Articular cartilage repair & joint preservation: A review of the current status of biological approach

The articular cartilage of the joint is the thin viscoelastic layer of the connective tissue. It has a unique anatomy and physiology, which makes the repair of the articular cartilage damage more difficult and challenging due to its limited healing capacity. Increasing knowledge regarding the importance of articular cartilage for joint preservation has led to increased attention on early identification of cartilage damage as well as degeneration in order to delay osteoarthritis. There are various treatment modalities ranging from preventive management, physical therapy, pharmacological, non-pharmacological and surgical treatments exist in current literature. However most of the studies have limited long term follow up and mainly consists of small case series and case reports. This is an up to date concise review discussing the available management options for articular cartilage damage starting to lifestyle modification to pharmacotherapy, physiotherapy, and osteobiologics till various joint preservation techniques that have been in use currently.     

Early axonal loss predicts long-term disability in chronic inflammatory demyelinating polyneuropathy

ObjectiveTo investigate early pre-treatment nerve fiber loss as a predictor of long-term clinical outcome in chronic inflammatory demyelinating polyneuropathy (CIDP).MethodsIn 14 patients, motor and sensory conduction studies of the median, fibular, and sural nerves were performed at pre-treatment and follow-up 11–28 years later. Z-scores of amplitudes were combined as biomarkers of axonal loss and Z-scores of conduction properties as demyelination scores. The axonal loss was further examined by electromyography (EMG) and motor unit number estimation. Axonal and demyelination scores were compared to clinical outcomes in the Inflammatory Rasch-built Overall Disability Scale, the Neuropathy Impairment Score, and dynamometry.ResultsAt follow-up 12 patients walked independently, one needed support and one could not walk. The initial and follow-up axonal and demyelination scores were markedly abnormal. The initial axonal loss but not demyelination was strongly associated with both the follow-up axonal loss and the clinical measures. Moreover, delay of treatment initiation negatively influenced the axonal scores and clinical outcomes.ConclusionIn this hypothesis generating limited study, we found that axonal loss at early CIDP was highly predictive for long-term nerve fiber loss and disability.SignificanceThe study indicates that prompt initiation of treatment to prevent nerve fiber loss is necessary for outcome in CIDP.     

牙拔除术新技巧

随着口腔外科器械的发展与技术的进步，牙拔除术的治疗理念已逐渐向标准化、规范化、舒适化和人性化过渡，除普及规范、标准的手术技术外，在牙拔除术中如何选择合适的手术方法、掌握正确的拔牙技巧与原理是牙拔除术得以安全、微创、高效进行的保证，也为牙槽骨功能性保存与修复重建提供良好的条件与基础。文章就牙拔除术相关的新技巧做一介绍。     

Background rates of all-cause mortality,hospitalizations, and emergency department visits among nursing home residents in Ontario,Canada to inform COVID-19 vaccine safety assessments

BackgroundNursing home (NH) residents are prioritized for COVID-19 vaccination. We report monthly mortality, hospitalizations, and emergency department (ED) visit incidence rates (IRs) during 2010–2020 to provide context for COVID-19 vaccine safety assessments.MethodsWe observed outcomes among all NH residents in Ontario using administrative databases. IRs were calculated by month, sex, and age group. Comparisons between months were assessed using one-sample t-tests; comparisons by age and sex were assessed using chi-squared tests.ResultsFrom 2010 to 2019, there were 83,453 (SD: 652.4) NH residents per month, with an average of 2.3 (SD: 0.28) deaths, 3.1 (SD: 0.16) hospitalizations, and 3.6 (SD: 0.17) ED visits per 100 residents per month. From March to December 2020, mortality IRs were increased, but hospitalization and ED visit IRs were reduced (p < 0.05).ConclusionWe identified consistent monthly mortality, hospitalization, and ED visit IRs during 2010–2019. Marked differences in these rates were observed during 2020, coinciding with the COVID-19 pandemic.     

MCI的情志病机及疏肝法干预的可行性探讨＊

轻度认知障碍（Mild cognition impairment， MCI）是尚未达到阿尔兹海默病（Alzheimer’s disease， AD）的诊断标准且可逆转为正常脑老化状态的最佳窗口期。情志异常、肝失疏泄（肝失疏泄日久致肝郁）已被证实为MCI的重要情志病机，且“长期负性情绪积累肝失疏泄致衰加速脑老化”的科学假说已在本课题组前期研究中得到初步证实，疏肝法干预肝郁型MCI患者疗效显著，但以上作用机制尚未得到完全阐述。因此本研究系统总结了中医学对MCI的认识，长期情绪不调肝失疏泄对MCI的影响及可能机制，疏肝解郁方药及其成分改善肝郁型MCI的可行性，并提出使用无束缚性设计的眼动技术以探索疏肝法改善肝郁型MCI的可行性，为MCI的中医药干预及其神经机制探讨提供新思路，为中医情志衰老学说增添新内涵。     

Multidisciplinary management of early rectal cancer – The role of surgical local excision in current and future clinical practice

The implementation of bowel cancer screening programs has led to a rise in the incidence of early rectal cancer. The combination of increased incidence and the growing interest in organ-sparing treatment options has led to an amplified importance of local excision techniques in treatment strategies for early rectal cancer. In addition, developments in new technologies of single-port surgery have popularized surgical techniques. Although local treatment of early rectal cancer seems promising, a multidisciplinary approach is necessary and awareness of the oncological robustness is warranted to enable shared decision-making. This review illustrates the position of surgical local excision in the treatment of early rectal cancer and reflects on its role in current and future clinical practice.