BACKGROUND:Nowadays,posterior cruciate ligament injury caused by a sports injury or vehicle injury is more common than people think.Posterior cruciate ligament reconstruction is one of the main treatment methods,but there are still a lot of controversies about the surgical method and ligament selection of posterior cruciate ligament reconstruction. OBJECTIVE:To comprehensively analyze the global application trend of posterior cruciate ligament reconstruction and identify promising research hotspots of posterior cruciate ligament reconstruction based on bibliometrics and visual analysis. METHODS:Publications(articles and reviews)related to posterior cruciate ligament reconstruction from 2000 to 2022 were retrieved from the Web of Science(WOS).The country,institution,publication year,author,journal,average citations per item,H index,title,keywords of publication,and the top 25 cited articles were extracted and analyzed in detail.The VOSviewer/citespace/Pajek software was used to analyze the co-occurrence result of keywords to predict the hotspots of posterior cruciate ligament reconstruction. RESULTS AND CONCLUSION:A total of 664 articles were included.(1)In the past 22 years,the number of posterior cruciate ligament reconstruction articles has shown an increasing trend in general.The top 3 countries(the USA,China,and South Korea)accounted for 65.51%of all articles published.The USA has the largest number of publications.The University of Pittsburgh is the largest contributor.Knee Surgery Sports Traumatol Arthrosc and American Journal of Sports Medicine are the most influential journals.Laprade,Robert F.is the professor who has published the most articles in the field of posterior cruciate ligament reconstruction,and Fanelli,GC is the professor who has the highest total chain strength in the field of posterior cruciate ligament reconstruction.(2)The research direction can be divided into the following five clusters:"posterior cruciate ligament anatomical and biomechanical studies","posterior cruciate ligament reconstruction prognosis,outcome,and complications","posterior cruciate ligament reconstruction surgical method and tendon selection","surgical technique",and"posterior cruciate ligament tear combined with multiple ligament injury".(3)It is concluded that in terms of the trend of previous years,an increasing number of articles related to posterior cruciate ligament reconstruction will be published in the future.The USA is a world leader in the field of posterior cruciate ligament reconstruction.China and South Korea presented great potential in this area.Anatomical and biomechanical research of posterior cruciate ligament and posterior cruciate ligament reconstruction methods and the selection of tendons may be the future hotspots in the field of posterior cruciate ligament reconstruction.

Background::Cardiovascular disease (CVD) has emerged as the leading cause of death from prostate cancer (PCa) in recent decades, bringing a great disease burden worldwide. Men with preexisting CVD have an increased risk for major adverse cardiovascular events when treated with androgen deprivation therapy (ADT). The present study aimed to explore the prevalence and risk evaluation of CVD among people with newly diagnosed PCa in China.Methods::Clinical data of newly diagnosed PCa patients were retrospectively collected from 34 centers in China from 2010 to 2022 through convenience sampling. CVD was defined as myocardial infarction, arrhythmia, heart failure, stroke, ischemic heart disease, and others. CVD risk was estimated by calculating Framingham risk scores (FRS). Patients were accordingly divided into low-, medium-, and high-risk groups. χ2 or Fisher’s exact test was used for comparison of categorical variables. Results::A total of 4253 patients were enrolled in the present study. A total of 27.0% (1147/4253) of patients had comorbid PCa and CVD, and 7.2% (307/4253) had two or more CVDs. The enrolled population was distributed in six regions of China, and approximately 71.0% (3019/4253) of patients lived in urban areas. With imaging and pathological evaluation, most PCa patients were diagnosed at an advanced stage, with 20.5% (871/4253) locally progressing and 20.5% (871/4253) showing metastasis. Most of them initiated prostatectomy (46.6%, 1983/4253) or regimens involving ADT therapy (45.7%, 1944/4253) for prostate cancer. In the present PCa cohort, 43.1% (1832/4253) of patients had hypertension, and half of them had poorly controlled blood pressure. With FRS stratification, as expected, a higher risk of CVD was related to aging and metabolic disturbance. However, we also found that patients with treatment involving ADT presented an originally higher risk of CVD than those without ADT. This was in accordance with clinical practice, i.e., aged patients or patients at advanced oncological stages were inclined to accept systematic integrative therapy instead of surgery. Among patients who underwent medical castration, only 4.0% (45/1118) received gonadotropin releasing hormone antagonists, in stark contrast to the grim situation of CVD prevalence and risk.Conclusions::PCa patients in China are diagnosed at an advanced stage. A heavy CVD burden was present at the initiation of treatment. Patients who accepted ADT-related therapy showed an original higher risk of CVD, but the awareness of cardiovascular protection was far from sufficient.

Research on the mechanisms of depression is currently a focus of the field of neuroscience.The degeneration of brain plasticity(e.g.,decrease in volume,structural degradation,and functional disorder of the hippocampus,PFC,and CG)leads to depression.Exercise is an important means of improving the symptoms of depression.Current research confirms the importance of improving the volume,structure,and function of the hippocampus,PFC,and CG,in this process,but related research has focused solely on changes to the volume of certain brain regions or connectivity functions.Thus,we lack a comprehensive understanding of the antidepressant mechanisms that improve brain plasticity with exercise.Therefore,this study aimed to explore the roles of brain plasticity in the occurrence of depression and improvements to depression through exercise,promoting a more comprehensive understanding the role of brain plasticity in depression.We also provide new ideas for exercise intervention in depression.

The purpose of this article is to review the mechanism and intervention strategies of alexithymia， in order to provide a new direction for clinical treatment and research of alexithymia. Alexithymia is not only related to a variety of psychosomatic diseases， but also exists in mental diseases such as depression， anxiety and eating disorders， which seriously affects the quality of life of patients. This article reviews alexithymia and its mechanism in different diseases from cognition， neurological and social-psychological factors， and summarizes the intervention strategies， aiming to provide references for the clinical treatment of alexithymia.

Abstract Teen E sports and their negative impact should not be underestimated. The effects of gaming, as an emerging sport, should be examined to determine whether it plays an active role in contributing to the onset of adolescent depression. Therefore, this study outlines the development status of E sports, analyzes the influence of E sports on adolescent depression, and highlights the hidden concerns that E sports pose for the mental health development of adolescents. While taking into account the advantages of E sports and exercise intervention programs, an emphasis should be placed on the prevention of depression, and feasible suggestions and countermeasures should be put forward to promote E sports, while at the same time safeguarding the healthy and orderly development of adolescent mental health.

BACKGROUND: Obtaining synovial fluid for diagnostic test of periprosthetic joint infection is invasive and painful to patients. Platelet count is a regular blood test which has been used as a possible predictor of several infectious diseases. Presumably, it could be one of the indicators of periprosthetic joint infection. OBJECTIVE: To identify the accuracies of platelet combined with white blood cell, erythrocyte sedimentation rate or C-reactive protein in the diagnosis of periprosthetic joint infection. METHODS: Patients undergoing revision arthroplasty from March 2013 to December 2018 in the First Affiliated Hospital of Guangzhou University of Chinese Medicine were retrospectively enrolled. A diagnosis of periprosthetic joint infection was confirmed in 77 patients according to the criterions from the Musculoskeletal Infection Society; the remaining 137 patients were confirmed as aseptic cases. White blood cell, erythrocyte sedimentation rate, or C-reactive protein and platelet count were compared between the two groups. The sensitivity, specificity, positive predictive value, and negative predictive value were calculated. RESULTS AND CONCLUSION: The platelet values were significantly increased in periprosthetic joint infection cases. Sensitivity and specificity of the platelet for periprosthetic joint infection were 64.94％ and 86.13％, respectively. Platelet demonstrated a higher accuracy when compared to erythrocyte sedimentation rate and C-reactive protein. In such cases, the platelet shows a certain reference value in confirming the diagnosis of periprosthetic joint infection. Platelet was enough used as adjunct diagnostic tool in patients suspected with periprosthetic joint infection.

Objective:To investigate the effects of different lymph node dissection methods in radical resection of intrahepatic cholangiocarcinoma (ICC) on the number of harvested lymph nodes and prognosis of patients.Methods:The retrospective cohort study was conducted. The clinicopathological data of 57 patients with ICC who underwent radical resection in the Second Affiliated Hospital of Nanchang University from January 2011 to January 2016 were collected. There were 25 males and 32 females, aged from 45 to 72 years, with an average age of 59 years. Of the 57 patients, 36 undergoing en bloc fusion lymph node dissection and 21 undergoing conventional lymph node dissection were allocated into observation group and control group, respectively. Observation indicators: (1) intraoperative situations; (2) results of postoperative pathological examination; (3) postoperative complications; (4) follow-up. Follow-up using outpatient examination or telephone interview was performed once every six months after hospital discharge to detect survival of patients up to January 2019. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was done using the t test. Measurement data with skewed distribution were described as M (range), and comparison between groups was analyzed by the Mann-Whitney U test. Count data were described as absolute numbers or percentages, and comparison between groups was analyzed using the chi-square test or Fisher exact propability. Comparison of ordinal data between groups was analyzed using the Mann-Whitney U test. The survival curve and rate were drawn and calculated using the Kaplan-Meier method, and survival of patients was analyzed by the Log-rank test. Results:(1) Intraoperative situations: operation time, volume of intraoperative blood loss, hepatic portal occlusion time, cases with <3 segments of hepatectomy and ≥3 segments of hepatectomy for the observation group were (218±53)minutes, (266±24)mL, (21±9)minutes, 5, 31, respectively, versus (207±45)minutes, (270±23)mL, (19±8)minutes, 2, 19 for the control group, showing no significant difference in the above indicators between the two groups ( t=-0.530, 0.774, 0.590, χ2=0.004, P>0.05). (2) Results of postoperative pathological examination: the number of harvested lymph nodes and percentage of positive lymph nodes of the observation group were 11±3 and 16.58%(66/398), respectively, versus 5±2 and 6.80%(7/103) of the control group, showing significant differences in the above indicators between the two groups ( t=-9.454, 2.148, P<0.05). (3) Postoperative complications: cases with Clavien-Dindo grade Ⅰ-Ⅱ complications or Clavien-Dindo grade Ⅲ-Ⅳ complications, cases with bile leakage, cases with postoperative hemorrhage, cases with incision infection, cases with gastroparesis were respectively 35, 1, 6, 1, 8, 0 in the observation group and 19, 2, 3, 1, 1, 2 in the control group. There was no significant difference in the cases with complications of Clavien-Dindo classification, cases with bile leakage, cases with incision infection between the two groups ( χ2=0.236, 0.000, 1.870, P>0.05) and no significant difference in the cases with postoperative hemorrhage, cases with gastroparesis between the two groups ( P>0.05). (4) Follow-up: 57 patients were followed up for 5-42 months, with a median time of 36 months. The survival time and postoperative 3-year survival rate were respectively 36 months (range, 8-42 months) and 66.7% of the observation group, versus 23 months (range, 5-39 months) and 38.1% of the control group, showing significant differences in the above indicators between the two groups ( Z=-2.253, χ2=5.317, P<0.05). Conclusion:For radical resection of ICC, the en bloc fusion lymph node dissection is beneficial to increase the number of harvested lymph nodes and improve survival rate of patients.

Identifying antimicrobial resistant (AMR) bacteria in metagenomics samples is essential for public health and food safety. Next-generation sequencing (NGS) technology has provided a powerful tool in identifying the genetic variation and constructing the correlations between genotype and phenotype in humans and other species. However, for complex bacterial samples, there lacks a powerful bioinformatic tool to identify genetic polymorphisms or copy number variations (CNVs) for given genes. Here we provide a Bayesian framework for genotype estimation for mixtures of multiple bacteria, named as Genetic Polymorphisms Assignments (GPA). Simulation results showed that GPA has reduced the false discovery rate (FDR) and mean absolute error (MAE) in CNV and single nucleotide variant (SNV) identification. This framework was validated by whole-genome sequencing and Pool-seq data from Klebsiella pneumoniae with multiple bacteria mixture models, and showed the high accuracy in the allele fraction detections of CNVs and SNVs in AMR genes between two populations. The quantitative study on the changes of AMR genes fraction between two samples showed a good consistency with the AMR pattern observed in the individual strains. Also, the framework together with the genome annotation and population comparison tools has been integrated into an application, which could provide a complete solution for AMR gene identification and quantification in unculturable clinical samples. The GPA package is available at https://github.com/IID-DTH/GPA-package.
Bacteria ; genetics ; Bayes Theorem ; DNA Copy Number Variations ; Genome, Bacterial ; Genotyping Techniques ; High-Throughput Nucleotide Sequencing ; Humans ; Klebsiella pneumoniae ; genetics ; Metagenomics ; methods ; Polymorphism, Genetic ; Software

PURPOSE: The significance of neuroendocrine differentiation (NED) in gastric carcinoma (GC) is controversial, leading to ambiguous concepts in traditional classifications. This study aimed to determine the prognostic threshold of meaningful NED in GC and clarify its unclear features in existing classifications. MATERIALS AND METHODS: Immunohistochemical staining for synaptophysin, chromogranin A, and neural cell adhesion molecule was performed for 945 GC specimens. Survival analysis was performed using the log-rank test and univariate/multivariate models with percentages of NED (PNED) and demographic and clinicopathological parameters. RESULTS: In total, 275 (29.1%) cases were immunoreactive to at least 1 neuroendocrine (NE) marker. GC-NED was more common in the upper third of the stomach. PNED, and Borrmann's classification and tumor, lymph node, metastasis stages were independent prognostic factors. The cutoff PNED was 10%, beyond which patients had significantly worse outcomes, although the risk did not increase with higher PNED. Tumors with ≥10% NED tended to manifest as Borrmann type III lesion with mixed/diffuse morphology and poorer histological differentiation; the NE components in this population mainly grew in insulae/nests, which differed from the predominant growth pattern (glandular/acinar) in GC with <10% NED. CONCLUSIONS: GC with ≥10% NED should be classified as a distinct subtype because of its worse prognosis, and more attention should be paid to the necessity of additional therapeutics for NE components.
Adenocarcinoma ; Chromogranin A ; Classification ; Humans ; Immunohistochemistry ; Lymph Nodes ; Neoplasm Metastasis ; Neural Cell Adhesion Molecules ; Prognosis ; Stomach ; Stomach Neoplasms ; Synaptophysin

Objective? To explore the effects of enhanced recovery after surgery (ERAS) intervention on functional rehabilitation among patients with anterior cruciate ligament (ACL) reconstruction under arthroscope. Methods? From January 2013 to April 2016, we selected 120 patients with ACL reconstruction under arthroscope in Department of Orthopedics in West China Hospital of Sichuan University by convenience sampling. All of the patients were divided into two groups according to the admission time including control group (n=60, traditional rehabilitation) and observation group (n=60, ERAS intervention). We compared the ankle swelling, effusion and the knee flexion as well as knee rehabilitation effect of patients in two groups with the Judet score and the Lysholn score after surgery. Results? The early ankle swelling of patients in observation group was more obvious than that in control group, and there were 12 cases with joint puncture drainage after surgery in observation group and 5 cases in control group with no statistical difference (χ2=3.358, P=0.067). There were 6 cases with knee functional disorder after surgery in control group reaching the excellent knee function after manual release. The excellent rates of knee function activity in observation group were respectively 83.33% and 96.67% three and six months after surgery superior than those (58.33% and 83.33%) in control group with statistical differences (χ2=9.076, 5.926; P＜0.05). The excellent rates of scores of knee function in observation group were respectively 80.00%, 91.67% three and six months after surgery higher than those (56.67% and 78.33%) in control group with statistical differences (χ2=7.548, 4.183;P＜ 0.05). Conclusions? The application of ERAS intervention in ACL reconstruction under arthroscope can effectively improve early function and scope of activity of knee, however the complications may occur, such as ankle swelling and effusion.