Background: and Purpose The optimal management of patients with acute basilar artery occlusion (BAO) is uncertain. We aimed to evaluate the safety and efficacy of endovascular thrombectomy (EVT) compared to medical management (MM) for acute BAO through a meta-analysis of randomized controlled trials (RCTs). Methods: We performed a systematic review and meta-analysis of RCTs of patients with acute BAO. We analyzed the pooled effect of EVT compared to MM on the primary outcome (modified Rankin Scale [mRS] of 0–3 at 3 months), secondary outcome (mRS 0–2 at 3 months), symptomatic intracranial hemorrhage (sICH), and 3-month mortality rates. For each study, effect sizes were computed as odds ratios (ORs) with random effects and Mantel-Haenszel weighting. Results: Four RCTs met inclusion criteria including 988 patients. There were higher odds of mRS of 0-3 at 90 days in the EVT versus MM group (45.1% vs. 29.1%, OR 1.99, 95% confidence interval [CI] 1.04–3.80; P=0.04). Patients receiving EVT had a higher sICH compared to MM (5.4% vs. 0.8%, OR 7.89, 95% CI 4.10–15.19; P<0.01). Mortality was lower in the EVT group (35.5% vs. 45.1%, OR 0.64, 95% CI 0.42–0.99; P=0.05). In an analysis of two trials with BAO patients and National Institutes of Health Stroke Scale (NIHSS) <10, there was no difference in 90-day outcomes between EVT versus MM. Conclusion In this systematic review and meta-analysis, EVT was associated with favorable outcome and decreased mortality in patients with BAO up to 24 hours from stroke symptoms compared to MM. The treatment effect in BAO patients with NIHSS <10 was less certain. Further studies are of interest to evaluate the efficacy of EVT in basilar occlusion patients with milder symptoms.

Component malrotation is one of the major causes of failure in total knee arthroplasty.Based on previous researches,Insall line has excessive external rotation tendency.Although Akagi line is the most recognized anatomical axis at present,it still has a certain tendency of internal rotation.The tibial posterior condylar axis is not suitable for symmetrical component and yet the Curve-on-Curve technique is not suitable for anatomic component.In addition,reference to any fixed anatomical markers cannot ensure the rotation consistency of tibiofemoral component in extension position.Although range of motion technique is beneficial to tibiofemoral rotation synchronization,its clinical effect seems to be unstable.Nevertheless,Patients can obtain good postoperative results with all major techniques.Before the recognized "gold standard" is defined,orthopedic surgeons can determine the rotation alignment of tibial component according to their most accustomed surgical method.With a deeper understanding of knee anatomy,biomechanics and kinematics,digital assistive technology may be expected to become a breakthrough in the tibial rotational alignment.
Arthroplasty, Replacement, Knee/methods* ; Femur/surgery* ; Humans ; Knee Joint/surgery* ; Knee Prosthesis ; Osteoarthritis, Knee/surgery* ; Range of Motion, Articular ; Tibia/surgery*

Thymoquinone (TQ) is a bioactive component derived from the seeds of Nigella sativa that are commonly as black cumin. Evidences indicate that the medicinal properties of TQ have been recognized for more than 2000 years. TQ has been shown to possess potent chemopreventive properties that include anti-inflammatory and anti-neoplastic activities. Recent studies have unraveled the multiple mechanisms through which TQ exerts its chemopreventive and anticancer activity in different cancer cells in a contextual manner. The present review aims to provide a brief compendium on the molecular mechanisms through which TQ inhibits signaling pathways underlying cancer genesis, progression, and metastasis.

Objective: Non-technical skills (NTS) are necessary to evaluate the comprehensive quality of surgeons. In this study, we proposed the concept of C-NTS, a scoring criterion for NTS based on real scenarios (for example, history taking) and video recording, and verified its practical application effects. Methods: Study objects were divided into the tutor group and the student group. The tutor group contained four senior attending physicians in gastrointestinal surgery department of one tertiary hospital (all male with doctor degree). The student group had four rotating surgeons who were randomly selected from the same department in 2018 (two males and two females). Before and after the training, the tutor rated the same anonymous video by C-NTS. One-factor analysis of variance was used to compare the differences between and within the groups, and Kendall concordant coefficient was used to test the consistency by SPSS 22.0. Results: After the tutor receiving training, Kendall concordant coefficient was increased from 0.425 to 0.853 and the latter suggested the difference had statistical significance (P=0.017), which confirmed the effectiveness of the training. Conclusion C-NTS has preliminarily solved the difficulty of homogenization of NTS assessment. Relevant C-NTS discussions and trainings for clinical tutors may be beneficial to save time and manpower in clinical teaching and evaluation.

Objective Toanalyzetheimagingfeaturesofmedulloepitheliomaforfurtherunderstanding.Methods Theimaging findingsof12casesofmedulloepitheliomaprovedbypathologywereanalyzedretrospectively.Results Thelesionswerelocatedin cerebralhemisphere(6),cerebellum (3),ventricularsystem (3),andalloftheminvolvedbothgrayandwhitematter.Thefeatures includedlargegrosstumorvolume,clearboundaryandperitumoraledema(8/12).Othersincludedcystic-solidlesions(11/12),completelysolidlesion (1/12),andiso-orslightlyhyper-densitywithcalcificationonCTscan.ThetypicalfeatureofMRIwas "mid-lakeisland"sign,and solidcomponentshowediso-orhypo-intensityonT1WI,isoorhyper-intensityonT2WIwithhemorrhageandnecrosis,aswellasthe tumorshowedobviousheterogeneousenhancementaftercontrast.Cystcomponentshowedthin-wallring-enhancement.Conclusion Thetypicalfeatureofthemedulloepitheliomaisthe "mid-lakeisland"sign.Thetumorhasalargevolume,andthe majorityshow cystic-solidlesions.Aboveall,medulloepitheliomashouldbeconsideredifthereisasolid-cysticlesionwithclearboundaryatchildren andadolescents.

PURPOSE: The purpose of this study is to review the use of an allograft or autograft in medial patellofemoral ligament (MPFL) reconstruction. MATERIALS AND METHODS: Various electronic databases were searched for relevant articles published from January 2000 to September 2017 that evaluated clinical outcomes of MPFL reconstruction using an autograft or allograft. Data search, extraction, analysis, and quality assessments were performed based on Cochrane Collaboration guidelines. RESULTS: The study of 21 autografts and one allograft was included in this review. Although direct comparative studies were unavailable, the Kujala score and subjective results were reported in the majority of these studies. While the use of an autograft for MPFL reconstruction yielded satisfactory clinical outcomes with few perioperative complications, no new outcome has been drawn from the use of allografts. CONCLUSIONS Although many studies have shown favorable clinical results for MPFL reconstruction using an autograft, the clinical results of MPFL reconstruction using an allograft have not yet been sufficient to achieve meaningful clinical results due to low levels of evidence. Direct comparisons were not conducted because there were very few studies on allografts; thus, further research in this area should be performed in the future.

Objective: To analyze the burden of disease (BOD) on diabetes attributable to high BMI in China from 1990 to 2016. Methods: Data based on population of the 2016 Global Burden of Disease Study for China were used to analyze the attributable fractions (PAF) of BOD for diabetes attributable to high BMI. Measurements for attributable BOD of diabetes included disability adjusted life years (DALY), years of lost life (YLL), years living with disability (YLD), death number and mortality rate. The average world population from 2010 to 2035 was used as a reference. Results: In 2016, death number of diabetes attributable to high BMI was 40 310, which was significantly higher than that in 1990 (15 008). Age-standardized death rate of diabetes attributable to high BMI increased from 2.01/100 000 in 1990 to 2.60/100 000 in 2016, which showed a more significant increasing trend in both males and people aged 15-49 years. DALYs of diabetes attributable to high BMI increased from 1.09 million person years to 3.30 million person years. YLL and YLD also showed increasing trends. The highest increasing rate of YLD was in people aged 15-49 years. High BMI was responsible for 26.01% of the diabetes deaths in 2016 in China, an increase of 39.39% compared with that in 1990 (18.66%). Most provinces in China experienced a sharp increase of DALY of diabetes attributable to high BMI from 1990 to 2016. Inner Mongolia, Xinjiang, Zhejiang, Macao SAR, Sichuan and Qinghai had the most significant increase tendency in terms of DALY rate during this period. Conclusions: There was a rapid increase of the deaths and mortality rate of diabetes attributable to high BMI, causing a heavy disease burden, in China from 1990 to 2016. The BOD varied in both different age and gender groups. More attention should be paid to males and people aged 15-49 years in the prevention and control programs of diabetes.
Adolescent ; Adult ; Body Mass Index ; China/epidemiology* ; Cost of Illness ; Diabetes Mellitus/ethnology* ; Disabled Persons ; Humans ; Macau ; Male ; Middle Aged ; Quality-Adjusted Life Years ; Sickness Impact Profile ; Young Adult

Objective: To assess the disease burden on uterine fibroids in China in 1990 and 2016. Methods: Data were extracted from the Global Burden of Disease Study 2016. Burdens of uterine fibrosis among different age groups and provinces were measured in 1990 and 2016, with key indicators including number of cases, prevalence rates, disability-adjusted life year (DALY) and the rates of DALY. The WHO world standard population, 2010-2035 was used to calculate the age- standardized rates. Results: In 1990 and 2016, there were 13 695 567 and 27 169 312 women aged 15 years and older, suffered from uterine fibrosis respectively, with prevalence rate as 2.48% and 4.10%, DALY as 146 045.05 life years and 281 976.67 life years, and the DALY rate as 26.40/100 000 and 42.50/100 000, in 1990 and 2016 respectively. Both the prevalence rate and the DALY rate increased with age, reaching the peak on the 45-49 years-old, in both 1990 and 2016. Women aged 40-54 years accounted for 55.60% (1990) and 66.74% (2016) of the total cases while 48.37% (1990) and 60.65% (2016) of the total DALY. The first three provinces with highest DALYs were Shandong (1990: 12 574.67 life year; 2016: 22 728.12 life year), Henan (1990: 10 849.29 life year; 2016: 18 454.32 life year) and Jiangsu (1990: 10 501.55 life year; 2016: 18 274.10 life year), while the three provinces with leading standardized DALY rates were Heilongjiang (1990: 48.20/100 000; 2016: 47.00/100 000), Shanxi (1990: 44.50/100 000; 2016: 47.70/100 000) and Tianjin (1990: 43.80/100 000; 2016: 46.40/100 000) in both 1990 and 2016. Compared with 1990, the number of cases with uterine fibroids increased by 13 473 745 (with rate of change as: 98.38%), standardized prevalence rate increased by 1.88%, DALY value increased by 135 931.62 life years (with the rate of change as 93.08%) and standardized DALY rate increased by 5.92% among Chinese women, in 2016. Conclusion: Menopausal women were the ones hard hit by uterine fibrosis. Compared with data from 1990, the disease burden of uterine fibrosis increased rapidly in China, in 2016.
Adolescent ; Adult ; Asian People/statistics & numerical data* ; China/epidemiology* ; Cost of Illness ; Disabled Persons ; Female ; Humans ; Leiomyoma/psychology* ; Middle Aged ; Quality-Adjusted Life Years ; Young Adult

The prevalence of child and adolescent growth and mental-behavior related diseases are increasing, and the pathogenesis are complex. Twins are excellent natural resources for complex chronic diseases research as they share the maternal intrauterine environment, born at the same time and share the same family environment in early years, which could benefit the adjust ment of confounding factors, such as age, genetic factors and early family environmental factors. Birth cohort with twin families involved could be more effective in exploring the genetic and environmental factors for complex chronic diseases at the very beginning of life. This paper summarizes the objective, content, progress, strengths and potential problems of Wuhan Twin Birth Cohort, with emphasis on the overall design and progress of the study.
Adolescent ; Asian People ; Birth Weight ; Child ; China ; Cohort Studies ; Diseases in Twins/genetics* ; Epidemiological Monitoring ; Female ; Humans ; Male ; Twin Studies as Topic ; Twins

OBJECTIVE: To investigate how bracket slot size affects the direction of maxillary anterior tooth movement when en-masse retraction is performed in sliding mechanics using an induction-heating typodont simulation system. METHODS: An induction-heating typodont simulation system was designed based on the Calorific Machine system. The typodont included metal anterior and resin posterior teeth embedded in a sticky wax arch. Three bracket slot groups (0.018, 0.020, and 0.022 inch [in]) were tested. A retraction force of 250 g was applied in the posterior-superior direction. RESULTS: In the anteroposterior direction, the cusp tip of the canine in the 0.020-in slot group moved more distally than in the 0.018-in slot group. In the vertical direction, all six anterior teeth were intruded in the 0.018-in slot group and extruded in the 0.020- and 0.022-in slot groups. The lateral incisor was significantly extruded in the 0.020- and 0.022-in slot groups. Significant differences in the crown linguoversion were found between the 0.018- and 0.020-in slot groups and 0.018- and 0.022-in slot groups for the central incisor and between the 0.018- and 0.022-in slot groups and 0.020- and 0.022-in slot groups for the canine. In the 0.018-in slot group, all anterior teeth showed crown mesial angulation. Significant differences were found between the 0.018- and 0.022-in slot groups for the lateral incisor and between the 0.018- and 0.020-in slot groups and 0.018- and 0.022-in slot groups for the canine. CONCLUSIONS: Use of 0.018-in slot brackets was effective for preventing extrusion and crown linguoversion of anterior teeth in sliding mechanics.
Crowns ; Incisor ; Mechanics ; Tooth Movement ; Tooth*