3.Long-term clinical outcomes following total knee arthroplasty in patients with hemophilic arthropathy: a single-surgeon cohort after a 10- to 17-year follow-up.
Bin FENG ; Yingjie WANG ; Xiying DONG ; Zeng LI ; Jin LIN ; Xisheng WENG
Chinese Medical Journal 2023;136(12):1478-1484
BACKGROUND:
Total knee arthroplasty (TKA) can reduce severe joint pain and improve functional disability in hemophilia. However, the long-term outcomes have rarely been reported in China. Therefore, this study aimed to evaluate the long-term outcomes and complications of TKA in Chinese patients with hemophilic arthropathy.
METHODS:
We retrospectively reviewed patients with hemophilia who underwent TKA between 2003 and 2020, with at least 10 years of follow-up. The clinical results, patellar scores, patients' overall satisfaction ratings, and radiological findings were evaluated. Revision surgery for implants during the follow-up period was recorded.
RESULTS:
Twenty-six patients with 36 TKAs were successfully followed up for an average of 12.4 years. Their Hospital for Special Surgery Knee Score improved from an average of 45.8 to 85.9. The average flexion contracture statistically significantly decreased from 18.1° to 4.2°. The range of motion (ROM) improved from 60.6° to 84.8°. All the patients accepted patelloplasty, and the patients' patellar score improved from 7.8 preoperatively to 24.9 at the last follow-up. There was no statistically significant difference in clinical outcomes between the unilateral and bilateral procedures, except for a better ROM at follow-up in the unilateral group. Mild and enduring anterior knee pain was reported in seven knees (19%). The annual bleeding event was 2.7 times/year at the last follow-up. A total of 25 patients with 35 TKAs were satisfied with the procedure (97%). Revision surgery was performed in seven knees, with 10- and 15-year prosthesis survival rates of 85.8% and 75.7%, respectively.
CONCLUSIONS
TKA is an effective procedure for patients with end-stage hemophilic arthropathy, which relieves pain, improves knee functions, decreases flexion contracture, and provides a high rate of satisfaction after more than ten years of follow-up.
Humans
;
Arthroplasty, Replacement, Knee/methods*
;
Hemophilia A/surgery*
;
Follow-Up Studies
;
Retrospective Studies
;
Treatment Outcome
;
Knee Joint/surgery*
;
Range of Motion, Articular
;
Arthritis/complications*
;
Pain
;
Contracture/surgery*
;
Surgeons
;
Knee Prosthesis
4.Clinical efficacy of simple taper retentive implants in immediate posterior dental implantation for 5-7 years.
Bihui REN ; Shuigen GUO ; Yehao XU ; Jieting DAI ; Hongwu WEI
West China Journal of Stomatology 2023;41(3):341-349
OBJECTIVES:
This study aimed to evaluate the long-term clinical efficacy of simple taper retentive implants in the posterior dental area after immediate implantation for 5-7 years.
METHODS:
Selected from January 2015 to December 2017 in the Fourth Affiliated Hospital of Nanchang University dental clinic line tooth area immediately after the implant prosthesis, a total of 38 patients, 53 implants, were deep into (bone under 2 mm or higher) and the upper structure was repaired. In addition, after the completion of tracking observation of 60-90 months, the implant surrounding bone health was recorded and analyzed.
RESULTS:
After 5-7 years of follow-up, 1 of the 53 implants failed to fall out, and the implant retention rate was 98.1%. The amount of bone resorption in the proximal and distal margins 5-7 years after implant restoration was (0.16±0.94) mm and (-0.01±1.29) mm, respectively, and the difference in bone height between the proximal and distal margins of the implant and the immediate post-restoration period was not statistically significant (P>0.05). No statistically significant differences were found in the effects of periodontitis, implant site inflammation, and smoking on peri-implant marginal bone resorption (P>0.05).
CONCLUSIONS
The single taper-retained implant broadens the indications for immediate implant placement in the posterior region, and its deep sub-osseous placement (≥2 mm below the bone) avoids to a certain extent the disturbance of the implant by external stimuli and the exposure of the cervical abutment of the implant, with the good long-term stability of the marginal bone around the implant.
Humans
;
Dental Implantation, Endosseous
;
Dental Implants
;
Immediate Dental Implant Loading
;
Follow-Up Studies
;
Dental Implants, Single-Tooth
;
Alveolar Bone Loss/surgery*
;
Treatment Outcome
;
Dental Prosthesis, Implant-Supported
;
Dental Restoration Failure
5.Follow-up of fetuses with de novo copy number variations of unknown significance detected by chromosomal microarray analysis.
Leilei GU ; Wei LIU ; Chunxiang ZHOU ; Peixuan CAO ; Xiangyu ZHU ; Jie LI
Chinese Journal of Medical Genetics 2023;40(4):442-445
OBJECTIVE:
To analyze the prognosis of fetuses identified with de novo variants of unknown significance (VOUS) by chromosome microarray analysis (CMA).
METHODS:
A total of 6 826 fetuses who underwent prenatal CMA detection at the Prenatal Diagnosis Center of Drum Tower Hospital from July 2017 to December 2021 were selected as the study subjects. The results of prenatal diagnosis, and outcome of fetuses identified with VOUS of de novo origin were followed up.
RESULTS:
Among the 6 826 fetuses, 506 have carried VOUS, of which 237 were detected for the parent-of-origin and 24 were found to be de novo. Among the latters, 20 were followed up for 4 to 24 months. Four couples had opted elective abortion, 4 had developed clinical phenotypes after birth, and 12 were normal.
CONCLUSION
Fetuses with VOUS should be continuously follow-up, in particular those carrying de novo VOUS, in order to clarify their clinical significance.
Pregnancy
;
Female
;
Humans
;
DNA Copy Number Variations
;
Follow-Up Studies
;
Prenatal Diagnosis/methods*
;
Chromosomes
;
Microarray Analysis/methods*
;
Fetus
;
Chromosome Aberrations
6.Mid-term follow-up of superior pubic ramus osteotomy in locked symphysis pubis with urethral injury: A case report.
Anindansu BASU ; Navin SHUKLA ; Sandeep VELAGADA ; Sudarsan BEHERA
Chinese Journal of Traumatology 2023;26(4):244-248
A locked pubic ramus body is an unusual variant of lateral compression injury. Till date, there have been only 25 cases reported in the published literature. We herein described a case where the right pubic ramus was entrapped within the opposite obturator foramen with an overlap of greater than 4 cm, with associated urethral injury. When all maneuvers of closed and instrumented reduction failed, we performed a superior pubic ramus osteotomy on the left side and unlocked the incarcerated right pubic ramus. The osteotomy site was stabilized with a 6-hole recon plate. The patient underwent delayed urethral repair 10 weeks after the index surgery. At 3-year follow-up, the patient has sexual dysfunction especially difficulty in maintaining erection, secondary urethral stricture, heterotopic ossification, and breakage of implants.
Humans
;
Pubic Bone/injuries*
;
Follow-Up Studies
;
Osteotomy, Sagittal Split Ramus
;
Pelvis
;
Urethra/surgery*
;
Pubic Symphysis/injuries*
7.Follow-up and prognostic study of infants with positional plagiocephaly.
Wei-Wei PAN ; Jiao-Jiao LIAO ; Xiao-Mei TONG
Chinese Journal of Contemporary Pediatrics 2023;25(4):368-373
OBJECTIVES:
To study the effects of infantile positional plagiocephaly on the growth and neural development.
METHODS:
A retrospective study was conducted on the medical data of 467 children who underwent craniographic examination and were followed up to 3 years of age in Peking University Third Hospital from June 2018 to May 2022. They were divided into four groups: mild positional plagiocephaly (n=108), moderate positional plagiocephaly (n=49), severe positional plagiocephaly (n=12), and normal cranial shape (n=298). The general information of the four groups and the weight, length, head circumference, visual acuity screening results, hearing test results, and the scores of Pediatric Neuropsychological Developmental Scales/Gesell Developmental Schedules of the four groups from 6 to 36 months old were compared.
RESULTS:
The rates of adverse perinatal factors, congenital muscular torticollis, and supine fixed sleeping posture in the mild, moderate, and severe positional plagiocephaly groups were higher than the normal cranial group (P<0.05). There was no significant difference in weight, length, and head circumference among the four groups at 6, 12, 24 and 36 months of age (P>0.05). The incidence rate of abnormal vision in the severe positional plagiocephaly group was higher than that in the mild positional plagiocephaly, moderate positional plagiocephaly and normal cranial shape groups at 24 and 36 months of age (P<0.05). The scores of the Pediatric Neuropsychological Developmental Scales at 12 and 24 months of age and the scores of the Gesell Developmental Schedules at 36 months of age in the severe positional plagiocephaly group were lower than those in the mild positional plagiocephaly, moderate positional plagiocephaly and normal cranial shape groups, but the difference was not statistically significant (P>0.05).
CONCLUSIONS
Adverse perinatal factors, congenital muscular torticollis, and supine fixed sleeping position may be associated with infantile positional plagiocephaly. Mild or moderate positional plagiocephaly has no significant impact on the growth and neural development of children. Severe positional plagiocephaly have adverse effects on the visual acuity. However, it is not considered that severe positional plagiocephaly can affect the neurological development.
Child
;
Humans
;
Infant
;
Child, Preschool
;
Plagiocephaly, Nonsynostotic/therapy*
;
Follow-Up Studies
;
Prognosis
;
Retrospective Studies
8.Research hotspots in post-discharge follow-up management of preterm infants.
Chinese Journal of Contemporary Pediatrics 2023;25(6):560-565
Preterm infants, especially those born extremely or very prematurely, are at high risk for growth retardation and neurodevelopmental disorders. Regular follow-up after discharge, early intervention, and timely catch-up growth are important guarantees for improving the quality of life of preterm infants and improving the quality of the population. This article provides an overview of the research hotspots in follow-up management of preterm infants after discharge over the past two years, including follow-up modes, nutritional metabolism and body composition follow-up, growth pattern follow-up, neurodevelopmental follow-up, early intervention, etc., in order to provide clinical guidance and research ideas for domestic peers.
Humans
;
Infant, Newborn
;
Aftercare
;
Follow-Up Studies
;
Infant, Premature
;
Patient Discharge
;
Quality of Life
9.Tanshinone IIA inhibits hypoxia/reoxygenation-induced cardiomyocyte apoptosis and autophagy by regulating ABCE1.
Chinese Critical Care Medicine 2023;35(6):627-632
OBJECTIVE:
To investigate the effects of tanshinone IIA on apoptosis and autophagy induced by hypoxia/reoxygenation in H9C2 cardiomyocytes and its mechanism.
METHODS:
H9C2 cardiomyocytes in logarithmic growth phase were divided into control group, hypoxia/reoxygenation model group and tanshinone IIA low-dose, medium-dose and high-dose groups (50, 100, 200 mg/L tanshinone IIA were treated after hypoxia/reoxygenation respectively). The dose with good therapeutic effect was selected for follow-up study. The cells were divided into control group, hypoxia/reoxygenation model group, tanshinone IIA+pcDNA3.1-NC group and tanshinone IIA+pcDNA3.1-ABCE1 group. The cells were transfected with the overexpressed plasmids pcDNA3.1-ABCE1 and pcDNA3.1-NC and then treated accordingly. Cell counting kit-8 (CCK-8) was used to detect H9C2 cell activity in each group. The apoptosis rate of cardiomyocytes was detected by flow cytometry. The ATP-binding cassette transporter E1 (ABCE1), apoptosis-related proteins Bcl-2 and Bax, caspase-3, autophagy-related proteins Beclin-1, microtubule-associated protein 1 light chain 3 (LC3II/I) and p62 mRNA expression level of H9C2 cells in each group were detected by real-time fluorescence quantitative reverse transcription-polymerase chain reaction (RT-qPCR). The protein expression levels of the above indexes in H9C2 cells were detected by Western blotting.
RESULTS:
(1) Cell activity and ABCE1 expression: tanshinone IIA inhibited the activity of H9C2 cells induced by hypoxia/reoxygenation, and the effect was significant at medium-dose [(0.95±0.05)% vs. (0.37±0.10)%, P < 0.01], mRNA and protein expression of ABCE1 were significantly reduced [ABCE1 mRNA (2-ΔΔCt): 2.02±0.13 vs. 3.74±0.17, ABCE1 protein (ABCE1/GAPDH): 0.46±0.04 vs. 0.68±0.07, both P < 0.05]. (2) Expression of apoptosis-related proteins: medium-dose of tanshinone IIA inhibited the apoptosis of H9C2 cells induced by hypoxia/reoxygenation [apoptosis rate: (28.26±2.52)% vs. (45.27±3.07)%, P < 0.05]. Compared with the hypoxia/reoxygenation model group, medium-dose of tanshinone IIA significantly down-regulated the protein expression of Bax and caspase-3 in H9C2 cells induced by hypoxia/reoxygenation, and significantly up-regulated the protein expression of Bcl-2 [Bax (Bax/GAPDH): 0.28±0.03 vs. 0.47±0.03, caspase-3 (caspase-3/GAPDH): 0.31±0.02 vs. 0.44±0.03, Bcl-2 (Bcl-2/GAPDH): 0.53±0.02 vs. 0.37±0.05, all P < 0.05]. (3) Expression of autophagy-related proteins: compared with the control group, the positive rate of LC3 in the hypoxia/reoxygenation model group was significantly increased, while the positive rate of LC3 in the medium-dose of tanshinone IIA group was significantly decreased [(20.67±3.09)% vs. (42.67±3.86)%, P < 0.01]. Compared with hypoxia/reoxygenation model group, medium-dose of tanshinone IIA significantly down-regulated Beclin-1, LC3II/I and p62 protein expressions [Beclin-1 (Beclin-1/GAPDH): 0.27±0.05 vs. 0.47±0.03, LC3II/I ratio: 0.24±0.05 vs. 0.47±0.04, p62 (p62/GAPDH): 0.21±0.03 vs. 0.48±0.02, all P < 0.05]. (4) Expression of apoptosis and autophagy related proteins after transfection with overexpressed ABCE1 plasmid: compared with tanshinone IIA+pcDNA3.1-NC group, the protein expression levels of Bax, caspase-3, Beclin-1, LC3II/I and p62 in tanshinone IIA+pcDNA3.1-ABCE1 group were significantly up-regulated, while the protein expression level of Bcl-2 was significantly down-regulated.
CONCLUSIONS
100 mg/L tanshinone IIA could inhibit autophagy and apoptosis of cardiomyocytes by regulating the expression level of ABCE1. So, it protects H9C2 cardiomyocytes injury induced by hypoxia/reoxygenation.
Humans
;
Apoptosis
;
ATP-Binding Cassette Transporters/metabolism*
;
Autophagy
;
bcl-2-Associated X Protein/metabolism*
;
Beclin-1/metabolism*
;
Caspase 3/metabolism*
;
Follow-Up Studies
;
Myocytes, Cardiac
;
Proto-Oncogene Proteins c-bcl-2/metabolism*
;
RNA, Messenger/metabolism*
;
Cell Hypoxia
10.A single-centre experience of His bundle pacing without electrophysiological mapping system: implant success rate, safety, pacing characteristics and one-year follow up.
Swee Leng KUI ; Colin YEO ; Lisa TEO ; Ai Ling HIM ; Sherida Binte SYED HAMID ; Kelvin WONG ; Vern Hsen TAN
Singapore medical journal 2023;64(6):373-378
INTRODUCTION:
Despite the challenges related to His bundle pacing (HBP), recent data suggest an improved success rate with experience. As a non-university, non-electrophysiology specialised centre in Singapore, we report our experiences in HBP using pacing system analyser alone.
METHODS:
Data of 28 consecutive patients who underwent HBP from August 2018 to February 2019 was retrospectively obtained. The clinical and technical outcomes of these patients were compared between two timeframes of three months each. Patients were followed up for 12 months.
RESULTS:
Immediate technical success was achieved in 21 (75.0%) patients (mean age 73.3 ± 10.7 years, 47.6% female). The mean left ventricular ejection fraction was 53.9% ± 12.1%. The indications for HBP were atrioventricular block (n = 13, 61.9%), sinus node dysfunction (n = 7, 33.3%) and upgrade from implantable cardioverter-defibrillator to His-cardiac resynchronisation therapy (n = 1, 4.8%). No significant difference was observed in baseline characteristics between Timeframe 1 and Timeframe 2. Improvements pertaining to mean fluoroscopy time were achieved between the two timeframes. There was one HBP-related complication of lead displacement during Timeframe 1. All patients with successful HBP achieved non-selective His bundle (NSHB) capture, whereas only eight patients had selective His bundle (SHB) capture. NSHB and SHB capture thresholds remained stable at the 12-month follow-up.
CONCLUSION
Permanent HBP is feasible and safe, even without the use of an electrophysiology recording system. This was successfully achieved in 75% of patients, with no adverse clinical outcomes during the follow-up period.
Humans
;
Female
;
Middle Aged
;
Aged
;
Aged, 80 and over
;
Male
;
Bundle of His
;
Follow-Up Studies
;
Stroke Volume
;
Retrospective Studies
;
Treatment Outcome
;
Cardiac Pacing, Artificial/adverse effects*
;
Electrocardiography
;
Ventricular Function, Left/physiology*

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