机器人辅助与传统人工全髋关节置换术后下肢长度差异的Meta分析

目的系统评价机器人辅助与传统人工全髋关节置换术（total hip arthroplasty，THA）术后下肢长度差异（leg length discrepancy，LLD）。方法计算机检索The Cochrane Library、PubMed、Web of Science、EMbase、CNKI、万方、维普、CBM数据库，搜集机器人辅助与传统THA比较的队列研究，检索时限均从建库至2021年8月11日。由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后，使用RevMan 5.3软件进行Meta分析。结果共纳入10个高质量队列研究。Meta分析结果表明：与传统THA相比，机器人辅助THA术后LLD更小 ［MD=−1.64，95%CI（−2.25，−1.04），P<0.001］，术后3、12个月Harris评分更高 ［MD=1.50，95%CI（0.44，2.57），P=0.006；MD=7.60，95%CI（2.51，12.68），P=0.003］；但手术时间更长 ［MD=8.36，95%CI（4.56，12.17），P<0.000 1］，术后髋臼前倾角更大 ［MD=1.91，95%CI（1.43，2.40），P<0.001］。两组术后6个月Harris评分、关节遗忘度评分（FJS）以及术后髋臼外展角、并发症发生率差异无统计学意义（P>0.05）。 结论机器人辅助THA在术后LLD方面优于传统THA。     

异氟醚和卡托普利联合预处理对兔心肌缺血-再灌注细胞超微结构的影响

目的观察异氟醚、卡托普利联合预处理对兔心肌缺血-再灌注心肌细胞超微结构的作用。方法新西兰大白兔48只,随机均分为六组:假手术组(S组)、单纯缺血-再灌注组(IR组)、缺血预处理组(IPC组)、异氟醚组(I组)、卡托普利组(C组)和异氟醚、卡托普利联合预处理组(IC组)。采用结扎冠状动脉左前降支法制备兔心肌缺血-再灌注模型。观察各组心肌细胞超微结构变化。结果 IPC组心肌细胞损伤轻于IR组,IC组损伤最轻。结论异氟醚、卡托普利联合预处理对缺血-再灌注兔心肌细胞超微结构有更好的保护作用。     

综合医院口腔科“四期”临床教学模式探讨

目的探讨综合医院口腔科实习学生的临床教学方法。方法采用＂四期＂临床教学模式：学生经过技术培训期、临床前见习期、临床操作期和操作后总结期来完成整个实习过程。结果 ＂四期＂临床教学模式可以增加学生临床＂上手＂的机会;使学生掌握目前最新的＂四手操作＂技术;有利于提高学生的临床应变能力;尽快进入临床工作状态。结论 ＂四期＂临床教学模式是综合医院口腔科实习学生较好的临床教学方法。     

The effect of age on elbow range of motion in pitchers

BackgroundAlteration of elbow range of motion (ROM) has been observed in baseball pitchers. This study aims to compare dominant elbow ROM between early-puberty, late-puberty, and young–adult pitchers.MethodsWe recruited 62 pitchers, consisting of 17 early-puberty (mean age 13.1 years old), 22 late-puberty (mean age 17.7 years old), and 23 young–adult players (mean age 19.4 years old). Dominant elbow ROMs was measured. One-way ANOVA was used to compare the differences in elbow ROM variables between 3 groups.ResultsLate-puberty pitchers exhibited a significantly lower elbow hyperextension and flexion than early-puberty or young–adult pitchers (P < .05). Valgus angle was significantly lower in young–adult (7.7°±5.5°) versus early-puberty (12.1°±2.3°) and late-puberty pitchers (13.0°±4.1°; P < .05). Young–adult pitchers had the largest forearm supination range (101.2°±18.1°), followed by early-puberty (82.5°±6.5°; P < .05) and late-puberty pitchers (70.6°±15.8°). Elbow flexion-hyperextension total range was smallest in late-puberty pitchers (130.3°±7.4°), followed by young–adult (142.6°±9.3°) and early-puberty pitchers (144.6°±8.3°; P < .05). Forearm pronation–supination total range was also smallest in late-puberty pitchers (142.0°±20.3°), followed by early-puberty (159.8°±9.5°) and young–adult pitchers (177.2°±20.8°; P < .05).ConclusionsThese results indicate that careful monitoring of the elbow and forearm range of motion should be undertaken in adolescent baseball pitchers to prevent and or minimize injury risk.     

缝隙连接蛋白与前列腺癌的相关性研究

缝隙连接蛋白被认为是一种抑癌基因,在众多肿瘤的的发生、生长、侵袭及转移过程中有重要意义。通过其介导的细胞缝隙连接通讯和缝隙连接蛋白本身的独立作用两条途径对肿瘤产生抑制作用,同时降低癌细胞对抗肿瘤药物的抵抗性,降低肿瘤细胞的迁徙和侵袭力。现就缝隙连接蛋白在前列腺癌方面的研究进展作一综述。     

Differential influence of selective 5-HT5A vs 5-HT1A, 5-HT1B,or 5-HT2C receptor blockade upon light-induced phase shifts in circadian activity rhythms: Interaction studies with citalopram

Though serotonergic mechanisms modulate circadian rhythms, roles of individual serotonin (5-HT) receptors remain uncertain since data are lacking for antagonists. Herein, both the 5-HT_5A receptor antagonist, A843277 (10 mg/kg), and the 5-HT_1B antagonist, SB224289 (1 mg/kg), inhibited light-induced phase advances in hamster circadian wheel-running rhythms. Conversely, though 5-HT_1A and 5-HT₇ receptors are likewise implicated in circadian scheduling, their blockade by WAY100635 (0.5 mg/kg) and SB269970 (1 mg/kg), respectively, was ineffective. Since actions of 5-HT reuptake inhibitors are modified by antagonists, we evaluated their influence on suppression of phase advances by citalopram (10 mg/kg). Its action was potentiated by WAY100635 and the 5-HT_2C antagonist, SB242084 (1 mg/kg), but not by A842377, SB224289, SB269970, and antagonists at 5-HT_2A (MDL100907) and 5-HT₆ (SB399885) receptors. In conclusion, this is the first in vivo evidence for an influence of 5-HT_5A receptors upon circadian rhythms, but no single class of 5-HT receptor mediates their control by citalopram.     

Comparison of efficacy of conbercept, aflibercept, and ranibizumab ophthalmic injection in the treatment of macular edema caused by retinal vein occlusion: a Meta-analysis

AIM: To evaluate and compare the anatomical and functional outcomes and negative effects of the three anti-vascular endothelial growth factor (VEGF) drugs in the treatment of macular edema (ME) due to retinal vein occlusion (RVO) based on the evidence pooled from current clinical trials and observational studies. METHODS: A systematic literature search was conducted on nine online databases from inception until April 30, 2022. The main endpoints were best corrected visual acuity (BCVA), central macular thickness (CMT), and adverse events (AEs). Cumulative Meta-analysis was conducted to synthesize the outcomes of the drugs. The retrieved data were analyzed using Stata software (version 12.0). RESULTS: A total of 20 studies comprising 1674 eyes met the inclusion criteria to the Meta-analysis. It was observed that conbercept and aflibercept had better visual acuity effects compared with ranibizumab at 1mo [weight mean difference (WMD)=-0.03, P=0.001; WMD=-0.05, P=0.019], but the effects were not different from that of ranibizumab at 6mo. Moreover, there was not statistically significant difference in the proportion of patients gaining ≥15 letters at 12-24mo between aflibercept and ranibizumab [odds ratio (OR)=1.16, P=0.427]. Conbercept had higher mean CMT change effects at 1mo (WMD= -14.43, P=0.014) and 6mo (WMD=-35.63, P≤0.001) compared with ranibizumab. Meanwhile, the mean CMT change effects at 1mo (WMD=-10.14, P=0.170), 6mo (WMD=-26.98, P=0.140) and 12-24mo (WMD=-12.34, P=0.071) were comparable among the groups. Similarly, AEs were not significantly different among the treatments (OR=0.75, P=0.305; OR=1.04, P=0.89). The stability of effect size of mean BCVA and CMT improved with the increase in sample size. Aflibercept and conbercept required fewer injections compared with ranibizumab. CONCLUSION: This is the first study to evaluate the efficacy and AEs of intravitreal administration of conbercept, ranibizumab, and aflibercept in the treatment of RVO-ME. Intravitreal aflibercept or conbercept results in better mean change in vision and CMT reduction compared with ranibizumab. Conbercept can be considered to be a promising and innovative drug with good anti-VEGF effects.     

Formin-like 2 promotes angiogenesis and metastasis of colorectal cancer by regulating the EGFL6/CKAP4/ERK axis

Increasing evidence indicates that angiogenesis plays a pivotal role in tumor progression. Formin-like 2 (FMNL2) is well-known for promoting metastasis; however, the molecular mechanisms by which FMNL2 promotes angiogenesis in colorectal cancer (CRC) remain unclear. Here, we found that FMNL2 promotes angiogenesis and metastasis of CRC in vitro and in vivo. The GDB/FH3 domain of FMNL2 directly interacts with epidermal growth factor-like protein 6 (EGFL6). Formin-like 2 promotes EGFL6 paracrine signaling by exosomes to regulate angiogenesis in CRC. Cytoskeleton associated protein 4 (CKAP4) is a downstream target of EGFL6 and is involved in CRC angiogenesis. Epidermal growth factor-like protein 6 binds to the N-terminus of CKAP4 to promote the migration of HUVECs by activating the ERK/MMP pathway. These findings suggest that FMNL2 promotes the migration of HUVECs and enhances angiogenesis and tumorigenesis in CRC by regulating the EGFL6/CKAP4/ERK axis. Therefore, the EGFL6/CKAP4/ERK axis could be a candidate therapeutic target for CRC treatment.