OBJECTIVE: To investigate the accuracy, safety, and short-term effectiveness of a domestic robot-assisted system in total knee arthroplasty (TKA) by a multicenter randomized controlled trial. METHODS: Between December 2021 and February 2023, 138 patients with knee osteoarthritis who received TKA in 5 clinical centers were prospectively collected, and 134 patients met the inclusion criteria were randomly assigned to either a trial group ( n=68) or a control group ( n=66). Seven patients had lost follow-up and missing data, so they were excluded and the remaining 127 patients were included for analysis, including 66 patients in the trial group and 61 patients in the control group. There was no significant difference ( P>0.05) in gender, age, body mass index, side, duration of osteoarthritis, Kellgren-Lawrence grading, preoperative Knee Society Score (KSS) and Western Ontario and McMaster University Osteoarthritis Index (WOMAC) score between the two groups. The trial group completed the TKA by domestic robot-assisted osteotomy according to the preoperative CT-based surgical planning. The control group was performed by traditional osteotomy plate combined with soft tissue release. Total operation time, osteotomy time of femoral/tibial side, intraoperative blood loss, and postoperative complications were recorded and compared between the two groups. The radiographs were taken at 5 and 90 days after operation, and hip-knee-ankle angle (HKA), lateral distal angle of femur (LDFA), and posterior tibial slope (PTS) were measured. The difference between the measured values of the above indexes at two time points after operation and the preoperative planning target values was calculated, and the absolute value (absolute error) was taken for comparison between the two groups. The postoperative recovery of lower limb alignment was judged and the accuracy was calculated. KSS score and WOMAC score were used to evaluate the knee joint function of patients before operation and at 90 days after operation. The improvement rates of KSS score and WOMAC score were calculated. The function, stability, and convenience of the robot-assisted system were evaluated by the surgeons. RESULTS: The total operation time and femoral osteotomy time of the trial group were significantly longer than those of the control group ( P<0.05). There was no significant difference in the tibial osteotomy time and the amount of intraoperative blood loss between the two groups ( P>0.05). The incisions of both groups healed by first intention after operation, and there was no infection around the prosthesis. Nine patients in the trial group and 8 in the control group developed lower extremity vascular thrombosis, all of which were calf intermuscular venous thrombosis, and there was no significant difference in the incidence of complications ( P>0.05). All patients were followed up 90 days. There was no significant difference in KSS score and WOMAC score between the two groups at 90 days after operation ( P>0.05). There was significant difference in the improvement rate of KSS score between the two groups ( P<0.05), while there was no significant difference in the improvement rate of WOMAC score between the two groups ( P>0.05). Radiological results showed that the absolute errors of HKA and LDFA in the trial group were significantly smaller than those in the control group at 5 and 90 days after operation ( P<0.05), and the recovery accuracy of lower limb alignment was significantly higher than that in control group ( P<0.05). The absolute error of PTS in the trial group was significantly smaller than that in the control group at 5 days after operation ( P<0.05), but there was no significant difference at 90 days between the two groups ( P>0.05). The functional satisfaction rate of the robot-assisted system was 98.5% (65/66), and the satisfaction rates of stability and convenience were 100% (66/66). CONCLUSION Domestic robot-assisted TKA is a safe and effective surgical treatment for knee osteoarthritis, which can achieve favorable lower limb alignment reconstruction, precise implant of prosthesis, and satisfactory functional recovery.
Humans ; Arthroplasty, Replacement, Knee/methods* ; Osteoarthritis, Knee/surgery* ; Blood Loss, Surgical ; Robotics ; Knee Joint/surgery* ; Knee Prosthesis ; Retrospective Studies

OBJECTIVES: Magnetic resonance diffusion-weighted imaging (DWI) has important clinical value in diagnosis and curative effect evaluation on endometrial carcinoma. How to improve the detection rate of endometrial small lesions by DWI is the research focus of MRI technology. This study aims to analyze the image quality of small field MRI ZOOMit-DWI sequence and conventional single-shot echo-planar imaging (SS-EPI) DWI sequence in the scanning of endometrial carcinoma, and to explore the clinical value of ZOOMit-DWI sequence. METHODS: A total of 37 patients with endometrial carcinoma diagnosed by operation and pathology in the Second Xiangya Hospital of Central South University from July 2019 to May 2021 were collected. All patients were scanned with MRI ZOOMit-DWI sequence and SS-EPI DWI sequence before operation. Two radiologists subjectively evaluated the anatomical details, artifacts, geometric deformation and focus definition of the 2 groups of DWI images. At the same time, the signal intensity were measured and the signal-to-noise ratio (SNR), contrast to noise ratio (CNR), and apparent diffusion coefficient (ADC) of the 2 DWI sequences were calculated for objective evaluation. The differences of subjective score, objective score and ADC value of the 2 DWI sequences were analyzed. RESULTS: The SNR of the ZOOMit-DWI group was significantly higher than that of the SS-EPI DWI group (301.96±141.85 vs 94.66±41.26), and the CNR of the ZOOMit-DWI group was significantly higher than that of the SS-EPI DWI group (185.05±105.45 vs 57.91±31.54, P<0.05). There was no significant difference in noise standard deviation between the ZOOMit-DWI group and the SS-EPI DWI group (P>0.05). The subjective score of anatomical detail and focus definition in the ZOOMit-DWI group was significantly higher than that of the SS-EPI DWI group (both P<0.05). The subjective score of artifacts and geometric deformation of ZOOMit-DWI group was significantly lower than that of the SS-EPI DWI group (both P<0.05). ADC had no significant difference between the ZOOMit-DWI group and the SS-EPI DWI group (P>0.05). CONCLUSIONS The image quality of ZOOMit-DWI is significantly higher than that of conventional SS-EPI DWI. In the MRI DWI examination of endometrial carcinoma, ZOOMit-DWI can effectively reduce the geometric deformation and artifacts of the image, which is more conducive to clinical diagnosis and treatment.
Female ; Humans ; Signal-To-Noise Ratio ; Endometrial Neoplasms/diagnostic imaging* ; Diffusion Magnetic Resonance Imaging/methods* ; Endometrium ; Echo-Planar Imaging/methods* ; Reproducibility of Results

Objective:To observe the effect of enriched rehabilitation on dual-task gait disorder after a transient ischemic attack (TIA) and explore its mechanism.Methods:Sixty TIA patients were randomly divided into a control group and an observation group, each of 30. Another 30 healthy counterparts were selected to form a healthy control group. All of the TIA patients were given routine medication to lower blood pressure and improve brain function, while the observation group was additionally provided with enriched rehabilitation training for 12 weeks. Before and after the intervention, the gait and cognitive functioning of all of the subjects were quantified and their event-related potentials (P300s) and serum brain-derived neurotrophic factor (BDNF) levels were also measured.Results:Before the treatment there were significant differences between the TIA groups and healthy controls in all of the measurements, but there were no significant differences between the control and observation groups. After the treatment, no significant improvement was observed in any of the control group′s results, but there was significant improvement in the observation group′s gait parameters, cognitive functioning, average serum BDNF concentration and in the average latency and amplitude of its P300 signals.Conclusions:Enriched rehabilitation can improve the gait of TIA patients, perhaps through increasing their serum BDNF concentration and improving their cognition.

Objective:To develop a set of algorithms that could predict the precise size of acetabular cup preoperatively by the deep learning neural network technology.Methods:Retrospective analysis was performed on 30 patients with femoral head necrosis from April 2019 to April 2020, including 15 males and 15 females. At the age of (54.8±10.5) years (range 33-72 years). Thirteen hips on the left and seventeen hips on the right, who underwent primary unilateral THA. Based on the manually segmented hip joint CT database, a deep learning convolutional neural network was trained to realize automatic segmentation. A customized algorithm was created to fit the surface of the acetabulum. By the application of another deep learning convolutional neural network, the identification of anatomical points of the pelvis and correction of the pelvic position were realized. So that the placement of the acetabulum cup could be done. DOC (dice overlap coefficients) as well as the average error parameter were adopted to evaluate the accuracy of the above steps. The novel algorithm and Orthoview software were retrospectively used to template the acetabular cup separately. The results of both groups were compared with the actual size and the coincidence rate was calculated to evaluate the accuracy of the novel algorithm. To verify this algorithm, the conformance rate was calculated respectively.Results:Compared with other classical segmentation networks, the G-NET network can segment the pelvic with femoral head necrosis more accurately (DOC 92.51%± 6.70%). It also has better robustness. The average error of the point recognition network is 0.87 pixels. Among the 30 patients, the AI-based algorithm group had a complete coincidence rate of 96.7% and the Orthoview group had a complete coincidence rate of 73.3%. The difference was statistically significant ( χ2=6.405, P=0.011). Conclusion:The artificial intelligence-based algorithm can segment the CT image series and identify the feature points of the patient's hip accurately. Compared with the conventional 2D preoperative planning method, the AI-based algorithm is relatively more accurate. This artificial intelligence-based 3D preoperative software has promising prospect to makeaccurate surgical plan efficiently.

OBJECTIVETo screen for KIT gene mutations in two Han Chinese pedigrees affected with Piebaldism.

METHODSClinical data of the pedigrees was collected. Genomic DNA was extracted from blood samples collected from the pedigrees and 120 unrelated healthy controls. All coding exons of the KIT gene were subjected to PCR amplification and direct sequencing.

RESULTSTwo missense mutations, c.1861G>A(p.Ala621Thr) and c.1872G>A(p.Met624Ile), were identified respectively in the two pedigrees. Neither mutation was found among healthy members from the respective pedigree and the 120 unrelated healthy controls. c.1872G>A is a novel mutation.

CONCLUSIONMutations of the KIT gene may affect the structure and function of the transmembrane receptor KIT, which lead to the disease.

Objective To study the current situation of migrant children' s social adaptation and ex?plore its influencing factors. Methods The study population was 1547 children aged 10?16 years recruited from Shijiazhuang city. Social adaptation was collected through social adaptation questionnaire,whereas self?control was measured by children' s self?control investigating questionnaire. The data were statistically ana?lyzed with the ANOVA and stepwise regression analysis. Results ①There was no significant difference on social adaptation scores between migrant children and urban children (3.71±0.65,3.70±0.69, P>0.05). ②Among migrant children,girls scored significantly higher than boys(3.80±0.59,3.63±0.69, P<0.01). And as the grade of the migrant children increased,the social adaptation scores decreased (3.82±0.68,3.72±0.64, 3.58±0.60, P<0.01). ③The poor control system had a significantly negative prediction on migrant children' s social adaptation ( β=-0.299, P<0.01),whereas the good self?control system had a significantly positive prediction on migrant children' s social adaptation ( β=0.243, P<0.01) . Both parent?child relationship and peer relationship significantly positively predicted migrant children ' s social adaptation ( β=0. 179, β=0.092, P<0.01) . There was no significant correlation between the proportion of the migrant children in the classes and migrant children's social adaptation (P>0.05). Conclusion There is no significant difference on social adaptation between migrant children and urban children. Children' s self?control,parent?child rela?tionship and peer relationship have significant influence on social adaptation of migrant children .

Objective:To validate the Chinese Version of Depletion Sensitivity Scale (DSS) and test its validity and reliability.Methods:A sample of 499 postgraduates coming from a university in Beijing was investigated with preliminary questionnaire,249 of them were assessed for exploratory factor analysis(EFA) and 250 of them were assessed for confirmatory factor analysis (CFA) and testing of validity and reliability.The criterion validity was tested with the Self-Regulatory Fatigue Scale (SRF-S),Dual-Mode of Self-Control Scale (DMSC-S) and Adolescent Self-rating Life Events Check-list (ASLEC).Totally 280 students were retested for test-retest reliability with 2 week interval.Results:DSS was composed of 8 items in two factors,which were cognitive factor and behavioral factor.The two factors explained 60.7％ of the variances.The confirmatory factor analysis identified a two factor model (x2/df=4.18,RMSEA =0.09,NFI =0.95,NNFI =0.94,CFI =0.96,IFI =0.96,GFI =0.96,SRMR =0.05).The scores of depletion sensitivity were positively correlated with the scores of cognitive fatigue,behavioral fatigue,emotional fatigue poor control,punished,loss,relationship pressure and adaption problem (r =0.13-0.55,Ps ＜0.001).The Cronbach α coefficients were 0.80 for the total questionnaire and 0.79 and 0.73 for the two factors.The test-retest reliability were 0.52 for the total questionnaire and 0.46 and 0.58 for the two factors.Conclusion:It suggests that the Chinese version of Depletion Sensitivity Scale (DSS) is reliable and valid enough to be applicable to measure the depletion sensitivity of Chinese graduate students.

Objective To examine the differences and influential factors of ego-depletion source and its aftereffects between Chinese and non-Chinese graduate students (international graduate students) enrolled graduate programs in Chinese Universities.Methods Three different questionnaires were employed to assess the current situation of ego-depletion of 647 graduate students:demographic information questionnaire,Ego Depletion Source Scale (EDS-S) in postgraduates and Ego Depletion Aftereffects Scale (EDA-S).Collected data were analyzed by an independent samples t test,correlation analysis and multiple regression analysis.Results ①The scores of non-Chinese graduate students in China (83.59±25.97) were higher than those of Chinese students (67.39± 25.46) on EDA-S in postgraduates,the difference was significant (P＜ 0.01).②The scores of non-Chinese graduate students (132.71± 19.89) were higher than those of Chinese students (104.15±33.02) on EDS-S,the difference was significant (P＜0.01).③Of all the 11 dimensions of EDS-S,social distress,challenging task,thought suppression,compulsive task positively anticipated the EDA-S for Chinese graduate students (R2adj =0.584,R2adj =0.450,R2adj =0.624,R2adj =0.615,P＜0.05) and social distress,decision making,compulsive task positively anticipated the EDA-S for non-Chinese graduate students (R2adj =0.698,R2adj =0 603,R2adj =0.668,P＜0.05).Conclusion Compared to Chinese graduate students,egodepletion source and ego depletion aftereffects of non-Chinese graduate students were higher.Of all the 11 dimensions of EDS-S,social distress,challenging task,thought suppression,compulsive task was in high correlation with EDA-S for Chinese graduate students,and social distress,decision making,compulsive task was in high correlation with EDA-S for non-Chinese graduate students.

Objective To study the effect of parenting styles on the children' s self-control,and distinguish the influence between father and mother.Methods The present study selected 1 531 children (766 girls) between 3-10 years old.Data on parenting style were collected by parenting style questionnaire,while data on children' s self-control were measured by dual-system of self-control scale.Principal component analysis was conducted to examine common method bias.Results (1) No common method bias was found in this study.(2) Boys scored (31.66±5.95) on control system lower than girls (32.91±5.49),t=4.071,P＜ 0.01,but they had higher scores (43.19±8.32) on impulsive system than girls (41.96±8.32),t=2.226,P=0.027.(3)The associations of children's self-control scores with parents' spoiling,neglectful,authoritarian,inconsistent style were significant (r=-0.054～-0.174,P＜0.05),while it correlated positively with parents' democratic style (r=0.231,r=0.243,P＜0.05).The correlation between children's impulsive system scores and parents' spoiling,neglectful,authoritarian,inconsistent style were significantly positive (r=0.116-0.195,P＜0.05),while its associations with parents' democratic style were significant (r=-0.107,r=-0.108,P＜0.05).(4) As controlling children's age and sex,father democracy (β=0.120),inconsistency (β=-0.159),and mother democracy (β=0.188) were significantly correlated with children' s self-control (R 2adj =0.107,P＜0.05).Father despotism (β=0.070),inconsistency (β=0.136),mother's democracy (β=-0.063),despotism (β=0.099) and inconsistency (β=0.061) significantly predicted children's impulsive system (R 2adj =0.082,P＜0.05).Conclusion Each dimension of self-control and parenting style is high correlation.Father and mother's different rearing traits and the combination of different rearing traits contributed variously to children' s self-control system.

Objective To develop the ego depletion aftereffects scale (EDA-S) and test its validity and reliability.Methods Based on literature analysis and the open questionnaire survey this study compiled the preliminary questionnaire.A sample of 801 subjects coming from a university in Beijing was investigated with preliminary questionnaire and 406 students were retested for test-retest reliability with 2 week interval.Results The EDA-S was composed of 38 items in nine factors,which were emotional regulation difficulty,social withdrawal,low efficacy,working memory impairment,low processing fluency,work burnout,fatigue,somatic distress and low adherence.The eleven factors explained 72.09％ of the variances.Furthermore,the result of CFA indicated that the model fitted the data with well construct validity(x2 =1744.62,df=629,x2/df =2.77,RMSEA =0.06,NFI =0.98,NNFI =0.98,CFI =0.98,IFI =0.98,GFI =0.85,SRMR =0.05) and its factors scores were positively correlated with the SFR-S scores(r=0.31-0.59,P＜0.001).The Cronbach α coefficients were 0.95 for the total questionnaire and 0.73-0.91 for the eleven factors.The test-retest reliabilities were 0.60 for the total questionnaire and 0.26-0.57 for the nine factors.Conclusion It suggests that the EDA-S is reliable and valid enough to be applicable to measure the depletion degree of adolescents.