Objective:To evaluate the clinical outcomes of applying an enhanced workflow in robotic-assisted total hip revision arthroplasty.Methods:A retrospective study was conducted to analyze the 25 consecutive patients who had undergone robotic-assisted total hip revision arthroplasty in which an enhanced workflow was applied at Department of Orthopaedic Surgery, Beijing Jishuitan Hospital from September 2021 to October 2024. The cohort consisted of 8 males and 17 females with an age of (64.0±12.8) years. The left side was affected in 18 cases and the right side in 7 cases. The time from initial total hip arthroplasty to revision was (159.6±86.7) months. In all patients, no significant difference was found in the preoperative femoral cortical thickness between the healthy and the affected sides. The enhanced workflow included preoperative CT modeling and planning, intraoperative registration, prosthetic removal and reconstruction, and verification of prosthesis position. A total of 18 patients underwent total hip revision involving both the acetabular and the femoral sides; 6 patients underwent simple acetabular reconstruction with retention of the original femoral stem and replacement of the femoral head; 1 patient underwent femoral revision with retention of the acetabular cup and replacement of the acetabular liner. The operative time, intraoperative blood loss, modified Harris Hip Score (mHHS) and visual analogue scale (VAS) for hip pain at the final follow-up, and follow-up complications were recorded.Results:All patients successfully completed robotic registration during surgery, with no case of intraoperative robotic termination. For the 25 patients, the operative time was (152.2±43.8) minutes, the intraoperative blood loss 600 (400, 1,000) mL, and the follow-up time 12.0 (6.0, 31.5) months. At the final follow-up, their mHHS improved from 66.0 (26.4, 75.6) points preoperatively to 93.5 (80.3, 98.9) points, and their VAS pain score decreased from 5.0 (3.0, 7.0) points preoperatively to 0.0 (0.0, 2.0) point ( P<0.05). Follow-ups revealed no case of reoperation, prosthetic loosening, joint dislocation, periprosthetic infection, or periprosthetic fracture. Conclusion:The enhanced workflow can achieve satisfactory outcomes in robotic-assisted total hip revision for patients with adequate proximal femoral bone stock.

Objective:To evaluate the clinical outcomes of applying an enhanced workflow in robotic-assisted total hip revision arthroplasty.Methods:A retrospective study was conducted to analyze the 25 consecutive patients who had undergone robotic-assisted total hip revision arthroplasty in which an enhanced workflow was applied at Department of Orthopaedic Surgery, Beijing Jishuitan Hospital from September 2021 to October 2024. The cohort consisted of 8 males and 17 females with an age of (64.0±12.8) years. The left side was affected in 18 cases and the right side in 7 cases. The time from initial total hip arthroplasty to revision was (159.6±86.7) months. In all patients, no significant difference was found in the preoperative femoral cortical thickness between the healthy and the affected sides. The enhanced workflow included preoperative CT modeling and planning, intraoperative registration, prosthetic removal and reconstruction, and verification of prosthesis position. A total of 18 patients underwent total hip revision involving both the acetabular and the femoral sides; 6 patients underwent simple acetabular reconstruction with retention of the original femoral stem and replacement of the femoral head; 1 patient underwent femoral revision with retention of the acetabular cup and replacement of the acetabular liner. The operative time, intraoperative blood loss, modified Harris Hip Score (mHHS) and visual analogue scale (VAS) for hip pain at the final follow-up, and follow-up complications were recorded.Results:All patients successfully completed robotic registration during surgery, with no case of intraoperative robotic termination. For the 25 patients, the operative time was (152.2±43.8) minutes, the intraoperative blood loss 600 (400, 1,000) mL, and the follow-up time 12.0 (6.0, 31.5) months. At the final follow-up, their mHHS improved from 66.0 (26.4, 75.6) points preoperatively to 93.5 (80.3, 98.9) points, and their VAS pain score decreased from 5.0 (3.0, 7.0) points preoperatively to 0.0 (0.0, 2.0) point ( P<0.05). Follow-ups revealed no case of reoperation, prosthetic loosening, joint dislocation, periprosthetic infection, or periprosthetic fracture. Conclusion:The enhanced workflow can achieve satisfactory outcomes in robotic-assisted total hip revision for patients with adequate proximal femoral bone stock.

Objective To establish a nomogram model for efficiently predicting overall survival(OS)and cancer-specific survival(CSS)in patients with CRCHBM.Method 2239 patients from 2010 to 2019 were retrospectively analyzed from the Surveillance,Epidemiology,and End Results Program(SEER)databases and Wuhan Union Hospital Cancer Center.SEER is randomly assigned to the training and internal validation cohorts,and the Wuhan database serves as the external validation.Cox regression analyses were used to determine the independent clinicopathological prognosis factors affecting OS and CSS,and a nomogram was constructed to predict OS and CSS.The clinical utility of columnar plots was assessed using calibration curves,area under the curve(AUC),and decision curve analysis(DCA).Result OS column line graphs were constructed based on nine independent predictors:age,tumor location,degree of differentiation,tumor size,TNM stage,chemotherapy,primary focus surgery,number of lymph nodes sampled,and serum carcinoembryonic antigen(CEA)level.The C-index of the nomogram to predict the 1-,3-,and 5-year OS were 0.764,0.790,and 0.805 in the training group,0.754,0.760,and 0.801 in the internal validation group,and 0.822,0.874,and 0.906 in the external validation group.CSS column line graphs were constructed based on 3 independent predictors of TNM staging,radiotherapy and chemotherapy.The 1-,3-,and 5-year CSS AUROC values of the training group were 0.791,0.757,and 0.782,respectively.0.682,0.709,0.625 in the internal validation group and 0.759,0.702,0.755 in the external validation group,respectively.The results of receiver operating characteristic curve(ROC),ROC and DCA showed that the use of our model was more effective in predicting OS and CSS than other single clinicopathological features.Conclusion In summary,the nomogram based on significant clinicopathological features can be conveniently used to predict OS and CSS individually in patients with CRCHBM.

Objective To explore whether hepatocyte Perilipin-2(Plin2)is involved in the development of fatty liver related to comparative gene identification-58(CGI-58)deficiency mice and compare the effects of Plin2 and Plin3 on lipid droplet formation and lipid accumulation.Methods Based on CGI-58Flox/Flox mice as animal model,the adeno-associated viruses targeting mouse liver,CGI-58 knockout and Plini2 knockdown were achieved by co-expression Cre protein and micro-RNA targeting Plin2(Mi-KD).Then CGI-58 deficiency mice were used as control(NC)to detect the differences in metabolic phenotype and liver pathology.AML-12 mouse hepatocytes were used as cellular model and interfered with siRNA to achieve Plin2/Plin3 knockdown in AML-12 cells.Lipid droplet formation and lipid accumulation were compared with Bodipy staining and enzyme colorimetry in basal condition or lipid-overloaded condition(OA inducement)after Plin2/Plin3 knockdown.Results Plin2 knockdown(Mi-KD)reduced PLIN2 protein level by＞99％in mouse livers.Mi-KD decreased hepatomegaly(P=0.019 5)and liver injury(P=0.000 4),while reduced the histological NAS score(P=0.000 2)and hepatic triglyceride content(P=0.016 6)in the CGI-58 deficiency female mice.Mi-KD prevented microvesicular hepatic steatosis in the CGI-58 deficient female mice.Plin3 knockdown significantly reduced the triglyceride content in basal condition of hepatocytes(P=0.001 4),and Plin2 knockdown just showed a decreased trend.Plin2 or Plin3 knockdown significantly reduced the triglyceride content separately in lipid-overloaded hepatocytes(P＜0.05).Conclusion Hepatocyte Plin2 is essential in the development of microvesicular hepatic steatosis caused by CGI-58 deficiency.Both Plin2 and Plin3 are involved in lipid droplet formation and lipid accumulation in hepatocytes,and Plin3 shows a stronger effect.

Objective:Although Wu Hu Tang has the effect of treating cough variant asthma(CVA),its specific mechanism of action remains unclear.Methods:Predicted targets,autophagy genes,cough variant asthma genes and differentially expressed genes(DEGs)of CVA of Wu Hu Tang were obtained and mined from the Traditional Chinese Medicine Systematic Pharmacology Data-base and Analysis Platform(TCMSP),Bioinformatics Analysis Tool for Molecular Mechanism of Traditional Chinese Medicine(BAT-MAN-TCM)and TCM Integrated Pharmacology Research Platform v2.0(TCMIP),PubChem,Chemspider,Swiss Target Prediction,GEO,GeneCards and other databases.The intersection tool of line Venn diagram was used to obtain the key genes.Using Cyto-scape3.8.0 software build active ingredient-key network;Wu Hu Tang intervention CVA autophagy targets with autophagy genes corre-lation analysis;Use the STRING database,Cytohubba plug-in build protein interaction network and core gene screening.GO and KEGG enrichment analysis of key targets were performed using R Biomanager and ClusterProfiler package,and finally molecular dock-ing was performed.Results:A total of 42 active ingredients,536 potential action targets,7 236 autophagy-related genes,1 987 CVA genes and 460 DEGs of Wu Hu Tang Tang were collected and screened.Thirteen key targets were obtained after taking the intersec-tion,and 12 genes were found to be statistically significant by validated used wilcoxon non-parametric test.The results of the enrich-ment analysis showed that these target genes mainly functioned in cellular autophagy through the VEGF signaling pathway,and some amino acid metabolic pathways.Conclusion:Wu Hu Tang is capable of multi-component,multi-level and multi-target involvement in autophagy-related processes to achieve intervention in CVA,which promotes the development of the idea of combining Chinese and Western medicine in the treatment of CVA and provides a new idea for the development of new clinical drugs.

Objective:To investigate the alteration of glymphatic system based on diffusion tensor image-analysis along the perivascular space(DTI-ALPS)in bipolar disorder Ⅰ(BD-Ⅰ).Methods:A total of 44 BD-Ⅰ patients(BD-Ⅰ group) admitted to the Affiliated Brain Hospital of Guangzhou Medical University from January 2012 to December 2017 were selected.In addition, totally 30 healthy controls (HC group) were recruited. The diffusion tensor image data were analyzed retrospectively, and along the perivascular space (ALPS) index was calculated. Hamilton anxiety scale (HAMA), 17-item Hamilton depression rating scale (HAMD-17), Young mania rating scale (YMRS) and global assessment function (GAF) were used to evaluate the severity of anxiety, depression, mania and social function respectively. SPSS 25.0 software was used for t-test, Z-test and chi-square test, and the differences in clinical data and DTI-ALPS index between the two groups were compared. The partial correlation test was used to analyze the correlations between DTI-ALPS index and the clinical indicators such as HAMA, HAMD-17, YMRS and GAF. Results:The DTI-ALPS indexes in left(1.69±0.17), right(1.44±0.15) and bilateral cerebral hemispheres(1.56±0.15) of BD-Ⅰ group were lower than those in HC group ((1.71±0.15), (1.46±0.13) and (1.58±0.12)), but the differences were not statistically significant ( t=-0.441, -0.545, -0.556, all P>0.05). After controlling for gender, age, years of education and course of disease, there were significant negative correlations between bilateral average DTI-ALPS index and somatic anxiety ( r=-0.334, P=0.038), as well as between right DTI-ALPS index and somatic anxiety( r=-0.349, P=0.030) in BD-Ⅰ group. Conclusion:The dysfunction of cerebral glymphatic system is not obvious in BD-Ⅰ patients, but their anxiety may be related to dysfunction cerebral glymphatic system.

OBJECTIVE To establish and optimize tablets adding mechanism of automatic tablet dispensing machine in the inpatient pharmacy, realize tablets checking and fine management for tablets inventory and expiration date in process of tablets adding, reduce incidence of errors, improve work efficiency, and ensure the safety of tablets use for patients. METHODS Intelligent software combined with barcode scanning technology was used to carry out intelligent intervention on the error-prone link in the process of tablets adding of automatic drug dispensing machine. The error ratio of tablets adding(%), average of daily tablets adding time(min), error ratio of tablets quantity in monthly inventory check(%) were compared before and after intelligent intervention. RESULTS Compared with before optimization, the error ratio of tablets adding decreased from 0.11 % to 0%, average of daily tablets adding time decreased from (96.50±21.84)min to (64.23±19.59)min(P<0.01), which saved 32.27 min on average, and error ratio of tablets quantity in monthly inventory check decreased from (9.42±1.13)% to (3.42±0.88)%(P<0.01) after optimizing the dosing process of the automatic drug dispensing machine. CONCLUSION The optimized process of tablets adding of automatic drug dispensing machine is simple and rapid to operate, which has high accuracy. The tablets inventory and expiration date can be tracked and managed in real time, which ensures the safety of tablets use for patients, promotes development of digital pharmacy management system, and improves quality of pharmaceutical care.

Objective:Acute kidney injury (AKI) is one of the common complications in critically ill septic patients, which is associated with increased risks of death, cardiovascular events, and chronic renal dysfunction. The duration of AKI and the renal function recovery status after AKI onset can affect the patient prognosis. Nevertheless, it remains controversial whether early recovery status after AKI is closely related to the prognosis in patients with sepsis-associated AKI (SA-AKI). In addition, early prediction of renal function recovery after AKI is beneficial to individualized treatment decision-making and prevention of severe complications, thus improving the prognosis. At present, there is limited clinical information on how to identify SA-AKI patients at high risk of unrecovered renal function at an early stage. The study aims to investigate the association between early recovery status after SA-AKI, identify risk factors for unrecovered renal function, and to improve patients ' quality of life.Methods:We retrospectively analyzed clinical data of septic patients who were admitted to the intensive care unit (ICU) and developed AKI within the first 48 hours after ICU admission in the Second Xiangya Hospital and the Third Xiangya Hospital of Central South University from January 2015 to March 2017. Sepsis was defined based on the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). AKI was diagnosed and staged according to the 2012 Kidney Disease:Improving Global Outcomes (KDIGO) guideline. SA-AKI patients were assigned into 3 groups including a complete recovery group, a partial recovery group, and an unrecovered group based on recovery status at Day 7 after the diagnosis of AKI. Patients ' baseline characteristics were collected, including demographics, comorbidities, clinical and laboratory examination information at ICU admission, and treatment within the first 24 hours. The primary outcome of the study was the composite of death and chronic dialysis at 90 days, and secondary outcomes included length of stay in the ICU, length of stay in the hospital, and persistent renal dysfunction. Multivariate regression analysis was performed to evaluate the prognostic value of early recovery status after AKI and to determine the risk factors for unrecovered renal function after AKI. Sensitivity analysis was conducted in patients who still stayed in hospital on Day 7 after AKI diagnosis, patients without premorbid chronic kidney disease, and patients with AKI Stage 2 to 3.Results:A total of 553 SA-AKI patients were enrolled, of whom 251 (45.4％), 73 (13.2％), and 229 (41.4％) were categorized as the complete recovery group, the partial recovery group, and the unrecovered group, respectively. Compared with the complete or partial recovery group, the unrecovered group had a higher incidence of 90-day mortality (unrecovered vs partial recovery or complete recovery: 64.2％ vs 26.0％ or 22.7％; P<0.001) and 90-day composite outcome (unrecovered vs partial recovery or complete recovery:65.1％vs 27.4％or 22.7％;P<0.001). The unrecovered group also had a shorter length of stay in the hospital and a larger proportion of progression into persistent renal dysfunction than the other 2 groups. After adjustment for potential confounders, patients in the unrecovered group were at an increased risk of 90-day mortality (HR=3.50, 95％ CI 2.47 to 4.96, P<0.001) and 90-day composite outcome (OR=5.55, 95％CI 3.43 to 8.98, P<0.001) when compared with patients in the complete recovery group, but patients in the partial recovery group had no significant difference (P>0.05). Male sex, congestive heart failure, pneumonia, respiratory rate>20 beats per minute, anemia, hyperbilirubinemia, need for mechanical ventilation, and AKI Stage 3 were identified as independent risk factors for unrecovered renal function after AKI. The sensitivity analysis further supported that unrecovered renal function after AKI remained an independent predictor for 90-day mortality and composite outcome in the subgroups. Conclusion:The early recovery status after AKI is closely associated with poor prognosis in critically ill patients with SA-AKI. Unrecovered renal function within the first 7 days after AKI diagnosis is an independent predictor for 90-day mortality and composite outcome. Male sex, congestive heart failure, pneumonia, tachypnea, anemia, hyperbilirubinemia, respiratory failure, and severe AKI are risk factors for unrecovered renal function after AKI. Therefore, timely assessment for the renal function in the early phase after AKI diagnosis is essential for SA-AKI patients. Furthermore, patients with unrecovered renal function after AKI need additional management in the hospital, including rigorous monitoring, avoidance of nephrotoxin, and continuous assessment for the renal function, and after discharge, including more frequent follow-up, regular outpatient consultation, and prevention of long-term adverse events.

Objective : To investigate whether NaHS，a hydrogen sulfide donor，can improve myocardial injury in sepsis by inhibiting oxidative stress and activating the Xc －/ GPX4 signaling pathway in ferroptosis． Methods : Lipopolysacc-haride(LPS) induced H9c2 in rat cardiomyocytes to form an in vitro model of myocardial injury in sep- sis，which was divided into Control group，LPS group and LPS + NaHS group．The kits were applied to detect the changes of cardiomyocyte viability，Fe2 + ，LDH and CK-MB，determine the levels of oxidative stress indexes GSH and MDA，detect the changes of cellular ROS and mitochondrial membrane potential levels by fluorescent probes， and detect the expression levels of ferroptosis regulatory proteins SLC7A11 and GPX4 by Western blot. Results: Compared with the Control group，H9c2 cell viability decreased，Fe2 + concentration increased ，GSH ，MDA and ROS levels increased，mitochondrial JC-1 monomer increased ，expression levels of ferroptosis regulatory proteins SLC7A11 and GPX4 decreased，and cell damage increased after LPS stimulation (P＜0. 05) ．Compared with the LPS group，NaHS attenuated LPS-induced H9c2 cell injury and elevated Fe2 + concentration，decreased the level of LPS-induced oxidative stress in H9c2 cells ，and increased the expression levels of ferroptosis regulatory proteins SLC7A11 and GPX4 (P＜0. 05 ) ． Conclusion The mechanism by which NaHS attenuates myocardial injury in sepsis may be related to the inhibition of oxidative stress and activation of the Xc －/ GPX4 signaling pathway in fer- roptosis.

【Objective】 To summarize a rapid and effective method to eliminate autoantibodies interference with blood group identification and evaluate its treatment effect. 【Methods】 Blood samples with suspicious results in initial blood group identification were collected, and those caused by autoantibodies were chosen, and their red blood cells were washed, dispersed or treated with sulfhydryl reagent. After allogeneic or autologous absorption of plasma, blood groups of those patients were re-detected to evaluate the effectiveness of the above method. 【Results】 Among 39 patients presenting suspicious ABO blood group, 9 were interfered by autoantibodies. After appropriate treatment, the ABO/RhD blood group of those patients could be identified. 【Conclusion】 Autoantibodies could interfere the identification of ABO/RhD blood group, and the efficiency and accuracy of blood group identification could be improved by analyzing the test results and selecting appropriate treatment methods.