BACKGROUND:There are few studies on the effect of different patellar morphologies on the outcome after unicompartmental knee arthroplasty.OBJECTIVE:To investigate the effect of different patellar morphologies on functional recovery and patellofemoral joint alignment after unicompartmental knee arthroplasty based on patellar Wiberg classification.METHODS:A retrospective study was conducted in 186 patients with medial knee osteoarthritis who underwent unicompartmental knee arthroplasty at Affiliated Hospital of Xuzhou Medical University between January 2022 and March 2023.Patients were categorized into group A(type Ⅰ,n=43),group B(typeⅡ,n=104),and group C(type Ⅲ,n=39)according to the Wiberg classification.The Hospital for Specia Surgery knee score,Feller score,and incidence of anterior knee pain,as well as radiologic data(patellar index,patellar tilt angle,and lateral patellofemoral angle)were compared among the three groups.RESULTS AND CONCLUSION:(1)There was no significant difference in the Feller patellar score and Hospital for Specia Surgery score at the final postoperative follow-up in patients with Wiberg type Ⅰ,type Ⅱ,and type Ⅲ patellae(P＞0.05).(2)Although there was no significant difference in the incidence of anterior knee pain among the three groups at the final follow-up,patients with type Ⅲ patellae were significantly more likely to have experienced anterior knee pain early in the postoperative period.(3)Different patellar morphologies can improve patellar position to some extent after unicompartmental knee arthroplasty,but type Ⅲ had greater patellar tilt than types Ⅰ and Ⅱ,both preoperatively and postoperatively.(4)This finding highlights the need for tailored morphological adjustments to the Wiberg Ⅲ patella during unicompartmental knee arthroplasty to improve surgical outcomes.

BACKGROUND:Unicompartmental knee arthroplasty effectively addresses medial knee osteoarthritis.The accurate tibial component rotational alignment is crucial to ensure the best surgical outcome.OBJECTIVE:To assess the impact of tibial component rotational alignment on short-term outcomes after unicompartmental knee arthroplasty in medial knee osteoarthritis patients.METHODS:From February 2021 to February 2023,91 patients who underwent mobile-bearing unicompartmental knee arthroplasty in Affiliated Hospital of Xuzhou Medical University were selected.According to the rotational alignment of tibial prosthesis relative to Akagi's line measured by postoperative CT,the patients were divided into three groups.Group A had internal rotation greater than 0°,group B had external rotation from 0° to 5°,and group C had external rotation greater than 5°.The knee range of motion,Oxford knee score,and forgotten joint score were recorded and compared among three groups preoperatively,at the last follow-up after surgery.RESULTS AND CONCLUSION:(1)At the last follow-up after surgery,the Oxford knee score of group B was significantly lower than that of group A(P=0.003)and group C(P=0.025).The knee range of motion of group B was higher than that of group A(P=0.011)and group C(P=0.024),and the forgotten joint score of group B was higher than that of group A(P=0.001)and group C(P=0.049).(2)The forgotten joint score in group C was significantly higher than that in group A at the last follow-up(P=0.044).(3)Patients were followed up for 12-36 months after arthroplasty.There were 2 and 7 cases of postoperative knee pain in groups B and C,and the difference was statistically significant(P=0.033).(4)It is indicated that external rotation of the tibial prosthesis by 0°-5° is ideal for achieving satisfactory short-term clinical outcomes,so we should avoid intraoperative tibial prosthesis malrotation.

BackgroundPatients with schizophrenia experience low quality of life， and internalized stigma is considered an important indicator for quality of life， while the mediating role of self-esteem and severity of negative symptoms in the relationship between internalized stigma and quality of life remains underexplored. ObjectiveTo examine the mediating role of self-esteem and severity of negative symptoms in the relationship between internalized stigma and quality of life， so as to provide references for improving their quality of life. MethodsA total of 342 patients with schizophrenia who were hospitalized in 6 hospitals in Xiangyang City， Siping City and Changchun City from April to September 2023 were included， and all of whom met the diagnostic criteria for schizophrenia according to the International Classification of Diseases， tenth edition （ICD-10）. Internalized Stigma of Mental Illness Scale （ISMI）， Schizophrenia Quality of Life Scale （SQLS）， Self-Esteem Scale （SES） and negative symptom subscale of Positive and Negative Symptom Scale （PANSS） were administered to all patients. Spearman correlation analysis was adopted to determine correlations between the different scales. A structural equation modeling was constructed using Amos 28.0， and Bootstrap method was employed to verify the mediating effect of self-esteem and negative symptom severity in the association between internalized stigma and quality of life. ResultsA total of 309 patients （90.35%） completed questionnaires in this study. The ISMI score of schizophrenia patients was positively correlated with both SQLS score and the PANSS negative symptom subscale score （r=0.612， 0.492， P<0.01）， while was negatively correlated with SES score （r=-0.513， P<0.01）. The SQLS score was negatively associated with the SES score （r=-0.555， P<0.01） and positively associated with PANSS negative symptom subscale score （r=0.672， P<0.01）. The SES score was negatively correlated with PANSS negative symptom subscale score （r=-0.433， P<0.01）.The total effect value of internalized stigma on quality of life was 0.746 （95% CI： 0.680~0.806）. Self-esteem and severity of negative symptoms independently mediated the relationship between internalized stigma and quality of life， and the indirect effect values were 0.151 （95% CI： 0.062~0.254） and 0.126 （95% CI： 0.047~0.205）， accounting for 20.24% and 16.89% of the total effect， respectively. In addition， a chained mediation effect of self-esteem and quality of life was also demonstrated， the indirect effect value was 0.102 （95% CI： 0.049~0.165）， accounting for 13.67% of the total effect）. ConclusionInternalized stigma in patients with schizophrenia patients can not only directly affect the quality of life， but also indirectly affect the quality of life of patients through either separate or chained mediation of self-esteem and the severity of negative symptoms. ［Funded by Hubei Provincial Undergraduate Innovation and Entrepreneurship Project （number， S202410519027）］

In recent years,significant breakthroughs have been achieved in the immunotherapy for Alzheimer's disease.In line with global advancements,two anti-amyloid-β monoclonal antibodies have been approved and successfully launched in China for clinical use.Lecanemab and Donanemab were officially used in June 2024 and April 2025 in China,respectively.In order to standardize the rational and safe application of anti-amyloid-β monoclonal antibodies for Alzheimer's disease in China,this article integrates recom-mendations from the clinical trials and real-world experience from the author's team and domestic peers to further update the recom-mendations for the clinical use of anti-amyloid-β monoclonal antibody based on the 2024 version.It includes indications for therapy,pre-treatment evaluation and preparation,administration protocols and safety measures during treatment,and post-treatment monitor-ing strategies.

Objective:To evaluate the efficacy and safety of percutaneous nephrolithotomy (PCNL) in the treatment of severe acute pancreatitis (SAP) with infected pancreatic necrosis (IPN).Methods:A retrospective analysis was conducted on the clinical data of 113 patients with SAP and IPN admitted to Qingdao Municipal Hospital between January 2018 and June 2023. The cohort included 66 males and 47 females, aged (46.2±13.6) years. Based on the treatment approach, patients were divided into two groups: those who underwent percutaneous catheter drainage (PCD) alone were assigned to the PCD group ( n=60), and those who received PCNL were assigned to the PCNL group ( n=53). Clinical parameters such as age, sex, number of debridement procedures, and postoperative complications were recorded. Results:Compared with the PCD group, the PCNL group had a higher CT severity index [8(6, 9) vs. 7(6, 8)], a greater proportion of patients with multiloculated abscesses [71.7%(38/53) vs. 41.7%(25/60)], and a higher percentage of patients with IPN involving >50% necrosis [56.6%(30/53) vs. 33.3%(20/60)]. These differences were statistically significant (all P<0.05). The PCNL group also showed a higher proportion of patients with post-treatment IPN necrosis involving <30% [91.4%(49/53) vs. 70.8%(42/60)], a lower rate of requiring step-up laparoscopic or open surgery [3.8%(2/53) vs. 10.0%(6/60)], fewer debridement sessions [2(1, 4) vs. 4(2, 6)], and a shorter total hospital stay [45(35, 58) d vs. 54(23, 72) d]. These differences were statistically significant (all P<0.05). Additionally, the PCNL group had lower rates of postoperative complications, including enteric fistula [3.8%(2/53) vs. 11.7%(7/60)], intra-abdominal bleeding [5.7%(3/53) vs. 13.3%(8/60)], and pancreatic fistula [15.1%(8/53) vs. 20.0% (12/60)]. These differences were also statistically significant (all P<0.05). The recurrence rate of abscesses was significantly lower in the PCNL group [11.3%(6/53) vs. 16.7%(10/60), χ2=4.14, P=0.042]. Conclusion:PCNL is an effective treatment for SAP complicated by IPN. Compared with PCD, it improves the clearance of necrotic tissue, reduces the number of debridement procedures, shortens the total hospital stay, and lowers the risk of postoperative complications.

BACKGROUND:At present,the surgical treatment of atlantoaxial dislocation mainly adopts the posterior atlantoaxial screw-rod internal fixation system for lifting and reduction.During the operation,the curvature of the connecting rod is often increased to increase the drop between the atlantoaxial vertebrae to improve the reduction effect,but it increases the difficulty and risk of surgery.The axis pivot screw directly increases the reduction drop between the atlantoaxial vertebrae,but the extent to which it increases the reduction capacity is unclear.OBJECTIVE:To test the reduction ability of axis pivot screw and compare it with ordinary screw.METHODS:Six fresh human craniocervical specimens were used in study.The joint capsules of two lateral mass joints and atlanto-odontoid joint and transverse ligament were removed to make an atlantoaxial instability model.Three kinds of internal fixation were performed successively on both sides of the axis of each specimen:uniaxial axis pivot screws(group A),multi-axial axis pivot screws(group B)and ordinary screws(group C).Flexible ultra-thin film pressure sensors were placed in the anterior atlanto-odontoid space.Two connecting rods with the same curvature were placed to simulate the lifting and reduction,and the pressure of the anterior atlanto-odontoid space was obtained.Comparative analysis was conducted among the three groups.RESULTS AND CONCLUSION:(1)The anterior atlanto-odontoid space pressure of groups A-C was(97.59±8.58),(60.43±5.09),and(22.74±0.81)N,respectively.There were significant differences among the three groups(F=251.603,P=0.000).The pairwise comparison among the three groups showed significant differences(P=0.000).(2)The axis pivot screw applied to the posterior atlantoaxial screw-rod internal fixation system can improve the reduction capacity compared with the common cervical posterior screw,and the uniaxial axis pivot screw has more reduction capacity than the multi-axis uniaxial axis pivot screw to improve the posterior atlantoaxial screw-rod internal fixation system.

Objective:Explore the protective effect and mechanism of methyl badosolone (CDDO-Me) on rats with traumatic brain injury (TBI).Methods:A total of 72 SPF-grade SD rats aged 8 weeks were randomly (random number) divided into 4 groups ( n=18) using the random number table method: Sham, TBI, TBI+Vehicle, and TBI+CDDO-Me. The rat TBI model was established using the hydraulic impact head injury method. The TBI+CDDO-Me group was administered CDDO-Me (dissolved in 1% DMSO, at a dose of 10 mg/kg) via intraperitoneal injection 30 minutes after modeling, twice a day for a total of 3 days. On the third day after modeling, brain tissue was collected for pathological and water content detection after mNSS scoring. Immunofluorescence double staining was used to detect the expression of nuclear factor erythroid2 related factor 2 (Nrf2); immunohistochemical staining was used to detect the expression of ionized calcium binding adapter molecule-1(Iba-1); ELISA was used to detect the levels of tumor necrosis factor-α(TNF-α), interleukin (IL)-1β, and IL-18 in serum; kits were used to detect the levels of malondialdehyde (MDA) and reactive oxygen species (ROS); Western blot was used to detect the expression of the Nrf2 pathway, B-cell lymphoma-2 (BCL-2), and BCL-2 associated X protein (BAX). Results:(1) Compared with the Sham group, the mNSS scores and water content in the injured cortex of the TBI group rats were significantly increased (both P<0.05), and both significantly decreased after CDDO-Me intervention (both P<0.05). (2) Compared with the Sham group, the proportion of Nissl-stained injured neurons and apoptotic positive cells in the TBI group rats were significantly increased (both P<0.05), and both significantly decreased after CDDO-Me intervention (both P<0.05), accompanied by a decrease in BAX protein expression and upregulation of BCL-2 protein expression (both P<0.05). (3) Immunofluorescence and Western blot results showed that compared with the Sham group, the expression of total Nrf2, nuclear Nrf2, HO-1, and NQO1 proteins in the TBI group were all increased (all P<0.05), and the increase was more significant after CDDO-Me intervention (all P<0.05). (4) Immunohistochemistry and ELISA results showed that compared with the Sham group, the levels of MDA, ROS, Iba-1 in brain tissue and the levels of TNF-α, IL-1β, and IL-18 in serum in the TBI group rats were all significantly increased (all P<0.05), and all significantly decreased after CDDO-Me intervention (all P<0.05). Conclusion:CDDO-Me helps to reduce oxidative stress and inflammatory responses in TBI rats, and the mechanism may be related to the activation of the Nrf2/HO-1 antioxidant stress pathway.

Concepts are the cornerstone of the development of disciplines. The concepts of TCM present that a superior concept contains more subordinate concepts. The superordinate concepts are often used to refer to different subordinate concepts, which can refer to both superior concepts themselves and non-specific subordinate concepts, that is, the characteristics of subordinate coverage and indefinite reference, which cause confusion in concept meaning, concept relationships, reasoning logic, and other problems. Nowadays, the TCM scholars pay little attention to this characteristic. Therefore, this article analyzed this characteristic, discussed its impact on the inheritance and development of TCM, and proposed that starting from the anchoring of concepts and entities to clarify the connotation of concepts, looking forward to provide new ideas for the definition of the concepts of TCM and the development of the discipline.

Oxygen generation technologies with lower requirement and higher performance urgently need to be developed to meet the challenges of manned lunar landing and Mars exploration.In this paper,the mission requirements,technical characteristics,key technologies and operation status of oxygen generation assembly by water electrolysis(OGAWE)in China Space Station(CSS)are introduced.Furthermore,the latest developments about oxygen generation by electrolyzing carbon dioxide based on solid oxide electroyte is reported.The application effects and research achievements demonstrate the oxygen generation by electrolysis is one of the most suitable techniques for oxygen regeneration in manned space mission.In addition,the oxygen generation by novel electrolysis technology provides feasible approach for improving the performance of oxygen regeneration and producing oxygen by in-situ utilization of extraterrestrial resource.These development experiments of OGAWE in CSS and research results of novel electrolysis provide valuable references for the technical progress of oxygen generation by electrolysis for manned spaceflight.