Objective:To evaluate the curative effects of 3D printed microporous titanium (tantalum) prosthesis in reconstruction of large segmental bone defects caused by lower extremity osteomyelitis.Methods:A retrospective study was conducted to analyze the clinical data of 18 patients who had been treated for large segmental bone defects caused by lower extremity osteomyelitis between January 2020 to May 2022 at Department of Orthopaedics, The 920th Hospital of Joint Logistics Support Force. There were 10 males and 8 females with an age of (45.3±14.1) years. The defects were at the left side in 13 cases and at the right side in 5 cases, at the femur in 11 cases and at the tibia in 7 cases. The duration of osteomyelitis was 1.0 (1.0, 3.5) years. The length of bone defects was 8.35 (6.50, 9.84) cm. Their bone defects were repaired by an individually 3D printed microporous titanium (tantalum) prosthesis after operative removal of osteomyelitis lesions. The wound healing was observed after surgery. The clinical efficacy was comprehensively evaluated by the Paley grading for bone defect healing, visual analog scale (VAS), lower extremity functional scale (LEFS), and imaging examination.Results:The postoperative follow-up period for the 18 patients was (12.2±0.3) months. Wound infection occurred 2 months after surgery in one patient who was treated with Ilizarov bone transfer after removal of the microporous titanium prosthesis. The remaining 17 patients had good postoperative wound healing. At the last follow-up, the 18 patients had a VAS pain score of 2.0(1.0, 4.0) points, significantly lower than the preoperative one [(6.1±2.3) points], and a LEFS score of 54.00(34.50, 69.25) points, significantly higher than the preoperative one [18.50(9.00, 26.50) points] ( P<0.05). At the last follow-up, according to the Paley grading, the bone union was rated as excellent in 16 patients, as good in 1 patient and as poor in 1 patient. The integration of femoral fractures with 3D printed microporous titanium prostheses was fine. Conclusion:In reconstruction of large segmental bone defects caused by lower extremity osteomyelitis, implantation of a 3D printed microporous titanium (tantalum) prosthesis is feasible and effective, not only reducing pain but also restoring the limb function.

Objective:To explore the association rules of personality traits and health-promoting lifestyle in patients with primary angle closure glaucoma, so as to provide advice for the synthetical treatment.Methods:From July to November 2021, a total of 117 primary angle closure glaucoma patients(acute patients n=89, chronic patients n=28) in ophthalmology department of five hospitals in Nanjing were investigated with type A behavior pattern scale, health-promoting lifestyle scale Ⅱ and general information questionnaire.Based on Weka 3.8.5, algorithm of Apriori was used to mine its association relationship. Results:(1) The total scores of type A behavior pattern scale for patients with acute and chronic types of primary angle closure glaucoma were (32.48±6.43) and (27.54±6.49) respectively.The total scores of health-promoting lifestyle scale Ⅱ were (101.69±11.83) and (97.79±7.78) respectively.(2) There were positive associations among patients with acute primary angle closure glaucoma, type A/A-personality (including impatience and hostility) and health-promoting lifestyle (including stress management disorder, interpersonal relationship management disorder, well sense of health responsibility and adequate dietary nutrition intake)(all support>0.1, confidence >0.6, lift >1.0). And patients with chronic primary angle closure glaucoma were associated with B/B-personality (including patience and mild), health-promoting lifestyle (including stress management disorder, interpersonal relationship management disorder, well sense of health responsibility and adequate dietary nutrition intake)(all support>0.1, confidence >0.6, lift >1.0).Conclusion:Primary angle closure glaucoma is strongly related with personality traits and health-promoting lifestyle.Its synthetical treatment plan should take both physical and mental measures, and classified health management for patients with different disease types.

Objective:To evaluate the safety and efficacy of eltrombopag combined with immunosuppressive therapy in patients with aplastic anemia (AA) in China.Methods:We investigated and analyzed the clinical data of AA patients from 14 hematological treatment centers who were treated with oral eltrombopag for at least 3 mon.Results:We enrolled 56 AA patients, including 19 treatment-na?ve patients and 37 IST-refractory patients. The median administration period for eltrombopag was 7 (3-31) months, and the median maximum stable dosage was 75 mg/d (50-150 mg/d) . The 3-month hematological response (HR) rate was 60%, and the complete response (CR) rate was 30% in 10 SAA patients who were treated with first-line eltrombopag and standard IST (ATG+CsA) . Eight of 9 eltrombopag and CsA ± androgen first-line treated SAA patients responded (8/9, 89%) and 4 (44%) gave CR. The overall HR and CR rates were 79% and 52.6%, respectively, among these 19 patients by the end of the follow-up period. Of the 19 AA patients who were refractory to CsA ± androgen, 11 achieved HR (57.9%) at 3 mon, and the best HR rate was 44% in standard IST (ATG+CsA) refractory 18 patients after eltrombopag treatment. Fifty-one percent of the patients experienced mild or moderate adverse events, and gastrointestinal discomfort was the most common adverse effect reported by the study subjects.Conclusion:Adding Eltrombopag in first-line IST can accelerate the acquisition and improve the quality of hematological responses in AA patients. AA with relatively more residual hematopoietic cells may be well treated with eltrombopag and non-ATG IST. Eltrombopag can be used as salvage therapy for CsA±androgen refractory patients. Eltrombopag was generally safe and well tolerated by AA patients in China.

is one of the mandatory examinations for the Diplomate of Oriental Medicine (Dipl.OM.) or Acupuncture (Dipl. Ac.) by American National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM). In reference to, and, the authors introduced the examination pattern and examination-related contents including such aspects as safety and professional responsibilities, treatment plan, and point location and discussed additionally the enlightening effects on acupuncture practice and examination in universities and international associations of Chinese medicine in our country.

Objective To investigate the mineralization impact of fibroblast growth factor receptors 1 dominant negative (FGFR1DN) on osteogenic induction culture of bone marrow stromal cells (BMSCs).Methods The 3rd generation BMSCs were divided into 4 equal groups (n =24).FGFR1-DN group was transfected by pcDNA3.1 (+)-FGFR1DN,FGFRI group by pcDNA3.1 (+)-FRFR1,blank load group by pcDNA3.1 (+)-blank vehicle and non-transtection group by nothing.After successful transfection was confirmed when the cells were in the logarithmic phase,osteogenic induction culture was conducted continuously for 21 days.Mineralized nodule formation was observed by alizarin red staining.The amount of mineralized material was calculated according to the standard curve of alizarin red concentration.Results Continuous osteogenic induction for 21 days showed on the bottom of the hole visible round opaque calcified nodules after alizarin red staining.The BMSCs in the FGFR1-DN group induced in the logarithmic growth phase by osteoblasts exhibited significantly increased osteogenic capacity while those in the FGFR1 group displayed diminished osteogenic capacity.The concentration of alizarin red was the highest in the FGFRI-DN group (1.33 ±0.19),the lowest in the FGFRI group (1.00 ± 1.17),and moderate in the blank load group (1.20 ± 0.16) and non-transfection group (1.17 ± 0.17),showing significant between-group differences (P ＜ O.05).Conclusions FGFR1-DN can promote cell proliferation in the early differentiation of BMSCs and also mineralization of osteoblasts in bone induction culture after the logarithmic growth phase.This may provide a hint for local gene treatment of bone defects.

OBJECTIVE:To investigate the effect of Danggui shaoyao powder (DSS) on uterine structure and expressions of estrogen receptorα(ERα),estrogen receptorβ(ERβ)in uterine cavity epithelium and matrix in model rats in perimenopausal peri-od. METHODS:40 female SD rats were randomly divided into sham operation group (normal saline),model group (normal sa-line),DSS low-dose,medium-dose,high-dose groups(1.94,3.87,7.44 g/kg),8 in each group. Except that rats in sham opera-tion group received resection of fat nearby ovaries,rats in other groups received resection of bilateral ovaries to induce models in perimenopausal period. After modeling,rats were intragastrically administrated once a day,for 8 weeks. After administration,wet mass of uterine was weighted. Changes in uterine morphology and structure of rats were observed,expressions levels of ERα and ERβ in uterine cavity epithelium and matrix were determined. RESULTS:Compared with sham operation group,rats in model group showed low columnar in endometrial columnar epithelium,lamina propria layer,muscular layer and serous layer were signifi-cantly atrophied,stromal cells had obvious nuclear condensation. There was marked decrease in uterine wet mass,uterine cavity ar-ea and endometrial thickness as well as the number of uterine glands(P<0.01),and the expression levels of ERαand ERβin uter-ine cavity epithelium and matrix were significantly reduced(P<0.01). Compared with model group,the atrophy degree of endome-trium and lamina propria layer had no significant differences in DSS each dose groups. However,lamina propria layer was rich in glands,and there were significant differences in uterine wet mass,uterine cavity area,endometrial thickness,ERα expression level in uterine cavity epithelium and matrix (P>0.05). However, the number of uterine glands in DSS medium-dose,high-dose groups was significantly increased(P<0.01),and ERβexpres-sion level in uterine cavity epithelium and matrix in DSS high-dose group was significantly increased (P<0.05 or P<0.01). CONCLUSIONS:DSS has not obvious effect on im-proving the symptoms of uterine gland atrophy of model rats in perimenopausal period,but it can increase the number ofuterine glands,and the mechanism may be associated with improving the ERβ expression level in uterine cavity epithelium and ma-trix.

SUMMARY Takayasu’s arteritis is a rare,idiopathic,chronic inflammatory disease.Its course is un-predictable,but slow progression is usual,leading to stenosis,occlusion,or aneurismal degeneration of the aorta or its major branches.We present the anesthesia management of pregnancy in four women ad-mitted to Peking University Third Hospital for caesarean section from year 2006 to 2015 complicated with Takayasu’s arteritis and review this disease with special reference to natural history,diagnostic criteria, classification,prognostic factors,and anesthesia considerations.Anesthesiological data were retrospec-tively analyzed for clinical manifestations,anesthesia process,perioperative complications,and pregnan-cy outcome.One patient received only epidural anesthesia,while the other three patients received com-bined spinal and epidural anesthesia (CSEA).Surgeries for all the four patients were successful with sta-ble vital signs.We found comprehensive examinations including whether the disease was in the active phase and the clinical classification of the disease before conception was recommended for patients diag-nosed with Takayasu’s arteritis.CSEA and continuous epidural block could be both used as anesthesio-logical method in patients with Takayasu’s arteritis.During the surgery,to avoid rapid hemodynamic fluctuations and protect the major organs’function is very essential to allow for a satisfactory outcome.

Objective To explore the effect of fibroblast growth factor receptors 1-dominant negative strategy (FGFR1-DN) on alkaline phosphatase (ALP) activity of bone marrow stromal stem cells (BMSCs) after osteogenic induction.Methods BMSCs were transfected with eukaryotic expression plasmid pcDNA 3.1 (+)-DN FGFR1 and pcDNA3.1 (+)-FGFR1.The experiment was conducted in 4 groups:FGFR1-DN transfection group,FGFR1 transfection group,pcDNA3.1(+) empty vector transfection group and non-transfection group.The ALP activity of BMSCs was detected in logarithmic growth phase after osteogenic culture.The qualitative detection of ALP activity was carried out immunohistochemically while the quantitative detection by cALP kit.The ALP activity was compared between the 4 groups at 7 and 14 days after osteogenic induction.Results Compared with 7 days,the ALP activity at 14 days was significantly increased in the 4 groups,and the increase in FGFR1-DN transfection group was significantly higher than in the other 3 groups (P ＜ 0.05).At both 7 and 14 days,the ALP activity in FGFR1-DN transfection group was the highest while that in FGFR1 transfection group was the lowest (P ＜ 0.05).Conclusions FGFR1-DN can promote the ALP activity of BMSCs during osteogenesis.This may provide an experimental basis for the joint application of local gene therapy and tissue engineering and for construction of tissue engineered bone with better biocompatibility.

Objective: To evaluate the effect of echocardiography for occluding the multiple seconded atria1 septal defects ( MASD) in relevant patients.
Methods: A total of 42 MASD patients were selected by transthoracic echocardiography (TTE) or transesophageal echocardiography (TEE). The transcatheter closure was monitored by TTE and X-ray, the effect of treatment was evaluated by TTE, ECG and chest X-ray at 24 hours and 1, 3, 6 months after the procedure. There were 38 patients with 2 defects, 3 with many central small defects and 1 with 3 defects. The patients included 17 male and 25 female with the mean age of (32.6 ± 13.4) years.
Results: The size and distance of the defects were measured with 4 cardiac chambers cross sectional study. The mean diameter of bigger defect from up to down was (9-27) mm, with the mean of (20.7 ± 6.1) mm, from front to back was (8-23) mm, with the mean of (16.9 ± 5.7) mm;the mean diameter of small defect from up to down was (3-12) mm, with the mean of (6.8 ± 3.6) mm. The length of the defect interva1 was (4-18) mm, with the mean of (7.9 ± 2.6) mm. There were 4 patients with 2 defect interval at 8.7 mm who received 2 occluders without post-operative lfow shunt. The rest 38 patients received 1 Amplatzer occluder which was (14-36) mm with the mean of (25.1 ± 6.4) mm which was (6.9 ± 1.7) mm larger than echocardiographic prediction. The success rate of implantation was 100%. There were 17 (40.5%) patients with post-operative lfow shunt. The patients were followed-up for (6-36) months, with the mean of 18.7 months, there were 11 (26.2%) patients with small amount of lfow shunt at 3 months after the operation.
Conclusion: Echocardiography is important for choosing the type and size of occluder devices, in-operative monitoring and post-operative effect evaluation for treating the ASD patients.

Objective To investigate the effects of continuous invasive mechanical ventilation combined with BAL on COPD patients with respiratory failure. Methods Sixty COPD patients with respiratory failure were divided into BAL and control group randomly. Control group were treated with sputum suction tube to aspire sputum and BAL group treated with BAL. The changes in the indicators were observed. Results The SpO2, airway peak inspiratory pressure and blood gas analysis were improved significantly compared with the control group (P < 0.01). The number of peripheral blood leucocytes and the level of CRP in BAL group were lower than those in control group at the seventh day (P < 0.01). The duration of invasive mechanical ventilation and hospital stay in BAL group was shorter than that in control group (P < 0.01) and there was no severe complication in both groups. Conclusion BALwith continuous mechanical ventilation support are safe and effective and shorten hospitalization time and improve the prognosis of COPD patients with respiratory failure.