OBJECTIVE: To analyze the effectiveness of single three-dimensional (3D)-printed microporous titanium prostheses and flap combined prostheses implantation in the treatment of large segmental infectious bone defects in limbs. METHODS: A retrospective analysis was conducted on the clinical data of 76 patients with large segmental infectious bone defects in limbs who were treated between January 2019 and February 2024 and met the selection criteria. Among them, 51 were male and 25 were female, with an age of (47.7±9.4) years. Of the 76 patients, 51 had no soft tissue defects (single prostheses group), while 25 had associated soft tissue defects (flap combined group). The single prostheses group included 28 cases of tibial bone defects, 11 cases of femoral defects, 5 cases of humeral defects, 4 cases of radial bone defects, and 3 cases of metacarpal, or carpal bone defects, with bone defect length ranging from 3.5 to 28.0 cm. The flap combined group included 3 cases of extensive dorsum of foot soft tissue defects combined with large segmental metatarsal bone defects, 19 cases of lower leg soft tissue defects combined with large segmental tibial bone defects, and 3 cases of hand and forearm soft tissue defects combined with metacarpal, carpal, or radial bone defects, with bone defect length ranging from 3.8 to 32.0 cm and soft tissue defect areas ranging from 8 cm×5 cm to 33 cm×10 cm. In the first stage, vancomycin-loaded bone cement was used to control infection, and flap repair was performed in the flap combined group. In the second stage, 3D-printed microporous titanium prostheses were implanted. Postoperative assessments were performed to evaluate infection control and bone integration, and pain release was evaluated using the visual analogue scale (VAS) score. RESULTS: All patients were followed up postoperatively, with an average follow-up time of (35.2±13.4) months. In the 61 lower limb injury patients, the time of standing, walk with crutches, and fully bear weight were (2.2±0.6), (3.9±1.1), and (5.4±1.1) months, respectively. The VAS score at 1 year postoperatively was significantly lower than preoperative one ( t=-10.678, P<0.001). At 1 year postoperatively, 69 patients (90.8%) showed no complication such as infection, fracture, prosthesis displacement, or breakage, and X-ray films indicated good integration at the prosthesis-bone interface. According to the Paley scoring system for the healing of infectious bone defects, the results were excellent in 37 cases, good in 29 cases, fair in 3 cases, and poor in 7 cases. In the single prostheses group, during the follow-up, there was 1 case each of femoral prostheses fracture, femoral infection, and tibial infection, with a treatment success rate of 94.1% (48/51). In lower limb injury patients, the time of fully bear weight was (5.0±1.0) months. In the flap combined group, during the follow-up, 1 case of tibial fixation prostheses screw fracture occurred, along with 2 cases of recurrent foot infection in diabetic patients and 1 case of tibial infection. The treatment success rate was 84.0% (21/25). The time of fully bear weight in lower limb injury patients was (5.8±1.2) months. The overall infection eradication rate for all patients was 93.4% (71/76). CONCLUSION The use of 3D-printed microporous titanium prostheses, either alone or in combination with flaps, for the treatment of large segmental infectious bone defects in the limbs results in good effectiveness with a low incidence of complications. It is a feasible strategy for the reconstruction of infectious bone defects.
Humans ; Male ; Female ; Middle Aged ; Printing, Three-Dimensional ; Titanium ; Retrospective Studies ; Surgical Flaps ; Adult ; Prosthesis Implantation/methods* ; Plastic Surgery Procedures/methods* ; Treatment Outcome ; Prostheses and Implants ; Bone Diseases, Infectious/surgery* ; Extremities/surgery* ; Prosthesis Design

Objective:To evaluate the analgesic effects of lidocaine cream and ice application during botulinum toxin type A treatment on bilateral gastrocnemius hypertrophy.Methods:A retrospective study was conducted, including 60 patients who underwent botulinum toxin type A treatment for bilateral gastrocnemius hypertrophy at Peking University Shenzhen Hospital from January 2020 to January 2022. Patients were divided into two groups based on the analgesic methods: lidocaine surface anesthesia group (lidocaine group, 30 cases) and ice application analgesia group (ice group, 30 cases). The lidocaine group consisted of 2 males and 28 females, with a mean age of (27.0±5.0) years, while the ice group consisted of 30 females, with a mean age of (26.2±4.4) years. Depending on individual needs, 100-200 U of botulinum toxin type A was injected into the calf muscle of each patient. In the lidocaine group, nurses applied lidocaine cream to the injection area and covered it with a film before injection. In the ice group, nurses used custom-made ice packs to surround the injection site for 10 minutes. Pain levels were assessed using the visual analog scale (VAS) during injection, including pain scores for needle puncture and drug injection. The incidence of postoperative adverse reactions and patient satisfaction rates were also recorded.Results:The VAS score for needle puncture pain was (2.60±1.25) in the lidocaine group and (2.30±1.12) in the ice group, with no statistically significant difference ( P=0.331). However, the VAS score for drug injection pain was significantly higher in the lidocaine group (3.47±1.25) than that in the ice group (2.77±1.28, P=0.036). The overall analgesic VAS score was (3.37±1.16) in the lidocaine group, also significantly higher than that (2.60±1.25) in the ice group ( P=0.017). Two patients in the lidocaine group experienced localized swelling, and one reported localized itching with a rash, while no adverse reactions were observed in the ice group. Patient satisfaction rates were 86.7% (26/30) in the lidocaine group and 93.3% (28/30) in the ice group. Conclusions:Ice application provides superior analgesic effects compared to lidocaine cream surface anesthesia during botulinum toxin type A treatment for bilateral gastrocnemius hypertrophy.

Objective:To investigate the impact of overweight/obesity on postoperative complications in breast reduction surgery.Methods:A retrospective study was conducted on patients who underwent breast reduction surgery in our hospital from 2016 to 2022. Basic patient information and postoperative complications, such as poor wound healing, infection, hematoma, nipple necrosis, etc., were collected. Patients were categorized into normal/low weight group and overweight/obese group according to their body mass index (BMI). The differences in postoperative complications between the two groups were compared and statistically analyzed.Results:The study included 82 patients, 48 in the normal/low weight group and 34 in the overweight/obese group. The gender, age, and surgical methods of the two groups of patients were relatively balanced, and there was no statistical difference. However, the incidence of postoperative complications was 50.0% (17/34) in overweight/obeseitg group, higher than 18.8% (9/48) in normal/low weight group. Common complications included delayed healing such as infection or dehiscence in 8 cases (9.8%), skin necrosis in 5 cases (6.1%), and hypertrophic scars in 5 cases (6.1%). The incidence of skin necrosis and delayed healing in the overweight/obese group was higher than that in the normal/low weight group, but the difference was not statistically significant ( P>0.05). Postoperative hematoma and hypertrophic scars occurred in both groups, while fat liquefaction and thrombosis only occurred in the overweight/obese group. Conclusions:Overweight/obesity is an important risk factor for postoperative complications in breast reduction surgery. Patients should be evaluated before surgery, and necessary measures should be taken to reduce the risk of complications.

Background: Both type 1 diabetes mellitus (T1DM) and metabolic syndrome (MetS) are associated with an elevated risk of morbidity and mortality yet with increasing heterogeneity. This study primarily aimed to evaluate the prevalence of MetS among adult patients with T1DM in China and investigate its associated risk factors, and relationship with microvascular complications. Methods: We included adult patients who had been enrolled in the Guangdong T1DM Translational Medicine Study conducted from June 2010 to June 2015. MetS was defined according to the updated National Cholesterol Education Program criterion. Logistic regression models were used to estimate the odds ratio (OR) for the association between MetS and the risk of diabetic kidney disease (DKD) and diabetic retinopathy (DR). Results: Among the 569 eligible patients enrolled, the prevalence of MetS was 15.1%. While female gender, longer diabetes duration, higher body mass index, and glycosylated hemoglobin A1c (HbA1c) were risk factors associated with MetS (OR, 2.86, 1.04, 1.14, and 1.23, respectively), received nutrition therapy education was a protective factor (OR, 0.46). After adjustment for gender, age, diabetes duration, HbA1c, socioeconomic and lifestyle variables, MetS status was associated with an increased risk of DKD and DR (OR, 2.14 and 3.72, respectively; both P<0.05). Conclusion Although the prevalence of MetS in adult patients with T1DM in China was relatively low, patients with MetS were more likely to have DKD and DR. A comprehensive management including lifestyle modification might reduce their risk of microvascular complications in adults with T1DM.

Circular RNA (circRNA) is a single-stranded circular closed RNA molecule formed from linear RNA through reverse splicing. circRNAs are stable, highly conserved, and tissue-specific. circRNAs can regulate physiological and pathological processes through various mechanisms such as formation of competing endogenous RNA and interaction with binding proteins. It has been recently revealed that circRNAs can be translated into peptides and proteins to participate in the initiation and development of cancer. circRNAs are promising diagnostic and prognostic markers for human cancers as well as potential drug targets for cancer therapy. This review summarized the research progresses related to circRNA-encoded peptides and proteins in a variety of cancers. These peptides and proteins are translated through two different mechanisms that depend on internal ribosome entry site and m6A, respectively. We also summarized the potential use of circRNA-encoded peptides and proteins in the diagnosis, treatment, prognosis and mechanistic studies of various cancers.
Humans ; Internal Ribosome Entry Sites ; Neoplasms/genetics* ; Peptides, Cyclic ; RNA/genetics* ; RNA, Circular/genetics*

Objective: To explore the clinical effect of Shufeng Tongqiao and Yifei Jianpi prescription in the treatment of allergic rhinitis. Methods: From September 2015 to October 2017, 60 patients with allergic rhinitis in the Traditional Chinese Medicine Hospital of Tongxiang were selected according to include and exclude standards.The patients were randomly divided into two groups according to the digital table, with 30 cases in each group.The control group was treated with conventional western medicine: loratadine tablets combined with budesonide nasal spray.The treatment group was given traditional Chinese medicine on the basis of the control group.Before and after treatment, the nasal congestion, runny nose, nasal itching, sneezing four indicators were recorded in the two groups.And nasal discharge, tears flowed pharyngeal from eye pain, oral cavity on the forehead, nose, or pain, headache, five secondary indicators, as well as in the case of a change rhinitis, quality of life questionnaire were collected.The data were statistically analyzed. Results: Before treatment, there were no statistically significant differences in the main symptoms, secondary symptoms, serum IgE and quality of life between the two groups (all P>0.05). After 3 months of treatment, all the indicators in the two groups were significantly improved compared with those before treatment, and the differences were statistically significant (all P<0.05). In addition, the improvement of main symptoms and serum IgE in the treatment group were better than those in the control group, and the differences were statistically significant (z/t=-2.708, -2.033, -3.757, -2.208, -2.432; P=0.007, 0.042, 0.000, 0.027, 0.018), but there were no statistically significant differences between the two groups in terms of subtypes and quality of life improvement (P=0.488, 0.448, 0.519, 0.228, 0.278, 0.338). After 1 year of follow-up, the mean scores of each group were analyzed and compared.The indicators in the treatment group showed a different degree of recovery after 3 months of treatment.However, compared with before treatment, the indicators were still significantly improved.The scores of nasal obstruction, runny nose, nasal itching, sneezing, quality of life, and serum IgE in the treatment group were (1.13±0.81)points, (1.00±0.94)points, (0.93±0.74)points, (1.00±0.74)points, (6.13±2.30)points, (92.23±12.55)points, compared with those before treatment, the differences were statistically significant (t/z=-5.575, -5.222, -6.281, -5.918, 5.633, 9.199, all P<0.01). Compared with the control group, all indicators were significantly better, the differences were statistically significant (z/t=-2.388, -2.390, -2.738, -2.350, 4.800, 4.022, 4.444, 4.356, 5.934, -2.023, -4.381; P=0.017, 0.017, 0.006, 0.019, 0.028, 0.045, 0.035, 0.037, 0.015, 0.048, 0.000). After 3 months of clinical treatment and 1 year follow-up analysis, the total effective rate of the treatment group was 93.3%, that of the control group was 86.7%, the difference between the two groups was statistically significant (Z=-2.221, P=0.026). Conclusion The clinical efficacy of Shufeng Tongqiao and Yifei Jianpi prescription combined with western medicine in the treatment of allergic rhinitis is more significant than conventional western medicine alone, and the long-term efficacy is significant, which can effectively reduce the symptoms of patients, improve the quality of life of patients, and significantly reduce the level of serum IgE.

Objective To investigate the clinical effect of Shufeng Tongqiao,Yifei Jianpi therapy on persis-tent allergic rhinitis.Methods From January 2014 to February 2015,80 patients with allergic rhinitis in our hospital were chosen.Using random number table,they were randomly divided into control group and treatment group.The con-trol group was given western medicine,the treatment group was given self designed formula on the basis of the control group.The clinical symptoms,the efficacy and related indicators of the two groups before and after treatment were compared.Results After treatment for 3 months and 1 year,the IgE test results in the treatment and control groups were significantly lower than before treatment(t =13.93,14.45,12.11,7.46,all P <0.05),the IgE test results after 1 year of treatment in the treatment group was significantly lower than the control group (t =-4.59,P <0.05).IgE test results in the control group after one year of treatment was significantly higher than treatment for 3 months (t =-2.61,P <0.05 ).The total effective rate of the treatment group was 87.5%,which was significantly higher than 70.0% of the control group(P <0.05 ).Conclusion Shufeng Tongqiao,Yifei Jianpi method in the treatment of persistent allergic rhinitis has significant clinical effect,it can effectively alleviate rhinitis symptoms,stabilize serum IgE levels.

Objective To analyze the effects of salmeterol/fluticasone propionate aerosols fluticasone propionate and salmeterol joint tiotropium aerosol on pulmonary function and exercise tolerance in patients with chronic obstructive pulmonary disease (COPD),and to provide a theoretical basis for clinical treatment.Methods 119 COPD patients were selected in this study.They were randomly divided into 65 cases of seretide group and 54 cases of combined treatment group.Before treatment,three months after treatment and six months after treatment,the pulmonary function and 6MWD were measured in all patients.Results After 3 months,6 months of treatment,the FEV1,FEV1/FVC,FVC,6MWD of the combined treatment group had significant differences compared with before treatment (ta =-5.89,tb =-6.88,te =-8.46,tf =-8.86,ti =-10.74,tj =-8.52,tm =-9.37,tn =-13.04,all P ＜0.05).After 3 months,6 months of treatment,the FEV1,FEV1/FVC,FVC,6MWD in the control group had significant differences compared with before treatment (tc =-4.29,td =-7.19,tg =-6.16,th =-11.40,tk =-11.69,tl =-7.43,to =-11.71,tp =-10.53,all P ＜ 0.05).After 3 months of treatment,the differences of FEV1,FEV1/FVC,FVC between two groups were significant (tv =2.69,tq =6.74,tr =2.91,all P ＜ 0.05).In the control group,theFEV1,FEV1/FVC,FVC after 6 months of treatment had significant differences compared with after 3 months of treatment(ts =-2.50,tt =-9.46,tu =-1.65,all P ＜ 0.05).Conclusion Seretide and tiotropium aerosol aerosol can better improve lung function in patients with COPD and exercise tolerance,but the result of using two drugs to improve the patients'lung function was significantly better than seretide alone.

200 papers on nerve root type cervical spondylosis treated with Chinese medicine were retrieved and 38 papers with complete diagnostic criteria and medical statistics were included for study. The results showed acupuncture, massage, and herbal therapy were three common methods and have their own advantage, but systemic, standardized and normative treatment program was lack. In the meantime of treating nerve root type cervical spondylosis, prevention should also be paid attention. The treatment, prevention and exercise on the whole therapeutic idea should be established, which has far-reaching significance.

China ; Critical Care ; trends ; Pediatrics ; trends