ObjectiveTo explore the effect of piercing electroacupuncture on ankle muscle strength, dynamic balance and subjective stability in patients with functional ankle instability (FAI). MethodsA total of 48 patients with FAI admitted to the Affiliated Hospital of Traditional Chinese Medicine, Shandong Second Medical University from April, 2024 to July, 2025 were enrolled and randomly divided into control group (n = 24) and experimental group (n = 24). The control group received multimodal functional training, while the experimental group received piercing electroacupuncture in addition, for six weeks. Relative peak torque of ankle plantarflexion, dorsiflexion, inversion and eversion were measured with isokinetic muscle strength testing system before and after treatment, while Y-Balance Test (YBT) and Cumberland Ankle Instability Tool (CAIT) were adopted for evaluation. ResultsOne case dropped out in each group. Relative peak torque of ankle plantarflexion, dorsiflexion, inversion and eversion at each angular velocity, the normalized distance in each direction and composite score of YBT, as well as the score of CAIT increased in both groups after treatment (|t| > 2.891, P < 0.01), while all the indicators were better in the experimental group than in the control group (|t| > 2.104, P < 0.05), except dorsiflexion muscle strength. ConclusionCombination of piercing electroacupuncture can further improve perimalleolar muscle strength, dynamic balance and subjective stability in patients with FAI.

BACKGROUND:Pelvic fractures encompass a range of types,and the utilization of a pelvic reduction frame for restoration often lacks a systematic repositioning method.Instead,it relies on the operator's experience in conjunction with fluoroscopic findings,which can lead to uncertainty and non-reproducibility. OBJECTIVE:To investigate the clinical efficacy of combining computer-simulated repositioning techniques with a pelvic reduction frame for the treatment of anteroposterior compression-III pelvic fractures. METHODS:A retrospective analysis was conducted on 19 patients with anteroposterior compression-III pelvic fractures who underwent preoperative repositioning via computer simulation and intraoperative repositioning with the assistance of a pelvic reduction frame between January 2018 and December 2021.Among them,7 cases were fixed with double plate in anterior ring and 12 cases were fixed with single plate combined with anterior subcutaneous internal fixation(INFIX).All patients received posterior ring fixation with two sacroiliac screws.Operative duration,intraoperative reduction time,the frequency of intraoperative fluoroscopy use,blood loss,and follow-up duration were documented.These data were utilized to monitor fracture healing time and postoperative complications.Fracture reduction quality was evaluated according to the Matta scale,and the Majeed Pelvic Function Score was employed to assess patient function during the final follow-up. RESULTS AND CONCLUSION:(1)Surgery was successfully completed in all 19 patients.The anterior ring was secured with double plates in 7 cases,while a single plate combined with INFIX was utilized in 12 cases.The posterior ring was stabilized with two sacroiliac screws,specifically targeting the S1 and S2 cones.(2)The operation duration ranged from 74 to 147 minutes,with a mean of(101.63±19.55)minutes.Intraoperative repositioning took place over a period of 26 to 41 minutes,with a mean of(38.11±3.31)minutes.The number of intraoperative fluoroscopies conducted ranged from 35 to 81,with a mean of(62.68±13.11)times.Intraoperative bleeding volumes varied from 60 to 130 mL,with a mean of(85.37±20.57)mL.(3)All the patients were diligently monitored for a duration of 12 to 26 months.Fracture healing was observed within a time frame of 12 to 20 weeks,with a mean of(16.37±2.50)weeks.(4)The evaluation according to Matta's criteria one day post-surgery revealed excellent outcomes in 14 cases and good outcomes in 5 cases.At the final follow-up,the Majeed function score indicated excellent results in 16 cases and good results in 3 cases.(5)Two patients experienced localized fat liquefaction phenomena,characterized by redness,swelling,and oozing at the incision site,which gradually resolved with proactive dressing changes.None of the patients encountered complications such as internal fixation loosening,loss of fracture reduction,or nerve injuries post-surgery.It is concluded that the combined approach of using computer-simulated repositioning techniques in conjunction with pelvic reduction frames for the treatment of anteroposterior compression-III pelvic fractures has advantages in enhancing repositioning efficiency and improving pelvic function.

Objective:To investigate the factors influencing the persistence of prostate specific antigen(PSA) following radical prostatectomy, and to develop and validate a predictive model for PSA persistence.Methods:Clinical data from 1 828 patients who underwent radical prostatectomy at Shanghai Changhai Hospital between January 2015 and December 2023 were retrospectively analyzed. Of these, 1 295 patients from January 2015 to April 2021 comprised the modeling group, while 533 patients from May 2021 to December 2023 formed the validation group. Additionally, 109 patients who underwent radical surgery at the Third Affiliated Hospital of Naval Medical University between March and December 2023 were included as an external validation group. Patients with incomplete clinical information, serum PSA levels exceeding 100 ng/ml, or those who received preoperative neoadjuvant therapy were excluded. Ultimately, 1 003, 369, and 86 patients were included in the modeling, validation, and external validation groups, respectively. The modeling group had serum PSA of 19.29 (8.43, 23.73) ng/ml; the clinical stages were distributed as T 1, T 2, T 3, and T 4 in 191, 673, 123, and 16 patients, respectively; the primary Gleason scores of biopsy were 3, 4, and 5 in 460, 466, and 77 patients, respectively; and the secondary Gleason scores were 3, 4, and 5 in 363, 486, and 154 patients, respectively. The validation group had serum PSA of 12.80 (6.82, 14.40) ng/ml; the clinical stages were distributed as T 1, T 2, T 3, and T 4 in 40, 289, 37, and 3 patients, respectively; the primary Gleason scores of biopsy were 3, 4, and 5 in 218, 145, and 6 patients, respectively; and the secondary Gleason scores were 3, 4, and 5 in 140, 184, and 45 patients, respectively. The external validation group had serum PSA of 12.84 (7.11, 12.97) ng/ml; the clinical stages were distributed as T 1, T 2 and T 3 in 9, 68, and 9 patients, respectively; the primary Gleason scores of biopsy were 3, 4, and 5 in 58, 27, and 1 patient, respectively; and the secondary Gleason scores were 3, 4, and 5 in 28, 50, and 8 patients, respectively. Logistic regression analysis was used to identify independent risk factors for PSA persistence after radical prostatectomy in the modeling group and a prediction model was constructed. The predictive performance of the model was analyzed using the area under the curve (AUC) of the receiver operating characteristics (ROC) curve, the calibration curve, and the clinical decision curve. The predictive performance of the model was verified by the ROC curve in the validation group and the external validation group. Results:The incidence of persistent PSA after surgery in the modeling group, validation group, and external validation group was 8.97% (90/1 003), 7.32% (27/369), and 17.4% (15/86), respectively. In the modeling group, univariate and multivariate logistic regression analysis revealed that serum PSA, percentage of positive needle cores, primary Gleason score on biopsy, and secondary Gleason score on biopsy were independent risk factors for PSA persistence ( P<0.05), and a prediction model was constructed based on these factors. The AUC value of this model was 0.790 (95% CI 0.745-0.835). Calibration curve and clinical decision curve analyses showed that the model's predicted probabilities aligned well with actual risks within the 0-40% prediction interval, providing clinical benefit. The AUC values of the ROC curves in the validation group and external validation group were 0.808 (95% CI 0.719-0.897) and 0.822 (95% CI 0.714-0.929), respectively, indicating that the model had good predictive performance. Conclusions:The predictive model for PSA persistence, constructed based on serum PSA, percentage of positive needle cores, primary and secondary Gleason score on biopsy, demonstrated good clinical predictive performance, exhibiting high accuracy in both internal and cross-center validation.

Objective:To investigate the factors influencing the persistence of prostate specific antigen(PSA) following radical prostatectomy, and to develop and validate a predictive model for PSA persistence.Methods:Clinical data from 1 828 patients who underwent radical prostatectomy at Shanghai Changhai Hospital between January 2015 and December 2023 were retrospectively analyzed. Of these, 1 295 patients from January 2015 to April 2021 comprised the modeling group, while 533 patients from May 2021 to December 2023 formed the validation group. Additionally, 109 patients who underwent radical surgery at the Third Affiliated Hospital of Naval Medical University between March and December 2023 were included as an external validation group. Patients with incomplete clinical information, serum PSA levels exceeding 100 ng/ml, or those who received preoperative neoadjuvant therapy were excluded. Ultimately, 1 003, 369, and 86 patients were included in the modeling, validation, and external validation groups, respectively. The modeling group had serum PSA of 19.29 (8.43, 23.73) ng/ml; the clinical stages were distributed as T 1, T 2, T 3, and T 4 in 191, 673, 123, and 16 patients, respectively; the primary Gleason scores of biopsy were 3, 4, and 5 in 460, 466, and 77 patients, respectively; and the secondary Gleason scores were 3, 4, and 5 in 363, 486, and 154 patients, respectively. The validation group had serum PSA of 12.80 (6.82, 14.40) ng/ml; the clinical stages were distributed as T 1, T 2, T 3, and T 4 in 40, 289, 37, and 3 patients, respectively; the primary Gleason scores of biopsy were 3, 4, and 5 in 218, 145, and 6 patients, respectively; and the secondary Gleason scores were 3, 4, and 5 in 140, 184, and 45 patients, respectively. The external validation group had serum PSA of 12.84 (7.11, 12.97) ng/ml; the clinical stages were distributed as T 1, T 2 and T 3 in 9, 68, and 9 patients, respectively; the primary Gleason scores of biopsy were 3, 4, and 5 in 58, 27, and 1 patient, respectively; and the secondary Gleason scores were 3, 4, and 5 in 28, 50, and 8 patients, respectively. Logistic regression analysis was used to identify independent risk factors for PSA persistence after radical prostatectomy in the modeling group and a prediction model was constructed. The predictive performance of the model was analyzed using the area under the curve (AUC) of the receiver operating characteristics (ROC) curve, the calibration curve, and the clinical decision curve. The predictive performance of the model was verified by the ROC curve in the validation group and the external validation group. Results:The incidence of persistent PSA after surgery in the modeling group, validation group, and external validation group was 8.97% (90/1 003), 7.32% (27/369), and 17.4% (15/86), respectively. In the modeling group, univariate and multivariate logistic regression analysis revealed that serum PSA, percentage of positive needle cores, primary Gleason score on biopsy, and secondary Gleason score on biopsy were independent risk factors for PSA persistence ( P<0.05), and a prediction model was constructed based on these factors. The AUC value of this model was 0.790 (95% CI 0.745-0.835). Calibration curve and clinical decision curve analyses showed that the model's predicted probabilities aligned well with actual risks within the 0-40% prediction interval, providing clinical benefit. The AUC values of the ROC curves in the validation group and external validation group were 0.808 (95% CI 0.719-0.897) and 0.822 (95% CI 0.714-0.929), respectively, indicating that the model had good predictive performance. Conclusions:The predictive model for PSA persistence, constructed based on serum PSA, percentage of positive needle cores, primary and secondary Gleason score on biopsy, demonstrated good clinical predictive performance, exhibiting high accuracy in both internal and cross-center validation.

Infection is an important cause of early death in patients with acute leukemia, and exploring how to reduce infectious complications during intensive chemotherapy for acute leukemia is of great theoretical and practical significances. Studies have shown that the intestinal flora of leukemia patients undergoes significant changes in the process of receiving treatment, and the changes in the intestinal flora of acute leukemia patients are closely related to the occurrence of infectious complications after chemotherapy. This article reviews the characteristics of intestinal flora, the relationship between intestinal flora and infectious complications, and the methods to restore the diversity of intestinal flora in acute leukemia patients.

OBJECTIVE: To evaluate the effectiveness of limited internal fixation combined with a hinged external fixator in the treatment of peri-elbow bone infection. METHODS: The clinical data of 19 patients with peri-elbow bone infection treated with limited internal fixation combined with a hinged external fixator between May 2018 and May 2021 were retrospectively analyzed. There were 15 males and 4 females with an average age of 44.6 years (range, 28-61 years). There were 13 cases of distal humerus fractures and 6 cases of proximal ulna fractures. All the 19 cases were infected after internal fixation of fracture, and 2 cases were complicated with radial nerve injury. According to Cierny-Mader anatomical classification, 11 cases were type Ⅱ, 6 cases were type Ⅲ, and 2 cases were type Ⅳ. The duration of bone infection was 1-3 years. After primary debridement, the bone defect was (3.04±0.28) cm, and the antibiotic bone cement was implanted into the defect area, and the external fixator was installed; 3 cases were repaired with latissimus dorsi myocutaneous flap, and 2 cases were repaired with lateral brachial fascial flap. Bone defects repair and reconstruction were performed after 6-8 weeks of infection control. The wound healing was observed, and white blood cell (WBC), erythrocyte sedimentation rate (ESR), and C-reaction protein (CRP) were reexamined regularly after operation to evaluate the infection control. X-ray films of the affected limb were taken regularly after operation to observe the bone healing in the defect area. At last follow-up, the flexion and extension range of motion and the total range of motion of the elbow joint were observed and recorded, and compared with those before operation, and the function of the elbow joint was evaluated by Mayo score. RESULTS: All patients were followed up 12-34 months (mean, 26.2 months). The wounds healed in 5 cases after skin flap repair. Two cases of recurrent infection were effectively controlled by debridement again and replacement of antibiotic bone cement. The infection control rate was 89.47% (17/19) in the first stage. Two patients with radial nerve injury had poor muscle strength of the affected limb, and the muscle strength of the affected limb recovered from grade Ⅲ to about grade Ⅳ after rehabilitation exercise. During the follow-up period, there was no complication such as incision ulceration, exudation, bone nonunion, infection recurrence, or infection in the bone harvesting area. Bone healing time ranged from 16 to 37 weeks, with an average of 24.2 weeks. WBC, ESR, CRP, PCT, and elbow flexion, extension, and total range of motions significantly improved at last follow-up ( P<0.05). According to Mayo elbow scoring system, the results were excellent in 14 cases, good in 3 cases, and fair in 2 cases, and the excellent and good rate was 89.47%. CONCLUSION Limited internal fixation combined with a hinged external fixator in the treatment of the peri-elbow bone infection can effectively control infection and restore the function of the elbow joint.
Male ; Female ; Humans ; Adult ; Elbow ; Elbow Joint/surgery* ; Retrospective Studies ; Bone Cements ; Treatment Outcome ; External Fixators ; Fracture Fixation, Internal/methods* ; Fractures, Bone ; Range of Motion, Articular

Objective: To evaluate clinical outcomes of autologous and allogeneic peripheral blood stem cell transplantation (PBSCT) for aggressive peripheral T-cell lymphoma (PTCL). Methods: From June 2007 to June 2017, clinical data of PTCL patients who underwent PBSCT were assessed retrospectively. Results: Among 41 patients, 30 was male, 11 female, and median age was 38(13-57) years old. Seventeen patients with autologous PBSCT (auto-PBSCT) and 24 patients with allogeneic PBSCT (allo-PBSCT) were enrolled in this study. Eight patients (8/17, 47.1%) in auto-PBSCT group were ALK positive anaplastic large cell lymphoma (ALCL), 7 patients (7/24, 29.2%) with NK/T cell lymphoma and 9 patients (9/24, 37.5%) with PTCL-unspecified (PTCL-U) in allo-PBSCT group (P=0.035). There were 58.8% patients (10/17) in complete response (CR) status and 11.8% (2/17) in progression disease (PD) status before transplantation in auto-PBSCT group, and 8.3% (2/24) in CR status and 45.8% (11/24) in PD status before transplantation in allo-PBSCT group (P=0.026). The 2-years cumulative overall survival (OS) were (64.0±10.8)% and (53.5±9.7)% for auto-PBSCT and allo-PBSCT respectively (P=0.543). The 2-years cumulative disease-free survival (DFS) were (57.1±12.4)% and (53.5±10.6)% for auto-PBSCT and allo-PBSCT respectively (P=0.701). In patients with dead outcomes after PBSCT, 83.3% (5/6) of death cause was relapse in auto-PBSCT and 41.7% (5/12) of death cause was relapse in allo-PBSCT. Conclusion Both auto-PBSCT and allo-PBSCT were effective for PTCL. Allo-PBSCT maybe was better than auto-PBSCT for high-risk PTCL with poor prognosis.

Objective To introduce the initial application experience of SUTURE (suture-undertent and underside-reposition-enhancement) technique in robotic-assisted radical prostatectomy and discuss its safety and effectiveness.Methods The surgeon has performed 64 cases of Robotic-assisted radical prostatectomy between November 2016 to April 2017.The mean age was (66.6 ± 1.6) years (53-81 years);median PSA was 15.29 ng/ml(1.41-152.53 ng/ml),tumor stage was T1cN0M0-T3bN0M0.The patients were diagnosed by ultrasound-guide prostate biopsy.The number of cores was 6-15,average Gleason score was 7.3 points (6-10 pionts).ECT and MR were used to assess local stage and bone metastasis.The tPSA and urine recovery (urine pad test) was followed-up regularly.SUTURE technique consists of two parts,control the DVC effectively by retain the puboprostatic ligaments and puboprostatic ligaments reconstruction.Result All cases were successfully completed without complication,the average operation time was 95 min (66-150 min);bleeding (106 ± 15) ml(50-300 ml).All the catheters were released 14 days after surgery.Postoperative pathological staging was pT2aN0-pT3bN1,25 cases of capsule invasion,12 cases with seminal vesicle invasion,37 cases with nerve invasion.Average Gleason score was 7.2 points (6-10 points).The median tPSA detected 4 weeks after surgery was 0.047 ng/ml(0.007-12.050 ng/ml).The follow-up time was 1-6 months.The rate of urine control in 1 month and 3 month were 40.8％ (20/49) and 75.8％ (25/33).Conclusions By using SUTURE technique we can control thedorsal vascular complexstrictly,and complete the puboprostatic ligaments reconstruction by stitch it to the anterior vesicourethral.The SUTRUE is a safe and effective systematic DVC controlling technique,and the early urinary control rate is satisfactory.

To explore the spatial distribution mechanism of Japanese encephalitis virus (JEV), PhyML v3.0 was used to build phylogenetic tree using JEV sequences in the dataset. PAUP v4.0 and Migrapyhla softz ware were then used to analyze the migration events. The results showed that a total of 95 migration events were observed during the dispersal of JEV throughout Asia. Further analysis revealed that Thailand, and several Chinese provinces (including Shandong, Shanghai, Sichuan and Yunnan), were the main migration sources of JEV. JEV spread from these migration sources as follows: from Thailand to Australia, Cambodia, Tibet and India; from Shanghai to eastern coastal Asian regions and Yunnan; from Shandong to Korea, Zhejiang, Hubei, Shanxi and Liaoning; from Sichuan mainly to inland regions of China, as well as Vietnam and Japan; and from Yunnan to Zhejiang. This study indicated that frequent migration events occurred during the dispersal of JEV in the Asia and Pacific regions, and that Thailand, Shandong, Shanghai, Sichuan and Yunnan were the sources of JEV dispersal.
Asia ; epidemiology ; China ; epidemiology ; Encephalitis Virus, Japanese ; classification ; genetics ; isolation & purification ; physiology ; Encephalitis, Japanese ; epidemiology ; transmission ; virology ; Phylogeny

OBJECTIVETo investigate the effects of orthodontic treatment of skeletal crossbite adults with mandibular deviation.

METHODSEighteen skeletal Class III adult patients with borderline skeletal crossbite and mandibular deviation were selected (5 males, 13 females). The mean age was 25 years. All cases were treated with straight-wire appliance in upper arch and occlusal plate in the lower arch.Elastics were applied to correct mandibular deviation. Cephalometric analysis was carried out before and after treatment. Paired t-test was performed.

RESULTSAfter treatment, the anterior crossbite was corrected and Class I molar and canine relationships were achieved. The inclination of upper incisors was increased significantly.

CONCLUSIONSStraight-wire appliance combined with occlusal plate was effective on correcting adult patients with mild, moderate skeletal crossbite and mandibular deviation.

Adult ; Cephalometry ; Female ; Humans ; Incisor ; Male ; Malocclusion ; therapy ; Molar ; Orthodontic Wires