Objective To investigate the application of a 3-D printed femoral locator designed based on the modified quadrant method,combined with patient imaging data,then assist in femoral positioning for anterior cruciate ligament(ACL)reconstruction.Methods From January 2023 to January 2024,60 patients with primary ACL rupture who met the inclusion criteria were randomly assigned to either the 3-D printed guide group(using a 3-D printed femoral positioning guide to assist ACL reconstruction with nylon material)or the traditional surgery group(traditional surgery with direct visualization ACL reconstruction),with 30 patients in each group.Preoperative and postoperative knee CT scans and three-dimensional reconstructions were performed.The modified quadrant method was used to analyze and compare the percentage coordinates(Fx and Fy)of the femoral tunnel center point pre-and postoperatively within the same group and between different groups.Results The guides were made using nylon material.The surgery duration was significantly shorter in the 3D-printed guide group(53.8±6.0)min compared to the traditional surgery group(62.4±7.8)min,the difference was statistically significant(P＜0.05).Analysis using the modified quadrant method showed that the postoperative relative coordinate position percentages of the femoral tunnel center in the 3D-printed guide group(28.4±2.0)％and(35.5±2.3)％were not significantly different from the preoperative planned values(28.4±0.0)％and(35.7±0.0)％,the differences were not statistically significant(P＞0.05).Similarly,in the traditional surgery group,the postoperative coordinate percentages(28.1±2.9)％and(35.2±3.2)％showed no significant difference compared to the preoperative planned values(28.4±0.0)％and(35.7±0.0)％,the differences were not statistically significant(P＞0.05).There was no statistically significant difference in the postoperative femoral tunnel center position percentages between the two groups(P＞0.05).The Lysholm score and International Knee Documentation Committee(IKDC)score of the two groups showed an increasing trend after surgery,and the differences between Lysholm score and IKDC score at each time point were statistically significant(P＜0.05).However,no statistical differences were found between the two groups at each postoperative time point(P＞0.05).Conclusion Both intra-articular 3D-printed guide-assisted and traditional surgery-assisted femoral positioning for ACL reconstruction can achieve anatomical reconstruction,with no significant difference in bone tunnel positioning.However,the use of intra-articular 3D-printed guide technology has a more centralized distribution of the femoral tunnel center point and a shorter surgery duration.This study provides proof of concept for the creation of personalized femoral tunnel locators for patients undergoing ACL reconstruction.

Objective To investigate the application of a 3-D printed femoral locator designed based on the modified quadrant method,combined with patient imaging data,then assist in femoral positioning for anterior cruciate ligament(ACL)reconstruction.Methods From January 2023 to January 2024,60 patients with primary ACL rupture who met the inclusion criteria were randomly assigned to either the 3-D printed guide group(using a 3-D printed femoral positioning guide to assist ACL reconstruction with nylon material)or the traditional surgery group(traditional surgery with direct visualization ACL reconstruction),with 30 patients in each group.Preoperative and postoperative knee CT scans and three-dimensional reconstructions were performed.The modified quadrant method was used to analyze and compare the percentage coordinates(Fx and Fy)of the femoral tunnel center point pre-and postoperatively within the same group and between different groups.Results The guides were made using nylon material.The surgery duration was significantly shorter in the 3D-printed guide group(53.8±6.0)min compared to the traditional surgery group(62.4±7.8)min,the difference was statistically significant(P＜0.05).Analysis using the modified quadrant method showed that the postoperative relative coordinate position percentages of the femoral tunnel center in the 3D-printed guide group(28.4±2.0)％and(35.5±2.3)％were not significantly different from the preoperative planned values(28.4±0.0)％and(35.7±0.0)％,the differences were not statistically significant(P＞0.05).Similarly,in the traditional surgery group,the postoperative coordinate percentages(28.1±2.9)％and(35.2±3.2)％showed no significant difference compared to the preoperative planned values(28.4±0.0)％and(35.7±0.0)％,the differences were not statistically significant(P＞0.05).There was no statistically significant difference in the postoperative femoral tunnel center position percentages between the two groups(P＞0.05).The Lysholm score and International Knee Documentation Committee(IKDC)score of the two groups showed an increasing trend after surgery,and the differences between Lysholm score and IKDC score at each time point were statistically significant(P＜0.05).However,no statistical differences were found between the two groups at each postoperative time point(P＞0.05).Conclusion Both intra-articular 3D-printed guide-assisted and traditional surgery-assisted femoral positioning for ACL reconstruction can achieve anatomical reconstruction,with no significant difference in bone tunnel positioning.However,the use of intra-articular 3D-printed guide technology has a more centralized distribution of the femoral tunnel center point and a shorter surgery duration.This study provides proof of concept for the creation of personalized femoral tunnel locators for patients undergoing ACL reconstruction.

Lipid storage myopathy (LSM) is a disease pathologically characterized by lipid accumulation and storage in muscle fiber. This is a case report of depression with a comorbid condition of LSM. The diagnostic process, symptoms, diagnostic key points, and treatment of this case were discussed in association with literature review to provide a better understanding of this comorbidity in clinical physicians.

Lipid storage myopathy (LSM) is a disease pathologically characterized by lipid accumulation and storage in muscle fiber. This is a case report of depression with a comorbid condition of LSM. The diagnostic process, symptoms, diagnostic key points, and treatment of this case were discussed in association with literature review to provide a better understanding of this comorbidity in clinical physicians.

Objective:To investigate the potential mechanism by which Brucella suis vaccine strain S2 induces the apoptosis of BV-2 microglia cells, and to discover new protein targets for neurobrucellosis treatment. Methods:BV-2 microglia cells were treated with Brucella suis vaccine strain S2 for 0, 3, 6, 12 and 24 h. Western blot assay and RT-qPCR were performed to detect the expression of p-JNK and p53 at protein and mRNA levels in BV-2 microglia cells. Cell apoptosis was measured by flow cytometry. Immunofluorescence was used to analyze nuclear p-JNK. Results:Brucella suis vaccine strain S2 could promote the expression of p-JNK and p53 at both protein and mRNA levels and increase nuclear p-JNK in BV-2 microglia cells. Moreover, it could also induce the apoptosis of BV-2 microglia cells. Conclusions:Brucella suis vaccine strain S2 could promote the apoptosis of BV-2 microglia cells through activating JNK and promoting p53 expression.

This article reports the clinical data, diagnosis and treatment plan and prognosis of 3 patients with breast cancer under 20 years old. The clinical pathological features, treatment and prognosis were discussed in the literature, and compared with the biological characteristics of young (under 35 years old) breast cancer patients, providing a reference for the clinical individualized treatment of the disease.

Objective To investigate the clinical characteristics,diagnosis and treatment strategies of breast neuroendocrine carcinoma.Methods 20 cases with breast neuroendocrine carcinoma,who were admitted in Department of Breast Surgery,the Second Affiliated Hospital of Dalian Medical University from Mar.2005 to Dec.2017,were analyzed retrospectively.Results The average age of the 20 patients was(54.35±13.35) years.In aspect of surgery,18 patients received modified radical mastectomy,1 patient received total glandectomy and sentinel lymph node biopsy and stage I silicone implant breast reconstruction,and 1 patient received radical mastec tomy.In terms of pathological types,there were 5 cases (25.0％) of highly differentiated neuroendocrine carcinoma,4 cases (20.0％) of poorly differentiated neuroendocrine carcinoma (small cell carcinoma),and 11 cases (55.0％)of invasive breast cancer with neuroendocrine differentiation.In molecular typing,there were 7 cases (35.0％) of Luminal A,7 cases (35.0％) of Luminal B (HER2 negative),4 cases (20.0％) of Luminal B (HER2 positive),and one case(5.0％) of HER2 type and one case(5.0％) of Basal-like type.The positive rates of ER,PR and HER2 in this group were 90.0％,60.0％ and 25.0％ respectively.20 patients were followed up for 5 to 119 months,with an average follow-up of (59.85±24.51) months.One patient developed bone metastases in the 6th year after surgery and survived for 119 months.One patient developed pulmonary metastasis at the 20th month after surgery and died at the 28th month after surgery.So far,the remaining postoperative patients still survived and no sign of recurrence or metastasis was found.Conclusion The diagnosis of breast neuroendocrine carcinoma relies on histopathological and immunohistochemical detection.Its ER/PR positive rate is high,its molecular typing is mostly Luminal type,and neoadjuvant treatment can be performed when necessary.For specific patients whose ER or PR are positive,neoadjuvant endocrine therapy is also a well-established therapy,even the optimal results can be achieved.However,more cases are still needed for research.

Objective To study the expression of HER-3 in breast cancer patients and analyze its relationship with the clinical pathology and prognosis of breast cancer,ER,PR and HER-2.Methods Data of 139 female breast cancer patients undergoing operations at the Second Hospital of Dalian Medical University from Jan.2006 to Oct.2006 were collected.These 139 patients didn't have preoperative chemotherapy or radiation therapy,but had postoperative endocrine therapies.Immunohistochemisty was used to detect the expression of HER-3 in the 139 patients.Data like the expression of ER,PR and HER-2,histological grading,tumor size and lymph node metastasis were obtained from their medical records.The relationship between indicators and breast cancer was analyzed.Results ①The positive expression rate of HER-3,HER-2,ER,and PR was 30.2％ (42/139),42.5％ (59/139),66.9％ (93/139),and 59.7％ (83/139) respectively.(②)The statistical items had no relation with patients' age(P ＞0.05).③HER-3 expression was correlated with tumor sizes,lymph node metastasis,histological grading,5 year survival rate and HER-2 expression(P ＜ 0.05),and had no relation with ER or PR(P ＞0.05).④)The combined expression of HER-3 & HER-2 was correlated with tumor sizes,axillary lymph node metastasis,histological grading,ER and PR.(P ＜ 0.05).Conclusions HER-3 detection is of great significance for the diagnosis and prognosis of breast cancer.The combined examination of HER-3,HER-2,ER,and PR in breast cancer tissues is of clinical significance for early diagnosis/treatment,medication and prognosis of the tumor,as well as for new drug research and development.

Objective To review the clinical features and the follow-up results of 317 cases of patients treated with artificial heart valve replacement and evaluate the curative effect.Methods Data of 317 patients underwent artificial heart valve replacement from July 2005 to June 2010 was analyzed,among them,284 patients replaced with mechanical valve and 33 patients with biological valve.Clinical features including age,etiology,surgical approach,valve type,etc,were summarized and the recovery of cardiac function,the incidence of complication and mortality were observed through postoperative follow-up.Results There were 6 patients died in the perioperative period and 311 survived.Two hundred and ninety-one cases were followed up and the follow-up rate was 93.57％.The time of follow-up is 1.00 to 4.75 years( with average:2.23 ±1.37 years).The cardiac function(NYHA) was significantly improved after operation ( grade:2.05 ± 0.29 vs 3.17 ± 0.62 ) ( t =2.366,P ＜ 0.05 ).It was related to age,cardiac function before operation ( P ＜ 0.05 ).One patient died during the follow-up period.The statistics analysis showed that the long-term incidence of complication was related to the type of heart valve prosthesis ( P ＜ 0.05 ).Conclusion The therapeutic effect of artificial heart valve replacement surgery appears satisfactory.Heart function is improved significantly and the survival rate is high.Reasonable timing of surgery,appropriate type of prosthetic valve and intensified clinical follow-up can help to reduce the occurrence of postoperative complication.