Unicompartmental knee arthroplasty is associated with lower proportions of surgical site infection compared with total knee arthroplasty: A retrospective nationwide database study

BackgroundThis study aimed to clarify the association between types of knee arthroplasty (KA) (total knee arthroplasty (TKA) or unicompatmental knee arthroplasty (UKA)) and surgical site infection (SSI) with adjustment for various factors, using a Japanese national database.MethodsData on 181,608 patients who underwent unilateral primary KA for osteoarthritis from 2010 to 2017 were obtained from the Japanese Diagnosis Procedure Combination database. SSI was identified based on International Classification of Diseases 10th Revision codes. Deep SSI (i.e. periprosthetic joint infection (PJI)) was identified as SSI treated with surgical procedures. Multivariable logistic regression analyses for SSI and PJI were performed, in which dependent variables included types of KA, patient backgrounds (sex, age, body mass index (BMI), smoking status, comorbidities), and seasonality.ResultsEight percent of analyzed patients underwent UKA, while 92% underwent TKA. The proportions of SSI and PJI after UKA were 0.9% and 0.3%, respectively, both of which were lower than those after TKA (1.9% and 0.6%) (P < 0.001). Multivariable analyses showed lower proportions of SSI for UKA (adjusted odds ratio, 0.47; 95% confidence interval, 0.37–0.60; P < 0.001) and PJI (adjusted odds ratio, 0.47; 95% confidence interval, 0.34–0.65; P < 0.001) than TKA. Other factors associated with both SSI and PJI included male sex, BMI >30 kg/m², renal dysfunction and summer season.ConclusionUKA was associated with lower proportions of SSI and PJI than TKA. Surgeons should carefully consider the indication of UKA before performing TKA, especially in patients with knee unicompartmental osteoarthritis who are at a high risk for SSI or PJI.     

食管鳞癌患者远处转移部位与预后的相关性及生存分析

目的:探讨食管鳞癌患者远处转移部位与预后的相关性及生存分析。方法:从SEER数据库中提取2010年至2015年共439例食管鳞癌伴远处转移患者的临床资料，回顾性分析比较食管鳞癌远处转移部位与预后的相关性，通过χ2检验比较两组变量的差异，采用Kaplan-Meier法绘制生存曲线，Log-rank检验进行单因素分析，COX回归进行多因素分析。结果:肺转移、骨+肺转移、肝+肺转移患者预后较好；骨转移、脑转移、骨+脑转移、骨+脑+肝+肺转移患者预后较差。单因素分析显示:年龄、原发灶部位、T分期、手术情况、多器官转移情况与食管鳞癌远处转移患者的预后有关（P＜0.05）；多因素分析显示:年龄、手术情况与多器官转移情况是影响食管鳞癌远处转移患者总生存时间（OS）的独立危险因素。结论:食管鳞癌伴远处转移的患者整体预后较差，但年龄在60~69岁区间、接受手术治疗与较好的预后相关。仅单器官转移的食管鳞癌患者中，骨转移、脑转移患者预后较差；合并多器官转移的患者中，骨+脑转移、骨+脑+肝+肺转移患者预后较差。     

Meaningful word acquisition is associated with walking ability over 10 years in Rett syndrome

PurposeTo investigate walking ability in Japanese patients with Rett syndrome (RTT).MethodsWalking ability was assessed in 100 female Japanese patients with RTT using univariate and multivariate analysis in all age groups, and in patients over 10 years of age. We analyzed walking ability and confounding factors including prenatal-perinatal histories, developmental milestones, somatic and head growth, anthropometric data, body mass index, age of loss of purposeful hand use, age at onset of stereotypic hand movement, history of autistic behavior, age at regression, presence or absence of seizures, and the results of MECP2 genetic examination from the Japanese Rett syndrome database.ResultsUnivariate analysis revealed that acquisition of walking in all age groups was significantly correlated with the acquisition of meaningful words, microcephaly, and crawling (P < 0.0001, P = 0.005, P < 0.0001, respectively). Univariate analysis revealed that walking ability over 10 years of age was significantly correlated with acquisition of meaningful words, microcephaly, and body mass index (P < 0,0001, P = 0.005, P = 0.0018, respectively). MECP2 mutations R306C, R133C, and R294X were significantly associated with different acquisition of crawling (P = 0.004) and walking (P = 0.01). Multivariate analysis revealed that only acquisition of meaningful words was significantly correlated with walking ability over 10 years of age. This trend excluded the genetic effects of R306C, R133C, and R294X.ConclusionsMeaningful word acquisition was robustly associated with walking ability over 10 years. Prognosis of walking ability may be predicted by the acquisition of meaningful words. This information is potentially useful for early intervention and the planning of comprehensive treatment for young children with RTT.     

建立下肢形态学数据库为匹配术后即装假肢提供参考

文题释义： 术后假肢：现代截肢康复的方法包括手术后安装临时假体，即在完成截肢手术后，医生为患者佩戴合适的临时假体。 大腿影像数据：研究采集的大腿数据包括膝上缘周径、膝上缘5 cm处周径、膝上缘10 cm处周径和膝上缘15 cm处周径，将大腿MRI数据导入3D重建软件，得到大腿截肢范围段表面积、体积。 大腿截肢范围段：为膝关节间隙上10-25 cm。 背景：目前假肢的制作是通过取型、修型、成型3个步骤完成的，由于修型过程是人工完成，与临床技师的经验技术密切相关，制作出来的假肢不美观，接受腔与残肢很难做到全接触。 目的：收集健康志愿者大腿MRI影像数据，评估成人大腿截肢范围段(膝关节间隙上10-25 cm)的对称性；将MRI影像数据建立成数据库，为下肢截肢患者匹配合适的术后即装假肢提供参考数据。 方法：招募40名健康志愿者，采集基本信息：年龄、身高、体质量、膝上缘周径、膝上缘5 cm处周径、膝上缘10 cm处周径和膝上缘15 cm处周径。所有志愿者对试验方案均知情同意，且得到医院伦理委员会批准。对大腿截肢范围进行三维重建，以模型的表面积、体积为参数，对每一例志愿者大腿进行解剖测量，利用三维逆向工程软件对测量结果进行3D偏差分析，完成大腿形态对称性的定量化和可视化分析。 结果与结论：①同体分析：同一个体左右大腿截肢范围段表面积之间的最大百分差异比不超过0.56%(P=0.109)；左右大腿截肢范围段体积之间最大百分差异比不超过1.19%(P=0.182)；三维偏差分析结果显示，最大平均负偏差为-1.47 mm，最大平均正偏差为1.14 mm。40例受试者的3D偏差分布78.02%在2 mm以内，20.97%在2.1-3.0 mm，仅1.01%大于3 mm。②异体分析：三维偏差分析结果显示，最大平均负偏差为-1.97 mm，而最大平均正偏差为1.89 mm。③提示成人双侧大腿截肢范围具有高度的解剖学对称性；当2名成人的膝上缘周径、膝上缘5 cm处周径、膝上缘10 cm周径和膝上缘15 cm处周径分别都相差在2 cm以内时，则认为这2名成人双侧大腿截肢范围段表面轮廓具有高度相似性，与性别、身高和体质量无关。 ORCID: 0000-0001-6838-3042(伍笑棋) 中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程     

药学知识库发展与建设

介绍药学知识库内涵，分析建立药学知识库的必要性、意义、发展情况，从数据来源、模型构建、设计要点及应用几方面阐述其构建方法，提出未来发展方向。     

Development of a food composition database to study complementary feeding: An Italian experience

Food Composition Databases (FCDBs) are important tools for epidemiological research, public health nutrition and education, clinical practice and nutrition declaration on food labels. The aim of this paper is to describe the methodology used to compile a FCDB for the analysis on the dietary intake of an Italian cohort of infants, and to assess its strengths and weaknesses. Dietary data were collected using a 3-DD records compiled at 6, 9 and 12 months of age of the infants. We developed a FCDB that contains data from the Italian and the USDA food composition databases and other sources. Our FCDB includes 563 food derived from the analysis of 623 3-DD records. Non-commercial products are more consumed than commercial products (25.5% vs. 9.1% at 6 months, 58.4% vs. 18.1% at 9 months and 77.8% vs. 11.3% at 12 months) but the latter are the main source of missing data (>70% in each database, with the exception of the energy components), which is one of the major weaknesses of this tool. An integrated system of data collection (NUTRIRETE.lab) that brings together food composition data from public and private laboratories will allow us to build a more complete and representative food composition database.     

本草纲目药物警戒数据库设计与应用研究

目的:为深入分析研究本草纲目中的药物警戒思想提供新方法。方法:基于本草纲目金陵本文献著作设计了药物警戒数据库,阐述了数据库建立的要求和存储模型的选取,以及数据库的概念和逻辑设计。结果:在此数据库的基础上可建立知识发现系统,应用数据挖掘算法,对本草纲目中的药物警戒思想进行分析。结论:本草纲目药物警戒思想数据库的建立可以为深入研究药物警戒思想提供方便、准确的手段,此方法也可应用于其他文献著作研究。     

基于HMMR在肺腺癌组织中表达水平及其对LUAD患者预后影响的生物信息学分析

探讨透明质酸介导的细胞游走受体 （HMMR） 在肺腺癌 （LUAD） 组织中的表达及其对LUAD患者预后的影响，阐明HMMR在LUAD发生发展中的作用。     

基于UPLC-Q-TOF-MSn的化妆品中40种性激素非法添加分析方法及筛查数据库的建立

目的 建立基于UPLC-Q-TOF-MSⁿ的化妆品中40种性激素非法添加分析方法及筛查数据库。方法 色谱柱为Agilent SB-C₁₈(2.1 mm×50 mm，1.8 μm)，正离子模式以0.1%甲酸水溶液-乙腈为流动相，负离子模式以水-乙腈为流动相，梯度洗脱，流速0.2 mL·min^-1，柱温35 ℃；采用电喷雾电离源(ESI)，采集模式为Scan MS及Targeted MS/MS，将40种性激素的精确质量数、保留时间、二级质谱图导入PCDL软件建立筛查数据库。结果 采用所建立的数据库方法快速筛查100批化妆品，1批育发类产品检出少量黄体酮。结论 本研究所建立的40种性激素分析方法和筛查数据库具有简便、快速、灵敏和准确的特点，适合化妆品中非法添加性激素的高通量筛查和准确定性。