The biomechanical effects of graded upper articular process arthroplasty on lumbar spine: A finite element study

BackgroundSuperior articular process arthroplasty is important for intervertebral foramen microscopy but may lead to spinal instability. Currently, there has been no relevant study in relation to the biomechanical analysis of superior articular process arthroplasty. Hence, this study is intended to verify biomechanical effects after unilateral S1 superior articular process arthroplasty.MethodsEight finite element (FE) models of lumbosacral vertebrae (L4-S) were constructed, and the superior articular process formation was simulated with the help of Geomagic studio. Then, the models were imported into Nastran software after optimization. Normal load and appropriate torque were applied to simulate forward flexion, back extension, lateral flexion and lateral rotation. In the end, changes of lumbar range of motion (ROM) and structural stress were compared with those of normal model.ResultsCompared with the normal model, formed from ventral to dorsal (Longitudinal), the larger motion of lumbar spine and the greater larger stress of articular process showed statistical significance (P < 0.05) in most of directions when the forming range was greater than 3/5. Formed from the apex to the base (transverse), the larger motion of lumbar spine and the greater stress of articular process showed statistical significance (P < 0.05) in most of directions when the forming range was great than 1/5.ConclusionWhen conducting unilateral S1 articular process arthroplasty from ventral to dorsal, the forming range is recommended to be less than 3/5 of the superior articular process. Notably, it is not advisable to form from the apex to the base.     

同性交友方式对男男性行为人群高危性行为及感染HIV的相关影响

目的 了解同性交友方式对MSM的高危性行为及HIV感染的相关影响。方法 采用横断面调查方法,2018年4-11月在宁波市采用滚雪球的非概率抽样法招募MSM,收集其人口学特征、交友方式、同性社交软件使用、高危性行为发生情况等相关信息,研究对象均需进行HIV抗体检测。分类资料采用χ²检验,采用多因素logistic回归分析MSM的HIV感染相关因素。结果 共调查MSM 735人,同性社交软件交友者、QQ或微信交友者和场所交友者分别为447人（60.8%）、237人（32.3%）和51人（6.9%）。同性社交软件交友者最近6个月性行为次数≥ 1次/周和发生多性伴的分别有75人（16.8%）和187人（41.8%）;最近1次和最近6个月发生无保护肛交行为的分别有54人（12.1%）和234人（52.3%）;HIV感染率为12.1%（54/447）。感染时间<2年的HIV/AIDS中,同性社交软件使用时间<2年的比例为68.6%（24/35）。多因素logistic回归分析结果显示,与QQ或微信交友者比较,同性社交软件交友者更易感染HIV（OR=3.03,95% CI：1.30~7.07）。结论 宁波市MSM中,同性社交软件交友者比例较高,存在较高危险性行为和HIV感染风险。应针对同性社交软件交友者加强监测和干预。     

Induction of apoptosis in human cervical carcinoma HeLa cells by polymethoxylated flavone-rich Citrus grandis Osbeck (Dangyuja) leaf extract

Citrus grandis Osbeck (Dangyuja) has a high content of flavonoids with health-related properties. Although previous data have revealed the anticancer potency of some Citrus species, the underlying molecular mechanisms of this activity by leaf extracts have not been studied in detail. The purpose of this study was to evaluate the cytotoxic effects of citrus leaves on five human cancer cell lines and to determine the possible mechanisms of cell death elicited by the chloroform fraction (CF) of the Dangyuja leaf. The CF of Dangyuja strongly decreased the survival rate of HeLa cells, among the tested cell lines. CF treatment induced the down-regulation of anti-apoptotic Bcl-2 expression, resulting in the proteolytic activation of caspases and the degradation of poly (ADP–ribose) polymerase (PARP) protein. Arrested cell growth and induction of apoptosis were confirmed by flow cytometry and DNA fragmentation analysis, respectively. The major components of the CF were identified as isosinensetin, sinensetin, tetramethyl-O-isoscutellarein, nobiletin, tangeretin, and 5-hydroxy-6,7,8,3′,4′-pentamethoxyflavone by liquid chromatography–electrospray ionization tandem mass spectrometry (LC–ESI–MS/MS). Our results suggest that the CF of Dangyuja leaves is an excellent source of functional polymethoxylated flavones, which may help prevent cervical cancer and may potentially be a useful agent for the treatment of certain malignancies.     

Clinical application of intraoperative O-arm navigation in reverse shoulder arthroplasty

BackgroundInaccurate fixation and positioning of the glenoid component using conventional techniques are problematic in reversed shoulder arthroplasty (RSA). Our objective was to investigate the accuracy of O-arm navigation of the glenoid component in RSA.MethodsThis retrospective case–control study comprised 2 groups of 25 patients who underwent reversed shoulder arthroplasty with or without intraoperative O-arm navigation. The intraoperative goal was to place the component neutrally in the glenoid in the axial plane and 10° inferiorly tilted in the scapular plane. Glenoid version angle and inclination were measured by computed tomography obtained preoperatively and a year postoperatively. Operative time, intraoperative bleeding, and the presence of postoperative complications were recorded.ResultsCompared with the ideal, the range of error for version was 7.3° (SD 3.6°) in the control group and 5.6° (SD 3.6°) in the navigated group (P = 0.278), and the range of error for inclination was 18.3° (SD 11.7°) in the control group and 4.9° (SD 3.8°) in the navigated group (P = 0.0004). The mean operative time was 164.6 (SD 21.2) min in the control group and 192.0 (SD 16.2) min in the navigated group (P = 0.001). The mean intraoperative bleeding was 201.0 (SD 37.0) mL in the control group and 185.3 (SD 35.6) mL in the navigated group (P = 0.300). There were no complications reported related to the intraoperative O-arm navigation.ConclusionO-arm navigation may be a useful tool for the placement with inferior tilt of the glenoid procedure in reversed shoulder arthroplasty.     

Revisability of polyetheretherketone suture anchors utilised in primary and revision Bankart repair

BackgroundPolyetheretherketone (PEEK) suture anchors are frequently used in Bankart shoulder stabilisation. This study analyzed the primary stability and revisability of PEEK anchors in-vitro in case of primary Bankart repair and revision Bankart repair after failed primary repair.MethodsTo simulate primary Bankart repair, 12 anchors (Arthrex PEEK PushLock® 3.5 mm) were implanted in 1, 3, 5, 7, 9 and 11 o'clock positions in cadaveric human glenoids and then cyclically tested. To simulate revision Bankart repair, 12 anchors were implanted in the same manner, over-drilled and 12 new anchors of the same diameter were implanted into the same bone socket as the primary anchors and then cyclically tested. The maximum failure loads (F_max), system displacements, force at clinical failure and modes of failure were recorded.ResultsOne primary anchor failed prematurely due to a technical problem. Three out of 12 revision anchors (25%) dislocated while setting the 25 N preload. The F_max, the displacement and clinical failure of the remaining 9 revision anchors were non-significant when compared to the 11 primary repair anchors. The main mode of failure in the primary and revision Bankart surgery group was suture slippage. Anchor dislocations were observed four times in the primary and once in the revision repair groups.ConclusionsRevision Bankart repair using PEEK anchors of the same diameter in a pre-existing bone socket is possible but bears high risk of premature anchor failure and can jeopardize the reconstruction. PEEK suture anchor in revision Bankart surgery should be implanted in a new bone socket if possible.     

High-performance liquid chromatographic mapping of the oligosaccharides released from the humanised immunoglobulin,CAMPATH ™1H

A sensitive and reproducible method for the routine mapping of oligosaccharides in a humanised immunoglobulin (IgG) is described.The method involves the enzymic release of intact glycans using the endoglycosidase glycopeptidase-F, and subsequent derivatisation with 1-phenyl-3-methyl-5-pyrazolone to facilitate analysis by high-performance liquid chromatography (HPLC). The heterogeneous oligosaccharide chains are separated by a phosphate buffer-acetonitrile gradient reversed-phase HPLC method and monitored by ultraviolet detection at 245 nm, allowing the detection of picomole amounts. A number of standard oligosaccharides are similarly derivatised to enable classification of the types of structures present from a comparison of retention times.     

单孔腹腔镜下应用硬膜外穿刺针治疗小儿腹股沟斜疝682例

目的探讨经脐单孔腹腔镜下应用硬膜外穿刺针联合行疝囊高位结扎治疗小儿腹股沟斜疝的应用价值。 方法回顾分析2016年2月至2018年7月,安徽阜阳疝病专科医院利用硬膜外穿刺针在单孔腹腔镜下治疗腹股沟疝682例患儿的临床疗效。 结果682例患儿手术均在单孔腹腔镜下顺利完成,无精索血管或输精管损伤。手术时间：单侧5～12 min,平均8.5 min;双侧10～24 min,平均17 min。术中发现并同时处理对侧隐匿性斜疝75例（13.09%）。术中出血量为0.5～2 ml,平均1 ml。患儿麻醉完全清醒后恢复饮食,并可下床活动。所有患儿均在术后次日上午办理出院。术后及随访期间均未发现并发症及复发病例。 结论应用硬膜外穿刺针行单孔法腹腔镜高位结扎疝囊治疗小儿斜疝初步结果显示安全有效,操作简便,而且具有创伤小,术后恢复快、不留瘢痕等优点,值得临床开展及推广应用。     

Pseudoaneurysm as a rare complication in the treatment of superior mesenteric artery embolism via percutaneous mechanical thrombectomy: a case report

Percutaneous mechanical thrombectomy is a safe and effective treatment for addressing thrombosis in various embolic diseases. In recent years, this approach has also been actively applied in the management of acute embolic occlusion of the superior mesenteric artery. A pseudoaneurysm as a complication of this operation is remarkably rare. This is the first case report of the diagnosis and treatment of a pseudoaneurysm that developed as a complication after the application of percutaneous mechanical thrombectomy via an AngioJet device for thrombolysis in the superior mesenteric artery.     

预防性使用盐酸西替利嗪治疗PD-1抑制剂所致斑丘疹的多中心随机对照研究

目的 探讨盐酸西替利嗪片预防性治疗PD-1抑制剂所致常见斑丘疹的临床疗效。方法 选择2020年7月—2021年12月于深圳大学第三附属医院、中国科学院大学宁波华美医院和丽水市中心医院收治的60例适合PD-1抑制剂治疗的肿瘤患者。随机分为预防用药组和治疗用药组,每组各30例。预防用药组在给予PD-1抑制剂治疗的当天同步口服盐酸西替利嗪片,每晚10mg/次,每疗程连续7d,7d内未出现斑丘疹则停止使用,如在预防用药期间出现斑丘疹,则继续口服直到斑丘疹好转停药。治疗用药组使用PD-1抑制剂治疗期间出现1级或以上级斑丘疹,则开始口服盐酸西替利嗪片,每晚10mg/次,每疗程使用的时间为出现1级或以上级斑丘疹开始口服盐酸西替利嗪片至斑丘疹级别小于1级的用药天数,观察4个疗程。比较治疗前后两组患者斑丘疹发生情况,斑丘疹发生后服用盐酸西替利嗪片天数,不同PD-1抑制剂斑丘疹发生情况。结果 治疗后,盐酸西替利嗪片预防用药组斑丘疹发生率（6.7%）显著低于治疗用药组发生率（26.7%,P＜0.05）。斑丘疹发生后,预防用药组较治疗用药组用药天数减少（P＜0.05）。使用同种PD-1抑制剂中,预防用药组斑丘疹发生率明显低于治疗用药组（P＜0.05）。结论 预防性使用盐酸西替利嗪片对PD-1抑制剂所致常见斑丘疹具有较好的预防作用,能显著降低斑丘疹发生率及斑丘疹发生后盐酸西替利嗪片的用药天数。