Objective To explore the differences in MRI signs between traumatic and non-traumatic rotator cuff tears and their correlation with the degree of rotator cuff tears.Methods A retrospective analysis was conducted on the clinical data and MRI man-ifestations of 82 patients in the trauma group and 80 patients in the non-trauma group with rotator cuff tears confirmed by arthroscopy.MRI indicators included 10 parameters:the degree of rotator cuff tear,tendon kinking-sign,tendon retraction,muscle edema,fatty degeneration,muscle atrophy,long head of the biceps tendon injury,acromion type,acromio-humeral distance(AHD),and lateral acro-mion angle(LAA).The clinical data and MRI indicators of the two groups were compared,and the correlation between MRI indica-tors and the degree of rotator cuff tears was analyzed.Results There were no significant difference in age and gender between the trauma group and the non-trauma group(P＞0.05),but the onset time of symptoms was significantly shorter in the trauma group compared to the non-trauma group(30 d vs 135 d,P＜0.001).Muscle edema,tendon kinking-sign,and long head of the biceps tendon injury were more common in the trauma group(P＜0.05),while fatty degeneration and type Ⅲ acromion were more common in the non-trauma group.The average AHD was smaller in the non-trauma group compared to the trauma group(P＜0.001).In addition,type Ⅲ acromion was more commonly seen in full-thickness rotator cuff tears,and AHD value was negatively correlated with the degree of rotator cuff tears(P＜0.05).Conclusion Muscle edema,tendon kinking-sign,and long head of the biceps tendon injury on MRI are highly suggestive of traumatic rotator cuff tears,while fatty degeneration,type Ⅲ acromion and smaller AHD indicate non-traumatic rotator cuff tears.Type Ⅲ acromion and decreased AHD increase the risk of full-thickness rotator cuff tears.

Char syndrome is a rare autosomal dominant genetic disorder characterized by patent ductus arteriosus, facial dysmorphism, and dysplasia of fingers/toes. It may also be associated with multiple papillae, dental dysplasia, and sleep disorders. TFAP2B has proven to be a pathogenic gene for neural crest derivation and development, and several variants of this gene have been identified. Bone morphogenetic protein signaling plays an important role in embryonic development by participating in limb growth and patterning, and regulation of neural crest cell development. TFAP2B is an upstream regulatory gene for bone morphogenetic proteins 2 and 4. Variants of the TFAP2B gene may lead to abnormal proliferation of neural crest cells by affecting the expression of bone morphogenetic proteins, resulting in multiple organ dysplasia syndrome. In addition, TFAP2B variants may only lead to patent ductus arteriosus instead of typical Char syndrome.

As the robotic assisted single port surgery arousing attention, a novel single-arm single-port micro-traumatic laparoscopic robotic surgical system is proposed in this study. From the perspective of the mechanics, joints with high rigidity and high reliability were utilized to realize the remote center of motion (RCM). Besides, the cost of consumables was reduced by adding the support of the rigid endoscope. From the perspective of the algorithm, high-precision motion control method and feedback force protection mechanism were implemented. The effectiveness of the aforementioned characteristics were verified by five clinical experiments of cholecystectomy. The results showed that the system is able to reduce the amount of bleeding, accelerate the patient recovery, reduce the infection risk and shorten the learning period. The robotic surgical system had significant clinical application value.
Humans ; Robotic Surgical Procedures ; Reproducibility of Results ; Laparoscopy ; Motion

Objective:To establish the normal values of water-perfused high resolution esophageal manometry (HREM)(GAP-36A) at resting period, water swallowing, semisolid swallowing and solid swallowing in Chinese population.Methods:From September 1, 2019 to June 30, 2020, 91 healthy volunteers receiving water-perfused HREM (GAP-36A) at resting period, water swallowing, semisolid swallowing and solid swallowing were selected from 9 hospitals (Union Hospital, Tongji Medical College, Huazhong University of Science and Technology; the First Affiliated Hospital of Dalian Medical University; the Second Hospital of Hebei Medical University; the Second Affiliated Hospital, Naval Medical University; the First Affiliated Hospital, Sun Yat-sen University; the First Affiliated Hospital, University of Science and Technology of China; Aviation General Hospital of China Medical University; the Affiliated Hospital of Medical School of Nanjing University and the First People′s Hospital of Yichang). Parameters included the position of the upper and lower edges of the upper esophageal sphincter (UES) and lower esophageal sphincter (LES), the length of the LES and UES, the position of the pressure inversion point (PIP), the resting pressure of UES and LES and swallow-related parameters such as the distal contraction integral (DCI), 4 s integrated relaxation pressure (IRP), distal latency (DL) and UES residual pressure. One-way analysis of variance, post-hoc test and sum rank test were used for statistical analysis.Results:A total of 87 healthy volunteers were enrolled, including 40 males and 47 females, aged (38.5±14.2) years old (ranged from 19 to 65 years old). The position of the upper and lower edges of the LES was (42.7±2.8) and (45.6±2.8) cm, respectively, the length of the LES was (2.9±0.4) cm, and the position of PIP was (43.3±2.8) cm. The position of the upper and lower edges of the UES was (18.1±3.0) and (22.6±2.0) cm, respectively, and the length of the UES was (4.8±1.0) cm. The resting pressure of LES and UES was (17.4±10.7) and (84.1±61.1) mmHg (1 mmHg=0.133 kPa), respectively. The DCI value at solid swallowing was higher than those at water swallowing and semisolid swallowing ((2 512.4±1 448.0) mmHg·s·cm vs. (2 183.2±1 441.2) and (2 150.8±1 244.8) mmHg·s·cm), and the differences were statistically significant ( t=-4.30 and -3.74, both P<0.001). The values of 4 s IRP at semisolid swallowing and solid swallowing were lower than that at water swallowing ((4.6±4.1) and (4.9±3.9) mmHg vs. (5.4±3.9) mmHg), and the differences were statistically significant ( t=3.38 and 2.09, P=0.001 and 0.037). The DL at water swallowing was shorter than those at semisolid swallowing and solid swallowing ((8.5±1.8) s vs. (9.8±2.2) and (10.6±2.8) s), and the DL at semisolid swallowing was shorter than that at solid swallowing, and the differences were statistically significant ( t=-10.21, -13.91 and -4.68, all P<0.001). The UES residual pressure at water swallowing was higher than those at semisolid swallowing and solid swallowing (9.5 mmHg, 6.5 to 12.3 mmHg vs. 8.0 mmHg, 4.5 to 11.7 mmHg and 5.5 mmHg, 2.0 to 9.3 mmHg), and the UES residual pressure at semisolid swallowing was higher than that at solid swallowing, and the differences were statistically significant ( t=3.48, 10.30 and 6.35, all P<0.001). Conclusions:The normal values of water-perfused HREM (GAP-36A) in Chinese population at resting period, water swallowing, semisolid swallowing and solid swallowing can provide a reference basis for clinical diagnosis and treatment for patients receiving water-perfused HREM examination.

Objective To analyze the difference in ground reaction force (GRF) between male and female runners and between left and right limbs using the one-dimensional statistical parametric mapping (SPM). Methods Thirty male and female runners participated the running test on force treadmill at the speed of 12 km/h. GRF of consecutive five steps were recorded. The independent-sample t test and paired-sample t test in the SPM package were used to check the male vs female and right limb vs left limb differences. Results Male and female runners showed inter-limb asymmetry in vertical average loading rate (VALR), and the VALR of male runners was significantly higher than that of female runners in the left limb, while no significant differences were found in the right limb. Male and female runners showed significant differences in the right vertical GRF during push-off and medial-lateral GRF during landing, while left medial-lateral GRF presented significant differences during landing and mid stance. Male runners showed right limb vs left limb significance in the anterior-posterior GRF during push-off, vertical GRF during landing and push-off and medial-lateral GRF during landing, while female runners exhibited right limb vs left limb significance in vertical GRF during landing and push-off. Conclusions This study introduced the application of SPM in statistical analysis of GRF, elaborated the procedures and theory, compared the test of time-series data in SPM and discrete value with traditional statistics, and discussed the difference and features in SPM and SnPM, thus providing references for the application in data analysis of sports biomechanics. Comparison in the male vs female and right limb vs left limb revealed the genders and inter-limb symmetrical differences in the landing, mid-stance and push-off phases during stance. The research findings laid the foundation for future investigation of mechanism in running related injuries and strategy of prevention and treatment.

Objective:To understand the basic characteristics of COVID-19 cases and the virus carrying status of different samples in Ma′anshan.Methods:Descriptive epidemiological method was used to describe the distribution of 2019-nCoV infections in Ma′anshan. Real-time fluorescence RT-PCR was used to detect 2019-nCoV nucleic acid in sputum and/or throat swabs. Data was analyzed by EXCEL and SPSS 20.0. P<0.05 was considered to be statistically significant by using χ2 test. Results:Until 14 March 2020, 38 confirmed cases and no death had been reported in Ma′anshan, there were also 11 asymptomatic infections. 2019-nCoV infection was first detected on January 23, and the last was on February 20. No new infections have been found for 23 consecutive days until March 14; 77.55%(38/49)of the infections were in He county. Among the 1 447 subjects, the positive rate was 4.50% (27/600) in females and 2.60% (22/847) in males (χ 2=3.886, P=0.049). The minimum age of the infections was 4 years and the maximum was 85. There was no significant difference between age groups ( χ2=10.675, P=0.058). Among the 49 infections, 20 of them (40.82%) were from Wuhan, 24 (48.98%) were locally infected, and 5 (10.20%) were imported from other places. For the first positive infections, the positive rate of sputum (100%, 36/36) was higher than the throat swab (77.78%, 28/36), and the difference was statistically significant (χ 2=6.125, P<0.05). Conclusions:In Ma′anshan, 2019-nCoV infections were concentrated in He county, sputum was beneficial to the detection of 2019-nCoV.

Objective: To analyze the distribution of glomerular immunofluorescence IgG4 subtypes in primary membranous nephropathy, and to explore the relationship between IgG4 deposit intensity and renal pathology, clinical manifestations and prognosis. Methods: All the patients of biopsy-proven primary membranous nephropathy with IgG staining and at least one IgG subtype staining 1+ or higher on capillary loops from September 2015 to April 2017 were retrospectively enrolled. The distribution of IgG4 deposits were analyzed, and the relationship between IgG4 positive intensity and clinical manifestations, pathological indexes and clinical remission was investigated. Results: A total of 250 cases were enrolled, including 157 males (62.8%) and 93 females (37.2%), and age was (54.4 ± 14.6) years. There were 40 patients in IgG4-negative group, and 210 patients in IgG4-positive group. The IgG4-positive group was divided into subgroups as 114 cases of the mild positive subgroup (1+) and 62 cases of the moderate positive subgroup (2+), and 34 cases of the strong positive subgroup (3+, 4+). The IgG4-positive group had higher 24-hour urine protein and higher positive rate of phospholipase A2 receptor staining than those in the negative group (both P<0.05), while the strong positive subgroup had lower serum albumin and higher IgG1 staining than those in the mild positive subgroup (both P<0.05). There was no difference in the ratio of glomerular sclerosis, tubular atrophy, IgG2, IgG3 or other immunofluorescence between the groups. After a median follow-up of 180(122, 209) days, 32 individuals were lost to follow-up. Among the rest 218 patients, 45 patients (20.6%) got complete remission, 104 patients (47.7%) got partial remission, and 69 patients (31.7%) showed no response. For no response as the outcome event, multivariate Cox regression analysis showed that higher IgG4 staining intensity (HR=1.371, 95%CI 1.068-1.759, P=0.013), male (HR=1.818, 95%CI 1.028-3.214, P=0.040), higher 24-hour urine protein level (HR=1.108, 95%CI 1.003-1.225, P=0.043) were independent risk factors for disease remission. Conclusions The glomerular IgG4 positivity and intensity are related to the severity of primary membranous nephropathy. The glomerular IgG4 deposit degree may be an effective prognostic marker for the treatment response of primary membranous nephropathy.

This paper presents a three-dimensional electronic laparoscopy system, including three-dimensional laparoscope pipe and medical video system. The three-dimensional laparoscope pipe adopts a dual-optical structure, which can collect three-dimensional information of the surgical region. By selecting a reasonable initial structure, the MTF curve of the objective lens is close to the diffraction limit, and the distortion is less than 25%. The medical video system also achieved high-definition image with 1 080 P, 30 Hz by GPU. At the mean time, the three-dimensional electronic laparoscope has achieved quantitative production and has been tested in a number of animals, which has broad application prospects and significant clinical application value.
Electronics, Medical ; Imaging, Three-Dimensional ; Laparoscopes ; Laparoscopy

Pachydermoperiostosis is a rare genetic disease characterized by finger clubbing, periostosis, cutis verticis gyrata and pachydermia accompanied by acroosteolysis and hyperhidrosis. Recently, two susceptibility genes, HPGD and SLCO2A1, have been identified, whose protein products are involved in the transportation of prostaglandin and metabolism underlying pachydermoperiostosis. Here the genetic basis of pachydermoperiostosis and its correlation with its clinical phenotype are reviewed, which may provide a reference for basic research and clinic diagnosis for the disease.
Animals ; Humans ; Hydroxyprostaglandin Dehydrogenases ; genetics ; Organic Anion Transporters ; genetics ; Osteoarthropathy, Primary Hypertrophic ; diagnosis ; genetics ; therapy ; Phenotype

Adult ; Air Pollutants, Occupational ; analysis ; Dust ; analysis ; Female ; Humans ; Male ; Middle Aged ; Occupational Exposure ; adverse effects ; Occupational Health ; Welding ; Young Adult