To introduce and analyze guideline terminology related to clinical question formulation, evidence retrieval and appraisal, and recommendation development.

BACKGROUND:Periprosthetic joint infection is one of the most unwanted complications for surgeons and patients after arthroplasty,and its recalcitrance and intractability have always been a headache for arthroplasty surgeons. OBJECTIVE:To review the latest domestic and international clinical treatments used in the treatment of periprosthetic joint infection after hip and knee arthroplasty in recent years,including antibiotic treatment,surgical treatment,biological treatment and Chinese medicine treatment,to promote the research progress in the treatment of periprosthetic joint infection in China. METHODS:The literature from January 2000 to October 2022 on CNKI,WanFang,VIP,and PubMed was retrieved by the first author.762 articles were obtained by reading the titles for initial screening,then 194 articles were obtained by reading the abstracts and excluding studies with duplicate contents,low data reliability,and outdated views.Finally,88 articles were included through intensive reading of the original text. RESULTS AND CONCLUSION:(1)Combined antibiotic regimens may help eradicate the infection in the treatment of periprosthetic infections.(2)Two-stage revision remained the golden indicator for the treatment of periprosthetic infection.(3)One-stage revision lacked large-sample clinical studies and required more clinical observation.(4)Phage therapy and newer drug delivery systems in biological therapy had been applied in small amounts in the clinic,showing their advantages in the prevention and eradication of periprosthetic infections.(5)Chinese medicine with antibiotics and surgical treatment methods can improve the prevention and treatment of periprosthetic joint infection,but high-level evidence-based medical evidence was lacking.

Purpose: The risk stratification of pediatric anaplastic large cell lymphoma (ALCL) has not been standardized. In this study, new risk factors were included to establish a new risk stratification system for ALCL, and its feasibility in clinical practice was explored. Materials and Methods: On the basis of the non-Hodgkin’s lymphoma Berlin–Frankfurt–Munster 95 (NHL-BFM-95) protocol, patients with minimal disseminated disease (MDD), high-risk tumor site (multiple bone, skin, liver, and lung involvement), and small cell/lymphohistiocytic (SC/LH) pathological subtype were enrolled in risk stratification. Patients were treated with a modified NHL-BFM-95 protocol combined with an anaplastic lymphoma kinase inhibitor or vinblastine (VBL). Results: A total of 136 patients were enrolled in this study. The median age was 8.8 years. The 3-year event-free survival (EFS) and overall survival of the entire cohort were 77.7% (95% confidence interval [CI], 69.0% to 83.9%) and 92.3% (95% CI, 86.1% to 95.8%), respectively. The 3-year EFS rates of low-risk group (R1), intermediate-risk group (R2), and high-risk group (R3) patients were 100%, 89.5% (95% CI, 76.5% to 95.5%), and 67.9% (95% CI, 55.4% to 77.6%), respectively. The prognosis of patients with MDD (+), stage IV cancer, SC/LH lymphoma, and high-risk sites was poor, and the 3-year EFS rates were 45.3% (95% CI, 68.6% to 19.0%), 65.7% (95% CI, 47.6% to 78.9%), 55.7% (95% CI, 26.2% to 77.5%), and 70.7% (95% CI, 48.6% to 84.6%), respectively. At the end of follow-up, one of the five patients who received maintenance therapy with VBL relapsed, and seven patients receiving anaplastic lymphoma kinase inhibitor maintenance therapy did not experience relapse. Conclusion This study has confirmed the poor prognostic of MDD (+), high-risk site and SC/LH, but patients with SC/LH lymphoma and MDD (+) at diagnosis still need to receive better treatment (ClinicalTrials.gov number, NCT03971305).

With the gradual deepening of artificial intelligence(AI)research in the medical field,the workflow of interventional diagnosis and treatment will be greatly changed.This paper aims to make a detailed introduction about the application of AI in interventional diagnosis and treatment,focusing on the use of predictive model for the screening of high-risk patients,the selection of treatment options,the use of augmented reality(AR)technology for improving surgical treatment,the training of young physicians,etc.Besides,the difficulties and challenges currently encountered in the clinical practice of AI are also discussed.(J Intervent Radiol,2023,32:1251-1255)

Traditional Chinese Medicine (TCM) has its own unique features in the treatment of post-stroke depression (PSD). The kidney is the congenital foundation and is closely related to the brain. Kidney deficiency runs through the entire course of stroke. Liver regulates the normal operation of qi in the human body, which is closely related to depression syndrome. Kidney deficiency and liver depression affect each other. The treatment of PSD with the Bushen Shugan (tonifying the kidney and soothing the liver) method has achieved good efficacy in clinic. The method of tonifying kidney and soothing liver can not only reflect the holistic view of TCM and the association of viscera, but also coordinate the relationship between body and spirit. In the future, the development direction of PSD in TCM research should be to further strengthen the concept of co-regulation of body and spirit and integration of brain and viscera.

Objective An X-shaped cushioning insole with variable stiffness was designed to explore its effects on plantar pressure and internal stress of diabetic patients with toe amputation. Methods Based on CT images, the feet-calf finite element model of diabetic patients with toe amputation was established, and the insole was divided into different areas according to distribution characteristics of the planter pressure. The three-dimensional (3D) printed cushioning insole with an X-shaped sandwich structure was designed. The modulus of the sandwichstructure was changed by changing thickness of the sandwich structure panel. For simulation analysis, the divided area was filled with the X-shaped sandwich structure with different modulus. Results The peak plantar pressure of diabetic patients with toe amputation was in calcaneal region, and the combined insoles with 1. 2 mpanel thickness in toe area, 1. 4 mm panel thickness in metatarsal area, 2. 0 mm panel thickness in middle area and 1. 6 mm panel thickness in heel area had the best decompression effect. Compared with bare feet, the peak pressure in heel area of the insole, the peak pressure in phalangeal head area and the stress in plantar softissues were reduced by 40. 18% , 31. 7% , and 50. 44% , respectively. Conclusions The 3D printed insoles with variable stiffness can effectively reduce surface pressure and internal stress of the sole and reduce probability of the 2nd toe amputation

ObjectiveTo analyze the characteristics of plantar pressure of diabetic patients during gait cycle, and to design a offloading insole with variable stiffness. MethodsThe plantar pressure experiment was carried out and a database including 157 subjects was established. The differences of plantar pressure distribution were analyzed among diabetic patients with and without peripheral neuropathy, and healthy people. The insole pressure area was divided, and porous units were filled in different insole areas according to the pressure gradient. The fed-calf-insole finite element model of diabetic patients was constructed. The simulation analysis of different insole schemes was carried out under the conditions of push-off, footheel-strike and dynamic neutrality posture, and to explore the most reasonable insole stiffness design. ResultsCompared with the healthy group, the percentage of peak pressure and high pressure in the left and right heel areas of diabetic neuropathy patients showed a decreasing trend, in which the left peak pressure was significantly reduced by 11% (P = 0.026) and the percentage of high pressure was significantly reduced by 9.8% (P = 0.02). When the porous elements of 2.5 MPa and 1.9 MPa were used in the high pressure area of the insole metatarsal and high pressure area of the heel, the peak plantar pressure of footheel-strike, dynamic neutral and push-off was reduced by 42.4%, 27.4% and 26.4%, and the peak stress of the soft tissue was reduced by 49.8%, 43.6% and 25.1%, respectively. ConclusionThere is a higher risk of ulcer in the metatarsal region than in the heel region for diabetic patients. The variable stiffness insoles based on the optimization of plantar pressure and internal stress under multi-posture can effectively reduce the peak pressure of plantar and peak stress of soft tissue during walking, which provides a reference for the design of variable stiffness insoles.

Meige syndrome is one of the rare Diseases of neurology. It is a part of the group of segmental cranial dystonia, which affects more than two cranial muscle groups. Especially, blepharospasm is associated with another cranial dystonia. Currently, the etiology and pathogenesis of this disorder are not well-understood. Based on the theory of collaterals and the relationship between collateral disease and five zang organs,we try to classify the disease into the category of collateral disease, and hold that the mechasnism of disease is not only linked to brain, but also the five zang organs. The disorder of qi and blood leads to the "deficiency of qi and blood", "phlegm-damp" and "stagnant blood" in collateral. These pathological changes cause the deficiency of both qi and blood in brain marrow and tendon.We think that "unblocking and regulating the collterals"is the general program. Adjusting the five zang organs to heel the brain is the key point of the treatment. What's more, we create Tongmai Heluo Decoction to regulate qi and blood of the collateral. This decoction is composed of Huangqi Jianzhong Decoction with some herbal medicine for tonifying qi and activating blood. By adjusting the middle energizer, the qi and the qi movement of five zang organs are well regulated. We use this decoction effectively on refractory Meige syndrome.

BACKGROUND: Numerous studies have concentrated on high-dose radiation exposed accidentally or through therapy, and few involve low-dose occupational exposure, to investigate the correlation between low-dose ionizing radiation and changing hematological parameters among medical workers. METHODS: Using a prospective cohort study design, we collected health examination reports and personal dose monitoring data from medical workers and used Poisson regression and restricted cubic spline models to assess the correlation between changing hematological parameters and cumulative radiation dose and determine the dose-response relationship. RESULTS: We observed that changing platelet of 1265 medical workers followed up was statistically different among the cumulative dose groups (P = 0.010). Although the linear trend tested was not statistically significant (P CONCLUSION We concluded that although the exposure dose was below the limit, medical workers exposed to low-dose ionizing radiation for a short period of time might have increased first and then decreased platelets, and there was a dose-response relationship between the cumulative radiation dose and platelets changing.
Adult ; Aged ; Blood Platelets/radiation effects* ; Female ; Health Personnel/statistics & numerical data* ; Humans ; Male ; Middle Aged ; Occupational Exposure/adverse effects* ; Prospective Studies ; Radiation Dosage ; Radiation Exposure/adverse effects* ; Radiation, Ionizing ; Young Adult

Periodontium regeneration and repair is a controversial and difficult point in the treatment of periodontosis. The proliferation, differentiation, migration and adhesion of periodontal ligament cells and the dynamic relationship between periodontal ligament cells and their extracellular matrix proteins are the basis of periodontium morphological reconstruction, functional maintenance and tissue repair. This article reviews the mechanism of estrogen-regulated periodontal membrane fine repair and periodontal tissue reconstruction to provide the basis for follow-up research on the treatment of periodontitis and the promotion of periodontal tissue repair and reconstruction by exogenous estrogen-mediated periodontal membranes. Under the regulation of certain concentrations of estrogen, the proliferation and differentiation ability of periodontal ligament stem cells (PDLSCs) and bone mesenchymal stem cells (BMSCs) to other periodontal ligament cells were enhanced. At the same time, PDLSCs, BMSCs, human periodontal ligament fibroblasts (HPLFSs), osteoblasts and cementoblasts synthesized and secreted collagen I (COLI), osteopontin (OPN), bone sialoprotein (BSP) and osteocalcin (OCN) into the extracellular matrix. They interact with fibronectin (FN) and cementum attachment protein (CAP) in the extracellular matrix to form a variety of chain complexes and regulate each other, thus promoting the growth, migration, adhesion and fibrosis of periodontal ligament cells, repairing the collagen fiber skeleton of the periodontal ligament and adhering the two ends to the new cementum and the inherent alveolar bone.