BACKGROUND: Mechanisms undelying diagnosis and treatment of arthritis can be analyzed by metabonomics to study the metabolites. The combination of metabonomics and bibliometrics can systematically clarify the research status of osteoarthritis. OBJECTIVE: To analyze and summarize the research status of metabonimics in arthritis, and to prospect the future tendency. METHODS: CNKI, VIP, WanFang, CBM, PubMed, EBSCO, Web of Science and Elsevier databases were searched for the articles addressing the metabonimics in arthritis published before May 2017. The keywords were "metabolomics and arthritis" in English and Chinese, respectively. Initially 201 articles were retrieved, and finally 59 articles were included based on the inclusion and exclusion criteria for basic information and result analysis. RESULTS AND CONCLUSION: (1) Literature of metabonomics on arthritis began to be reported from 2007, and the number of literature increased with time. (2) The first author's affiliations were concentrated in universities 37(63%), hospitals 15 (25%) and institutes 7 (12%). (3) The articles included 44 articles from journals (75%), 12 dissertation (19%), 4 conference papers (7%), and the 44 papers were published in 38 kinds of journals. (4) Totally 36 articles were funded, 29 articles (49%) funded by the National Natural Science Foundation, 18 (31%) funded by department-level foundation, 10 (17%) funded by provincial foundation, 5 (8%) foreign foundation and 5 (8%) funded by school foundation. (5) The types of arthritis were mainly rheumatoid arthritis 40 (68%), osteoarthritis 7 (12%), gouty arthritis 6 (10%) and others 6 (10%). (6) The main research directions were metabonomis on treatment effectiveness 30 (51%), pathogenesis of arthritis 17 (29%), Chinese medicine syndromes 6 (10%) and research progress 6 (10%). (7) Metabolomics samples in the literature included the body fluid samples 53 (90%) and tissue samples 6 (10%). (8) Metabonomics analysis techniques included liquid chromatography-mass spectrometry 33 (56%), nuclear magnetic resonance technology 15 (25%), gas chromatography-mass spectrometry 10 (17%), NMR combined with GC-MS 1 (2%). In summary, metabonomics has been extensively applied in arthritis and has been an issue of concern. Understanding the side events in Chinese medicines for arthritis based on metabonomics can provide reference for the following prospective study and clinical application.

OBJECTIVETo compare the analgesic effect between multimodal and patient-controlled intravenous analgesia(PCIA) in patients with rheumatoid arthritis(RA) in the perioperative period of knee joint replacement.

METHODSFrom June 2015 to June 2016, 40 RA patients undergoing total knee arthroplasty were randomly divided into two groups. There were 20 patients in PCIA group, including 3 males and 17 females, with an average age of(59.6±2.3) years old, who received controlled instillation of sufentanil analgesia controlled by an intravenous analgesia pump. There were 20 patients in multiple model analgesia group, including 2 males and 18 females, with an average age of(56.3±1.3) years old, who were treated with continuous femoral nerve block, local injection of knee joint and combined buprenorphine patches. The VAS score and the incidence of adverse reactions and HSS score were compared between the two groups after operation. The advantages and disadvantages of the two modes of analgesia were evaluated.

RESULTSOn the 6 th and 24 th hours after surgery, the VAS scores of the multimodal analgesia group were significantly lower than those of the PCIA group(<0.01). On the 48 th hour after surgery, the VAS scores was significantly lower in the multimodal analgesia group than those in PCIA group(<0.000 1), both in the state of motion and at rest. On the 1 st week after surgery, the HSS score of the multimodal analgesia group was significantly higher than that in the PCIA group(<0.000 1). The pain score and the degree of activity in HSS score of the multimodal analgesia group were better than those in PCIA group (<0.05). The functional score of multimodal analgesia group was significantly better than that of PCIA group(<0.01). But there was no significant difference in muscle strength scores between two groups.

CONCLUSIONSMultimodal analgesia is an ideal analgesic plan for total knee arthroplasty TKA patients with RA in perioperative period, which has good effects and little adverse reaction.

BACKGROUNDEbstein's anomaly (EA) has various spectrums in clinical and anatomic features. This study aimed to report the experience of two-dimensional intraoperative transesophageal echocardiography (2D-ITEE) during the EA surgery and to analyze the characteristics of the tricuspid valve (TV) by comparing the data from 2D-ITEE with the results from the surgery.

METHODS2D-ITEE data of 164 patients with EA who were operated in the First Hospital of Tsinghua University between July 2004 and April 2014 were retrospectively analyzed in this study. 2D-ITEE was applied in all patients. Downward displacement distances were measured, and the numbers of downward displacement or absent leaflets were compared with that of the surgery and with that of the two-dimensional-transthoracic echocardiogram (2D-TTE). Data comparison was performed using the Chi-square test.

RESULTSThe anterior leaflet partial or total downward displacement was 37.76 ± 17.50 mm in 54 cases, absent in one patient; septal leaflet downward displacement was 29.07 ± 12.34 mm in 134 cases, absent in 17 cases; and posterior leaflet downward displacement was 43.18 ± 19.16 mm in 115 cases, absent in 34 cases. Statistically, there was no significant difference between the results from 2D-ITEE and that of 2D-TTE. The consistency rates of 2D-ITEE with operation for septal and posterior leaflets were 93.2% and 96.1%, respectively, while the rate for anterior was only 40.1%, which was significantly different. Color Doppler flow image showed severe regurgitation in 150 cases and moderate in 14 cases. After surgical correction, moderate regurgitation of TV was found in 58 cases with 2D-ITEE, repair was performed again until the effect was satisfied. No complication occurred relating to the use of 2D-ITEE.

CONCLUSIONS2D-ITEE could help diagnose anterior leaflet, evaluate the effect of TV repair, increase operational success rate, and reduce complication.

Objective To summarize the safety and experience of operative cooperation of the laparoscopic transhiatal proximal gastrectomy therapy for esophagogastric junction adenocarcinoma.Methods Totals of 98 cases with esophagogastric junction adenocarcinoma underwent the treatment of laparoscopic transhiatal proximal gastrectomy were analyzed and summarized.Results Totals of 96 patients underwent laparoscopic transhiatal proximal gastrectomy successfully and 2 converted to open operation (one patient combined splenectomy and the other combined splenectomy and resection of the tail of the pancreas).The mean operative time was (224.1 ± 33.7) main and the mean blood loss was (69.4 ±26.1) ml.The mean length of esophageal resection was (4.0 ± 0.6) cm and no cancer cells were found in the incision edge.The number of lymph nodes removed was (16.4 ± 5.7).Among 96 patients,pleural laceration occurred 14 cases and spleen injury occurred 3 cases,no postoperaive mortalities happened.After follow-up from 3 month to 30 month,5 patients died.Conclusions Fully preoperative assessment and closely cooperation of operation team are important for the laparoscopic transhiatal proximal gastrectomy therapy for esophagogastric junction adenocarcinoma,which have a good short-term clinical effects.

Objective To explore the effect of oxytocin on uterine fibroids treated by ultrasound ablation. Methods Eighty-two single points in 29 uterine fibroids from 26 patients were sonicated with magnetic resonance imaging guided by high intensity focused ultrasound before and after using oxytocin. The required total energy, sonication time required to reach 60 ℃ and the acoustic energy for increasing 1 ℃ of temperature at the single point before and after using oxytocin were compared. Results Before intravenous infusion of oxytocin, the average total sonication energy required to reach 60 ℃ was (5320 ±910) J and it took (21 ±20) seconds for sonicating a single point, the energy required for increasing 1 ℃ was (255 ± 302) J. In contrast, after intravenous infusion of oxytocin, the average total sonication energy required to reach 60 ℃ was (2890 ±325) J, and it took (12 ±7) seconds for sonicating a single point, the energy required for increasing 1 ℃ was ( 126 ± 94 ) J. Those three index all reached statistical difference ( P = 0.002, P = 0.001, P= 0.002, respectively). Conclusion It seemed that Oxytocin could significantly decrease the energy required for ablating uterine fibroids, shorten treatment time and improve the treatment efficiency.

The present study was aimed to investigate the pathological changes after magnetic resonance imaging (MRI) guided high intensity focused ultrasound (MRgHIFU) therapy for ablating the liver tissue adjacent to goat portal vein. Fifty goats were involved in this study. Normal liver tissues at 0, 5, and 10 mm distance from portal vein, respectively, were ablated with MRgHIFU. Among the 50 tested subjects, 40 goats were sacrificed immediately after the operations, and the other 10 were sacrificed 7 days after the procedure for pathological examination of the targeted areas and the contiguous portal veins. Coagulation necrosis was observed in all the treated liver tissues. Collagen swelling (CS) and vessel wall fracture (VWF) emerged more frequently in the 0 mm group than that in the 5mm group: CS [0 mm group VS 5mm group = 27/40 (67.5%) VS 7/40 (17.5%), P < 0.05], VWF [0 mm group VS 5mm group = 8/40 (20%) VS 0/40 (0%), P < 0.05]. Seven days after ablation, no portal vein damages (CS and VWF) were observed under light microscope. The results indicated that MRgHIFU could be used to ablate the liver tissue adjacent to goat portal vein effectively, which may cause blood vessel damage when the focus is on the wall of blood vessels (0 mm). However, the pathological results indicated that these damages are reversible.
Animals ; Female ; Goats ; High-Intensity Focused Ultrasound Ablation ; adverse effects ; methods ; Liver ; pathology ; Magnetic Resonance Imaging ; Male ; Portal Vein ; pathology