OBJECTIVE: To investigate the clinical efficacy and advantages of robot-assisted total knee arthroplasty (TKA) in patients with varus knee osteoarthritis. METHODS: Between October 2022 and June 2023, a total of 59 patients with severe knee osteoarthritis resulting in varus were treated with total knee arthroplasty, aged from 59 to 81 years with an average (70.90±4.63) years, including 19 mals and 40 females. The patients were divided into two groups based on the surgical method used:28 patients in the robot group and 31 patients in the traditional group. The robot group consisted of 8 males and 20 femalse patients, with an average age of (70.54±4.80) years and an average disease duration of (14.89±8.72) months. The traditional group consisted of 11 males and 20 females patients, with an average age of (71.39±4.5) years and an average disease duration of (12.32±6.73) months. The operative duration, amount of bleeding during the operation, postoperative activity time after the operation, hip-knee-ankle angle (HKA), lateral distal femoral angle (LDFA), medial proximal tibial angle (MPTA), and complications were compared between the two groups before and after the operation. Lateral tibia component (LTC), frontal tibia component (FTC), frontal femoral component (FFC) and lateral femoral component (LFC) were measured 6 months after operation Additionally, the degree of knee joint motility, American Knee Society score (KSS), and visual analogue scale(VAS) were compared before and after the operation. RESULTS: All patients had gradeⅠwound healing without any complications, and all patients were followed up for 6 to 8 months, with an average of (6.5±1.5) months. There were no significant differences preoperative imaging evaluation indexes (including HKA, LDFA, and MPTA), preoperative knee mobility, preoperative VAS, and preoperative KSS between the two groups (P>0.05). Comparing the operation time (109.11±7.16) min vs. (83.90±7.85) min, length of the incision (16.60±2.33) cm vs. (14.47±1.41) cm, intraoperative bleeding (106.93±6.15) ml vs. (147.97±7.62) ml, postoperative activity time (17.86±1.84) h vs. (21.77±2.68) h, between the two groups showed statistically significant differences (P<0.05). There were significant differences in FFC (88.96±0.84)° vs. (87.93±1.09)° and LFC (88.57±1.10)° vs. (87.16±1.2)° between the two groups at 6 months after operation (P<0.05). The robotic group 1, 3, 6 months after KSS (75.96±3.96), (81.53±3.78), (84.50±3.29) scores, VAS (3.68±0.67), (2.43±0.79), (0.54±0.64), knee joint mobility (113.32±4.72) °, (123.93±3.99) °, (135.36±2.34) °;Traditional group KSS (73.77±4.18), (76.48±3.60), (80.19±3.28) scores, VAS (4.16±1.04), (3.03±0.75), (1.42±0.76) scores, knee joint mobility (109.19±6.95) °, (119.94±6.08) °, (134.48±2.14) °. Compared to before surgery, both groups showed significant improvement in KSS, VAS and knee mobility during the three follow-up visits (P<0.001). Additionally, postoperative HKA (180.39±1.95)° vs. (178.52±2.23)°, LDFA (89.67±0.63) ° vs. (89.63±0.63)°, and MPTA (89.44±0.55)° vs. (89.29±0.60)° were significantly improved in both groups compared to before surgery (P<0.001). The robotic group had higher KSS than the traditional group at 1, 3, and 6 months after surgery (P<0.05). The robotic group also had lower VAS than the traditional group at 1, 3, and 6 months after surgery (P<0.05). Furthermore, knee mobility was higher in the robotic group than those in the traditional group at 1 and 6 months after surgery (P<0.05), but there was no significant difference between the two groups at 6 months after surgery. CONCLUSION Robot-assisted total knee arthroplasty is a safe and effective method for total knee replacement. The use of robotics can improve the limb axis and prosthesis alignment for patients with preoperative varus deformity, resulting in better clinical and imaging outcomes compared to the conventional group.
Humans ; Female ; Male ; Arthroplasty, Replacement, Knee/methods* ; Aged ; Middle Aged ; Osteoarthritis, Knee/physiopathology* ; Aged, 80 and over ; Robotic Surgical Procedures/methods*

Objective To investigate the protective effects of Coptis chinensis decoction on the metabolic index and renal function of rats with fructose-induced metabolism syndrome (MS).Methods From 56 male Wistar rats,6 were randomly selected as normal control group,the other rats were daily fed with 10％ fructose water for 8 weeks to reproduce the MS model.Twenty-four rats were established successfully as MS model and randomly divided into 4 groups (6 each):model group,Coptis decoction group,tauroursodeoxycholic acid (TUDCA) group and berberine hydrochloride (BH) group.The body weight,visceral fat weight,fasting blood glucose (FBG),fasting insulin (FINS),insulin resistance index (HOMA-IR),cholesterol (TC),triglyceride (TG),systolic blood pressure (SBP),diastolic blood pressure (DBP),urinary N-acetyl-β-D-glucosidase (NAG),urine microalbumin (m-ALB),blood urea nitrogen (BUN) and serum creatinine (Scr) levels were compared between the groups,and the renal pathological changes were observed by light microscopy and electron microscopy.Results The levels of body weight,visceral fat weight,FINS,HOMA-IR,TC,TG,SBP,DBP and urinary NAG were obviously higher in the four MS model groups than in normal control group (P＜0.05),while the levels of m-ALB,BUN and Scr showed no significant difference (P＞0.05).After the intervention,the levels of body weight,visceral fat weight,FINS,HOMA-IR,TC,TG,SBP and DBP decreased significantly in Coptis decoction group than in model group (P＜0.05).Compared with BH group and TUDCA group,the levels of FINS and HOMA-IR decreased obviously in Coptis decoction group (P＜0.05),while the levels of body weight,TC,TG,SBP,DBP,urinary NAG,BUN and Scr showed no significant difference (P＞0.05).It was observed in model group by light microscopy and electron microscopy that the glomerular swelled obviously,the capillary basement membrane of glomerular and renal tubules thickened,mesangial region and interstitial substances hyperplasia,podocytes swelled markedly and most of fusion,the epithelial cells of renal tubules serious vacuolar degeneration,and a lot of secondary lysosomes formed,autophagy of organelles occurred,and most of endoplasmic reticulum and mitochondria disappeared.The kidney pathological damage reduced obviously after treatment of Coptis decoction,but no significant difference when compared with that in BH group and TUDCA group.Conclusions Coptis decoction may decrease the body weight,reduce the levels of blood lipid and blood pressure,and better improve the insulin resistance when compared with BH and TUDCA.In addition,Coptis decoction can also reduce the renal pathological damage,and has the protective function for kidney.

Objective To study the overweight and obesity situation among Mongolian ethnic children and adolescents in the last 25 years and to provide a basis on related prevention and control measures.Methods A cross-sectional study was used,with 18 366 aged 7 to 18 Mongolian ethnic children and adolescents involved.Surveys on their physical health,in 1985,2000 and 2010 were carried out.Comparison on the mean of BMI and the prevalence rates of overweight and obesity in different years,genders,location of residence (urban or rural) was also made.Results Over the past 25 years,among the aged 7 to 18 Mongolian ethnic children and adolescents,the overall trend on their means of BMI was increasing.The prevalence rates of overweight and obesity in Mongolian ethnic children and adolescents were 2.1％,0.5％ in 1985,and 6.3％,2.4％ in 2000,with an increase of 2 to 4 times during the last 15 years.The prevalence rates of overweight and obesity were substantially increasing in the year 2010,to have reached 9.1％ and 6.6％,which were 4 to 12 times of the figures in 1985.The detection rates of overweight and obesity in urban boys were 1.2％,0 in 1985,7.9％,3.4％ in 2000 and 11.0％,11.8％ in 2010.However,the rate of obesity in the rural boys were 0.6％ and 0.6％ in 1985,2.8％,2.1％ in 2000 and 9.0％,3.4％ in 2010.In 1985 the rates of overweight and obesity in urban girls were 1.8％,0.3％,8.1％,4.3％ in 2000 and 9.4％,8.4％ in 2010.However,among the rural girls,the prevalence rates of overweight and obesity prevalence was 8.8％,2.2％ in 1985,4.5％,0.9％,in 2000 and 10.2％,4.5％ in 2010.The rates of overweight and obesity among groups in different years showed significant differences (P＜0.05).Conclusion Over the past 25 years,the prevalence rates on overweight and obesity increased significantly in Mongolian ethnic children and adolescents,and continued to rise,which called for reasonable and effective measures to be taken to prevent and control the occurrence of the problem.

Adult ; Biopsy ; DNA ; genetics ; Female ; Gene Expression Profiling ; Glomerulonephritis, IGA ; genetics ; pathology ; Humans ; Kidney ; pathology ; Male ; Middle Aged ; Young Adult