Knee osteoarthritis(KOA)is a prevalent chronic degenerative disorder among older adults,with biomechanical factors playing a crucial role in its pathogenesis and progression.This article aims to direct clinical studies on Tai Ji Quan(Shadow Boxing)therapeutic intervention for KOA by analyzing biomechanical factors in the pathogenesis of KOA and generalizing the biomechanical characteristics of Tai Ji Quan exercise and its impact on the gait pattern,overall mechanical balance,muscle function,plantar pressure,and proprioception of KOA patients,as well as summarizing the limitations in current clinical research.

Objective To research the correlation between triglyceride-glucose index(TyG)and the risk of colorectal polyps with different pathological types.Methods According to inclusion and exclusion criteria,453 patients who underwent fiberoptic colonoscopy at Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from May 2022 to December 2023 were selected.Based on colonoscopy results,patients were divided into non-colorectal polyp group and a colorectal polyp group.The polyp group was further classified according to pathological results into non-adenomatous polyps,adenomatous polyps,and colorectal cancer groups.A retrospec-tive analysis was conducted on the general data of the study subjects,including relevant test indicators such as blood glucose and lipids.Logistic regression analysis was employed to identify risk factors associated with the occurrence of colorectal polyps.Receiver operating characteristic(ROC)curves were constructed to evaluate the predictive role of the TyG index in the development of colorectal polyps,and the TyG levels among different pathological types of colorectal polyps were compared.Results Patients in the polyp group exhibited high-er age,male proportion,body mass index(BMI),glycosylated hemoglobin(HbA1c),triglycerides(TG),lipoprotein(a),and TyG in-dex compared to the non-polyp group.After adjusting for confounding factors,Logistic regression analysis indicated a correlation between the TyG index and the occurrence of colorectal polyps(P＜0.05).The area under the curve(AUC)for the TyG index predicting the development of colorectal polyps was 0.756(95％CI:0.702-0.809,P＜0.001).The TyG index level in the non-colorectal polyp group was lower than that in the non-adenomatous polyp,adenomatous polyp,and colorectal cancer groups,with statistically significant differences(P＜0.05).Pairwise comparisons also showed statistically significant differences(P＜0.05).Conclusion The TyG in-dex may be correlated with the occurrence of colorectal polyps.There are significant differences in the TyG index levels among different pathological types of colorectal polyps.

Objective To research the correlation between triglyceride-glucose index(TyG)and the risk of colorectal polyps with different pathological types.Methods According to inclusion and exclusion criteria,453 patients who underwent fiberoptic colonoscopy at Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from May 2022 to December 2023 were selected.Based on colonoscopy results,patients were divided into non-colorectal polyp group and a colorectal polyp group.The polyp group was further classified according to pathological results into non-adenomatous polyps,adenomatous polyps,and colorectal cancer groups.A retrospec-tive analysis was conducted on the general data of the study subjects,including relevant test indicators such as blood glucose and lipids.Logistic regression analysis was employed to identify risk factors associated with the occurrence of colorectal polyps.Receiver operating characteristic(ROC)curves were constructed to evaluate the predictive role of the TyG index in the development of colorectal polyps,and the TyG levels among different pathological types of colorectal polyps were compared.Results Patients in the polyp group exhibited high-er age,male proportion,body mass index(BMI),glycosylated hemoglobin(HbA1c),triglycerides(TG),lipoprotein(a),and TyG in-dex compared to the non-polyp group.After adjusting for confounding factors,Logistic regression analysis indicated a correlation between the TyG index and the occurrence of colorectal polyps(P＜0.05).The area under the curve(AUC)for the TyG index predicting the development of colorectal polyps was 0.756(95％CI:0.702-0.809,P＜0.001).The TyG index level in the non-colorectal polyp group was lower than that in the non-adenomatous polyp,adenomatous polyp,and colorectal cancer groups,with statistically significant differences(P＜0.05).Pairwise comparisons also showed statistically significant differences(P＜0.05).Conclusion The TyG in-dex may be correlated with the occurrence of colorectal polyps.There are significant differences in the TyG index levels among different pathological types of colorectal polyps.

Knee osteoarthritis(KOA)is a prevalent chronic degenerative disorder among older adults,with biomechanical factors playing a crucial role in its pathogenesis and progression.This article aims to direct clinical studies on Tai Ji Quan(Shadow Boxing)therapeutic intervention for KOA by analyzing biomechanical factors in the pathogenesis of KOA and generalizing the biomechanical characteristics of Tai Ji Quan exercise and its impact on the gait pattern,overall mechanical balance,muscle function,plantar pressure,and proprioception of KOA patients,as well as summarizing the limitations in current clinical research.

Objective: To investigate the effect of a modified puncture cannula on prevention of bone cement leakage in percutaneous vertebroplasty (PVP). Methods: From January 2014 to February 2018, 243 patients with single-segmental osteoporotic vertebral fracture were treated with PVP at Department of Orthopedics, Shanghai Ninth People's Hospital. Their clinical data were retrospectively analyzed. Of them, a common puncture cannula was used in 169 cases (control group) and a modified puncture cannula in 74 (modified group). In the control group, there were 41 men and 128 women with an age of 71.6±9.5 years, and the fracture was distributed from T5 to T10 in 7 cases, from T11 to L2 in 132 and from L3 to L5 in 30. In the modified group, there were 20 men and 54 women with an age of 73.6±9.3 years, and the fracture was distributed from T5 to T10 in 3 cases, from T11 to L2 in 63 and from L3 to L5 in 8. The 2 groups were compared in terms of postoperative recovery of vertebral height, reduction in visual analogue scale(VAS) and bone cement leakage. Results: There were no significant differences between the 2 groups in age, gender, distribution of fractured vertebral bodies, compression degree, condition of vertebral posterior wall, or bone cement volume injected (P>0.05). There were no significant differences either between the control and modified groups in the postoperative recovery of vertebral height (7.43%±7.82% versus 6.20%±7.84%) or reduction in VAS score (5.83±0.99 versus 5.81±0.89) (P>0.05). Bone cement leakage occurred in 93 cases (55.0%) in the control group but in 26 cases (35.1%) in the modified group, showing a significant difference (P<0.05). The incidences of bone cement leakage in the paravertebral vessels [13.5% (10/74)], paravertebral soft tissue [9.5%(7/74)] and spinal canal [4.1%(3/74)] in the modified group were all significantly lower than those in the control group [25.4%(43/169), 20.1%(34/169) and 15.4%(26/169)](P<0.05). Conclusion Application of the modified end-to-side puncture cannula is an optional scheme to prevent bone cement leakage in PVP, because it can reduce the incidence of bone cement leakage without compromising postoperative short-term outcomes, especially in the spinal canal, paraspinal vessels and paraspinal soft tissue.

Objective To investigate the association between warfarin drug effects and vitamin K epoxide reductase complex subunit 1 (VKORC1)-1639 G/A gene polymorphisms in Han Chinese very elderly patients.Methods The subjects were elderly patients aged more than 60 years, with stable anticoagulation with warfarin and the target international normalized ratio(INR), who were hospitalized in Beijing Friendship Hospital, Capital Medical University from August 2009 to August 2016.The patients were divided into the very elderly group and aged group.The first record of warfarin dosage, the duration of achieving stable dosage (defined as the initial stage of treatment) and warfarin stable dosage were recorded.The bleeding and embolism events during early treatment were observed.After INR was at the steady state, genotyping for the VKORC1-1639 G/A alleles were tested.The effects of drugs and complications in warfarin initiation therapy were also investigated.Results A total of 322 patients were enrolled, including 300 cases of atrial fibrillation and 22 cases of pulmonary embolism.The very elderly group had 200 cases, including 110 males and 90 females;their ages ranged from 75 to 96 years, the average age was (83+7).The aged group had 122 cases, including 68 males, 54 females, their ages ranged from 60 to less than 75 years, the average age was (67±8).The VKORC1-1639 G/A genotype included 256 cases of AA type (79.5%) which contained 150 males and 106 females, and 62 cases of type AG (19.3%) which contained 26 males and 36 females.The GG type included 4 cases (1.2%), containing 2 males and 2 females.Genotype distribution accorded with the law of genetic equilibrium.There was no significant difference in VKORC1-1639 G/A genotype distribution between the aged group and the very elderly group (P>0.05).The carriers of VKORC1-1639 AG+GG genotype had a significantly higher warfarin stable dosage than those of AA genotype [(2.90±1.39)mg vs.(2.00±1.14)mg, t=5.39, P<0.01].In the same genotype, the very elderly patients had a decreased warfarin stable dosage compared with the aged patients [AA: (1.62±1.24)mg vs.(2.58±0.98)mg, t=6.68, P<0.01;AG+GG: (2.43±0.55)mg vs.(3.36±1.52)mg, t=3.97, P<0.01].The AG+GG patients have a longer time to achieve stable dosage-effect relation compared with AA genotype [(18.9±2.8)d vs.(11.2±2.5)d, t=4.28, P=0.01].Conclusions Warfarin stable dosage was related to patient age and VKORC1-1639 gene polymorphism.According to the results of VKORC1-1639 genotype testing to adjust warfarin dose maybe have some clinical significance in Han elderly patients.

Objective To investigate the association between warfarin drug effects and vitamin K epoxide reductase complex subunit 1 (VKORC1)-1639 G/A gene polymorphisms in Han Chinese very elderly patients.Methods The subjects were elderly patients aged more than 60 years, with stable anticoagulation with warfarin and the target international normalized ratio(INR), who were hospitalized in Beijing Friendship Hospital, Capital Medical University from August 2009 to August 2016.The patients were divided into the very elderly group and aged group.The first record of warfarin dosage, the duration of achieving stable dosage (defined as the initial stage of treatment) and warfarin stable dosage were recorded.The bleeding and embolism events during early treatment were observed.After INR was at the steady state, genotyping for the VKORC1-1639 G/A alleles were tested.The effects of drugs and complications in warfarin initiation therapy were also investigated.Results A total of 322 patients were enrolled, including 300 cases of atrial fibrillation and 22 cases of pulmonary embolism.The very elderly group had 200 cases, including 110 males and 90 females;their ages ranged from 75 to 96 years, the average age was (83+7).The aged group had 122 cases, including 68 males, 54 females, their ages ranged from 60 to less than 75 years, the average age was (67±8).The VKORC1-1639 G/A genotype included 256 cases of AA type (79.5%) which contained 150 males and 106 females, and 62 cases of type AG (19.3%) which contained 26 males and 36 females.The GG type included 4 cases (1.2%), containing 2 males and 2 females.Genotype distribution accorded with the law of genetic equilibrium.There was no significant difference in VKORC1-1639 G/A genotype distribution between the aged group and the very elderly group (P>0.05).The carriers of VKORC1-1639 AG+GG genotype had a significantly higher warfarin stable dosage than those of AA genotype [(2.90±1.39)mg vs.(2.00±1.14)mg, t=5.39, P<0.01].In the same genotype, the very elderly patients had a decreased warfarin stable dosage compared with the aged patients [AA: (1.62±1.24)mg vs.(2.58±0.98)mg, t=6.68, P<0.01;AG+GG: (2.43±0.55)mg vs.(3.36±1.52)mg, t=3.97, P<0.01].The AG+GG patients have a longer time to achieve stable dosage-effect relation compared with AA genotype [(18.9±2.8)d vs.(11.2±2.5)d, t=4.28, P=0.01].Conclusions Warfarin stable dosage was related to patient age and VKORC1-1639 gene polymorphism.According to the results of VKORC1-1639 genotype testing to adjust warfarin dose maybe have some clinical significance in Han elderly patients.

Objective To observe the effects of ischemic postconditioning (IPTC) on myocardial infarction sizes (IS) and protein kinase Cα (PKCα) expression in aged rats with post-ischemia reperfusion injury,and to explore the mechanism.Methods A total of 120 male Wistar rats were divided into aged group and adult group.The aged group was randomly divided into control group (n=12,30-min ischemia and 3-h reperfusion),5 s,10 s,30 s and 60 s IPTC groups [n= 12,each;after 30 min occlusion of left coronary artery (LCA),three cycles of 5 s,10 s,30 s,60 s reperfusion respectively followed by the same interval LCA re-occlusion were applied at the beginning of reperfusion].The IS was measured with TTC dye,and PKC expression was investigated by immunohistochemistry.Results Different IPTC intervals had different effects on IS and PKC expression,10 s and 30 s IPTC could reduce IS both in aged rats and adult rats [(55.9±6.0)% and (47.4±5.5)%],IS in 10 s IPTC group in aged rats was (48.1±5.3)%,in adult rats was (39.2±5.7) %;IS in 30 s IPTC group in aged rats was (48.8 ± 6.8) %,in adult rats was (40.2 ± 6.1 ) %.PKCα expression increased in aged and adult rats (all P<0.05).5 s IPTC could increase IS [IS in 5 s IPTC group in aged rats was (63.5±5.4)%,and PKCα expression reduced in aged rats (all P<0.05)].Conclusions IPTC has cardio-protective effect in aged rats suffering from acute myocardial injury during reperfusion,the effect of IPTC is related to reperfusion-reocclusion interval.