Objective To develop the'E-Bone',a comprehensive one-stop preoperative planning system for reverse total shoulder arthroplasty with improved accuracy and efficiency.Methods The nnU-net deep neural network was utilized for scapula segmentation to obtain precise scapula segmentation results.Based on the 3 key factors,namely bone density,upward and downward angle and nail length,the base was automatically positioned.The quantitative parameters required for surgical planning were calculated.A personalized guide plate was generated by combining glenoid morphology and base positioning information.The system interface was developed to modularize various functions for easy use,providing interactive operation and real-time display.Results Compared with the Mimics system,the'E-bone'preoperative planning system reduced complex manual adjustments during the planning process.The average planned nail length was longer than that of the Mimics system,and the planning time was reduced by 86%.The scapula segmentation accuracy of this system reached 99.93%,better than that of Mimics to achieve a higher precision.Conclusion The"E-bone"system provides a one-stop,efficient,and accurate preoperative planning system for reverse shoulder replacement and potentially broader clinical applications.

Objective To develop the'E-Bone',a comprehensive one-stop preoperative planning system for reverse total shoulder arthroplasty with improved accuracy and efficiency.Methods The nnU-net deep neural network was utilized for scapula segmentation to obtain precise scapula segmentation results.Based on the 3 key factors,namely bone density,upward and downward angle and nail length,the base was automatically positioned.The quantitative parameters required for surgical planning were calculated.A personalized guide plate was generated by combining glenoid morphology and base positioning information.The system interface was developed to modularize various functions for easy use,providing interactive operation and real-time display.Results Compared with the Mimics system,the'E-bone'preoperative planning system reduced complex manual adjustments during the planning process.The average planned nail length was longer than that of the Mimics system,and the planning time was reduced by 86%.The scapula segmentation accuracy of this system reached 99.93%,better than that of Mimics to achieve a higher precision.Conclusion The"E-bone"system provides a one-stop,efficient,and accurate preoperative planning system for reverse shoulder replacement and potentially broader clinical applications.

Reverse shoulder arthroplasty (RSA) was proposed to deal with rotator cuff tear arthropathy in the 1970s and improved from 1985 to 1995 by Dr. Grammont who designed the contemporary type of reverse shoulder prosthesis successfully. The number of RSAs has grown rapidly over the past decade. Currently, the indications for RSA include, in addition to rotator cuff tear arthropathy, massive rotator cuff tears which can not be repaired, proximal humerus fractures or their sequelae, inflammatory shoulder disease, osteoarthritis with abnormal glenoid morphology, anatomic revision after failed total shoulder arthroplasty or hemiarthroplasty, and shoulder tumors. Absolute contraindications to RSA include infection, complete axillary nerve palsy, neuropathic shoulder arthropathy, and glenoid bone loss. At present, the stability of the glenoid baseplate, an important factor affecting the incidence of postoperative complications, is mainly achieved by implantation of the screws for the glenoid baseplate base. Therefore, correct implantation of the screws is of great significance to reduce the complications in RSA.

ObjectiveTo systematically review the effects of bilingual training on cognition for older adults. MethodsResearches about bilingual training for cognition for the older adults were retrieved from PubMed, Web of Science, ScienceDirect, SpringerLink, Wanfang Data, and CNKI from 2011 to May, 2021, supplemented by references backtracking and manual retrieval. The data was extracted for analysis. ResultsA total of 21 researches were included from twelve countries, which published mainly on journals of medicine, neurology, psychology, biology, etc., in 2017 and 2019. Most of the researches were prospective researches and retrospective researches, and the targeted groups including healthy people, people with dementia and people with Alzheimer's disease (AD). The objects mainly involved the effects of bilingualism on cognition, the pathways and the limitations. ConclusionBilingual training may improve the cognition for older adults, through the brain connection related with memory, attention and execution, to delay the onset of AD or dementia; which may associate with the improvement of brain structure and function, including connectivity among regions, activation of cortical circuits, and structural integrity and plasticity. The effects are mainly on execution and perception, and delaying the cognitive decline, which appear in a short term. Bilingual training may finally promote language function, maintain the integrity of the brain structures, and compensate cognitive decline using more potential neural circuits. However, these researches need more uniform criteria for subjects, more reasonable control conditions, and more uniform paradigms.

Objective To evaluate the role of M3 receptors in penehyclidine hydrochloride ( PHC)-induced reduction of lipopolysaccharide ( LPS)-induced injury to human pulmonary microvascular endotheli-al cells ( PMVECs) . Methods Human PMVECs transfected with M3 shRNA were seeded in 6-well plates (2 ml∕hole) or in culture flasks (4 ml∕flask) at the density of 1×105 cells∕ml and divided into 5 groups ( n=5 each) using a random number table method: control group ( group C) , LPS group, PHC plus LPS group ( group P+LPS) , LPS plus M3 shRNA transfection group ( group LPS+shRNA) , and PHC plus LPS plus M3 shRNA transfection group ( group P+LPS+shRNA) . Group C received no mediation, and LPS was added at the final concentration of 0. 1 μg∕ml in the other groups. PHC 2 μg∕ml was added at 1 h before adding LPS in P+LPS and P+LPS+shRNA groups. The cells were transfected with plasmid containing 2. 5 nmol∕L M3 receptor shRNA in LPS+shRNA group and P+LPS+shRNA group. Contents of filamentous actin ( F-actin) in endothelial cells were measured by flow cytometry at 1 h after adding LPS. The expression of myosin light chain kinase ( MLCK) and VE-cadherin protein was examined by immunofluorescence. The ex-pression of nuclear factor kappa B ( NF-κB) p65 and IκB was detected by Western blot. Contents of tumor necrosis factor-alpha ( TNF-α) and interleukin-6 ( IL-6) were determined by enzyme-linked immunosorbent assay. The M3 receptor mRNA transcription was detected by real-time polymerase chain reaction at 10, 30 and 60 min after adding LPS. Results Compared with group C, F-actin content was significantly de-creased, the expression of VE-cadherin and IκB was down-regulated, the contents of TNF-αand IL-6 were increased, and the expression of MLCK and NF-κB p65 was up-regulated in LPS and P+LPS groups ( P<0. 05) . Compared with group C, the expression of M3 receptor mRNA was significantly up-regulated in group LPS ( P<0. 05) , and no significant change was found in group P+LPS ( P>0. 05) . Compared with group LPS, F-actin content was significantly increased, the expression of VE-cadherin and IκB was up-reg-ulated, the contents of TNF-αand IL-6 were decreased, and the expression of MLCK, NF-κB p65 and M3 receptor mRNA was down-regulated in group P+LPS and group LPS+shRNA ( P<0. 05) . Compared with group P+LPS, F-actin content was significantly increased, the expression of VE-cadherin and IκB protein was up-regulated, TNF-α and IL-6 contents were decreased, and the expression of MLCK, NF-κB p65 and M3 receptor mRNA was down-regulated in group P+LPS+shRNA ( P<0. 05) . Conclusion PHC re-duces LPS-induced injury to human PMVECs through interfering with M3 receptors and inhibiting NF-κB-mediated inflammatory responses.

Objective To evaluate the role of M3 receptor in penehyclidine hydrochloride(PHC)-induced reduction of increased permeability of human pulmonary microvascular endothelial cells (PMVECs) caused by endotoxin and the relationship with mitogen-activated protein kinase (MAPK) signaling pathway.Methods Human PMVECs were seeded in 6-well plates (2 ml/hole) or in culture flasks (4 ml/flask) at the density of 1 × 105 cells/ml and randomly divided into 6 groups (n=5 each):control group (group C),M3 receptor shRNA transfection group (group shRNA),lipopolysaccharide (LPS) group,penehyclidine plus LPS group (group P+LPS),LPS plus M3 receptor shRNA transfection group (group LPS+shRNA) and PHC plus LPS plus M3 shRNA transfection group (group P+LPS+shRNA).The cells were transfected with shRNA plasmid containing 2.5 nmol/L M3 receptors in shRNA,LPS+shRNA and P+LPS+shRNA groups.LPS at the final concentration of 0.1 μg/ml was added at 24 h of incubation and then cells were incubated for 1 h in LPS and LPS+shRNA groups.PHC at the final concentration of 2 μg/ml was added at 24 h of incubation,cells were incubated for 1 h,then LPS at the final concentration of 0.1 μg/ml was added,and cells were incubated for another l h in P+LPS and P+LPS+shRNA groups.The permeability of PMVECs was measured using Transwell assay.The expression of phosphorylated p38 MAPK (p-p38 MAPK)and phosphorylated extracellular signal-regulated protein kinase 1/2 (p-ERK1/2) was detected by Western blot,the expression of heat shock protein 27 (HSP27) using immunofluorescent staining,and the expression of M3receptor mRNA by real-time polymerase chain reaction.Results Compared with group C,M3 receptor mRNA expression was significantly down-regulated in group shRNA,and the permeability of cells was significantly increased,and the expression of p-p38 MAPK,p-ERK1/2,HSP27 and M3 receptor mRNA was up-regulated in group LPS (P＜0.05).The permeability of cells was significantly decreased,and the expression of p-p38 MAPK,p-ERK1/2,HSP27 and M3 receptor mRNA was down-regulated in P+ LPS,LPS+shRNA and P+LPS+shRNA groups as compared with group LPS,and in group P+LPS+shRNA as compared with group LPS+shRNA (P＜0.05).Conclusion The mechanism by which PHC reduces endotoxin-caused increased permeability of human PMVECs is related to inhibiting activation of MAPK signaling pathway after down-regulating M3 receptor.

ObjectiveTo observe the effect of different needle-retaining lengths on the clinical efficacy of acupuncture in treating post-stroke shoulder pain.MethodSixty patients were randomized into a 30 min group and a 60 min group, 30 cases in each group. The same acupuncture treatment protocol was adopted in the two groups, and the acupuncture treatment was given once a day, 5 sessions a week, for 20 times in total. The Visual Analogue Scale (VAS), shoulder pain frequency, and Fugl-Meyer Assessment (FMA) were observed before treatment and after 4-week treatment.ResultThe scores of each index were significantly improved in both groups after treatment (P<0.01), and there were significant differences in comparing each index score between the two groups after treatment (P<0.05,P<0.01).ConclusionIn the treatment of post-stroke shoulder pain with acupuncture, 30 min needle-retaining is better than 60 min in comparing the analgesic effect.

Objective To evaluate the clinical efficacy of acupuncture-moxibustion in treating deglutition disorders after cerebral stroke.Method By computer and manual literature retrieval, eligible randomized controlled trials (RCTs) were collected for systematic review by using the Cochrane method, and the meta analysis was performed by using Revman 5.2.Result Nine studies were recruited, covering 577 subjects of deglutition disorders due to cerebral stroke. The total effective rate of the treatment group was significantly higher than that of the control group [RR=0.36, 95%CI (0.25,0.50), Z=5.80 (P<0.00001)]. The treatment group was superior to the control group in improving the water drinking test (χ2=108.73,P<0.00001).Conclusion Acupuncture can produce a content therapeutic efficacy in treating deglutition disorders due to cerebral stroke, which still requires high-quality large-sample-size clinical RCTs for further verification.

Objective To compare the effect of different needle-retaining time on post-stroke hypermyotonia in acupuncture treatment.Method Ninety patients with post-stoke hypermyotonia were randomized into group A, group B, and group C, 30 in each group. The three groups were all treated by the twelve hand-foot needling method from the thirteen therapies invented by acupuncture master WANG Le-ting, once a day, 5 times a week, 20 times in total. For group A, needles were removed right after needling qi arrived; for group B, needles were retained for 30 min after needling qi arrived; for group C, needles were retained for 60 min after needling qi arrived. The modified Ashworth Scale (MAS), Clinical Spasticity Index (CSI), and Fugl-Meyer assessment scale (FAS) were adopted for observation before and after intervention.Result After treatment, the MAS was significantly changed in all three groups (P<0.05). The CSI score and FAS score of the affected limb were significantly changed in all three groups after intervention (P<0.05). Both group A and B were significantly different from group C in comparing the CSI and FAS scores (P<0.05).Conclusion Compared to retaining needles for 60 min, acupuncture without retaining needles or retaining needles for 30 min can produce better effect in improving post-stroke hypermyotonia, spasticity, and motions of limbs.