Objective To explore clinical efficacy of autologous bone grafts and bone substitute for the treatment of tibial plateau fractures by Meta analysis.Methods Controlled clinical studies on autogenous bone transplantation and bone substitutes in treating tibial plateau fractures published on PubMed,Web of Science,CNKI,Wanfang and other databases from January 2005 to August 2022 were searched by computer.Literature screening and data extraction were performed according to random-ized controlled trial(RCT),and the quality of RCT were evaluated by using intervention meta-analysis criteria in Cochrane man-ual.Meta-analysis of joint depression,secondary collapse rate of articular surface,blood loss,operative time and infection rate between two methods were performed by Rev Man 5.3 software.Results Seven RCT studies(424 patients)were included,296 patients in bone replacement group and 128 patients in autograft group.Operative time[MD=-16.79,95％CI(-25.72,-7.85),P=0.000 2]and blood loss[MD=-70.49,95％CI(-79.34,-61.65),P＜0.000 01]between two groups had statistically differ-ences,while joint depression[MD=-0.17,95％CI(-0.91,0.58),P=0.66],secondary collapse rate of joint surface[RR=-0.74,95％CI(0.35,1.57),P=0.43],infection rate[RR=1.21,95％CI(0.31,4.70),P=0.78]between two groups had no differences.Conclusion The effects of bone substitute and autograft for the treatment of tibial plateau fracture have similar effects in terms of joint depression,secondary articular surface collapse rate and infection rate.However,compared with autologous bone trans-plantation,bone replacement could reduce blood loss and shorten operation time.

Objective To investigate application of the Codamotion 2CX1 three-dimensional dynamic joint motion capture system to analyze the kinematic characteristics of patients with different degrees of meniscus injury.Methods From December 2020 to June 2022,135 patients with meniscus injury and recruited normal people were collected,including 82 males and 53 females,aged 14 to 29 years old,with disease duration of 1 to 3 months.Combined with clinical symptoms and MRI examina-tion,the diagnosis of meniscus injury was confirmed,and the patients were divided into stages,including 37 cases of grade 0(normal),30 cases of grade I,33 cases of grade Ⅱ,35 cases of grade Ⅲ according to Stoller grading standard.Subjects in each group were tested walking by using Codamotion 2CX1 three-dimensional dynamic joint motion capture system.Quantita-tive indexes of walking and kinematics were collected,including knee flexion and extension,internal and external rotation and internal and external turning,and their kinematics were analyzed.Results In the distribution of knee flexion/extension,there were significant differences in maximum knee flexion,minimum knee extension and knee flexion and extension range among 4 groups(P＜0.05).In the distribution of internal/external rotation of knee joint,there were significant differences in the range of internal rotation and rotation of knee joint among 4 groups(P＜0.05).In the distribution of internal/external turning of knee joint,there were significant differences in the range of internal and external turning of knee joint among 4 groups(P＜0.05).The clinical stage progression was positively correlated with the range of motion of knee extension,external rotation,internal and external turning and turning range(P＜0.05).It was negatively correlated with knee flexion,internal rotation,flexion extension and rotation range(P＜0.05).The internal and external rotation angles of knee joint could be used as independent factors influ-encing the clinical stage of meniscus injury(P=0.006,0.019＜0.05).Conclusion The knee movement of patients with meniscus injury has obvious changes,and the changes are different under different clinical stages.Gait analysis provides a reliable basis for the kinematic analysis of meniscus injury,helps to better understand the kinematic indexes of joints,and provides a reliable auxiliary diagnosis and treatment plan,which provides a new direction for the follow-up medical research.

Objective To observe the computerized tomography(CT)imaging manifestations of coracoid process fractures associated with acromioclavicular(AC)joint dislocation and make classification and summary,and explore a new classification of coracoid process fracture combined with acromioclavicular joint dislocation.Methods The medical records of patients with the acute traumatic coracoid process fractures associated with AC joint dislocation who had undergone surgical management with clavicular hook plate fixation between May 2012 and June 2021 were retrospectively reviewed.Patients with fractures or dislocations of other parts of the ipsilateral upper limb,which affect the treatment and prognosis,or with chronic shoulder dis-eases on the affected side,which affect the function of the shoulder joint,were excluded.Eighteen patients were enrolled,in-cluding 10 males and 8 females,aged from 16 to 54 years old at the time of injury.The causes of injury were fall in 15 cases,traffic accident in 2 cases,and high fall in 1 case.The time from injury to operation ranged from 1 to 7 days.The morphology of coracoid process fracture and its corresponding relationship with scapula were observed on CT three-dimensional reconstruction images,and the reduction of coracoid process fracture was observed.The results were classified according to different manifes-tations and outcomes.Results A total of 18 patients with 18 shoulders were included according to the Inclusion and exclusion criteria.Three manifestations of coracoid process fracture associated with acromioclavicular joint dislocation were observed on CT three-dimensional reconstruction images.One case was type Ⅰ(avulsion fracture,coracoid process shape remained general intact),and the coracoid process fracture failed to self-reduction after AC joint reduction and fixation;Fifteen patients with typeⅡ(hinged fracture,in which one side of the coracoid process fracture remained attached to the scapula or was less displaced than the other side of the fracture)had spontaneous reduction after AC joint reduction and fixation,even 7 of them had cora-coid process fracture anatomical reduction;In 2 cases of type Ⅲ(translational fracture,coracoid process fracture with approxi-mately parallel profile),coracoid process fracture failed to self-reduce after AC joint reduction and fixation.Conclusion The new type of coracoid process fractures associated with acromioclavicular dislocation on CT three-dimensional reconstruction provides an overview of the injury involvement of coracoid process fracture associated with AC joint dislocation,better under-stand of the nature of the disease,and a reference for clinical diagnosis,treatment and prognosis to the surgeon.Based on the fact that most coracoid fractures especially hinged fractures have spontaneous reduction after AC joint reduction and fixation,we believe that simple fixation of the AC joint is feasible and satisfactory for coracoid process fractures with acromioclavicular joint dislocation,and no surgical intervention is required for coracoid process fractures.

Objective To investigate the changing distribution and antibiotic resistance profiles of clinical isolates of Staphylococcus in hospitals across China from 2015 to 2021.Methods Antimicrobial susceptibility testing was conducted for the clinical isolates of Staphylococcus according to the unified protocol of CHINET(China Antimicrobial Surveillance Network)using disk diffusion method and commercial automated systems.The CHINET antimicrobial resistance surveillance data from 2015 to 2021 were interpreted according to the 2021 CLSI breakpoints and analyzed using WHONET 5.6.Results During the period from 2015 to 2021,a total of 204,771 nonduplicate strains of Staphylococcus were isolated,including 136,731(66.8％)strains of Staphylococcus aureus and 68,040(33.2％)strains of coagulase-negative Staphylococcus(CNS).The proportions of S.aureus isolates and CNS isolates did not show significant change.S.aureus strains were mainly isolated from respiratory specimens(38.9±5.1)％,wound,pus and secretions(33.6±4.2)％,and blood(11.9±1.5)％.The CNS strains were predominantly isolated from blood(73.6±4.2)％,cerebrospinal fluid(12.1±2.5)％,and pleural effusion and ascites(8.4±2.1)％.S.aureus strains were mainly isolated from the patients in ICU(17.0±7.3)％,outpatient and emergency(11.6±1.7)％,and department of surgery(11.2±0.9)％,whereas CNS strains were primarily isolated from the patients in ICU(32.2±9.7)％,outpatient and emergency(12.8±4.7)％,and department of internal medicine(11.2±1.9)％.The prevalence of methicillin-resistant strains was 32.9％in S.aureus(MRSA)and 74.1％in CNS(MRCNS).Over the 7-year period,the prevalence of MRSA decreased from 42.1％to 29.2％,and the prevalence of MRCNS decreased from 82.1％to 68.2％.MRSA showed higher resistance rates to all the antimicrobial agents tested except trimethoprim-sulfamethoxazole than methicillin-susceptible S.aureus(MSSA).Over the 7-year period,MRSA strains showed decreasing resistance rates to gentamicin,rifampicin,and levofloxacin,MRCNS showed decreasing resistance rates to gentamicin,erythromycin,rifampicin,and trimethoprim-sulfamethoxazole,but increasing resistance rate to levofloxacin.No vancomycin-resistant strains were detected.The prevalence of linezolid-resistant MRCNS increased from 0.2％to 2.3％over the 7-year period.Conclusions Staphylococcus remains the major pathogen among gram-positive bacteria.MRSA and MRCNS were still the principal antibiotic-resistant gram-positive bacteria.No S.aureus isolates were found resistant to vancomycin or linezolid,but linezolid-resistant strains have been detected in MRCNS isolates,which is an issue of concern.

Chlamydia psittaci is a worldwide distributed zoonotic pathogen that infects a variety of birds.In order to char-acterization of the duck originated C.psittaci strains,lung samples were collected from suspected infection ducks and was de-tected by real-time PCR.The positive samples were homogenized in phosphate buffered saline with kanamycin and streptomy-cin,and then inoculated onto L929 cells monolayer.After several sets of passages,chlamydial inclusions of the isolate in cul-tured cells were observed after Giemsa staining or by electron microscope.For species identification,16S rRNA,16-23S IGS gene fragments were sequenced and analyzed.Genotyping of the isolate was performed by comparative analysis of the obtained ompA gene sequence with that of different genotype of C.psittaci strains.A C.psittaci strain was successfully isolated from the lung sample of duck by cell culture and was identified as genotype A.This study expanded our understanding of the host range of genotype A C.psittaci strain,and provided basis for further research on the pathogenicity,transmission,and public health risk of this pathogen.

Objective:To investigate the effect of CD8+CD28-T cells on acute graft-versus-host disease(aGVHD)after haploidentical hematopoietic stem cell transplantation(haplo-HSCT).Methods:The relationship between absolute count of CD8+CD28-T cells and aGVHD in 60 patients with malignant hematological diseases was retrospectively analyzed after haplo-HSCT,and the differences in the incidence rate of chronic graft-versus host disease(cGVHD),infection and prognosis between different CD8+CD28-T absolute cells count groups were compared.Results:aGVHD occurred in 40 of 60 patients after haplo-HSCT,with an incidence rate of 66.67％.The median occurrence time of aGVHD was 32.5(20-100)days.At 30 days after the transplantation,the absolute count of CD8+CD28-T cells of aGVHD group was significantly lower than that of non-aGVHD group(P=0.03).Thus the absolute count of CD8+CD28-T cells at 30 days after transplantation can be used to predict the occurrence of aGVHD to some extent.At 30 days after transplantation,the incidence rate of aGVHD in the low cell count group(CD8+CD28-T cells absolute count＜0.06/μl)was significantly higher than that in the high cell count group(CD8+CD28-T cells absolute count ≥0.06/μl,P=0.011).Multivariate Cox regression analysis further confirmed that the absolute count of CD8+CD28-T cells at 30 days after transplantation was an independent risk factor for aGVHD,and the risk of aGVHD in the low cell count group was 2.222 times higher than that in the high cell count group(P=0.015).The incidence of cGVHD,fungal infection,EBV infection and CMV infection were not significantly different between the two groups with different CD8+CD28-T cells absolute count.The overall survival,non-recurrent mortality and relapse rates were not significantly different between different CD8+CD28-T cells absolute count groups.Conclusion:Patients with delayed CD8+CD28-T cells reconstitution after haplo-HSCT are more likely to develop aGVHD,and the absolute count of CD8+CD28-T cells can be used to predict the incidence of aGVHD to some extent.The absolute count of CD8+CD28-T cells after haplo-HSCT was not associated with cGVHD,fungal infection,EBV infection,and CMV infection,and was also not significantly associated with the prognosis after transplantation.

Objective:To assess the deformation of the bladder-neck opening and the impact of the bladder-neck angle(BNA)on urination in male patients by fluid-structure interaction(FSI)analysis.Methods:We established geometric models of the blad-der,prostate and urethra were established,incorporating both normal and enlarged BNAs,and assessed the effects of BNA alteration on urinary flow by FSI simulation of the flow rate and pressure of the urine within the bladder,bladder neck and urethra,and that of pros-tate displacement as well.We retrospectively analyzed the clinical data on 145 male patients from the Second Hospital of Hebei Medical University between June 2020 and June 2023,39 with acute urine retention(the AUR group)and 106 without(the non-AUR group),and evaluate the impact of BNA on urination based on the urinary flow rate and prostate volume.Results:Comparative simulation a-nalysis showed significant differences in the total urethral pressure and flow rate between the normal and enlarged BNA models(P＜0.05).The maximum prostate displacement was found at the bladder neck,with moderate displacement and unchanged urethral diame-ter in the normal BNA model,but significant displacement and a reduced urethral opening diameter in the enlarged BNA model.FSI analysis confirmed an evident impact of enlarged BNA on urination,more significant in the AUR than in the non-AUR patients(P＜0.05).The BNAs in the patients with the maximum urinary flow rate(Qmax)of＜10,10-15 or＞15 ml/s were 83.7°±2.5°,67.5°±1.8° and 65.1°±4.8° respectively,with statistically significant difference between the former one and the latter two groups(P＜0.05).The BNAs in the patients with normal prostate volume or BPH of grade Ⅰ,Ⅱ,Ⅲ or Ⅳ were 65.0°±3.7°,67.2°±3.1°,71.5°±2.0°,82.8°±3.5° and 105.8°±6.0°,respectively(P＜0.05),with statistically significant difference between BPH grades Ⅲ and Ⅳ(P＜0.05)as well as between these two and the other three groups(P＜0.05),but not among the normal prostate volume,BPH grade Ⅰ and BPH grade Ⅱ groups(P＞0.05).Spearman correlation analysis indicated that BNA was strongly correlated with total prostate volume(TPV),transition zone volume(TZV),intravesical prostatic protrusion(IPP),prostatic urethral angle(PUA),IPSS,and Qmax(P＜0.05).Conclusion:Changes in BNA affect urination and are closely associated with the se-verity of prostate hyperplasia.The BNA may be an important anatomical factor for assessing the severity of lower urinary tract symptoms in BPH patients.

Objective To design a nurse-driven intelligent individualized medication management system to enhance the whole-course patient management efficiency.Methods The system consisted of an in-hospital PC terminal,a mobile patient terminal and a mobile medical terminal.The in-hospital PC terminal was developed with B/S architecture and.NET;the patient and medical terminals both were realized with Java.The patient terminal was made up of a personal information module,a data reporting module and a message center module,and the in-hospital PC and medical terminals were composed of several modules for patient management,data management,statistical analysis and system management.Results The system developed provided whole-course intelligent management for out-of-hospital patients comprehensively,continuously and actively,lowering acute morbidity and nurses'workload for follow-up.Conclusion The system developed enhances patients'awareness of self-health management and improves nurses'efficiency for individualized medication management.[Chinese Medical Equipment Journal,2024,45(11):44-48]

Microglia are the central nervous system's resident myeloid-derived immune cells, which play a major role in the innate and acquired immunological responses of brain. In the maintenance of brain tissue function under both healthy and pathological conditions, microglia take a protective or damaging role, depending on cell phenotypes and functions. The traditional microglia classification of pro- or anti-inflammatory phenotypes refers to the profile of macrophages, hence the term “brain macrophages:has been drawn. More microglia phenotypes are being discovered as new technologies and research methods are developed, and the newly discovered microglia phenotypes are often disease-, brain region-, and function-specific, providing an important foundation for studying the pathological processes underlying the development of specific diseases and developing appropriate interventions. Here, we provide a retrospective review of recent advances in the study of phenotype and function of microglia, and analyze the microglial cell lineage composition and its heterogeneous function.

Idiosyncratic drug-induced liver injury (IDILI) has long posed a challenging and pivotal concern in pharmaceutical research. The complex composition of traditional Chinese medicine (TCM) has introduced a bottleneck in current research, hindering the elucidation of the component basis associated with IDILI in TCM. Using Epimedii Folium (EF) and Psoraleae Fructus (PF) as illustrative examples, this study endeavors to establish an in vitro evaluation model, providing a high-throughput and preliminary assessment method for screening components related to TCM-induced IDILI. A TNF-α-mediated HepG2 susceptible model was first established in this study, with the focus on the index components present in EF and PF. The release of lactate dehydrogenase (LDH) in the cell supernatant served as the detection index. A concentration-toxicity response curve was constructed, and the hepatotoxic components of EF and PF were identified utilizing the synergistic toxicity index. The LDH results unveiled the hepatotoxic effects of bavachin, backuchiol, isobavachin, neobavaisoflavone, psoralidin, isobavachalcone, icarisid I, and icarisid II on both normal and susceptible cells, categorizing these 8 components as both direct hepatotoxicity components and idiosyncratic hepatotoxicity components. Bavachin and neobavaisoflavone exhibited no hepatotoxicity on normal cells but demonstrated significant effects on susceptible cells, designating them as potential idiosyncratic susceptible hepatotoxicity components. The study further delineated that 10 EF components and 3 PF components were direct immune-promoting hepatotoxicity components. Additionally, 14 idiosyncratic immune-promoting hepatotoxicity components were identified, encompassing 10 EF components and 4 PF components, with neobavaisoflavone, bavachinin, and isobavachin being potential idiosyncratic susceptible immune-promoting hepatotoxicity components. Synergistic toxicity index results indicated that 13 idiosyncratic immune-promoting hepatotoxicity components (except anhydroicaritin) combined with bavachin demonstrated synergistic hepatotoxicity on susceptible cells. Notably, 3 idiosyncratic susceptible immune-promoting hepatotoxicity components combined with bavachin exhibited synergistic hepatotoxicity, with neobavaisoflavone displaying the highest synergistic toxicity index and bavachinin the lowest. In summary, this methodology successfully screens hepatotoxic and immune-promoting hepatotoxic components in EF and PF, distinguishing the types of components inducing hepatotoxicity, evaluating the hepatotoxicity degree of each component, and elucidating the synergistic relationships among them. Importantly, these findings align with the characteristics of IDILI. The method provides an effective model tool for the fundamental research of TCM-related IDILI components.