Table of Content

25 October 2024, Volume 45 Issue 10

Previous Issue   

Effect of chronic intermittent hypobaric hypoxia on L-type Ca2+ channels in cardiomyocytes of developing rats

XU Shuang-qiao1, ZHAO Qi-yue2, MA Qing-min3, ZHOU Ming-zhong4, ZHANG Yi2, MA Hui-jie2

2024, 45(10):  1120-1128.  doi:10.3969/j.issn.1007-3205.2024.10.001

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Objective To investigate the effects of chronic intermittent hypobaric hypoxia (CIHH) on L-type calcium current (ICaL) in developing rats. 
Methods Newborn male SD rats were randomly divided into 28-day CIHH intervention group (CIHH28), 42-day CIHH intervention group (CIHH42), 28-day control group (CON28) and 42-day control group (CON42). The CIHH intervention group underwent exposure to hypobaric hypoxia at an altitude of 3 000 meters for a duration of 28 days and 42 days respectively, with each session lasting 5 h per day. These conditions were characterized by a partial oxygen pressure (PO2) of 108.8 mmHg （1 mmHg=0.133 kPa） and a barometric pressure (PB) of 525 mmHg. The whole-cell patch clamp technique was employed to record the ICaL in ventricular myocytes. 
Results No significant differences was observed in the peak current or the current-voltage (I-V) relationship curve of ICaLin cardiomyocytes between the CON group and CIHH group (P＞0.05). However, during simulated ischemia/reperfusion (I/R), the peak ICaL was observed to be decreased, accompanied by an upward shift in the I-V relationship curve(P＜0.05).But the change of ICaL in cardiomyocytes was significantly smaller in CIHH group than in CON group (P＜0.05). The steady-state activation and inactivation curves of ICaL in the CIHH group showed no significant changes before and after I/R (P＞0.05). However, during the process of I/R, the steady-state inactivation curve for ICaL underwent a shift towards the left in both CON28 and CON42 groups (P＜0.05), whereas no such shift was observed in cardiomyocytes of CIHH28 and CIHH42 groups (P＞0.05). 
Conclusion CIHH can attenuate the effect of I/R injury on ICaL in ventricular myocytes of developing rat. 





Design and structural optimization of novel folate receptor-targeted fluorescent probe

ZHANG Yi-ning1, LUO Zi-jun1, GUO Li-xiao1, GUO Bing-hao1, LIU Yu-heng2, WANG Lei1

2024, 45(10):  1129-1138.  doi:10.3969/j.issn.1007-3205.2024.10.002

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Objective To screen a variety of high-affinity small molecule folate analogs as targeting ligands and different linkers, to summarize the rational molecular design of folate receptor-targeted fluorescent probes, and develop a new type of excellent folate receptor-targeted fluorescent probe. 
Methods The target fluorescent probe was obtained through various chemical synthesis reactions. Flow cytometry was used to investigate the selectivity of fluorescent probes for folate receptors, and fluorescence microscopy was conducted to evaluate the targeted imaging ability of fluorescent probes on tumor cells. 
Results Eight targeted fluorescent probe products were obtained, among which the fluorescent probe GT-FITC-1 could specifically bind to folate receptor and enter cells to achieve fluorescent imaging. The introduction of glutamic acid side chains reduced the relative average fluorescence intensity of cell uptake. GT-FITC-2 decreased by about 17% compared with GT-FITC-1, and GT-FITC-5 decreased by approximately 15% compared with GT-FITC-4. The fluorescence intensity of the fluorescent probes GT-FITC-7 and GT-FITC-8 containing rigid benzene ring linkers increased by 2-3 times compared with GT-FITC-4, and GT-FITC-8 showed the largest relative average fluorescence intensity. 
Conclusion A series of fluorescent probes designed and synthesized in this study all show high specificity for folate receptors, and the fluorescent probe GT-FITC-8 with excellent affinity for folate receptors is discovered. 



Correlation analysis of composite dietary antioxidant index with cognitive function in children aged 6 to 11 years

WEN Rui, PEI Huan-ting, QIAO Si-meng, LIU Yi-qiu, LIU Xuan-yi, MA Yu-xia

2024, 45(10):  1139-1148.  doi:10.3969/j.issn.1007-3205.2024.10.003

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Objective To investigate the relationship between the composite dietary antioxidant index (CDAI) and cognitive function in children aged 6 to 11 years. 
Methods CADI was constructed based on the publicly available data from National Health and the Nutrition Examination Survey (NHANES Ⅲ) in the United States, as well as the data collected under a collaborative project with the University of Leeds in the United Kingdom titled "Food System Solutions for the Dual Burden of Malnutrition and Related Trace Nutrient Deficiency in Chinese Children" (referred to as Chinese data). Multiple Logistic regression was used to analyze the association between CDAI levels and cognitive function in children. Dietary surveys were conducted using 24-hour dietary regression and 24-hour dietary weighing methods. NHANES Ⅲ was analyzed using the Wide Range Achievement Test-Revised (WRAT-R) and the Wechsler Intelligence Scale for Children (WISC-R) of the Wechsler Intelligence Scale (WISC-R) test. The Chinese cognitive survey was analyzed using the Primary Cognitive Abilities Test (PCAT) and the perceptual reasoning (PR) of the WISC-R. 
Results A total of 470 Chinese children and 2 968 American children were included. Among Chinese survey respondents, there were 224 males, accounting for 47.70%, and 246 females, accounting for 52.30%. The survey respondents of NHANES Ⅲ included 1 494 males, accounting for 50.30%, and 1 474 females, accounting for 49.7%. After adjusting the covariates of gender, age, race, body mass index (BMI) and energy intake, CDAI was influencing factor of working memory (WM) of children aged 6  to 11 years (the China data: OR=1.04，95%CI： 1.00-1.20，P=0.047; The NHANES Ⅲ data: OR=1.13，95%CI： 1.01-1.28， P=0.038). The WM was significantly and positively associated with vitamin C and zinc intake in children aged 6 to 11 years (the China data: zinc P=0.009, vitamin C P=0.030; The NHANES Ⅲ data: Vitamin C P=0.040). 
Conclusion There is a significant correlation between CDAI and WM in children′s cognitive function, and among the components that make up CDAI, the role of zinc and vitamin C is more pronounced. The results of this study suggest that the development of WM in children can be promoted by increasing the intake of dietary antioxidant nutrients. 





Risk factor screening for systemic lupus erythematosus combined with pulmonary hypertension and the clinical value of p-ANCA testing

MA Jing-han, ZHANG Yue, TIAN Yu, YANG Yu-shu, LIU Zhi-feng, GUO Hui-fang

2024, 45(10):  1149-1155.  doi:10.3969/j.issn.1007-3205.2024.10.004

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Objective To investigate the risk factors of systemic lupus erythematosus(SLE) combined with pulmonary arterial hypertension (PAH) and the clinical value of perinuclear-ANCA(p-ANCA) test. 
Methods In total, 64 patients with SLE combined with PAH treated in the Second Hospital of Hebei Medical University were screened as the SLE-PAH group, of which 44 patients were positive for p-ANCA and 20 patients were negative for p-ANCA. Then according to the ratio of 1∶3 we matched 192 SLE patients without PAH hospitalized during the same period as SLE-nonPAH group. The patients′ basic information, clinical data related to SLE activities, laboratory test results and transthoracic echocardiography (TTE) results were recorded. Clinical characteristics of SLE-PAH patients as well as clinical and laboratory features of p-ANCA-positive and p-ANCA-negative patients with PAH were analyzed to explore the risk factors of SLE-PAH. 
Results Compared with the SLE-nonPAH group, patients in the SLE-PAH group had olderer age and a higher percentage of moderate-to-severe disease activity, showing significant difference between the two groups (P＜0.05). More patients showed Raynaud′s phenomenon, increased white blood cell count and absolute neutrophil count, elevated standardized SCT ratio of lupus anticoagulant, positive anticardiolipin antibodies, and abnormalities of pulmonary artery diameter, right atrial diameter, and interventricular septal thickness. There was a significant difference in the severity of PAH between the p-ANCA positive group and the p-ANCA negative group in SLE-PAH patients (P＜0.05). Multivariate Logistic regression analysis suggested that Raynaud′s phenomenon，anticardiolipin antibodies，and increased neutrophil count (OR=0.802) were independent risk factors for combined PAH in patients with SLE (P＜0.05). 
Conclusion SLE patients presenting with moderate to severe disease activity, elevated peripheral blood leukocytes, neutrophils, standardized SCT ratios, and positive anticardiolipin antibodies are alerted to the development of PAH. p-ANCA positivity may be associated with the severity of pulmonary hypertension and requires close follow up. 





Establishment of a Nomogram noninvasive prediction model for the risk of esophageal and gastric varices bleeding in liver cirrhosis based on multimodal ultrasound of liver and spleen

JIN Xiao-yan1, WEI Hong-dong2, WANG Wen-gang1, YAO Zhi-jun1, XU Wen-sheng1

2024, 45(10):  1156-1162.  doi:10.3969/j.issn.1007-3205.2024.10.005

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Objective To explore the value of hemodynamics of liver and spleen, stiffness of liver and spleen and laboratory test results in predicting the degree of esophageal and gastric varices in hepatitis B-induced liver cirrhosis patients, to screen the independent risk factors and to obtain the quantitative nomogram model. 
Methods In total, 128 patients with hepatitis B-induced liver cirrhosis who met the criteria were included in the Second Hospital of Hebei Medical University. According to the results of endoscopy, patients without varicose veins (G0) and patients with mild varicose veins (G1) were selected as low-risk group, and patients with moderate (G2) and severe (G3) varicose veins as high-risk group. The data including height, weight, body mass index (BMI), portal vein diameter, portal vein velocity, hepatic artery systolic velocity, diastolic velocity, resistance index, spleen thickness, splenic vein diameter at the splenic hilum, splenic vein velocity, liver and spleen stiffness values, white blood cells, red blood cells (RBC), hemoglobin, platelets, aspartate aminotransferase, alanine aminotransferase, albumin, total bilirubin and creatinine were collected from the two groups. Independent risk factors for predicting the degree of esophageal and gastric varices were screened through univariate analysis and multivariate logistic regression analysis. Receiver operating characteristic (ROC) curves were used to analyze the diagnostic efficacy of each factor and composite index, and a quantitative model was obtained through a nomogram. 
Results The results of univariate analysis showed that there was a significant difference in portal vein diameter, portal vein velocity, liver stiffness, spleen stiffness, and RBC count between the two groups (P＜0.05). Further multivariate logistic regression analysis showed that portal vein velocity, liver stiffness, and spleen stiffness were independent risk factors for high-risk esophageal and gastric varices (P＜0.05). ROC curve analysis showed that each factor had high sensitivity and specificity, especially the area under ROC curve of the spleen stiffness was as high as 0.92. 
Conclusion Multimodal ultrasound of liver and spleen can quantitatively predict the risk of esophageal and gastric varices bleeding in patients with hepatitis B-induced liver cirrhosis, the index of spleen stiffness has high diagnostic efficiency. 





Comparison of three broth microdilution methods for the detection of fluconazole susceptibility of Candida

LIU Yi-xin1, ZHANG Zhi-qing1, SHI Dong-yan2

2024, 45(10):  1163-1167.  doi:10.3969/j.issn.1007-3205.2024.10.006

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Objective To compare three broth dilution methods in drug sensitivity detection for detecting the sensitivity of Candida to fluconazole. 
Methods A total of 84 clinical isolates of Candida were collected in the Second Hospital of Hebei Medical University, and the sensitivity of Candida to fluconazole was detected by classical broth microdilution method, ATB FUNGUS 3 and Sensititre Yeast One method. 
Results Among the 84 strains of Candida, there were 26 isolates of Candida albicans, 34 ioslates of Candida tropicalis, 22 isolates of Candida glabrata and 2 isolates of Candida parapsilosi. The classical broth microdilution method was used as a reference method, the sensitivity of ATB FUNGUS method was 87.5%, with a specificity of 100.0%. The essential agreement was 95.2%, and the categorical agreement was 92.9%; The false resistance rate was 7.1%, while there was no false sensitivity rate. The sensitivity and specificity of Sensititre Yeast One method were 100.0% and 94.4% respectively. Both the essential agreement and the categorical agreement were 97.6%, and the false sensitivity rate and the false resistance rate were 0. 
Conclusion Sensititre Yeast One method to detect the effect of fluconazole on Candida activity is superior to that of ATB FUNGUS 3. 





Analysis of clinical and laboratory characteristics of neonates with central nervous system infection caused by different types of pathogens

PU Wei-cong, LIU Yu, WANG Le, GUO Ying-hui, SUN Min, MA Li

2024, 45(10):  1168-1174.  doi:10.3969/j.issn.1007-3205.2024.10.007

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Objective To analyze the clinical features, laboratory tests and clinical outcomes of neonates with central nervous system (CNS) infection caused by different types of pathogens. 
Methods Collected the medical records of neonates with central nervous system (CNS) infection caused by specific pathogens who were admitted to the NICU of Hebei Children′s Hospital from January 1, 2020, to December 31, 2022. Based on their pathogen results, the patients were divided into bacterial meningitis (BM) group and viral meningitis (VM) group. The clinical features, laboratory results and outcomes were compared between the two groups. 
Results A total of 63 eligible neonates were enrolled, including 38 patients in BM group and 25 in VM group. The median gestational age was 38.3 (3.0) weeks, including 47 full-term infants (74.6%) and 37 males (58.7%). The neonates had a mean birth weight of (2 970±731) g and the median age of onset was 9.6 (11.0) d. The clinical manifestations were fever (n=55, 87.3%), jaundice (n=29, 46.0%), poor feeding (n=20, 31.7%) and dystonic abnormalities (n=20, 31.7%). There was no significant difference in general clinical features and clinical manifestations between the two groups (P＞0.05). Cerebrospinal fluid (CSF) white blood cell count (WBC), abnormal ratio of WBC, percentage of polymorphonuclear cells, protein levels and blood WBC, percentage of neutrophils, C-reactive protein (CRP) and percentage of CRP>8 mg/L were higher in the BM group than that in the VM group (P＜0.05). In the BM group, the CSF WBC ranged from 6 to 258 233/mm3, which was below 20/mm3 in one infant. In the VM group, the CSF WBC ranged from 1 to 1 238/mm3, which was above 1 000/mm3 in two infants and below 20/mm3 in nine infants. E.coli (n=11, 28.9%) and Klebsiella pneumoniae (n=6, 15.8%) were the most common pathogens in BM group, and enterovirus (n=15, 60%) was the most common in VM group. The follow-up results showed that there was 1 death (2.6%) and 3 patients (7.9%) with severe neurological sequelae in the BM group, and 3 death (12%) and 1 patient (4%) with severe neurological sequelae in the VM group; The remaining patients had a good prognosis. 
Conclusion It is difficult to differentiate whether neonatal CNS infection is caused by bacteria or virus solely based on clinical features. Routine laboratory tests can be helpful to some extent in identifying pathogenic pathogens. It is crucial to detect pathogen in CSF, including viral targets, to achieve precise treatment and improve prognosis. 





Cause analysis of 25 unplanned reoperations after radical resection of esophageal cancer: Summary of 1 395 consecutive cases in thoracic surgery group

LYU Hui-lai, XU Shi, GAI Chun-yue, LIU Yu, LIU Zhao, TIAN Zi-qiang

2024, 45(10):  1175-1180.  doi:10.3969/j.issn.1007-3205.2024.10.008

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Objective To explore the clinical causes of unplanned reoperations after radical resection of esophageal cancer, in order to gain a deeper understanding of reducing the occurrence of unplanned reoperation after radical resection of esophageal cancer. 
Methods The clinical data of 1 395 patients who underwent radical resection for esophageal cancer in thoracic surgery group of the Fourth Hospital of Hebei Medical University were retrospectively analyzed, including 1 012 males and 383 females, with an average age of (64.21±7.27) years. The tumors were located in the cervical esophagus in 1 case, the upper thoracic esophagus in 154 cases, the middle thoracic esophagus in 589 cases, and the lower thoracic esophagus in 651 cases. Pathological stage included 782 cases (56.06%) in stage Ⅰ to Ⅱ, 613 cases (43.94%) in stage Ⅲ to Ⅳ A. 
Results In total, 25 cases (1.79%) of 1 395 patients who underwent radical resection for esophageal cancer had unplanned reoperation for different reasons. Univariate analysis of clinical data of included patients showed that age ≥65 years, body mass index (BMI)＜18, pathological stage Ⅲ-ⅣA and smoking rate in the non-planned operation group were higher than those in the normal operation group, and the difference was statistically significant (P＜0.05). The above factors were included in multivariate Logistic regression analysis, and the results showed that age ≥65 years (OR=0.38，95%CI： 0.161-0.896， P=0.027), BMI＜18(OR=0.176， 95%CI： 0.062-0.498， P=0.001) and smoking (OR=0.314， 95%CI： 0.128-0.771， P=0.011) were independent influencing factors for patients undergoing unplanned reoperation after radical resection of esophageal cancer. Anastomotic fistula (7/25, 28%), severe pulmonary complications (7/25, 28%), and postoperative bleeding (6/25, 24%) were the main causes of unplanned reoperation. 
Conclusion Advanced age, low BMI and smoking are high risk factors for unplanned reoperation after radical resection of esophageal cancer, and the main causes include anastomotic fistula, severe pulmonary complications and postoperative bleeding. For preoperative assessment of high-risk patients, the key to reducing the probability of unplanned reoperation is to improve perioperative management, reduce preoperative nutritional risks, and ensure prevention and supervision.





The predictive value of cuproptosis-related gene lipoyltransferase 1 on postoperative recurrence in patients with CNLC stage Ⅰa hepatocellular carcinoma

YANG Wu-han1, WANG Shu-bin2, CHEN Yao-wen1, LIU Cheng-yu1, LIU Yue-ping3, PENG Li1

2024, 45(10):  1181-1187.  doi:10.3969/j.issn.1007-3205.2024.10.009

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Objective To investigate the expression and significance of cuproptosis-related gene lipoyltransferase 1 (LIPT1) in patients with China liver cancer staging (CNLC) Ⅰa hepatocellular carcinoma (HCC) and to construct a LIPT1-related nomogram to predict the risk of postoperative recurrence in these patients. 
Methods Clinical data of 139 CNLC Ⅰa HCC patients who underwent radical surgery at the Fourth Hospital of Hebei Medical University were collected. Immunohistochemistry was used to detect LIPT1 expression in tumor tissues. Survival analysis was performed using the Kaplan-Meier method, and the Cox proportional hazards model was employed to evaluate factors affecting disease-free survival (DFS). A prediction model for DFS was established based on multivariate Cox regression analysis results and validated using calibration curves and time-dependent area under the receiver operating characteristic (ROC) curve. 
Results The 1-year, 3-year, and 5-year DFS rates of 139 CNLC Ⅰa HCC patients were 76.3%, 56.1%, and 46.5%, respectively. Among these patients, 89 had high LIPT1 expression, and 50 had low LIPT1 expression. Multivariate Cox regression analysis revealed that LIPT1 expression (HR=1.093, 95%CI: 1.001-1.193) and history of diabetes (HR=2.172, 95%CI: 1.126-4.191) were independent risk factors for DFS of CNLC Ⅰa HCC patients. The DFS prediction model constructed based on the above indicators showed good consistency. The time-dependent area under the ROC curve of the nomogram for 1-year, 3-year, and 5-year DFS was 0.785, 0.780， 0.766, respectively, and 0.712, 0.794， 0.716, respectively, which were higher than those for tumor size. 
Conclusion LIPT1 can serve as an effective marker to predict postoperative recurrence in CNLC Ia HCC patients. Compared with the traditional indicator tumor size, the nomogram has higher efficacy in predicting DFS of CNLC Ⅰa HCC patients, providing a new direction for postoperative monitoring and individualized treatment of early-stage liver cancer. 





Application of the modified cross-suture technique in ileostomy reversal after rectal cancer surgery

ZHANG Li-xiao1, ZHANG Li-fei1, DONG Jian-tao1, QI Jie2, CUI Yu-jie3, LIANG Wei1

2024, 45(10):  1188-1193.  doi:10.3969/j.issn.1007-3205.2024.10.010

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Objective To explore the effect of the modified cross-suture technique on abdominal wall incision during ileostomy reversal in patients with rectal cancer. 
Methods Retrospectively analyzed the clinical data of 150 patients who underwent ileostomy reversal following rectal cancer surgery. Based on the treatment method of abdominal wall incision, the patients were divided into the control group and the observation group, with 75 patients in each group. The control group received the conventional one-stage suture method, while the observation group received the modified cross-suture technique. Both groups were given compression dressing with inverted trapezoidal-shaped gauze after surgery. The duration of operation, blood loss, time of off-bed activity, exhaust time, healing time, infection rate, healing time after infection, length of hospital stay, pain score and satisfaction were compared between the two groups. 
Results There was no significant difference in anastomosis methods, duration of operation, intraoperative blood loss, and primary healing time between the two groups (P＞0.05). In the observation group, the time of postoperative off-bed activity ［(1.60±0.75) d vs. (1.96±0.62) d］, exhaust time ［(2.41±1.08) d vs. (2.88±0.80) d］, time of food intake［(2.60±1.22) d vs. (3.07±0.92) d］, healing time after incision infection ［(16.71±1.60) d vs. (20.38±3.59) d］, and length of hospital stay ［(7.32±1.88) d vs. (8.43±2.59) d］ were shorter than those in the control group; The early pain scores ［24 h： (2.75±0.64) points vs. (3.12±0.70) points; 72 h： (1.09±0.29) points vs. (1.29±0.49) points］, incision infection rate ［9.33% vs. 21.33%］, and medical expenses ［(31 506.89±4 147.59) yuan vs. (33 854.80±7 506.47) yuan］ were lower than those in the control group (P＜0.05). The overall satisfaction score of the observation group was higher than that of the control group ［29.0 (2.0) points vs. 28.0 (8.0) points］ (P＜0.05). 
Conclusion The modified cross-suture technique is an effective method for handing abdominal wall incisions during temporary ileostomy reversal after rectal cancer surgery. It can significantly reduce the incision infection rate and postoperative pain, shorten the postoperative recovery time, length of hospital stay and healing time after incision infection, promote postoperative recovery of patients, reduce hospitalization expenses, and improve patient satisfaction.


Finite element study on the biomechanical effects of different endplate healing morphology on intervertebral disc

SU Yun-shan, LI Jun-fei, PEI Xin-jian, CHEN Yu-feng, WANG Peng-cheng

2024, 45(10):  1194-1199.  doi:10.3969/j.issn.1007-3205.2024.10.011

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Objective To investigate the biomechanical effects of different healing morphology of cartilage endplate on endplate itself and intervertebral disc. 
Methods A healthy adult male volunteer in the Third Hospital of Hebei Medical University underwent computed tomography scans from T12 to L2 vertebrae. The solid spine model was constructed after three-dimensional reconstruction. Four different cartilaginous endplate models including normal endplate, increased curvature endplate, irregular healing endplate and traumatic Schmorl node endplate were constructed. After validation of the model, 500 N vertical load was applied to the upper surface of the T12 vertebral body to obtain the stress distribution of cartilage endplate and intervertebral disc in each model. 
Results The stress of nucleus pulposus increased slightly in increased curvature model, and decreased significantly in irregular healing model and traumatic Schmorl node model by 38.1% and 27.5%, respectively. The stress of annulus fibrosus decreased slightly in increased curvature model, and increased significantly in irregular healing model and traumatic Schmorl node model by 9.8% and 6.3%, respectively. In addition, the stress concentration of the annulus fibrosus was relatively clear, which was located in the junction area with the nucleus pulposus and the periphery of the annulus fibrosus. 
Conclusion The morphological changes of cartilage endplate can lead to the redistribution of stress in the intervertebral disc, which provides a biomechanical evidence for the morphological changes of cartilage endplate leading to intervertebral disc degeneration. 





Arthroscopic single thread double site ligation and suture technique in the treatment of medial meniscus posterior root tear

CHEN Jing-qing, NIU Hai-yun, DONG Zhen-yue, LI Ming, GU Ju-yuan, CHEN Bai-cheng

2024, 45(10):  1200-1205.  doi:10.3969/j.issn.1007-3205.2024.10.012

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Objective To evaluate clinical effect of arthroscopic single thread double site ligation and suture technique in the treatment of medial meniscus posterior root tear (MMPRT). 
Methods In total, 17 knees from 17 patients with MMPRT were selected and treated with arthroscopic single thread double site ligation and suture in the Third Hospital of Hebei Medical University. The Kellgren-Larence grading of 17 knees on X-ray was grade 0 in 2 patients, grade 1 in 5 patients, and grade 2 in 10 patients. During preoperative and postoperative follow-up, patients were evaluated for relevant functional scores and knee joint degeneration, including visual analogue scale (VAS) pain score, international knee documentation committee (IKDC) score, Lysholm score, X-ray Kellgren-Larence grading, and medial meniscus extrusion (MME) value. 
Results Seventeen patients were followed up for 13 to 20 months, with an average of (16.28±3.54) months. At the last follow-up, the knee joint VAS score ［1.00 (1.00) points］ was lower than that ［5.00 (1.00) points］ before operation, while the IKDC score, Lysholm score, and MME value were［(60.29±3.98) points, (89.88±4.11) points, and (3.08±0.19) mm］ respectively, which were higher than those ［(38.82 ± 2.48) points, (51.65±4.27) points, and (2.98±0.11) mm］ before operation, with statistical significance (P＜0.001). At the last follow-up, there was no significant difference in the Kellgren-Lawrence grading of X-ray films compared with preoperative levels (P＞0.05). 
Conclusion Arthroscopic single thread double site ligation and suture for the treatment of MMPRT has good clinical efficacy, as well as good security and operability. 



Study on the application value of targeted secondnext-generation sequencing technology in the clinical diagnosis of osteoarticular brucellosis

YAO Xiao-wei, ZHAO Gui-song, LI Zhuo, DONG Zhao-liang, LIU Shu-ren, JIA Chen-guang

2024, 45(10):  1206-1211.  doi:10.3969/j.issn.1007-3205.2024.10.013

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Objective To evaluate the application value of targeted next generation sequencing (tNGS) technology in the pathogenic diagnosis of osteoarticular brucellosis. 
Methods Case data of 108 patients with suspected osteoarticular brucellosis were included in Hebei Chest Hospital. The comprehensive clinical diagnosis was primarily based on an analysis of the epidemiologic history, clinical manifestations, imaging findings, results of laboratory and pathogenic examination, and the effect of anti-Brucella treatment. The patients were classified into two groups: the osteoarticular brucellosis group (n=78), and the non-brucellosis group (n=30) based on the final clinical diagnosis. All patients underwent a serum agglutination test (SAT), CT navigational puncture or surgical sampling of lesions for bacteriological culture (culture method) and tNGS after admission to the hospital. The diagnostic efficacy of these three tests for osteoarticular brucellosis was then compared using the final clinical diagnosis as the reference standard. 
Results Among the 108 patients with suspected osteoarticular brucellosis, the positive rate of osteoarticular brucellosis detected by tNGS (60/108, 55.56%) was significantly higher than that of the SAT test (57/108, 52.78%) and culture method (25/108, 23.15%), suggesting significant differences (χ2=24.982, 37.934, P＜0.001). The sensitivity of the tNGS test, SAT test and culture method for detecting osteoarticular brucellosis was 76.92%, 64.10% and 32.05%, respectively, when the final clinical diagnosis was taken as the criterion. The specificity was 100.00%, 76.67% and 100.00%, respectively, and the diagnostic compliance rate was 83.35%, 67.59% and 50.92%, respectively, with a Kappa value of 0.799, 0.590 and 0.504, respectively. 
Conclusion TNG has been demonstrated to have a high pathogen detection rate and sensitivity in the pathogenic diagnosis of patients with osteoarticular brucellosis, thereby providing an important reference for the precise diagnosis and treatment of patients with osteoarticular brucellosis. 





The value of ultrasonic fine features in identifying the source of multilocular and multilocular-solid ovarian masses

WANG Li-xian, WEI Xiao-xuan, WANG Nan, WEI Jia, LIANG Ya-kun, WANG Cui-ju

2024, 45(10):  1212-1218.  doi:10.3969/j.issn.1007-3205.2024.10.014

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Objective To explore the value of ultrasonic fine features in identifying the source of multilocular and multilocular-solid ovarian masses. 
Methods A total of 246 patients diagnosed with multilocular and multilocular-solid ovarian masses by ultrasound the Fourth Hospital of Hebei Medical University were selected as the research subjects. The ultrasonic fine features of these masses were observed and recorded. Combined with the clinical features and histopathological classifications, the relationship between the ultrasonic fine features and primary or metastatic ovarian neoplasms were compared and analyzed. 
Results The histological types of 246 patients with ovarian masses included primary ovarian neoplasms in 217 (88.21%) and metastatic ovarian neoplasms in 29 (11.79%) patients. Among primary tumors, 62 patients (25.20%) had benign tumors, mainly consisting of serous and mucinous cystadenomas; 27 patients (10.98%) had borderline tumors; 128 patients (52.03%) had malignant tumors, mainly consisting of serous and mucinous cystadenocarcinoma. In metastatic tumors, the primary site was mainly the colon and rectum. For clinical features, patients with ovarian metastases were older than those with primary ovarian neoplasms ［(60.80±8.04) years vs. (51.29±12.32) years, P=0.035］. Patients in primary tumor group had no confirmed history of tumors in other areas, while 9 patients in the metastatic tumor group had history of tumors in other areas when ovarian tumors were detected (P＜0.001). The proportion of patients with serum CA199≥37 000 U/L in the metastatic tumor group was higher than that in the primary tumor group, and the difference is statistically significant ［24(11.06%) vs. 17(58.62%), P＜0.001］, and there was no significant difference in other clinical features between the two groups (P＞0.05). In terms of sutble ultrasonic features, compared with primary neoplasms, patients with ovarian metastatic tumors had the characteristics of larger tumor size ［(15.7±4.80) cm vs. (9.54±3.96) cm, P＜0.001］, more than 10 cystic cavities inside the tumor (55.17% vs. 18.89%, P＜0.0001), fewer mural nodules (6.90% vs. 21.66%, P=0.007) but larger diameters ［(1.44±0.36) cm vs. (0.97±0.39) cm, P=0.031］, and lower resistance index of color doppler flow (0.46±0.07 vs. 0.61±0.13, P＜0.001). 
Conclusion In the ultrasound diagnosis of multilocular and multilocular-solid ovarian masses, especially accompanied by malignant tumors in other areas, the ultrasonic fine features can be used to improve the ability to identify the source of the masses. 





Experimental study of the effect of TGF-β1 and iRoot BP Plus on pulp capping

XU Ming-ming, MAI Tian-qian, HAO Jun-ling, LI Chun-nian

2024, 45(10):  1219-1225.  doi:10.3969/j.issn.1007-3205.2024.10.015

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Objective To investigate the feasibility of transforming growth factor β1 (TGF-β1) combined with iRoot BP Plus for pulp capping, so as to provide experimental reference for improving the success rate of vital pulp preservation. 
Methods A total of 40 upper and mandibular first molars of 4-week-old male SD rats were obtained, their roots were cut off, and the crown and crown pulp tissues of the first molar were retained. They were randomly divided into four groups for pulp capping: the control group, iRoot BP Plus group, TGF-β1 group, and iRoot BP Plus+TGF-β1 group. The experimental teeth after pulp capping were transplanted into the back pockets of 6-week-old male BALB/C nude mice. At 6 weeks after culture, the nude mice were killed and the samples were stained with HE to evaluate the degree of pulpal inflammation and the formation of reparative dentin or mineralized tissue. The expression of dentin matrix protein 1 (DMP-1) in odontoblasts was detected by immunohistochemistry. 
Results The degree of pulp inflammation and the formation of reparative dentin or mineralized tissue in iRoot BP Plus group, TGF-β1 group, and iRoot BP Plus+TGF-β1 group were better than those in the control group (P＜0.05). The degree of formation of reparative dentin or mineralized tissue in iRoot BP Plus+TGF-β1 group was significantly higher than that in iRoot BP Plus group and TGF-β1 group (P＜0.05). The expression of DMP-1 in odontoblasts of iRoot BP Plus group, TGF-β1 group, and iRoot BP Plus+TGF-β1 group was significantly stronger than that of the control group, and the expression of DMP-1 in odontoblasts of iRoot BP Plus+TGF-β1 group was significantly stronger than that of iRoot BP Plus group and TGF-β1 group (P＜0.05). 
Conclusion iRoot BP Plus and TGF-β1 can promote the formation of reparative dentin or mineralized tissue. iRoot BP Plus combined with TGF-β1 can be used in direct pulp capping, and the ability to form reparative dentin or mineralized tissue was superior to iRoot BP Plus or TGF-β1 alone.