The orientation of the acetabular cup in hip joint anteroposterior radiograph is a key factor in evaluating the postoperative outcomes of total hip arthroplasty (THA). Currently, measurement of the acetabular cup anteversion angle primarily relies on manual drawing of auxiliary lines by orthopedic surgeons and calculations using scientific calculators. This study proposes an automated computer-aided measurement method for the acetabular cup anteversion angle based on hip joint anteroposterior radiograph. The proposed method segments hip prosthesis images using an improved Otsu algorithm, identifies feature points at the acetabular cup opening by combining circle-fitting theory and the cup's geometric characteristics, and fits an ellipse to the cup opening to calculate the anteversion angle. A total of 104 hip joint anteroposterior radiographs, including 71 right-sided and 81 left-sided prostheses, were analyzed. Two orthopedic surgeons independently measured the postoperative anteversion angles, and the results were compared with computer-generated measurements for correlation analysis. Spearman and Pearson correlation analyses demonstrated significant correlations between the proposed method and manual measurements for both the right group ( r = 0.795, P < 0.01) and the left group ( r = 0.859, P < 0.01). This method provides a reliable reference for orthopedic surgeons to assess postoperative prognosis.
Humans ; Acetabulum/anatomy & histology* ; Arthroplasty, Replacement, Hip/methods* ; Algorithms ; Hip Prosthesis ; Hip Joint/diagnostic imaging* ; Radiography ; Image Processing, Computer-Assisted/methods*

Notum, a negative feedback regulator of the Wnt signaling, has emerged as a promising target for treating glucocorticoid-induced osteoporosis (GIOP). This study showcases an efficient strategy for discovering the anti-Notum constituents from herbal medicines (HMs) as novel anti-GIOP agents. Firstly, a rapid-responding near-infrared fluorogenic substrate for Notum was rationally engineered for high-throughput identifying the anti-Notum HMs. The results showed that Bu-Gu-Zhi (BGZ), a known anti-osteoporosis herb, potently inhibited Notum in a competitive-inhibition manner. To uncover the key anti-Notum constituents in BGZ, an efficient strategy was adapted via integrating biochemical, phytochemical, computational, and pharmacological assays. Among all identified BGZ constituents, three furanocoumarins were validated as strong Notum inhibitors, while 5-methoxypsoralen (5-MP) showed the most potent anti-Notum activity and favorable safety profiles. Mechanistically, 5-MP acted as a competitive inhibitor of Notum via creating strong hydrophobic interactions with Trp128 and Phe268 in the catalytic cavity of Notum. Cellular assays showed that 5-MP remarkably promoted osteoblast differentiation and activated Wnt signaling in dexamethasone (DXMS)-challenged MC3T3-E1 osteoblasts. In dexamethasone-induced osteoporotic mice, 5-MP strongly elevated bone mineral density (BMD) and improved cancellous and cortical bone thickness. Collectively, this study constructs a high-efficient platform for discovering key anti-Notum constituents from HMs, while 5-MP emerges as a promising anti-GIOP agent.

Background::The study aimed to describe the aortic valve morphology in Chinese patients underwent transcatheter aortic valve replacement (TAVR) for symptomatic severe aortic stenosis (AS), and the impact of sizing strategies and related procedural outcomes.Methods::Patients with severe AS who underwent TAVR were consecutively enrolled from 2012 to 2019. The anatomy and morphology of the aortic root were assessed. "Downsize" strategy was preformed when patients had complex morphology. The clinical outcomes of patients who performed downsize strategy were compared with those received annular sizing strategy. The primary outcome was device success rate, and secondary outcomes included Valve Academic Research Consortium-3 clinical outcomes variables based on 1-year follow-up.Results::A total of 293 patients were enrolled. Among them, 95 patients (32.4%) had bicuspid aortic valve. The calcium volume (Hounsfield Unit-850) of aortic root was 449.90 (243.15-782.15) mm 3. Calcium is distributed mostly on the leaflet level. Downsize strategy was performed in 204 patients (69.6%). Compared with the patients who performed annular sizing strategy, those received downsize strategy achieved a similar device success rate (82.0% [73] vs. 83.3% [170], P= 0.79). Aortic valve gradients (downsize strategy group vs. annular sizing group, 11.28 mmHg vs. 11.88 mmHg, P = 0.64) and percentages of patients with moderate or severe paravalvular regurgitation 2.0% (4/204) vs. 4.5% (4/89), P = 0.21) were similar in the two groups at 30 days after TAVR. These echocardiographic results were sustainable for one year. Conclusions::Chinese TAVR patients have more prevalent bicuspid morphology and large calcium volume of aortic root. Calcium is distributed mostly on the leaflet level. Compare with annular sizing strategy, downsize strategy provided a non-inferior device success rate and transcatheter heart valve hemodynamic performance in self-expanding TAVR procedure.

Objective To explore the value of RT-PCRin diagnosis of patients with HIV-negative hypoimmunity and pneumocystis pneumonia (PCP).Methods Totally 71 phlegm samples of pulmonary infection patients with suspected PCP and HIV-negative hypoimmunity were selected.ITS-nested PCRand ITS-real-time fluorescence quantitative PCRwere used to detect pneumocystis jiroveci in samples.Results Among the 71 patients,18 cases were diagnosed as PCP.There were 25 cases with positive results by n-PCR,but the false-positive rate was 36.00%,and sensitivity,specificity and positive predictive values of n-PCRwere 88.89%,83.01% and 64.00%,respectively.If the threshold was 103 copies/mL,the specificity and positive predictive value of RT-PCRwere significantly higheRthan n-PCR.In patients with PCP,the the gene load of pneumocystis by RT-PCRwas significantly higheRthan non-PCP patients.Conclusion In patients with HIV-negative hypoimmunity,RT-PCRis more accurate and rapid than nested PCRin the diagnosis of PCP,and it can distinguish the infection and colonization of pneumocystis.

Objective To explore the value of RT-PCRin diagnosis of patients with HIV-negative hypoimmunity and pneumocystis pneumonia (PCP).Methods Totally 71 phlegm samples of pulmonary infection patients with suspected PCP and HIV-negative hypoimmunity were selected.ITS-nested PCRand ITS-real-time fluorescence quantitative PCRwere used to detect pneumocystis jiroveci in samples.Results Among the 71 patients,18 cases were diagnosed as PCP.There were 25 cases with positive results by n-PCR,but the false-positive rate was 36.00%,and sensitivity,specificity and positive predictive values of n-PCRwere 88.89%,83.01% and 64.00%,respectively.If the threshold was 103 copies/mL,the specificity and positive predictive value of RT-PCRwere significantly higheRthan n-PCR.In patients with PCP,the the gene load of pneumocystis by RT-PCRwas significantly higheRthan non-PCP patients.Conclusion In patients with HIV-negative hypoimmunity,RT-PCRis more accurate and rapid than nested PCRin the diagnosis of PCP,and it can distinguish the infection and colonization of pneumocystis.

Objective To investigate the association between the single nucleotide polymorphisms (SNPs) IL-18-137G/C (rs187238) and IL-18-607A/C (rs1946518) in interleukin-18 (IL-18) gene and hepatocellular carcinoma (HCC) caused by the hepatitis B virus (HBV).Methods The subjects were divided into HBV-related HCC group (109 patients),chronic HBV infection group (113 patients),and healthy control group (127 patients).The polymerase chain reaction-ligase detection reaction (PCR-LDR) was used to determine the alleles and genotypes of the two SNPs IL-18-137G/C and IL-18-607A/C.The t-test and chi-square test were used for baseline data.The chi-square test was used to investigate the differences in genotype and allele frequencies across the three groups.Non-conditional logistic regression analysis was used to compare the odds ratios (ORs) and 95％ confidence intervals (CIs) for different genotypes/alleles in predicting the risk ofHBV-related HCC.Results The HBV-related HCC group showed significantly higher AA genotype and A allele frequencies of the SNP IL-18-607A/C than the healthy control group (AA genotype frequency:29.4％ vs 18.1％,x2 =4.152,P ＜ 0.05;A allele frequency:54.6％ vs 44.1％,5.169,P ＜ 0.05),which were positively correlated with the risk of HBV-related HCC (AA genotype frequency:OR =1.879,95％ CI:1.020-3.464;A allele frequency:OR =1.524,95％ CI:1.059-2.193).The chronic HBV infection group had a significantly higher A allele frequency of the SNP IL-18-607A/C than the healthy control group (54.0％ vs 44.1％,x2 =4.680,P ＜ 0.05),which was positively correlated with the risk of chronic HBV infection (OR =1.487,95％ CI:1.037-2.132).The genotype and allele frequencies of the SNP IL-18-607A/C showed no significant differences between the HBV-related HCC group and the chronic HBV infection group (P ＞ 0.05).The genotype and allele frequencies of the SNP IL-18-137G/C showed no significant differences between any two groups of the three groups (P ＞ 0.05).Conclusion The AA genotype and A allele frequencies of the SNP IL-18-607A/C are positively correlated with the morbidity of HBV-related HCC,and the A allele frequency of the SNP IL-18-607A/C is positively correlated with the morbidity of chronic HBV infection.

Chronic hepatitis B virus (HBV) carriers are facing the risk of progression to liver fibrosis,liver cirrhosis,and hepatocellular carcinoma.However,due to low risk,slow disease progression,and unsatisfactory short-term effect of antiviral treatment,controversy still exists over whether such patients should be given antiviral treatment.This article reviews the research advances in the necessity and feasibility of antiviral therapy for chronic hepatitis B virus carriers,so as to provide a reference for clinical practice.

OBJECTIVETo evaluate the short-term effect and safety of entecavir for the treatment of chronic hepatitis B (CHB) virus carriers.

METHODSNinety-three cases of CHB virus infection (hepatitis B surface antigen (HBsAg)-positive, hepatitis B e antigen (HBeAg)-positive, hepatitis B core antibody (HBcAb)-positive, HBV DNA≥1x10(5) copies/mL) were divided into two groups: CHB virus carrier (47 cases) and CHB (46 cases). All of the 93 cases were given 0.5 mg entecavir orally once a day for 48 weeks. Virology, serology and biochemistry tests were perrmed at treatment weeks 0, 4, 12, 24 and 48. Side effects of entecavir and the incidence of liver cirrhosis and hepatocellular carcinoma were recorded.

RESULTSThe CHB virus carrier and CHB group had complete virological response rates of 14.9% and 17.4% at week 4, 51.1% and 63.0% at week 12, 76.6% and 89.1% at week 24, and 97.9% and 100% at week 48, respectively; there was no significant difference between the two groups (P>0.05). The CHB virus carrier and CHB group had partial virological response rates of 42.6% and 47.8% at week 4, 57.44% and 65.2% at week 12, 85.0% and 89.1% at week 24, and 100% and 100% at week 48, respectively; there was no significant difference between the two groups (P>0.05). No cases in either group experienced virologic breakthrough during the treatment course. The CHB virus carrier and CHB group had serological response (HBeAg-negative) rates of 0 and 4.3% at week 4, 2.1% and 8.7% at week 12, 4.3% and 13.0% at week 24, and 8.5% and 21.7% at week 48, respectively; there was no significant difference between the two groups (P>0.05). The CHB virus carrier and CHB group had HBeAg seroconversion rates of 0 and 0 at week 4, 0 and 4.4% at week 12, 2.1% and 10.9% at week 24, and 6.4% and 17.4% at week 48, respectively; there was no significant difference between the two groups (P>0.05). No case in either group showed HBsAg-negativity and seroconversion during the treatment course. The CHB group had a biochemical response (alanine aminotransferase normalization) rate of 26.1% at week 4, 65.2% at week 12, 91.3% at week 24, and 97.8% at week 48.No case in either group showed biochemical breakthrough during the treatment course. There were no cases of liver cirrhosis or hepatocellular carcinoma in either group. There were no side effects of the entecavir treatment experienced in either group.

CONCLUSIONAntiviral therapy with entecavir is effective, safe and well tolerated in CHB virus carriers.

Alanine Transaminase ; Antiviral Agents ; Carcinoma, Hepatocellular ; Guanine ; analogs & derivatives ; Hepatitis B e Antigens ; Hepatitis B virus ; Hepatitis B, Chronic ; Humans ; Liver Neoplasms

Objective To investigate the diagnostic value of the T-SPOT.TB test for diagnosing tuberculous meningitis(TBM) by meta-analysis.Methods A systematic retrieval from the databases of PubMed,EMBASE,etc.was performed.The literature on the T-SPOT.TB test for diagnosing TBM was collected.Two reviewers independently screened the literature,extracted the data and judged the quality.The meta analysis was conducted by the Meta-Disc 1.4 software.Results 8 articles were included,involving 425 patients including 232 cases of TBM.In the peripheral blood group,the combined sensitivity was 80%(95%CI:0.74-0.85),the combined specificity was 74%(95%CI:0.67-0.80),the area under the curve(AUC)of summary receiver operating characteristic (SROC)was 0.858 7;the diagnostic odds ratio(DOR)was 15.50.In the CSF group,the combined sensitivity was 76%(95%CI:0.70-0.82),the combined specificity was 83%(95%CI:0.77-0.88),AUC was 0.892 7;DOR was 22.62.Conclusion Adopting the T-SPOT.TB test conduces to increase the diagnostic rate of TBM.The diagnostic accuracy of the T-SPOT.TB test for CSF may be higher than that for peripheral blood.

Objective:To evaluate the clinical efficacy and safety of gatifloxacin in the treatment of mild and moderate bacterial infections of respiratory tract,urinary tract,genital tract,skin and soft tissues.Methods:115 patients in study group were treated with gatifloxacin 200mg taken orally q12h,and 108 patients in control group were treated with ciprofloxacin 250mg taken orally q8h for 7days to 14 days.Results:The total cure rates of study group and control group were 90.4% and 77.8%( P 0.05),respectively.The bacterial eradication rates of the two groups were 97.1% and 89.2%( P 0.05),respectively.Conclusion:Gatifloxacin is a highly effective and well tolerated antibacterial agent for treatment of acute bacterial infections of respiratory tract,urinary tract,genital tract,skin and soft tissues.