BACKGROUND: The correlation between the morphological structure of the patellofemoral joint (PFJ) and the severity of knee joint osteoarthritis (KOA) remains uncertain. This study aims to investigate the correlation between the severity of knee joint osteoarthritis and the alignment of patellofemoral and patellar height on radiographs. METHODS: This multi-center, retrospective study analyzed the magnetic resonance imaging (MRI) scans and anteroposterior radiographs of 534 adult outpatients with KOA. To evaluate the radiographic severity of KOA, anteroposterior radiographs of the knee and the Kellgren-Lawrence (K-L) grade were used. Knee MRI scans were used to measure the patellar length ratio (PLR), sulcus angle (SA), lateral patellar tilt angle (LPTA), and the distance between tibial tuberosity and trochlear groove (TT-TG). We examined the association between the configuration of the PFJ, arrangement, and harshness of the KOA. Information on participants' demographics, such as age, sex, side, height, and weight, was collected. A chi-squared test was used for the correlation of radiographic severity of KOA with sex and the affected side. Spearman correlation was used for patellofemoral alignment or morphology and the radiographic severity of lateral KOA. Multiple linear regression models were used for the association between LPTA, SA, TT-TG, and severity of KOA after accounting for demographic variables. RESULTS: The study comprised of 534 patients; of these, 339 (63%) were female. A total of 586 knees were evaluated in this study. Age showed a strong positive correlation with KOA severity ( r  = 0.516, P <0.01), whereas LPTA showed a strong negative correlation ( r  = -0.662, P <0.01). Additionally, SA ( r  = 0.616, P <0.05), and TT-TG showed a strong positive correlation ( r  = 0.770, P <0.01) with tibiofemoral osteoarthritis (TFOA) severity. Multiple linear regression analysis indicated that knee osteoarthritis severity (β = -2.946, P <0.001) and side (β = -0.839, P  = 0.001) was associated with LPTA; knee osteoarthritis severity (β = 5.032, P <0.001) and age (β = -0.095, P <0.001) was associated with SA; knee osteoarthritis severity (β = 2.445, P <0.001), sex (β = -0.326, P  = 0.041), body mass index (β = -0.061, P  = 0.017) and age (β = -0.025, P <0.001) was associated with TT-TG. CONCLUSION Radiographic severity of KOA was positively associated with age, SA, and TT-TG but negatively associated with LPTA.
Humans ; Female ; Male ; Osteoarthritis, Knee/pathology* ; Middle Aged ; Retrospective Studies ; Aged ; Patellofemoral Joint/pathology* ; Magnetic Resonance Imaging ; Adult ; Patella/pathology* ; Radiography

Sleep deprivation (SD) has a profound impact on the central nervous system, resulting in an array of mood disorders, including depression and anxiety. Despite this, the dynamic alterations in neuronal activity during sleep deprivation have not been extensively investigated. While some researchers propose that sleep deprivation diminishes neuronal activity, thereby leading to depression. Others argue that short-term sleep deprivation enhances neuronal activity and dendritic spine density, potentially yielding antidepressant effects. In this study, a two-photon microscope was utilized to examine the calcium transients of anterior cingulate cortex (ACC) neurons in awake SD mice in vivo at 24-hour intervals. It was observed that SD reduced the frequency and amplitude of Ca2+ transients while increasing the proportions of inactive neurons. Following the cessation of sleep deprivation, neuronal calcium transients demonstrated a gradual recovery. Moreover, whole-cell patch-clamp recordings revealed a significant decrease in the frequency of spontaneous excitatory post-synaptic current (sEPSC) after SD. The investigation also assessed several oxidative stress parameters, finding that sleep deprivation substantially elevated the level of malondialdehyde (MDA), while simultaneously decreasing the expression of Nuclear Factor erythroid 2-Related Factor 2 (Nrf2) and activities of Superoxide dismutase (SOD) in the ACC. Importantly, the administration of gallic acid (GA) notably mitigated the decline of calcium transients in ACC neurons. GA was also shown to alleviate oxidative stress in the brain and improve cognitive impairment caused by sleep deprivation. These findings indicate that the calcium transients of ACC neurons experience a continuous decline during sleep deprivation, a process that is reversible. GA may serve as a potential candidate agent for the prevention and treatment of cognitive impairment induced by sleep deprivation.

Objective:To understand the current status of abortion and contraception among nonparous adolescent women and explore the influence of post-abortion care (PAC) services on their contraceptive choice and repeated abortion.Methods:A retrospective study was conducted on the nonparous adolescent women who had undergone induced abortion in outpatient clinics of Guangdong Women's and Children's Hospital from January to December 2018 was recruited. Through PAC consultation and follow-up, their contraceptive options and the incidence of repeated abortions before and after surgery were compared.Results:1) There were 1137 cases of induced abortion among nonparous adolescent women, accounting for 85.30% (1137/1333) of the total number of adolescent abortions, 29.51% (1137/3853) of the total number of abortions during the same period, among which 23.39% (266/1137) had abortion history before surgery, 5.54% (63/1137) had abortion ≥3 times, 2.73% (31/1137) had repeated abortion (≥2 times within 1 year) within half a year, and 6.86% (78/1137) had abortion ≥2 times within 1 year. 2) There was a significant increase in the choice of high-efficiency contraceptive methods after PAC compared with that before surgery (2.73% vs. 84.43%, P<0.001), in which the use of combined oral contraceptive (COC) and intrauterine device (IUD) increased significantly (2.73% vs. 83.46%, P<0.001; 0 vs. 0.97%, P=0.001), and the number of married women using IUD was higher than that of unmarried women (5.71% vs.0.86%, P=0.047). On the other hand, the rate of continued use of COC at 3, 6, and 12 months of post-operative nonparous adolescent women gradually decreased (83.01%, 5.95%, 2.46%), while the rate of continued use of IUD remained stable (0.97%, 1.14%, 1.23%). 3) The repeated induced abortion rate among nonparous adolescent women in the half of a year and one year after PAC significantly decreased compared with that before PAC (1.26% vs. 2.73%, P=0.022; 3.70% vs. 6.86%, P=0.003). Conclusion:Nonparous adolescent women have a higher rate of repeated abortions, while a lower rate of the use of high-efficiency contraceptive methods. PAC services can significantly improve the immediate implementation rate of high-efficiency contraceptives, and it is necessary to further increase the immediate implementation rate of IUD and the continued use rate of the COC.

Objective:To understand the current status of abortion and contraception among nonparous adolescent women and explore the influence of post-abortion care (PAC) services on their contraceptive choice and repeated abortion.Methods:A retrospective study was conducted on the nonparous adolescent women who had undergone induced abortion in outpatient clinics of Guangdong Women's and Children's Hospital from January to December 2018 was recruited. Through PAC consultation and follow-up, their contraceptive options and the incidence of repeated abortions before and after surgery were compared.Results:1) There were 1137 cases of induced abortion among nonparous adolescent women, accounting for 85.30% (1137/1333) of the total number of adolescent abortions, 29.51% (1137/3853) of the total number of abortions during the same period, among which 23.39% (266/1137) had abortion history before surgery, 5.54% (63/1137) had abortion ≥3 times, 2.73% (31/1137) had repeated abortion (≥2 times within 1 year) within half a year, and 6.86% (78/1137) had abortion ≥2 times within 1 year. 2) There was a significant increase in the choice of high-efficiency contraceptive methods after PAC compared with that before surgery (2.73% vs. 84.43%, P<0.001), in which the use of combined oral contraceptive (COC) and intrauterine device (IUD) increased significantly (2.73% vs. 83.46%, P<0.001; 0 vs. 0.97%, P=0.001), and the number of married women using IUD was higher than that of unmarried women (5.71% vs.0.86%, P=0.047). On the other hand, the rate of continued use of COC at 3, 6, and 12 months of post-operative nonparous adolescent women gradually decreased (83.01%, 5.95%, 2.46%), while the rate of continued use of IUD remained stable (0.97%, 1.14%, 1.23%). 3) The repeated induced abortion rate among nonparous adolescent women in the half of a year and one year after PAC significantly decreased compared with that before PAC (1.26% vs. 2.73%, P=0.022; 3.70% vs. 6.86%, P=0.003). Conclusion:Nonparous adolescent women have a higher rate of repeated abortions, while a lower rate of the use of high-efficiency contraceptive methods. PAC services can significantly improve the immediate implementation rate of high-efficiency contraceptives, and it is necessary to further increase the immediate implementation rate of IUD and the continued use rate of the COC.

Objective To compare the efficacy of different hysteroscopic surgical procedures in the treatment of endometrial polyps. Methods Ninety-two patients with endometrial polyps from January 2016 to December 2017 were selected. Among them, 37 patients with fertility requirements underwent polypectomy with MyoSure as group A; 25 patients without fertility requirements underwent polypectomy with resectoscopic hysteroscopy as group B, and 30 patients underwent polypectomy with hysterosopy and curettage as group C. The duration of the procedure, blood loss and hospital stays, effective rate, recurrence rate and postoperative pregnancy rate of the3 groups were compared. Results There was no significant difference in intraoperative blood loss and hospital stays among the 3 groups (P> 0.05). The duration of the procedure of group A and B was longer than that of group C, and the difference was statistically significant (P < 0.05). The effective rate of treatment was high in all 3 groups, and inter-group comparison indicated no statistically significant difference, but the recurrence rate of group C was significantly higher than that of group A and B. For those with fertility requirements, the pregnancy rate in group A was slightly higher than that in group C within one year after surgery, but the difference was not statistically significant. Conclusion Hysteroscopic procedures of endometrial polypectomy has the advantages of accuracy, safety, effectiveness and rapid recovery. The treatment with MyoSure and resectoscopic hysteroscopy can reduce the recurrence rate of patients effectively. For women with fertility requirements, the treatment with MyoSure can protect the endometrium and improve the postoperative pregnancy rate.

OBJECTIVE: To review the development of adult and pediatric liver transplantation in Tianjin First Center Hospital, and to enhance academic exchanges, improve technological innovation, and jointly promote the progress and maturity in the field of liver transplantation. METHODS: The development of liver transplantation in Tianjin First Center Hospital was analyzed. The clinical data of adult and pediatric liver transplantation from September 1998 to September 2018 were collected. The important events and technological innovation achievements of liver transplantation during the 20 years were summarized. RESULTS: The first clinical liver transplantation was attempted in Tianjin First Central Hospital in April 1980. The first long-term survival adult liver transplantation in China was completed in 1994 (11 years survival after the operation). The specialized team of liver transplantation was formally established in September 1998. The 20-year clinical exploration and progress reflected the characteristics of era changes and technological innovation during the rapid development of liver transplantation in China. Our center performed liver re-transplantation in January 1999, reduced-size pediatric liver transplantation in August 2000. In May 2001, we organized the formulation for the preventive and treatment plan for hepatitis B recurrence after liver transplantation. We performed combined liver and kidney transplantation in July 2002, split liver transplantation (SLT) in April 2004, the first domino liver transplantation (DLT) in August 2005. Pediatric living donor liver transplantation (LDLT) was initiated in October 2006, adult LDLT was carried out in August 2007. In September 2007, the first living donor combined liver and kidney transplantation from the same donor in Asia was performed. The first domino+living donor double grafts liver transplantation in the world was performed in January 2009. In March 2011, we performed laparoscopically assisted right hepatic lobe liver transplantation (LDLT) with middle hepatic vein. In May 2014, living donor laparoscopic left lateral lobe procurement was successfully established. In April 2016, simultaneous liver, pancreas and kidney multi-organ transplantation was completed. Domino donor-auxiliary liver transplantation was performed in February 2017. In December 2017, extracorporeal membrane oxygenation (ECMO)-supported liver transplantation in a patient with severe pulmonary hypertension was successfully completed. Liver transplantation combined with partial splenectomy was established in April 2018. Cross-domino liver transplantation (hypersensitive kidney transplantation with auxiliary liver transplantation+pediatric liver transplantation) was performed in May 2018. During the 20 years, the team has performed or assisted other centers in Beijing, Shanghai, Guangzhou and Shenzhen to carry out more than 10 000 cases of liver transplantations. A total of 7 043 cases of various types of liver transplantation were performed in the single center of the hospital (6 005 adult liver transplantations and 1 038 pediatric liver transplantations). Concerning adult liver transplantation, the cumulative 1-year, 3-year and 5-year survival rate from September 1998 to March 2003 were 83.1%, 73.0% and 69.0%, from April 2003 to March 2009 were 85.3%, 76.2% and 72.1% and from April 2009 to September 2018 were 87.5%, 79.2% and 75.1%, respectively. The cumulative 1-year, 3-year and 5-year survival rate for pediatric liver transplantation were 93.5%, 92.2% and 90.2%, respectively. The nucleoside (acid) analogue combined with low dose hepatitis B immunoglobulin (HBIG) was developed to prevent the recurrence of hepatitis B after liver transplantation, this plan has reduced the recurrence rate of hepatitis B and the 5-year re-infection rate of hepatitis B virus (HBV) after liver transplantation significantly. The risk assessment system for tumor recurrence after liver transplantation was established and individual treatment method was established based on this assessment system. Continuous exploration and improvement of liver transplantation for liver cancer, liver re-transplantation, liver transplantation with portal vein thrombosis, SLT, DLT and multi-organ combined transplantation have significantly improved the clinical efficacy of patients and the post-operative survival rate. CONCLUSIONS The liver transplantation team of Tianjin First Center Hospital has carried out a scientific and technological exploration on the key problems and technical difficulties of clinical liver transplantation. This work strongly has initiated and promoted the rapid development of liver transplantation in China. The restrictive barrier of hepatitis B recurrence after liver transplantation has been overcome. The risk prevention and control system of tumor recurrence after liver transplantation has been established. A series of innovative achievements that can be popularized have been achieved in the field of complex liver transplantation and expansion of donor liver source. The iterative progress and sustainable development of liver transplantation have been realized.
China ; Humans ; Liver Transplantation

Objective To discuss the modified eversion thrombectomy for portal vein thrombosis (PVT) in liver transplantation and the curative effectiveness.Methods All 613 cases complicated with PVT preoperation were given modified eversion thrombectomy,and there were 179,236,182 and 16 cases of PVT Yerdel grade Ⅰ,Ⅱ,Ⅲ and Ⅳ respectively.Results All 415 PVT patients of grade Ⅰ and Ⅱ received modified eversion thrombectomy and success rate was 100％.Among 182 PVT patients of grade Ⅲ received modified eversion thrombectomy (success in 176 cases,and failure in 6 cases).Sixteen PVT patients of grade Ⅳ received modified eversion thrombectomy (success in 13 cases and failure in 3 cases).The 1-year survival rate of PVT patients after surgical operation was 93.6％,and that of non-PVT patients was 94.6％ (P＞0.05).Conclusion Modified eversion thrombectomy could be adopted in PVT patients regarding to different Yerdel grades.

Objective To investigate the effect of fatty liver graft on early poor prognosis in postoperative liver transplant adult patients.Methods The clinical data of 125 adult patients undergoing liver transplantation (LT) from fatty liver graft from January 2008 to October 2012 were retrospectively analyzed.Patients were divided into poor-prognosis group and non-poor-prognosis group.18 clinical factors were compared between these two groups by single factor and multiple factor Logistic regression analysis.Results Degree of steatosis (x2 =10.088,P =0.004),recipients' age (t =-3.917,P =0.002),pre-LTserum creatinine values (Z =-2.623,P =0.009),liver warm ischemia time (Z =-2.305,P =0.021),cold ischemia time (Z =-3.394,P =0.001) were identified to be statistically significant by the single factor analysis (P ＜ 0.05);By multivariate stepwise Logistic regression analysis on the above parameters,cold ischemia time (x2 =10.141,P =0.001,OR =1.003) and degree of steatosis (x2 =8.360,P =0.004,OR =4.619) were found as the independent risk factors,into the regression equation:Y =0.003 × cold ischemia time + 1.530 × degree of steatosis-4.243.Conclusions Donor liver cold ischemia time,degree of steatosis are independent risk factors for poor prognosis in early stage after liver transplantation.

Objective To analyze and evaluate the efficacy of living donor liver transplantation (LDLT) and deceased
donor liver transplantation (DDLT). Methods The clinical data of prognosis and influencing factors of 320 children with liver transplantation were analyzed retrospectively. The 320 children were divided into LDLT group (n=252) and DDLT group (n=68) based on their operation styles. In LDLT group, all donors to recipients were immediate relatives within three generation. In DDLT group, all livers were obtained from cardiac death or brain death donors. The survival and incidence of complications were observed between two groups. Results The 1-year, 2-year and 3-year cumulative survival rates for recipients were 95.1%, 93.5% and 93.5% in LDLT group, and 92.3%, 92.3% and 82.4% in LDLT group. There was no significant difference between the two groups (Log-rank χ2=0.69,P=0.41). During the follow-up period,14 cases died (5.56%) in LDLT group, in which 8 deaths due to respiratory complication, 3 deaths due to multiple organ failure, and 3 deaths due to graft failure. In DDLT donor group, 5 cases died (7.35%), in which 1 death due to respiratory complication, 2 deaths due to multiple organ failure, 1 death due to intra-abdominal hemorrhage, and 1 case of unknown cause of death. There were no significant differences in portal vein thrombosis (PVT), outflow tract obstruction, biliary tract complications and pulmonary infection between the two groups (P>0.05). The ratio of hepatic artery thrombosis (HAT) was lower in LDLT group than that of DDLT group (1.98%vs. 10.29%,χ2=10.245,P<0.01). Conclusion Living donor liver transplantation is an effective method to treat end-stage liver disease.

Background Our previous study demonstrated that microglial activation is closely associated with photoreceptor apoptosis in rd mice.Recent studies on central nervous system (CNS) showed that activation of nicotinamide adenine dinucleotide phosphate (NADPH) oxidase plays a key role in the microglia activation and neural cell death.However,the mechanism of NADPH oxidase during the retinal degeneration and the effect of NADPH oxidase inhibitor on photoreceptor apoptosis are concerned.Objective The aim of this study was to further explore the production of reactive oxygen species (ROS) by NADPH oxidase in the retinal degenerative process of rd mice and protection of NADPH oxidase inhibitor on photoreceptors.Methods Sixty rd mice at postnatal day 9 (P9) were randomized into the experimental group and the control group by throwing coins method.Apocynin,a NADPH oxidase inhibitor,was intraperitoneally injected in the dose of 10 mg/kg (0.01 ml/kg) once daily for 5 days (P13) in the experimental group,and the equal amount of PBS was used in the same way in the control group,and 10 C57BL/6N mice without injection of any drugs served as the wild type mice group.All the mice were sacrificed in P14 for the preparation of retinal sections.The expression of ROS in the retina was detected by dihydroethidium (DHE) fluorescence staining.Expression level of rhodopsin mRNA in the photoreceptor of the mice was determined by real-time PCR,and the thickness of retinal outer nuclear layer (ONL) in the mice of the experimental group and the control group was measured using hematoxylin & eosin staining.The use and care of the animals complied with the Statement of Association for Research in Vision and Ophthalmology.Results DHE staining showed that the ROS presented with the red fluorescence in the mouse retinas.In the rd mice of the experimental group,the ROS fluorescence intensity was dramatically enhanced in comparison with C57BL/6N mice,but weakened in comparison with the rd mice of the control group.Real-time PCR revealed that the relative expressing level of rhodopsin mRNA in the photoreceptor was (4.21±0.33) in the experimental group and (0.93±0.24) in the control group,showing a significant difference between them (t =2.360,P =0.000).The thickness value of retinal ONL was (35.95±1.63)μm in the mice of the experimental group,which was significantly higher than that in the mice of the control group ([23.17±1.38] μm) (t=3.850,P=0.016).Conclusions In the retinal degeneration of rd mice,activation of NADPH oxidase increases the ROS production.Apocynin can slow the apoptosis procedure of photoreceptor cells of rd mice.