OBJECTIVE: To evaluate the early clinical efficacy of robot-assisted percutaneous short-segment bone cement-augmented pedicle screw fixation in the treatment of stageⅡ-Ⅲ Kümmell disease. METHODS: The clinical data of 20 patients with stageⅡ-Ⅲ Kümmell's disease who underwent robot-assisted percutaneous bone cement-augmented pedicle screw fixation between June 2017 and January 2021 were retrospectively analyzed. There were 4 males and 16 females, aged from 60 to 81 years old with an average age of (69.1±8.3) years. There were 9 cases of stageⅡand 11 cases of stage Ⅲ, all of which were single vertebral lesions, including 3 cases of T₁₁, 5 cases of T₁₂, 8 cases of L₁, 3 cases of L₂, and 1 case of L₃. These patients did not exhibit symptoms of spinal cord injury. The operation time, intraoperative blood loss, and complications were recorded. The position of pedicle screws and the filling and leakage of bone cement in gaps were observed using postoperative CT 2D reconstruction. The data of the visual analogue scale (VAS), Oswestry disability index (ODI), kyphosis Cobb angle, wedge angle of the diseased vertebra, and anterior and posterior vertebral height on lateral radiographs were statistically analyzed preoperatively, 1 week postoperatively, and at the final follow-up. RESULTS: Twenty patients were followed up for 10 to 26 months, with an average follow-up of (16.0±5.1) months. All operations were successfully completed. The surgical duration ranged from 98 to 160 minutes, with an average of (122±24) minutes. The intraoperative blood loss ranged from 25 to 95 ml, with an average of (45±20) ml. There were no intraoperative vascular nerve injuries. A total of 120 screws were inserted in this group, including 111 screws at grade A and 9 screws at grade B according to the Gertzbein and Robbins scales. Postoperative CT indicated that the bone cement was well-filled in the diseased vertebra, and cement leakage occurred in 4 cases. Preoperative VAS and ODI were (6.05±0.18) points and (71.10±5.37)%, respectively, (2.05±0.14) points and (18.57±2.77)% at 1 week after operation, and (1.35±0.11) points and (15.71±2.12) % at final follow-up. There were significant differences between postoperative 1 week and preoperative, and between final follow-up and postoperative 1 week(P<0.01). Anterior and posterior vertebral height, kyphosis Cobb angle, and wedge angle of the diseased vertebra were(45.07±1.06)%, (82.02±2.11)%, (19.49±0.77) °, and (17.56±0.94) ° preoperatively, respectively, (77.00±0.99)%, (83.04±2.02)%, (7.34±0.56) °, and (6.15±0.52) ° at 1 week postoperatively, and (75.13±0.86)%, (82.39±0.45)%, (8.38±0.63) °, and (7.09±0.59) ° at the final follow-up. CONCLUSION Robot-assisted percutaneous short-segment bone cement-augmented pedicle screw fixation demonstrates satisfactory short-term efficacy in treating stageⅡ-Ⅲ Kümmell's disease as an effective minimally invasive alternative. However, longer operation times and strict patient selection criteria are necessary, and long-term follow-up is required to determine its lasting effectiveness.
Male ; Female ; Humans ; Middle Aged ; Aged ; Aged, 80 and over ; Pedicle Screws ; Bone Cements ; Robotics ; Blood Loss, Surgical ; Retrospective Studies ; Spinal Fractures/surgery* ; Lumbar Vertebrae/injuries* ; Treatment Outcome ; Kyphosis ; Thoracic Vertebrae/injuries* ; Fracture Fixation, Internal

OBJECTIVE: To compare and analyze the biomechanical differences between different transosseous techniques in arthroscopic repairment of rotator cuff injuries by finite element analysis. METHODS: Finite element models of traditional arthroscopic transosseous(ATO) technique, giant needle technique, and ArthroTunneler(AT) technique were established based on the shoulder CT data of a healthy adult. Then, loads of 10 N and 20 N were applied to the sutures on the different technical models, respectively. Compare and analyze the stress changes of the bone tunnels and sutures of the three models were compared and analyzed. RESULTS: Under the same condition of loading, the stress on the lateral bone tunnels and sutures of the traditional ATO technology model was the largest, followed by the giant needle technology model. The stress on the mid-section bone tunnels and sutures of the AT technology model was the largest, followed by the giant needle technology model. Under the different conditions of loading, the high-stress areas of the three models were mainly concentrated on the contact area between the sutures and the bone tunnels. Besides, compared with the traditional ATO technology model, the stress distribution of the lateral bone tunnels and sutures of the giant needle technology and AT technology model were more dispersed, but there was obvious stress concentration phenomena in the stress distribution in the mid-section bone tunnels and sutures in the AT technology model. CONCLUSION Compared with the traditional ATO technique, both the giant needle technique and the AT technique can reduce the risk of cutout between the bone tunnel and suture, and may be better treatments for rotator cuff tear. However, compared with the giant needle technique, the application of AT technique in patients with osteoporosis may be limited.
Adult ; Humans ; Rotator Cuff Injuries/surgery* ; Rotator Cuff/surgery* ; Finite Element Analysis ; Arthroscopy/methods* ; Suture Techniques

Objective:To isolate HIV envelope specific monoclonal antibodies (mAbs) from a chronic HIV-1 subtype B′-infected individual with broadly neutralizing activity, and identify their binding activity, epitopes and neutralizing activity.Methods:Single B cell sorting were used to isolate antigen-specific B cells from an HIV-1 infected individual. Variable regions of heavy chain and light chain gene of mAbs were obtained by PCR amplification, and were ligated into the expression vector subsequently. After expression and purification of mAbs, the binding activity and neutralizing ability of mAbs were identified by ELISA and neutralization assay respectively.Results:Seven mAbs were obtained from the HIV-1 infected individual. The heavy chain genes of the mAbs are derived from IGHV1-69*09, IGHV1-08*01, IGHV1-46*01, IGHV4-34*01, IGHV4-61*01 and IGHV3-43*02 germline, SHM rates range from 10.76% to 21.05%. The light chain genes of the mAbs originate from IGKV3-20*01, IGKV1-39*01, IGKV1-NL1*01, IGKV3-15*01 and IGKV1-9*01 germline, SHM rates cover between 6.03% and 18.64%. Gp140 was well recognized by all seven antibodies. 508-B1, 508-C1, 508-C5, 508-D4 and 508-E5 are gp41-directed mAbs. 508-D6 and 508-F1 bind with gp120. 508-D4 and 508-F1 could neutralize pseudoviruses CNE8 and X2278 in Global Panel with IC 50 values of 38.1μg/ml and 41.7 μg/ml, respectively. Conclusions:This study successfully identified seven envelope specific mAbs, among them five mAbs are directed to gp41 region and two mAbs are targeted to gp120. Two mAbs showed limited neutralization spectrum. These mAbs may provide technical reserves for developing HIV-1 diagnostics kit, antibody-related drugs and vaccines.

The morbidity and mortality of lung cancer are the highest in China, and the non-small cell lung cancer(NSCLC) is the first one, accounting for about 80% of lung cancer.NSCLC includes squamous cell carcinoma, adenocarcinoma, etc.Because of the slow growth of lung cancer cells and the late diffusion and metastasis, most of the patients were in late stage and lost the best period of surgical treatment.In recent years, molecular targeted therapy for specific genes has become an important strategy for the treatment of NSCLC.Multiple target genes, such as EGFR, KRAS, BRAF and EML4-ALK have been identified.This article reviews the related driving genes and molecular targeted therapy of NSCLC, expecting to be helpful to the individualized treatment of advanced NSCLC patients.

Anterior Cruciate Ligament Injuries ; Biomechanical Phenomena ; Humans ; Knee Joint/surgery* ; Posterior Cruciate Ligament/surgery* ; Posterior Cruciate Ligament Reconstruction ; Reconstructive Surgical Procedures ; Robotics

OBJECTIVETo investigate the stability of internal fixation for femoral neck fracture(FNF) using two or three cannulated screws directed to different fracture lines, and to provide a theoretical basis for the clinical decision making.

METHODSFifteen fresh frozen human femur samples were selected and the FNF model was established with Pauwels angle of 30°, 50° and 70° respectively. The models were fixed with three or two cannulated screws, and their differences at tensile strength, subsidence, shear strength and composite displacement, gap distance, torsional angle and stiffness values of four types of femur were evaluated to identify their biomechanical stability.

RESULTSWith Pauwels angle of 30° and 50°, no statistical differences at the referenced outcomes were observed between two and three cannulated screw fixation for FNF(>0.05). With the Pauwels angle of 70 °, three cannulated screws fixation were significantly superior to two cannulated screws fixation for FNF(<0.05). Nevertheless, when Pauwels angle was 70°, three cannulated screws fixation turned out to be relative instable compared with Pauwels angle of 30° and 50°.

CONCLUSIONSWith Pauwels angle of 30° and 50°, two cannulated screws fixation was similarly stable as using three cannulated screws for FNF. Three cannulated screws fixation were obviously superior to two cannulated screws fixation when Pauwels angle was 70°, but the application of three cannulated screws could still be insufficiently stable when only such routine fixations were utilized. Therefore, Angle Stabilizing System or anti-sliding screws were needed to enhance the stability of FNF fixation.

Objective:To analyze the inhibiting mechanism of microRNA-199a/b-3p(miR-199)on cell proliferation of triple negative breast cancer(TNBC)cells.Methods:Expression of miR199 in BT549 and MDA-MB-231 cells transfected with miR-199a/b-3p was detected by qRT-PCR.The proliferation of BT549 and MDA-MB-231 cells transfected with miR-199 were analysed by MTT as-say.Cell cycle of TNBC cells transfected with miR-199 was detected by Flow Cytometry assay.Results:MiR-199a/b-3p could suppress the proliferation of BT549 and MDA-MB-231 cells.Comparing with normal control,the proliferation rate were up to(41.02±2.34)%and(28.42 ±6.70 )%,and the cell cycle were arrest at G 1 phase.Conclusion: MiR-199a/b-3p could suppress the proliferation of TNBC,and may be a promising anti-cancer drug for TNBC.

OBJECTIVETo explore the treatment methods and the effects of popliteal cyst with arthroscopy.

METHODSFrom January 2009 to January 2010,20 patients with popliteal cyst were treated with internal drainage under arthroscope, meanwhile, their joint disease were treated. There were 9 males and 11 females with an average age of (55.7 +/- 7.7) years (ranged, 46 to 70). The lump was found for 1-22 months with an average of (6.2 +/- 2.4) months and accompanying with knee pain of different degrees. All diagnosis depended on B ultrasound or MRI, which clearly showed communication of cyst and articular cavity. According to the grade of Rauschning and Lindgren,grade II was in 8 cases and grade III was in 12 cases. The clinical effects were evaluated by the grade of Rauschning and Lindgren.

RESULTSAll the patients were followed up from 6 to 18 months with an average of 12 months. No injuries of blood vessels and nerve or incision infection were found. The grade of Rauschning and Lindgren improved obviously in all patients, grade 0 was in 13 cases, grade I in 6 cases, grade II in 1 case at the 6 months after operation.

CONCLUSIONThe method not only can cure the popliteal cyst, but also can solve the disease of joint, which is avoiding re-operation and decreasing some shortages of traditional operation, can obtain good function recovery and satisfactory medium-term effects.

Aged ; Arthroscopy ; methods ; Drainage ; Female ; Humans ; Male ; Middle Aged ; Popliteal Cyst ; pathology ; surgery