BACKGROUND: The choice of unicompartmental knee arthroplasty (UKA) vs . total knee arthroplasty (TKA) in the surgical treatment of knee osteoarthritis (KOA) remains controversial. This study aimed to perform a systematic review and meta-analysis of randomized controlled trials (RCTs) to compare the clinical results of UKA and TKA for treating unicompartmental KOA. METHODS: PubMed, Embase, and the Cochrane Library were systematically searched for articles published up to January 2, 2023. The literature was rigorously screened to include only RCTs comparing UKA and TKA for unicompartmental KOA. A systematic review and meta-analysis were performed to calculate the mean difference (MD), relative risk (RR), and 95% confidence interval (CI) according to the Cochrane standards. RESULTS: Thirteen publications involving 683 UKAs and 683 TKAs were analyzed. Except for one study with a follow-up period of 15 years, all outcome measures reported were within 5 years of follow-up. Meta-analysis showed better knee recovery (MD: 1.23; 95% CI: 1.01-1.45; P  <0.001), greater knee function (MD: 1.78; 95% CI: 0.34-3.22; P  = 0.020), less pain (MD: 0.75; 95% CI: 0.43-1.06; P  <0.001), and better health status (MD: 3.75; 95% CI: 0.81-6.69; P  = 0.010) after UKA than TKA. However, considering the minimal clinically important difference values for these variables, the findings were not clinically relevant. Moreover, UKA patients had fewer complications (RR: 0.59; 95% CI: 0.45-0.78; P  <0.001) and shorter hospital stays (MD: -0.89; 95% CI: -1.57 to -0.22; P  = 0.009) than did TKA patients. There were no statistically significant differences in terms of postoperative range of movement, revision, failure, operation time, and patient satisfaction. CONCLUSIONS In terms of clinical efficacy, there was no obvious advantage of UKA over TKA in the surgical treatment of knee OA when considering the minimal clinically important difference. The main advantage of UKA over TKA is that it leads to fewer complications and a shorter length of hospital stay. It is ideal to perform prospective studies with longer follow-up periods to fully evaluate the long-term efficacy and safety of the two procedures in the future.
Humans ; Arthroplasty, Replacement, Knee/methods* ; Osteoarthritis, Knee/surgery* ; Randomized Controlled Trials as Topic ; Treatment Outcome

Objective To observe the effect of hypoxia(HX)on autophagy and pyroptosis-related protein expression of interleukin(IL)-1β-induced chondrocytes,and explore its mechanism of cartilage protection.Methods The expression of Bcl2/adenovirus E1B interacting protein 3-like(BNIP3L/NIX)in normal and osteoarthritis chondrocytes was analyzed by bioinformatics method.The primary chondrocytes from the knee joints of C57BL/6J neonatal mice were extracted and assigned to control group,IL-1β group,HX group,or IL-1β+HX group.The cells were treated with 10 ng/mL IL-1β for 24 h to simulate osteoarthritis-like chondrocyte injury,and HX treatment was by incubation with 1%O2 for 24 h.The expression levels of collagen typeⅡ α1(COL2α1),matrix metalloproteinase 13(MMP13),a disintegrin and metalloproteinase with thrombospondin 5(ADAMTS5),nucleotide-binding oligomerization domain-like receptor 3(NLRP3),gasdermin D N-terminal domain(GSDMD-N),apoptosis-associated speck-like protein containing a CARD(ASC),IL-18,hypoxia induced factor 1α(HIF1α),NIX,Beclin1,microtubule-associated protein-light chain 3(LC3),and p62 proteins were detected by Western blotting in each group.Results Bioinformatics analysis showed that the expression of NIX was lower in osteoarthritis chondrocytes than in normal chondrocytes.Western blotting showed that compared to the control group,the IL-1β group showed significant decreases in COL2α1 and NIX protein expression(both P＜0.05)and significant increases in MMP13,ADAMTS5,NLRP3,GSDMD-N,ASC,IL-18 and HIF1α protein expression(all P＜0.01).Compared to the IL-1β group,the IL-1β+HX group showed significant increases in COL2α1,HIF1α,NIX,Beclin1,and LC3 Ⅱ/LC3Ⅰ(all P＜0.01)and significant decreases in MMP13,ADAMTS5,NLRP3,GSDMD-N,ASC,IL-18 and p62(all P＜0.01).Compared to the control group,the HX group exhibited significant increases in HIF1α,NIX,Beclin1,and LC3Ⅱ/LC3Ⅰ(all P＜0.01)and decreases in p62,NLRP3,GSDMD-N and IL-18(all P＜0.05).Conclusion Hypoxia may eliminate NLRP3 inflammasome and inhibit chondrocyte pyroptosis through HIF1α/NIX-mediated mitochondrial autophagy,thereby reducing IL-1β-induced chondrocyte injury.

Objective:To explore the safety and efficacy of shunt reduction using the Interlock-35 fibered interlocking detachable coil (IDC) occlusion system in the treatment of refractory hepatic encephalopathy (HE) after transjugular intrahepatic portosystemic shunt (TIPS).Methods:From August 2022 to December 2023, at the Department of Gastroenterology of the Air Force Medical Center, the clinical data of patients with refractory HE after TIPS who were treated with shunt reduction using the Interlock-35 fibered IDC occlusion system were retrospectively collected, which included portal vein pressure gradient (PVPG), HE grades, blood ammonia levels, prothrombin time (PT), liver function parameters, and other related indicators. The primary indicators related to the efficacy of the shunt reduction included symptom improvement, and changes in PVPG, blood ammonia levels, and Child-Pugh score. The safety of shunt reduction was analyzed based on the incidence of complications such as gastrointestinal bleeding and ascites during the follow-up period. Paired t-test was used for statistical analysis. Results:A total of 21 patients were enrolled. Prior to shunt reduction, there were 5 cases with HE of grade 3 and 16 cases with HE of grade 2. Before operation, the blood ammonia was (103.14±27.69) mol/L; and the liver function Child-Pugh grade of 1 case was classified as grade A, 16 cases as grade B, and 4 cases as grade C. Shunt reduction was performed between 7 and 1 879 d, with a median time of 99 (54, 806) d after TIPS. The procedure was technically successful in all patients, with a total of 25 coils implanted. Before shunt reduction, the PVPG was (14.02±5.28) cmH 2O (1 cmH 2O=0.098 kPa), after shunt reduction procedure, the PVPG increased to (25.05±6.04) cmH 2O, and the difference was statistically significant ( t=-11.26, P<0.001). After operation, 16 patients returned to the hospital for follow-up examinations, with a median follow-up time of 114 (46, 195) d, the blood ammonia levels, PT, and Child-Pugh scores during the follow-up were all lower than those before operation ((78.19±27.85) μmol/L vs. (105.00±30.53) μmol/L, (14.09±1.65) s vs. (15.41±2.35) s, and 6.88±1.59 vs. 8.13±1.75, respectively), and the differences were statistically significant ( t=2.23, 3.23, and 2.61; P=0.040, <0.001, =0.020). There was no statistically significant in PVPG between during follow-up and immediately post-procedure ((28.91±6.20) cmH 2O vs. (25.22±5.92) cmH 2O, P>0.05). During the follow-up period, HE symptoms disappeared in 12 patients among the 16 patients who returned to hospital for follow-up, however gastrointestinal bleeding occurred in 5 patients and ascites occurred in 3 patients; additionally, 4 patients experienced intermittent HE symptoms (grade 1 in 3 cases, grade 2 in 1 case). After operation, 5 patients were followed up via telephone, among them, 3 patients died, and 2 patients experienced intermittent HE (grade 1) which could be spontaneously restored with dietary adjustments and(or) medication. Conclusions:Interlock-35 fibered IDC occlusion system for shunt reduction is a feasible and effective treatment for refractory HE after TIPS. It can effectively improve symptoms and decrease liver function score. After shunt reduction, early follow-up and adjustment of flow reduction can help reduce the occurrence of severe complications.

Objective:To investigate the epidemiological characteristics and source distribution of newly diagnosed occupational diseases among workers from other provinces in Guangdong Province from 2006 to 2023, providing a basis for occupational health risk assessment and government decision-making.Methods:In July 2024, through the Occupational Disease Report Card of the Occupational Disease and Health Hazard Monitoring Information System of the China Disease Prevention and Control Information System, the basic information of newly diagnosed occupational disease cases reported online in Guangdong Province from 2006 to 2023 was collected, and the epidemiological characteristics of new occupational diseases among workers from other provinces were described. The locations of employment units and their source provinces of different cases were analyzed. Counting data were described by component ratio (%) and compared by Pearson χ2 test. Results:From 2006 to 2023, 9763 cases of newly diagnosed occupational diseases among workers from other provinces in Guangdong Province were reported, accounting for 78.82% (9763/12387) of the total number of occupational diseases in the province. The cases of occupational diseases were mainly concentrated in the Pearl River Delta region (94.93%, 9268/9763) and the manufacturing industry (86.97%, 8491/9763), and the domestic enterprises accounted for 57.35% (5593/9753). Newly diagnosed occupational disease cases were mainly from province A in Central China (2767 cases, 28.34%), province A in Southwest China (2323 cases, 23.79%) and a province in South China (1070 cases, 10.96%) .Conclusion:The proportion of newly diagnosed occupational diseases among workers from other provinces in Guangdong Province is relatively high, and the cases are concentrated in the regions, industries and source provinces.

Objective To investigate the effect of the long noncoding RNA(lncRNA)FGD5-AS1 on the migration and invasion of gas-tric cancer cells by regulating the miR-133a-3p/SPAG5 axis.Methods Quantitative real-time PCR was used to detect FGD5-AS1,miR-133a-3p,and SPAG5mRNA expression in gastric cancer tissues and adjacent non-tumor tissues,the normal human gastric epithelial cell line GES-1,and gastric cancer cell lines(MKN-28 and NCI-N87,HGC-27,and AGS).Cell counting kit-8 method and 5-ethynyl-2-de-oxyuridine(EdU)staining were performed to detect cell proliferation.Transwell assays were performed to assess cell invasion.A scratch assay was performed to detect the migration ability.Western blotting was performed to detect the expression of the proliferative proteins Ki-67,SPAG5,migration,invasion enhancer factor 1(MIEN1),and matrix proteinase-9(MMP-9).A double-luciferase assay was used to confirm the relationship between miR-133a-3p,FGD5-AS1,and SPAG5expression.Results FGD5-AS1 and SPAG5mRNA levels were significantly elevated in gastric cancer tissues and cell lines,whereas miR-133a-3p was significantly reduced(P<0.05),with the most significant gene changes observed in MKN-28 cells(P<0.05).Compared with the blank and siNC groups,FGD5-AS1,SPAG5mRNA,EdU-positive rate,proliferative,invasive,and migratory abilities,Ki-67,MIEN1,SPAG5,and MMP-9 expression in the siFGD5-AS1 group decreased,and the expression of miR-133a-3p increased(P<0.05).Compared to the siFGD5-AS1+inhibitor NC group,the expres-sion of SPAG5mRNA;proliferative,invasive,and migratory abilities;and Ki-67,MIEN1,SPAG5,and MMP-9 expression in the siFGD5-AS1+miR-133a-3p inhibitor group increased,and the expression of miR-133a-3p decreased(P<0.05).Conclusion Interference with lncRNA RNA FGD5-AS1 can inhibit the migration and invasion of gastric cancer cells by upregulating the miR-133a-3p/SPAG5 axis.

Objective To investigate the effect of the long noncoding RNA(lncRNA)FGD5-AS1 on the migration and invasion of gas-tric cancer cells by regulating the miR-133a-3p/SPAG5 axis.Methods Quantitative real-time PCR was used to detect FGD5-AS1,miR-133a-3p,and SPAG5mRNA expression in gastric cancer tissues and adjacent non-tumor tissues,the normal human gastric epithelial cell line GES-1,and gastric cancer cell lines(MKN-28 and NCI-N87,HGC-27,and AGS).Cell counting kit-8 method and 5-ethynyl-2-de-oxyuridine(EdU)staining were performed to detect cell proliferation.Transwell assays were performed to assess cell invasion.A scratch assay was performed to detect the migration ability.Western blotting was performed to detect the expression of the proliferative proteins Ki-67,SPAG5,migration,invasion enhancer factor 1(MIEN1),and matrix proteinase-9(MMP-9).A double-luciferase assay was used to confirm the relationship between miR-133a-3p,FGD5-AS1,and SPAG5expression.Results FGD5-AS1 and SPAG5mRNA levels were significantly elevated in gastric cancer tissues and cell lines,whereas miR-133a-3p was significantly reduced(P<0.05),with the most significant gene changes observed in MKN-28 cells(P<0.05).Compared with the blank and siNC groups,FGD5-AS1,SPAG5mRNA,EdU-positive rate,proliferative,invasive,and migratory abilities,Ki-67,MIEN1,SPAG5,and MMP-9 expression in the siFGD5-AS1 group decreased,and the expression of miR-133a-3p increased(P<0.05).Compared to the siFGD5-AS1+inhibitor NC group,the expres-sion of SPAG5mRNA;proliferative,invasive,and migratory abilities;and Ki-67,MIEN1,SPAG5,and MMP-9 expression in the siFGD5-AS1+miR-133a-3p inhibitor group increased,and the expression of miR-133a-3p decreased(P<0.05).Conclusion Interference with lncRNA RNA FGD5-AS1 can inhibit the migration and invasion of gastric cancer cells by upregulating the miR-133a-3p/SPAG5 axis.

Objective:To explore the safety and efficacy of shunt reduction using the Interlock-35 fibered interlocking detachable coil (IDC) occlusion system in the treatment of refractory hepatic encephalopathy (HE) after transjugular intrahepatic portosystemic shunt (TIPS).Methods:From August 2022 to December 2023, at the Department of Gastroenterology of the Air Force Medical Center, the clinical data of patients with refractory HE after TIPS who were treated with shunt reduction using the Interlock-35 fibered IDC occlusion system were retrospectively collected, which included portal vein pressure gradient (PVPG), HE grades, blood ammonia levels, prothrombin time (PT), liver function parameters, and other related indicators. The primary indicators related to the efficacy of the shunt reduction included symptom improvement, and changes in PVPG, blood ammonia levels, and Child-Pugh score. The safety of shunt reduction was analyzed based on the incidence of complications such as gastrointestinal bleeding and ascites during the follow-up period. Paired t-test was used for statistical analysis. Results:A total of 21 patients were enrolled. Prior to shunt reduction, there were 5 cases with HE of grade 3 and 16 cases with HE of grade 2. Before operation, the blood ammonia was (103.14±27.69) mol/L; and the liver function Child-Pugh grade of 1 case was classified as grade A, 16 cases as grade B, and 4 cases as grade C. Shunt reduction was performed between 7 and 1 879 d, with a median time of 99 (54, 806) d after TIPS. The procedure was technically successful in all patients, with a total of 25 coils implanted. Before shunt reduction, the PVPG was (14.02±5.28) cmH 2O (1 cmH 2O=0.098 kPa), after shunt reduction procedure, the PVPG increased to (25.05±6.04) cmH 2O, and the difference was statistically significant ( t=-11.26, P<0.001). After operation, 16 patients returned to the hospital for follow-up examinations, with a median follow-up time of 114 (46, 195) d, the blood ammonia levels, PT, and Child-Pugh scores during the follow-up were all lower than those before operation ((78.19±27.85) μmol/L vs. (105.00±30.53) μmol/L, (14.09±1.65) s vs. (15.41±2.35) s, and 6.88±1.59 vs. 8.13±1.75, respectively), and the differences were statistically significant ( t=2.23, 3.23, and 2.61; P=0.040, <0.001, =0.020). There was no statistically significant in PVPG between during follow-up and immediately post-procedure ((28.91±6.20) cmH 2O vs. (25.22±5.92) cmH 2O, P>0.05). During the follow-up period, HE symptoms disappeared in 12 patients among the 16 patients who returned to hospital for follow-up, however gastrointestinal bleeding occurred in 5 patients and ascites occurred in 3 patients; additionally, 4 patients experienced intermittent HE symptoms (grade 1 in 3 cases, grade 2 in 1 case). After operation, 5 patients were followed up via telephone, among them, 3 patients died, and 2 patients experienced intermittent HE (grade 1) which could be spontaneously restored with dietary adjustments and(or) medication. Conclusions:Interlock-35 fibered IDC occlusion system for shunt reduction is a feasible and effective treatment for refractory HE after TIPS. It can effectively improve symptoms and decrease liver function score. After shunt reduction, early follow-up and adjustment of flow reduction can help reduce the occurrence of severe complications.

Objective:To investigate the epidemiological characteristics and source distribution of newly diagnosed occupational diseases among workers from other provinces in Guangdong Province from 2006 to 2023, providing a basis for occupational health risk assessment and government decision-making.Methods:In July 2024, through the Occupational Disease Report Card of the Occupational Disease and Health Hazard Monitoring Information System of the China Disease Prevention and Control Information System, the basic information of newly diagnosed occupational disease cases reported online in Guangdong Province from 2006 to 2023 was collected, and the epidemiological characteristics of new occupational diseases among workers from other provinces were described. The locations of employment units and their source provinces of different cases were analyzed. Counting data were described by component ratio (%) and compared by Pearson χ2 test. Results:From 2006 to 2023, 9763 cases of newly diagnosed occupational diseases among workers from other provinces in Guangdong Province were reported, accounting for 78.82% (9763/12387) of the total number of occupational diseases in the province. The cases of occupational diseases were mainly concentrated in the Pearl River Delta region (94.93%, 9268/9763) and the manufacturing industry (86.97%, 8491/9763), and the domestic enterprises accounted for 57.35% (5593/9753). Newly diagnosed occupational disease cases were mainly from province A in Central China (2767 cases, 28.34%), province A in Southwest China (2323 cases, 23.79%) and a province in South China (1070 cases, 10.96%) .Conclusion:The proportion of newly diagnosed occupational diseases among workers from other provinces in Guangdong Province is relatively high, and the cases are concentrated in the regions, industries and source provinces.

As artificial intelligence technology rapidly advances, its deployment within the medical sector presents substantial ethical challenges. Consequently, it becomes crucial to create a standardized, transparent, and secure framework for processing medical data. This includes setting the ethical boundaries for medical artificial intelligence and safeguarding both patient rights and data integrity. This consensus governs every facet of medical data handling through artificial intelligence, encompassing data gathering, processing, storage, transmission, utilization, and sharing. Its purpose is to ensure the management of medical data adheres to ethical standards and legal requirements, while safeguarding patient privacy and data security. Concurrently, the principles of compliance with the law, patient privacy respect, patient interest protection, and safety and reliability are underscored. Key issues such as informed consent, data usage, intellectual property protection, conflict of interest, and benefit sharing are examined in depth. The enactment of this expert consensus is intended to foster the profound integration and sustainable advancement of artificial intelligence within the medical domain, while simultaneously ensuring that artificial intelligence adheres strictly to the relevant ethical norms and legal frameworks during the processing of medical data.
Artificial Intelligence/legislation & jurisprudence* ; Humans ; Consensus ; Computer Security/standards* ; Confidentiality/ethics* ; Informed Consent/ethics*

Purpose: Polyacrylamide hydrogel (PAHG), which had been used widely for breast augmentation, has been banned for more than 15 years. Patients who had been injected PAHG for breast augmentation need evacuation surgery to remove as much as possible. To provide a series of diagnosis and treatment process MRI and intraoperative color Doppler ultrasound are combined for maximal removal of PAHG. Methods: The patients who received evacuation surgery in Peking University Third Hospital from 2010 to 2022 after PAHG injection for breast augmentation were included in this research. MR scanning was performed preoperatively and postoperatively in some of these patients and color Doppler ultrasound was applied to help evacuate PAHG intraoperatively. The mean clearance rate of PAHG was calculated according to the MRI outcomes. Results: Two hundred and 4 patients had received evacuation surgery after PAHG injection for breast augmentation with an average age of 42.8 years and an average body mass index of 21.2 kg/m 2 . The average PAHG retention time was 13.5 years. Among them, 52 patients underwent pre- and postoperative MRI scanning. The mean three-dimensional (3D) volume of PAHG was 684.8 mL (range, 350.0–1,123.9 mL), and the average residual 3D volume of PAHG was 53.7 mL (range, 12.4–98.3 mL). The mean clearance rate was 92.1%. Conclusion MRI and intraoperative color Doppler ultrasound can provide effective and precise location information of PAHG for evacuation surgery, which is a reliable method to ensure the maximal removal of PAHG.