissue (P<0.01). HE and Masson staining showed alleviated compensatory myocardial hypertrophy, reduced fibrosis, and decreased expression of p-p38 MAPK/p38 MAPK and p-NF-κB p65/NF-κB p65 in the myocardial tissue (P<0.01). In vitro experiment: When the concentration of Danhong injection reached 20 mL·L-1, the survival rate of H9C2 cardiomyocytes was the highest (P<0.01). Compared with the normal group, the model group showed up-regulated mRNA levels of ANP and BNP (P<0.01), increased relative cell surface area (P<0.01), and raised protein levels of p-p38 MAPK/p38 MAPK and p-NF-κB p65/NF-κB p65 (P<0.01). Compared with the model group, each administration group showed down-regulated mRNA levels of ANP and BNP (P<0.01), reduced relative cell surface area (P<0.05, P<0.01), and down-regulated protein levels of p-p38 MAPK/p38 MAPK and p-NF-κB p65/NF-κB p65 (P<0.05, P<0.01). ConclusionDanhong injection can regulate ventricular remodeling through the p38 MAPK/NF-κB pathway, thereby exerting a protective effect on the rat model of CHF with heart-blood stasis syndrome.
3.Effectiveness of Traditional Chinese Medicine Chronic Disease Management Programme after Colorectal Polyp Surgery:A Retrospective Cohort Study
Jiahao MO ; Yi CHENG ; Chang LIU ; Peixin HU ; Cailing ZHONG ; Beiping ZHANG
Journal of Traditional Chinese Medicine 2025;66(12):1241-1248
ObjectiveTo explore the effectiveness of traditional Chinese medicine (TCM) chronic disease management programme in preventing postoperative recurrence of colorectal polyps. MethodsThe clinical data of 447 postoperative colorectal polyp patients were retrospectively collected, and the patients were divided into an exposure group and a control group taking the acceptance of TCM chronic disease management programme as exposure factor, and the polyp recurrence rate as the main outcome indicator, comparing the differences in baseline characteristics, outcome events, and safety assessment between the two groups, and conducting correlation analysis between the length of medication and polyp recurrence. Multifactorial logistic regression was used to analyse the effects of receiving the TCM chronic disease management programme (TCM treatment and life management for spleen deficiency and dampness stasis syndrome, dampness and stasis obstruction in collaterals syndrome, and intestinal dampness and heat syndrome), gender, age, co-morbidities, TCM syndrome, and dietary and exercise factors on the outcome events. ResultsAmong 257 postoperative patients with colorectal polyps, there were 172 in the exposure group and 85 in control group. The recurrence rate of polyps in exposure group was 22.7% (39/172), while the recurrence rate in control group was 57.6% (49/85), and the difference between groups was statistically significant (P<0.01). The diameter of recurrent polyps in exposure group (median= 4.0 mm) was smaller than that in control group (median= 5.0 mm, P<0.01). The correlation analysis between the duration of medication taking and the recurrence of polyps in the spleen deficiency and dampness stasis syndrome group showed Phi value as -0.345 (P<0.001); the correlation analysis within the group of dampness and stasis obstruction in collaterals syndrome showed Phi value as -0.361 (P<0.05), indicating a negative correlation between the duration of medication taking and polyp recurrence. The results of multivariate logistic regression analysis indicated that the positive effect of accepting TCM chronic disease management programme on preventing polyp recurrence is statistically significant (OR=0.224, P<0.01). ConclusionAccepting TCM chronic disease management programme for colorectal polyps can help reducing the recurrence rate after polyp surgery, which is a protective factor for patients to the outcome event.
4.Dynamic Monitoring and Correlation Analysis of General Body Indicators, Blood Glucose, and Blood Lipid in Obese Cynomolgus Monkeys
Yanye WEI ; Guo SHEN ; Pengfei ZHANG ; Songping SHI ; Jiahao HU ; Xuzhe ZHANG ; Huiyuan HUA ; Guanyang HUA ; Hongzheng LU ; Yong ZENG ; Feng JI ; Zhumei WEI
Laboratory Animal and Comparative Medicine 2025;45(1):30-36
ObjectiveThis study aims to investigate the dynamic changes in general body parameters, blood glucose, and blood lipid profiles in obese cynomolgus monkeys, exploring the correlations among these parameters and providing a reference for research on the obese cynomolgus monkey model. Methods30 normal male cynomolgus monkeys aged 5 - 17 years old (with body mass index < 35 kg/m² and glycated hemoglobin content < 4.50%) and 99 spontaneously obese male cynomolgus monkeys (with body mass index ≥35 kg/m² and glycated hemoglobin content < 4.50%) were selected. Over a period of three years, their abdominal circumference, skinfold thickness, body weight, body mass index, fasting blood glucose, glycated hemoglobin, and four blood lipid indicators were monitored. The correlations between each indicator were analyzed using repeated measurement ANOVA, simple linear regression, and multiple linear regression correlation analysis method. Results Compared to the control group, the obese group exhibited significantly higher levels of abdominal circumference, skinfold thickness, body weight, body mass index, and triglyceride (P<0.05). In the control group, skinfold thickness increased annually, while other indicators remained stable. Compared with the first year, the obese group showed significantly increased abdominal circumference, skinfold thickness, body weight, body mass index, triglyceride, and fasting blood glucose in the second year(P<0.05), with this increasing trend persisting in the third year (P<0.05). In the control group, the obesity incidence rates in the second and third years were 16.67% and 23.33%, respectively, while the prevalence of diabetes remained at 16.67%. In the obese group, the diabetes incidence rates were 29.29% and 44.44% in years 2 and 3, respectively. Among the 11-13 year age group, the incidence rates were 36.36% and 44.68%, while for the group older than 13 years, the rates were 28.13% and 51.35%. Correlation analysis revealed significant associations (P<0.05) between fasting blood glucose and age, abdominal circumference, skinfold thickness, body weight, and triglyceride in the diabetic monkeys. Conclusion Long-term obesity can lead to the increases in general physical indicators and fasting blood glucose levels in cynomolgus monkeys, and an increase in the incidence of diabetes. In diabetic cynomolgus monkeys caused by obesity, there is a high correlation between their fasting blood glucose and age, weight, abdominal circumference, skinfold thickness, and triglyceride levels, which is of some significance for predicting the occurrence of spontaneous diabetes.
5.Danhong Injection Regulates Mitochondrial Dynamics in Rat Model of Chronic Heart Failure via AMPK/Drp1 Pathway
Jiahao YE ; Zizheng WU ; Yao ZHANG ; Lichong MENG ; Zhixi HU
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(16):126-135
ObjectiveTo investigate the effects of Danhong injection on mitochondrial dynamics, morphology, and function in the rat model of chronic heart failure by mediating the adenosine 5'-monophosphate (AMP)-activated protein kinase (AMPK)/dynamin-related protein 1 (Drp1) pathway. MethodsFrom 75 SD rats, 15 rats were randomly selected as the sham group, and the remaining 60 rats were used to prepare a rat model of chronic heart failure by abdominal aortic constriction (AAC). The modeled rats were randomly allocated into model, Danhong Injection (6 mL·kg-1), and captopril (8.8 mg·kg-1) groups and administrated with corresponding agents for 15 consecutive days. The levels of N-terminal pro-brain natriuretic peptide (NT-pro BNP), adenosine diphosphate (ADP), adenosine triphosphate (ATP), interleukin (IL)-6, IL-1β, and tumor necrosis factor (TNF)-α and the activities of mitochondrial respiratory chain complexes Ⅰ-Ⅳ were determined by enzyme-linked immunosorbent assay. The changes in cardiac function were detected by echocardiography. The ultrastructural changes of myocardial mitochondria were observed by transmission electron microscopy. Western blot was employed to assess the protein levels of AMPK, p-AMPK, Drp1, p-Drp1, optic atrophy 1 (Opa1), mitofusin (Mfn2), and fission l (Fis1) in the myocardial tissue. Real-time PCR was performed to determine the mRNA levels of Opa1, Mfn2, and Fis1, and immunohistochemistry to detect the expression of p-AMPK. ResultsCompared with the sham group, the model group showed elevated levels of NT-pro BNP, ADP, TNF-α, IL-6, and IL-1β (P<0.01), declined ATP level (P<0.01), weakened activities of mitochondrial respiratory chain complexes Ⅰ-Ⅳ (P<0.01), decreased left ventricular ejection fraction (LVEF) and left ventricular fraction shortening (LVFS) (P<0.01), and increased left ventricular internal diameter at end-diastole (LVDd) and leaf ventricular internal diameter at end-systole (LVIDs) (P<0.01). Electron microscopy results showed that the model group presented heavily abnormal myocardial structure, with large areas of myofilament structure destroyed and dissolved, significantly enlarged residual structural gaps, and fragmented mitochondria. Western blot results showed that the model group demonstrated down-regulated protein levels of p-AMPK, Mfn2, and Opa1 (P<0.01) and up-regulated protein levels of p-Drp1 and Fis1 (P<0.01) in the myocardial tissue. Real-time PCR results showed that the model group presented up-regulated mRNA level of Fis1 (P<0.01) and down-regulated mRNA levels of Mfn2 and Opa1 (P<0.01). Immunohistochemistry results showed reduced expression of p-AMPK in the model group compared with sham group (P<0.01). Compared with the model group, Danhong injection lowered the levels of NT-pro BNP, ADP, TNF-α, IL-6, and IL-1β (P<0.01), raised the level of ATP (P<0.01), increased the activities of mitochondrial respiratory chain complexes Ⅰ-Ⅳ (P<0.05, P<0.01), increased the LVEF and LVFS (P<0.01), decreased the LVDd and LVIDs (P<0.05, P<0.01), alleviated mitochondrial damage, up-regulated the protein levels of p-AMPK, Mfn2, and Opa1 (P<0.05, P<0.01), down-regulated the protein levels of p-Drp1 and Fis1 (P<0.01), reduced the mRNA level of Fis1 (P<0.01), elevated the mRNA levels of Mfn2 and Opa1 (P<0.05, P<0.01), and promoted the expression of p-AMPK (P<0.05). ConclusionDanhong injection repairs the imbalance of mitochondrial dynamics, restores the mitochondrial function, improves the myocardial energy metabolism, and reduces the inflammatory response by regulating the AMPK/Drp1 pathway, thus improving the cardiac function.
6.Evaluation and Consideration on Equity in Health Technology Assessment
Jiahao HU ; Jiayun WANG ; Xi CHEN ; Yuhan LIU ; Chunlin JIN ; Fen LI
Chinese Health Economics 2024;43(1):11-16
Health technology assessment(HTA)is an important tool to inform health decision-making.Although highly related to ethical issues in the context of HTA,equity has attracted much attention from the academia,a consensus has not yet been reached on how to define and evaluate equity in China and abroad.It introduces the concept of equity,pointes out the necessity to realize health equity and the reflection of equity in healthcare sector,and further elaborates four ways to consider equity,and described the official practice of equity in HTA at home and abroad.It proposes several suggestions for China's HTA:considering equity in HTA and the discussion of equity should depend on specific decision-making scenarios;clarifying what health measurement perspective should be adopted before measuring health equity;paying attention to the value judgment of equity adopted by various stakeholders;conducting basic researches on the general population's preference for health measurement perspectives and value judgments of equity in China in a gesture to improve the evaluation system of equity in HTA.
7.Effect of Osteoking on Inflammatory Injury and NF-κB/NFATc1 Signaling Pathway in Model Mice with Postmenopausal Osteoporosis
Tiantian YU ; Ruibing FENG ; Qing WANG ; Chaowen LI ; Jiahao CHEN ; Ruixuan JIANG ; Yinshuai DING ; Yong HUANG ; Hao HU
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(10):62-69
ObjectiveTo explore the possible mechanism of Osteoking (OK) on postmenopausal osteoporosis (PMOP). MethodForty adult female mice were randomly divided into a sham operation (Sham) group, osteoporosis model (OVX) group, estradiol intervention (E2) group, and OK group, with 10 mice in each group. The modeling was completed by conventional back double incision ovariectomy, and the corresponding drugs were given one week later. After 12 weeks, the body mass and uterine index of mice were measured, and the pathological changes of bone tissue and the number of osteoclasts (OCs) were determined by hematoxylin-eosin (HE) and tartrate-resistant acid phosphatase (TRAP) staining, respectively. Bone mineral density (BMD), trabecular number (Tb.N), trabecular separation (Tb.Sp), and bone volume fraction (BV/TV) were measured by microcomputed tomography (Micro-CT). The maximum load of the femur was detected by a three-point bending test. The contents of tumor necrosis factor-α (TNF-α) and bone resorption marker C-terminal telopeptide of type Ⅰ collagen (CTX-1) were measured by enzyme linked immunosorbent assay (ELISA). The protein expression levels of nuclear factor-kappa B p65 (NF-κB p65), phosphorylated nuclear factor-kappa B p65 (p-NF-κB p65), nuclear factor kappa B inhibitor alpha (IκBα), phosphorylated nuclear factor kappa B alpha (p-IκBα), nuclear factor of activated T cells 1 (NFATc1), and proto-oncogene (c-Fos) were detected by Western blot. The mRNA expressions of OCs-related specific genes matrix metalloproteinase-9 (MMP-9), NFATc1, TRAP, cathepsin K (CTSK), and c-Fos were detected by real-time fluorescence quantitative polymerase chain reaction (Real-time PCR). ResultCompared with the Sham group, the uterine index decreased significantly in the OVX group, and the body mass (BMI) increased significantly. The structure of bone trabeculae was completely damaged, and the number of OCs increased. BMD, Tb.N, BV/TV, and maximum load decreased, while Tb.Sp was up-regulated. The levels of TNF-α and CTX-1 in serum were up-regulated. The protein expressions of c-Fos, p-NF-κB p65/NF-κB p65, NFATc1, and p-IκBα/IκBα were increased. The mRNA expressions of NFATc1, c-Fos, CTSK, TRAP, and MMP-9 were up-regulated (P<0.05, P<0.01). Compared with the OVX group, the body mass of the OK and E2 groups decreased, and the uterine index increased. The bone trabeculae increased, and the number of OCs decreased. BMD, Tb.N, BV/TV, and maximum load increased, while Tb.Sp decreased. The levels of TNF-α and CTX-1 in serum were decreased. The protein expressions of c-Fos, p-NF-κB p65/NF-κB p65, NFATc1, and p-IκBα/IκBα were decreased, and the mRNA expressions of NFATc1, c-Fos, CTSK, TRAP, and MMP-9 were decreased (P<0.05, P<0.01). ConclusionOK can inhibit the NF-κB/NFATc1 signaling pathway and reduce bone mass loss by reducing the level of inflammatory injury factors in PMOP mice, which is one of the mechanisms for treating PMOP.
8.Value of mean platelet volume combined with thromboelastography in predicting thrombosis after total knee arthroplasty
Jiahao CHEN ; Shuo FENG ; Hu WANG ; Qiang ZHANG ; Xiangyang CHEN
Chinese Journal of Tissue Engineering Research 2024;28(21):3334-3338
BACKGROUND:Thromboelastography plays an important role in identifying the hypercoagulable state of blood and thrombosis in humans.Recent studies have shown a correlation between an increase in mean platelet volume and thrombosis.We can therefore ask whether the combined diagnosis of thromboelastography and mean platelet volume is a more accurate predictor of thrombosis. OBJECTIVE:To predict the status of blood and the occurrence of thrombosis after total knee arthroplasty by means of mean platelet volume combined with thromboelastography. METHODS:One hundred and twenty patients who underwent unilateral total knee arthroplasty between May 2015 and March 2022 were collected.Patients were divided into 60 patients in the thrombosis group and 60 patients in the control group based on ultrasound findings on postoperative day 7.Whole blood cell and thromboelastography were performed 1 day before,1 and 7 days after surgery,respectively.Multifactorial analysis was used to investigate independent predictors of thrombosis after total knee arthroplasty.The receiver operating characteristic curve and area under the curve were measured in the subjects. RESULTS AND CONCLUSION:Mean platelet volume correlated most strongly with maximum amplitude,followed by coagulation angle.Mean platelet volume and coagulation angle on postoperative day 1 were independent predictors of thrombosis.Mean platelet volume tended to rise and then fall in patients with thrombosis.The best critical value for mean platelet volume to predict thrombosis was 10.73 fL.The area under the receiver operating characteristic curve of subjects was 0.665(95%CI:0.568-0.762,P<0.05];whereas the area under the receiver operating characteristic curve for subjects using mean platelet volume combined with coagulation angle was 0.815(95%CI:0.750-0.879,P<0.05).In addition,the maximum amplitude,coagulation angle,coagulation index and mean platelet volume were significantly higher in the thrombosis group than in the control group postoperatively(P<0.05).The results suggest that the mean platelet volume can reflect the hypercoagulable state of blood after surgery,and the combination of mean platelet volume and coagulation angle on day 1 after total knee arthroplasty can improve the prediction of thrombosis.
9.Effect of varus and valgus angles of tibial prosthesis on short-term outcome of fixed bearing unicompartmental knee arthroplasty
Hu WANG ; Shuo FENG ; Qiang ZHANG ; Jiahao CHEN ; Xiangyang CHEN
Chinese Journal of Tissue Engineering Research 2024;28(24):3827-3832
BACKGROUND:Previous studies on the effects of valgus and varus angles of tibial component on short-term postoperative outcomes after mobile bearing unicompartmental knee arthroplasty have been reported in and outside China.However,there are few reports on the effect of the valgus and varus angles of tibial component on short-term postoperative outcomes after fixed bearing unicompartmental knee arthroplasty. OBJECTIVE:To investigate the effect of valgus and varus angles of tibial component on short-term clinical outcomes in patients with medial knee osteoarthritis undergoing fixed bearing unicompartmental knee arthroplasty. METHODS:120 patients(122 knees)who underwent fixed bearing unicompartmental knee arthroplasty for medial knee osteoarthritis in Department of Orthopedic Surgery,Affiliated Hospital of Xuzhou Medical University from August 2020 to January 2023 were selected as the study subjects.Two physicians measured the varus angle of femoral prosthesis,valgus and varus angles of tibial prosthesis,flexion and extension angles of femoral prosthesis,and posterior inclination angle of tibial prosthesis after unicompartmental knee arthroplasty based on postoperative X-ray.After excluding the influence of the other three angles,the measurement results of the tibial component varus angle were divided into three groups:<-2°,-2° to 2°,>2°,which were denoted as groups 1,2,and 3,respectively.The range of knee motion,the hospital for special surgery knee score,the American knee society score,and forgotten joint score were recorded and compared before and after the operation. RESULTS AND CONCLUSION:(1)A total of 120 patients(122 knees)were enrolled in this study.They were divided into three groups according to the size of the valgus and varus angles of the tibial prosthesis after operation:37 patients in the first group,60 patients in the second group,and 23 patients in the third group.There was no significant difference between the three groups in terms of baseline information such as age,gender,and side of surgery(P>0.05).(2)Patients were followed up for 3-30 months after arthroplasty.(3)The hospital for special surgery knee score of the second group was higher than that of the first group(P=0.015)and the third group(P=0.012).The American knee society score of the second group was significantly higher than that of the first group(P=0.014)and the third group(P<0.001).The forgotten joint score of the second group was higher than that of the first group(P=0.033)and the third group(P=0.016).(4)After fixed bearing unicompartmental knee arthroplasty,when the valgus angle of tibial prosthesis was-2° to 2°,which can achieve better short-term clinical results,the degree of prosthesis self-realization is higher.
10.Association between electrode fusion error and depression improvement during subthalamic nucleus-deep brain stimulation in PD
Junju LI ; Qingzhi LI ; Jiahao HU ; Bin MO
Chinese Journal of Geriatric Heart Brain and Vessel Diseases 2024;26(10):1167-1172
Objective To investigate the association between electrode fusion error and improve-ment of depression during subthalamic nucleus-deep brain stimulation(STN-DBS)surgery for Parkinson's disease(PD).Methods A prospective trial was conducted on 240 PD patients under-going STN-DBS treatment in our hospital from January 2020 to December 2022.According to their clinical outcomes,they were divided into effective group(211 cases)and ineffective group(29 cases).The electrode fusion error was compared among the patients with different efficacy,psychological status,and cognitive status to analyze the correlation of electrode fusion error dur-ing STN-DBS surgery with improvement of depression and cognition.Results There were no sig-nificant differences between the effective group and ineffective group in terms of gender,age,body mass index,hypertension,diabetes,hyperlipidemia,disease duration,or preoperative MMSE and PDQ-39 scores(P>0.05).STN-DBS treatment resulted in obviously improved clinical symptoms such as tremor,rigidity and bradykinesia,and higher UPDRSⅢ score when compared with the re-sults of preoperative impact test(P<0.01).Before treatment,no statistical differences were ob-served in the scores of SAS,SDS,MoCA,MMSE,Alzheimer's disease assessment scale cognitive subscale(ADAS-Cog)or Chinese medicine syndrome change overall impression scale(CGIC-S)between the effective and ineffective groups(P>0.05).After treatment,the scores of SAS,SDS,CGIC-S and ADAS-Cog were declined(P<0.01),and these four scores was notably lower in the effective than the ineffective groups(P<0.01).The scores of MoCA and MMSE were significant-ly elevated in both groups after surgery(P<0.01),and the scores were higher in the effective group than the ineffective group(P<0.01).The target coordinate deviation on the left and right was significantly higher in the patients with SDS≥53 and SAS≥50 than those of SDS<53 and SAS<50(P<0.01).The target coordinate deviation on the left and right of the patients with MoCA<26,MMSE<27,ADAS-Cog≥36 and CGIC-S>1 was statistically higher than that of the patients with MoCA≥ 26,MMSE≥27,ADAS-Cog<36 and CGIC-S≤1(P<0.01).Correlation analysis displayed that the bilateral fusion error of patients was negatively correlated with MoCA and MMSE scores(r=-0.678,P<0.01;r=-0.653,P<0.01;r=-0.448,P<0.01;r=-0.704,P<0.01),and positively with ADAS-Cog,CGIC-S,SDS and SAS scores(r=0.586,P<0.01;r=0.501,P<0.01;r=0.572,P<0.01;r=0.601,P<0.01;r=0.742,P<0.01;r=0.667,P<0.01;r=0.463,P<0.01;r=0.381,P<0.01).Conclusion In PD treatment,electrode fusion error during STN-DBS is significantly correlated with improvement of depression and cognitive score,which can be used as one of the important evidence for predicting clinical effectiveness.In the future,according to the intraoperative error,auxiliary treatment can be carried out timely and effectively to guide further clinical treatment.

Result Analysis
Print
Save
E-mail