Objective:To document any effect of combining kinesiotaping (KT) with Monitored Rehab Systems biofeedback training (MRS training) on the recovery of knee function after anterior cruciate ligament reconstruction (ACLR).Methods:Twenty-two patients after ACLR were randomly divided into an MRS group and a combined group, each of 11. In addition to conventional rehabilitation training, the MRS group had placebo taping in place during their MRS training, while the combined group had KT applied. Each training session lasted 45 minutes, with three sessions per week. Before the experiment and after 8 weeks of treatment, the affected foot support phase, impulse of each area of the affected foot′s sole, and lower limb reaction time were measured.Results:Significant improvement in the affected foot′s support phase and lower limb reaction time was documented in both groups, as well as in the average impulse percentage of the affected foot′s plantar forefoot area (F area), mid-foot area (MF area), and heel area (H area). All were significantly better in the combined group than in the MRS group, on average.Conclusion:Supplementing MRS biofeedback training with kinesiotaping can more effectively improve the knee joint functioning and postural control of patients after ACLR surgery. The combination is worthy of clinical promotion and application.

Objective:To analyze the effectiveness and safety of the second course radiotherapy for unresectable colorectal cancer liver metastases.Methods:We retrospectively collected the data of 28 patients with unresectable colorectal cancer liver metastases who received the second course radiotherapy at Peking University Cancer Hospital and Institute from 2017 to 2023, to analyze the feasibility of re-irradiation.Results:For the 28 patients, the median follow-up time after re-irradiation was 20.2 months. The median time interval between the first- and second-course radiotherapy was 11.1 months. The median biologically effective doses of the first- and second-course radiotherapy were 100 Gy and 96 Gy, respectively. Stereotactic body radiotherapy was administered to 25 patients (89.3%) during the first course and 24 patients (85.7%) during the second course of radiotherapy. The mean equivalent dose in 2 Gy fractions to the normal liver was 10.1 Gy in the first-course radiotherapy and 7.9 Gy in the second-course radiotherapy. The complete response rate, partial response rate, and objective response rate after re-irradiation were 54.5%, 18.2%, and 72.7%, respectively. After re-irradiation, the 2-year cumulative local failure rate was 17.0% when calculated based on patients and 15.1% when calculated based on lesions, the 1-year progression-free survival rate was 27.4%, and the 3-year overall survival rate was 46.7%. The second-course radiotherapy was well tolerated, with most patients (75.0%) experiencing grade 1-2 acute adverse reactions and only one case (3.6%) experiencing grade 3 acute adverse events.Conclusions:Second course radiotherapy is an effective and safe treatment approach for selected patients with unresectable colorectal cancer liver metastases.

Objective    To investigate the operation of transcatheter aortic valve replacement (TAVR), the use of TAVR instruments and the current situation of TAVR-related nursing in our country, to reveal the characteristics of TAVR in various hospitals in our country, and to provide reference data for improving perioperative nursing and industry development of TAVR. Methods    A questionnaire survey was conducted among the head nurses of the cardiac catheterization laboratories of 51 hospitals in China that carried out TAVR operations, with a total of 5 items and 23 questions. The current situation of TAVR operation methods, intraoperative instruments and nursing care in China were analyzed. Results    The number of hospitals in China which started conducting TAVR and the beginning year were: 2 in 2010, 1 in 2012, 1 in 2013, 1 in 2015, 11 in 2016, 13 in 2017, 15 in 2018 and 7 in 2019; the number of transfemoral TAVR in 2019: 32 (62.75%) hospitals conducted on less than 20 patients, 7 (13.73%) hospitals 20-<50 patients, 6 (11.76%) hospitals 50-100 patients and 6 (11.76%) hospitals more than 100 patients; TAVR strategies adopted by most hospitals were: general anesthesia (90.20%), the use of vascular sealers (80.39%), backing by cardiac surgeon (74.51%) and using homemade prosthetic valves. Conclusion     At present, the number of TAVR carried out in Chinese hospitals is still far behind that of developed countries in Europe and the United States. Our country has adopted the form of multi-disciplinary cardiac team cooperation and formed a TAVR nursing model with Chinese characteristics.

Microscopic extension (subclinical lesion) is the key factor for defining clinical target volume in radiotherapy. In this article, the research progresses on microscopic extension or extracapsular extension in esophageal cancer, lung cancer, hepatocellular carcinoma, prostate cancer, bladder cancer, rectal cancer, breast cancer, non-melanoma skin cancer and metastatic lymph nodes were reviewed. These results provide important basis for the definition of clinical target volume. However, a series of questions remain to be properly resolved.

Objective To investigate the efficacy of concurrent chemoradiotherapy for anal squamous cell carcinoma (ASCC) in the era of intensity-modulated radiotherapy.Methods A total of 19 patients with ASCC who underwent definitive radiotherapy in our hospital since 2011 were collected.The survival curves were depicted with K-M method.Risk factors of disease progression were analyzed using case-control study.Results The median follow-up time was 31 months.The 3 year-LFS and 3 year-OS were 88.1％ and 91.7％,respectively.Grade 3 acute toxicities during the chemoradiotherapy were mainly white blood cell reduction (15.8％),platelet reduction (10.5％),diarrhea (15.8％),and skin reaction (31.6％).Compared with historical data,volumetric intensity modulated arc therapy was superior to conventional radiotherapy in the treatment outcome and normal tissue protection in ASCC.Univariate analysis showed that concurrent chemotherapy with capecitabine was a favorable factor in disease progression (P＜ 0.05).Conclusions Volumetric intensity modulated arc therapy for ASCC may have advantages in terms of efficacy and normal tissue protection.Concurrent chemotherapy with a double-drug regimen containing capecitabine may be a beneficial factor in disease progression.

The present study shows the case of a patient with acetabular protrusions secondary to rheumatoid arthritis progressing to femoral neck fracture.The patient,a 64 years female,had a history of rheumatoid arthtitis for 38 years.The left hip pain and abnormal sound occurred when hip flexion for picking up.She was diagnosed with rheumatoid arthritis secordary to acetabular pelvic retraction and left femoral neck fracture by medical history,physical examination and imaging.Total hip arthroplasty was performed after preoperative examination.Hip dislocation,femoral head removal,acetabular reconstruction;cup fixation,and bone mass assessment are technical challenges during surgery.Based on literature review,this case is belonging to secondary acetabular pelvic retraction,which may be related to acetabular softening caused by rheumatoid arthritis.Whenthe stress from the femoral head exceeds the endurance of the softened acetabulum,the acetabulum protrudes into the pelvis and gradually wraps around the femoral head.Based on the pathological characteristics,itis speculated that the cause of femoral neck fracture is the direct hit of the femoral neck-acetabular rim during hip flexion.In this case,spiral cup prosthesis was used to achieve both the initial stability of the prosthesis and saving bone mass around the acetabulum.The patient was followed up for 3 months with satisfactory position of prosthesis and joint function.

Objective To investigate the species distribution characteristics of nontuberculous mycobacteria(NTM)in acquired immunodeficiency syndrome(AIDS)patients in Shanghai,and to provide evidences for clinical treatment.Methods A total of 775 Mycobacteria strains were isolated from patients(including 129 isolates from AIDS patients and 646 isolates from HIV-negative patients)admitted to Shanghai Public Health Clinical Center during 2015.All the species were identified by the sequence analysis of 16S rRNA gene and hsp65 gene.Differences in the species distribution were compared between patients with and without HIV infection.CD4+T lymphocyte count was detected by flow cytometry and its relation with mycobacteria infection was also analyzed.Chi-square test was used for comparison between groups.Results The ratio of NTM isolation from HIV-negative patients was 15.79%(102/646),while that was 46.51% in AIDS patients(60/129),and the difference was statistically significant(x2=61.38,P <0.01).Among the 60 NTM strains isolated from AIDS patients,mycobacterium avium-intracelluare complex(MAC)and Mycobacterium gordonae were the predominant species(43.33% and 20.00%,respectively).Moreover,five Mycobacterium colombiense strains,which were relatively rare,were also obtained.A total of 102 NTM were identified from HIV-negative patients,of which Mycobacterium gordonae(32 isolates,31.37%)and MAC(30 isolates,29.41%)were the most frequently isolated.In addition,the positive rates of NTM and MAC were significantly higher in patients with CD4+T lymphocyte counts ≤50 cells/μL(58.33% and 76.92%,respectively)than those with CD4+T lymphocyte counts>50 cells/μL(20.00% and 15.38%,respectively)(x2=4.048 and 6.524,respectively,both P<0.05).Four out of five Mycobacterium colombiense infected patients died of disseminated infections,except the remaining one whose CD4+T lymphocyte counts>50 cells/μL.Conclusions The prevalence of NTM isolation is significant higher in AIDS patients than HIV-negative patients in Shanghai,and the most prevalent NTM species is MAC.The NTM infection in AIDS patients is related with low CD4+T lymphocyte counts.

Objective To explore the value of MRI simulation in the pre-operative radiotherapy for locally advanced low rectal carcinoma.Methods A total of 40 patients diagnosed with locally advanced low rectal carcinoma by endoscopic biopsy and radiological staging examinations were included in this study.There were 22 male and 18 female with nedian age 58 years (range 31-80).Patients underwent CT and MRI simulation scanning in the same position and fixing device.GTV under CT images and MRI inages were delineated respectively by two experienced radiologists.Primary tumor length,tumor volume and distance of distal tumor from the anal verge were calculated by treatment planning system(TPS).The two groups of data were compared.Results The distance of distal tumor to the anal verge were all no more than 5 cm on digital examination.The mean length of GTVcT was remarkably longer than that of GTVMRI [(5.21 ±1.65) cm vs.(4.46 ± 1.51) cm,t =5.059,P ＜0.05].The mean volume of GTVcTWaS significantly larger than that of GTVMRI[(55.71 ±31.57) cm3vs.(44.02 ±25.11) cm3,t=6.977,P＜ 0.05)].The mean distance of distal tumor to the anal verge was (3.72 ± 0.93) cm,significantly longer than that of lower bounds of GTVCT to the anal verge,which had a high consistency with GTVMRI.The IMRT plan was based on CT-MRI fusion images.There were no 3-4 grade adverse effects of radiotherapy.The overall pCR rate was 32.5％.Conclusions MRI simulation could define smaller GTV and more precise lower bounds than CT.With improved accuracy of target volumes contours,the application of MRI simulation may promote the efficacy of radiotherapy and result in a reduction in the incidence of toxicities.

Purpose To explore the feasibility of low radiation dose combined with lowdose contrast agent in thyroid CT enhanced scan and investigate the benefit of reducing radiation hazard and contrast agent damage to thyroid.Materials and Methods 120 patients assigned for thyroid enhanced CT scan were prospectively and randomly divided into four groups (each group was 30 patients).Group A:radiation dose 120 kV,180 mA,contrast agent dose 1.2 ml/kg;group B:radiation dose 120 kV,180 mA,contrast agent dose 1.0 ml/kg;group C:radiation dose 100 kV,100 mA,contrast agent dose 1.2 ml/kg;group D:radiation dose 100 kV,100 mA,contrast agent dose 1.0 ml/kg.CT values,background sign,background noise of thyroid were measured;signal to noise ratio (SNR) and contrast to noise ratio (CNR) were calculated;CT dose index of volume (CTDIvol),dose length product (DLP),and the effective dose (ED) were recorded and calculated.The image quality was evaluated and the data was statistically analyzed by two radiologists.Results CT values,background sign and background noise of thyroid,as well as CTDIvol,DLP,ED among four groups were statistical significant (P＜0.05);there was no significant difference in SNR,CNR and image quality scores among four groups (P＞0.05).Conclusion It is beneficial of reducing radiation hazard and side-effect of contrast agent from low radiation dose combined with low-dose contrast agent under the condition of ensuring diagnostic image quality.

AIM: To observe the effect of Tripterygium glycosides on NOXs-ROS-NLRP3 inflammatory signa-ling pathways in the colon tissue in dextran sulphate sodium (DSS)-induced ulcerative colitis (UC) mice, and to investi-gate the underlying mechanisms.METHODS: BALB/c mice were used and the mouse model of UC was established by DSS induction.The mice were randomly divided into 5 groups (model group, low-, medium-and high-dose Tripterygium glycosides groups, and normal group).The colon tissues were collected 21 d after Tripterygium glycosides gavage.The mRNA expression of NLRP3, ASC and caspase-1 in the colon tissues was detected by real-time PCR.The caspase-1 ex-pression in the colorectal mucosa was observed by immunohistochemical method.ELISA was used to detect the protein le-
vels of IL-1α, TNF-αand IL-13.The production of reactive oxygen species (ROS) was measured by chemiluminescence technique, and the consumption rate of NADPH, which was inhibited by DPI, was analyzed to determine the activity of NADPH oxidases (NOXs).The neutrophils were isolated, and the ROS production, NOXs activity, and the mRNA ex-pression of NLRP3, ASC and caspase-1 were also detected.RESULTS: The colon tissues were abnormal with different de-grees in Tripterygium glycosides groups, and histopathological scores were lower than that in model group.In Tripterygium glycosides groups, in addition to the mRNA expression levels of caspase-1 in the colon tissues between normal group and high-dose group, ROS production, NOXs activity and the mRNA expression levels of NLRP3, ASC and caspase-1 in the colon tissues and colon-isolated neutrophils were lower than those in model group (P <0.05), and higher than those in normal group (P <0.05).The results of pairwise comparison for the efficacy of Tripterygium glycosides administration showed that the above indexes were statistically significant except the mRNA expression levels of caspase-1 between middle-dose group and high-dose group.Tripterygium glycosides administration significantly decreased the expression levels of proinflammatory cytokines IL-1αand TNF-αin the homogenates of colon tissues in the model mice (P <0.05).No differ-ence of IL-13 expression among the groups was observed.CONCLUSION: Tripterygium glycosides inhibits NOXs-ROS-NLRP3 inflammatory signaling pathways to reduce the expression of IL-1α, TNF-αand other proinflammatory cytokines, and attenuates DSS-induced ulcerative colitis in mice, by which the neutrophils might be involved in the process.