Objective To report a new offset parameter for total hip arthroplasty (THA)—greater trochanter offset (GTO), and analyze the effectiveness and feasibility of this parameter based on clinical data. Methods The 47 patients who met the selection criteria and admitted between January 2016 and May 2020 were selected as the research object. The global offset (GO) was used as the offset parameter in preoperative design. Firstly, the test-retest reliability and inter-rater reliability of GTO were analyzed based on pelvic X-ray films. The GTO reconstruction was defined as the difference between the operative side and the healthy side within ±5 mm, and 47 patients were divided into the reconstruction group and the non-reconstruction group. General data (age, gender, type and side of fracture, the interval between injury and operation), visual analogue scale (VAS) score, Harris score, gait score, and leg length discrepancy (LLD) were recorded and compared between two groups. Then, the GTO was used as the offset parameter in preoperative design of 21 patients (GTO group) admitted between June 2020 and December 2020. The pre- and post-operative clinical data were compared between GTO group and GO group to explore the feasibility of GTO for THA.Results Statistical analysis showed that GTO had good test-retest reliability (P<0.001) and inter-rater reliability (P<0.001). There was no significant difference in gender, age, type and side of fracture, the interval between injury and operation, preoperative VAS score, and LLD at 1 year after operation between the GTO reconstruction group and the non-reconstruction group, as well as between the GO and GTO groups (P>0.05). The Harris score and gait score at 1 year after operation, and difference of VAS score between pre- and post- operation in the reconstruction group and GTO group were significantly better than those in the non-reconstruction group and GO group, respectively (P<0.05). There were 23 cases (48.9%) in the GO group and 19 cases (90.5%) in the GTO group with GTO reconstruction, and the difference was significant (χ2=10.606, P=0.001). There were 25 cases (53.2%) in the GO group and 13 cases (61.9%) in the GTO group with GO reconstruction, and the difference was not significant (χ2=0.447, P=0.504). There were 34 cases (72.3%) in the GO group and 19 cases (90.5%) in the GTO group with LLD reconstruction, and the difference was not significant (χ2=2.777, P=0.096). Conclusion GTO has reliable test-retest reliability and inter-rater reliability. GTO as a parameter of preoperative offset reconstruction plan of THA can obtain good reconstruction of offset and limb length, and obtain a good effectiveness.
Robot rehabilitation has been a primary therapy method for the urgent rehabilitation demands of paralyzed patients after a stroke. The parameters in rehabilitation training such as the range of the training, which should be adjustable according to each participant’s functional ability, are the key factors influencing the effectiveness of rehabilitation therapy. Therapists design rehabilitation projects based on the semiquantitative functional assessment scales and their experience. But these therapies based on therapists’ experience cannot be implemented in robot rehabilitation therapy. This paper modeled the global human-robot by Simulink in order to analyze the relationship between the parameters in robot rehabilitation therapy and the patients’ movement functional abilities. We compared the shoulder and elbow angles calculated by simulation with the angles recorded by motion capture system while the healthy subjects completed the simulated action. Results showed there was a remarkable correlation between the simulation data and the experiment data, which verified the validity of the human-robot global Simulink model. Besides, the relationship between the circle radius in the drawing tasks in robot rehabilitation training and the active movement degrees of shoulder as well as elbow was also matched by a linear, which also had a remarkable fitting coefficient. The matched linear can be a quantitative reference for the robot rehabilitation training parameters.
ObjectiveTo observe the efficacy of high-frequency repetitive transcranial magnetic stimulation (rTMS) applied at contralesional hemisphere Broca’s homologue on patients with global aphasia after left massive cerebral infarction. Methods Patients with global aphasia after left massive cerebral infarction in the Department of Neurorehabilitation of China Rehabilitation Research Center between August 2021 and December 2023 were selected. According to the random number table method, patients were randomly divided into a low-frequency rTMS group and a high-frequency rTMS group. rTMS targeted the mirror area within the right hemispheric Broca’s area. Patients’ language ability was assessed pre- and post-treatment by the Chinese version of the western aphasia battery (WAB). Results A total of 27 patients were included, with 14 in the low-frequency rTMS group and 13 in the high-frequency rTMS group. Before treatment, there was no statistically significant difference in the WAB test indicators between the two groups of patients (P>0.05). After treatment, WAB scores (spontaneous speech, auditory comprehension, naming, repetition, aphasia quotients) in both groups were significantly improved (P<0.05); compared to the low-frequency rTMS group, the high-frequency rTMS group exhibited significant improvement in spontaneous speech, auditory comprehension, repetition, naming and aphasia quotients (P<0.05). Conclusion The effect of high-frequency rTMS excitation to contralesional hemisphere is better than that of conventional low-frequency rTMS inhibition to contralesional hemisphere in improving the speech function of patients with global aphasia after left massive cerebral infarction.
Anxiety disorder is a common emotional handicap, which seriously affects the normal life of patients and endangers their physical and mental health. The prefrontal cortex is a key brain region which is responsible for anxiety. Action potential and behavioral data of rats in the elevated plus maze (EPM) during anxiety (an innate anxiety paradigm) can be obtained simultaneously by using the in vivo and in conscious animal multi-channel microelectrode array recording technique. Based on maximum likelihood estimation (MLE), the action potential causal network was established, network connectivity strength and global efficiency were calculated, and action potential causal network connectivity pattern of the medial prefrontal cortex was quantitatively characterized. We found that the entries (44.13±6.99) and residence period (439.76±50.43) s of rats in the closed arm of the elevated plus maze were obviously higher than those in the open arm [16.50±3.25, P<0.001; (160.23±48.22) s, P<0.001], respectively. The action potential causal network connectivity strength (0.017 3±0.003 6) and the global efficiency (0.044 2±0.012 8) in the closed arm were both higher than those in the open arm (0.010 4±0.003 2, P<0.01; 0.034 8±0.011 4, P<0.001), respectively. The results suggest that the changes of action potential causal network in the medial prefrontal cortex are related to anxiety state. These data could provide support for the study of the brain network mechanism in prefrontal cortex during anxiety.
ObjectiveTo explore the related factors, responsible lesions, and prognosis of transient global amnesia (TGA).MethodsWe retrospectively collected TGA patients admitted to Zhongshan Hospital Xiamen University between October 1st 2011 and October 31st 2018 and age- and sex-matched health examinees in the Department of Physical Examination in the same period as a control group. We recorded the relevant clinical information of the two groups, such as sex, age, hypertension, diabetes, hyperlipidemia, atrial fibrillation, stroke, migraine, TGA and epilepsy, and the imaging data of the TGA patients. The occurrences of cerebral infarction, cerebral hemorrhage, recurrence of TGA, and myocardial infarction of the two groups were followed up.ResultsA total of 73 TGA patients and 73 age- and sex-matched controls were included. The difference in the history of migraine was statistically significant (χ2=4.000, P=0.038), while there was no significant difference in the history of hypertension, diabetes or other medical history between the two groups (P>0.05). It was found that the responsible focus of TGA was in the hippocampal CA1 region, while the fornix column and the hippocampal CA1 region existed in the same functional loop. The mean follow-up time was (36.0±22.6) months. Sixty-nine TGA patients and 67 healthy controls were followed up. During the follow-up, there was no significant difference in the incidence of cerebral infarction, cerebral hemorrhage, myocardial infarction, or TGA attacks between the two groups (P>0.05). There was no statistically significant difference (P>0.05) in the clinical or follow-up data between the TGA patients with lesion on DWI (n=9) and the ones without lesion on DWI (n=58).ConclusionsMigraine may be a risk factor for TGA. The responsible brain area of TGA may involve a memory loop, including hippocampal CA1 region, fornix column and so on. After the attack of TGA, the long-term prognosis is well.
ObjectiveTo understand the latest epidemiological situation of liver cancer worldwide and in China. MethodsThis team organized and briefly interpreted the results of the two reports, the International Agency for Research on Cancer team released the latest global cancer statistics report in its authoritative journal, CA: A Cancer Journal for Clinicians, in April 2024, the research team from the National Center for Chronic and Noncommunicable Disease Control and Prevention at the Chinese Center for Disease Control and Prevention published an article in the Lancet Public Health on the changes in cancer burden in China from 2005 to 2020. The epidemiological trends of liver cancer worldwide and in China from 2018 to 2022, the changes in age-standardized incidencerate by world standard population (ASIRW) and age-standardized mortality rate by world standard population (ASMRW) of liver cancer in countries with different human development index (HDI) and income levels in the world in 2022, the incidence and death of liver cancer in different age groups in the world and China in 2022, and the changes in the disease burden of liver cancer in China from 2005 to 2020 were anlyzed. ResultsIn 2022, there were 865 269 new cases and 757 948 deaths of liver cancer globally, it was the sixth most common malignancy and the third leading cause of cancer-related deaths worldwide. The incidence and mortality of liver cancer worldwide and in China from 2018 to 2022 tended to be stable or declining, which in men were higher than those in women, and which in all population and males in China were higher than those in the world. The ASIRW and ASMRW were the highest in the countries with high HDI and upper-middle income levels. With the increase of age, the ASIRW and ASMRW of liver cancer continued to increase in the world and in China. The average annual percentage changes (AAPCs) in the deaths, ASMRW, year of life loss, and age-standardized year of life loss for all age groups in China from 2005 to 2020 were negative, indicating a downward trend for each of these indicators. The ASMRW of liver cancer increased with the increasing of age in 2020 in China. ConclusionsLiver cancer continues to pose a significant disease burden worldwide and in China. Therefore, implementing primary and secondary prevention strategies for liver cancer in the future is a major measure for its prevention and control. Additionally, continuous efforts are needed to ensure multidisciplinary and standardized management of liver cancer throughout its course.
Objective To summarize the nutritional assessment methods for liver cancer patients and their development, and to provide reference for rationally nutritional assessment and nutritional support. Method Domestic and foreign literatures were searched to summarize the nutritional assessment methods for liver cancer patients and their development, in order to determine a practical and feasible assessment method. Results The evaluation validity of traditionally nutritional assessment methods which contained many individual indicators was low. But subjective global assessment (SGA), mini nutritional assessment (MNA), and nutritional risk screening 2002 (NRS-2002) had similar evaluation validity, this 3 kinds of nutritional assessment methods were more suitable for liver cancer patients compared with the traditionally nutritional assessment methods. Conclusion The clinician should simultaneously apply SGA, MNA, NRS-2002, and other comprehensively nutritional assessment methods, as well as related anthropometric and laboratory indexes, to get a more accurate assessment of the nutritional status for patients with liver cancer.
Objective This study utilized the 2021 Global Burden of Disease database to systematically analyze global liver cancer mortality, years lived with disability, years of life lost, and disability-adjusted life years (DALY) from 1990 to 2021. It focuses on differences across genders and age groups to reveal epidemiological patterns of liver cancer attributable to high BMI, providing reference for global liver cancer prevention and control. MethodBased on the 2021 Global Burden of Disease database, the Global Health Data Exchange query tool was used to extract the total number of global liver cancer deaths, DALY, age-standardized mortality rate (ASMR), and age-standardized DALY rate from 1990 to 2021. These metrics were assessed using estimated annual percentage change. Joinpoint regression analysis was employed to calculate annual percentage change and average annual percentage change , comparing differences in subtype composition from 1990 to 2021. Smooth curve regression analysis was applied to assess the correlation between liver cancer mortality and DALY rates attributable to high BMI and the socio-demographic index (SDI). ResultsFrom 1990 to 2021, the cumulative number of liver cancer deaths attributable to high BMI increased from 10 282.12 cases in 1990 ［95%UI (4 196.72, 16 721.85)］ to 46 200.88 cases［95%UI (38 606.14, 77 983.02)］ in 2021, representing a 3.5-fold increase. DALYs attributable to high BMI-related liver cancer increased from 292,696.35 years in 1990［95%UI (119 094.56, 475 962.67)］ to 1 273 312.58 years［95%UI (504 391.1, 2,101,957.87)］ in 2021, representing a 3.2-fold increase.② Cumulative deaths attributable to high BMI: For males, deaths increased from 5,913.45 cases [95% UI (2,479.64, 9,717.69)] in 1990 to 28,511.99 cases［95%UI (11 721.81, 49 277.60)］ in 2021, representing a 3.8-fold increase. For women, the cumulative number increased from 4,368.66 cases［95%UI (1 707.64, 7 078.83)］in 1990 to 17 691.88 cases［95%UI (7 169.44, 29 573.18)］in 2021, representing a threefold increase.③ Cumulative mortality values increased across all SDI income regions to varying degrees. ASMR and death counts steadily rose with increasing age, mirroring the growth trend in DALYs attributable to liver cancer associated with high BMI. Correlation analysis and slope index results demonstrated a significant positive correlation between SDI and both death counts and DALYs. The mortality concentration index rose from –0.277 (1990) to –0.258 (2021), while the DALY concentration index increased from –0.222 (1990) to –0.208 (2021). The mortality slope index increased from 0.284 (1990) to 0.881 (2021), while the DALY rate slope index rose from 7.002 (1990) to 19.244 (2021). ConclusionsThe burden of liver cancer associated with high BMI remains substantial and varies significantly across different age groups, genders, and geographic locations worldwide. The global disease burden of liver cancer linked to high BMI is projected to remain severe in the future, necessitating sustained attention and the development of more targeted prevention and control measures tailored to current circumstances.
ObjectiveTo systematically analyze the incidence and mortality of pancreatic cancer globally and in China from 2018–2022 based on GLOBOCAN 2018, 2020, and 2022 editions released by the International Agency for Research on Cancer, and summarize the main influencing factors to provide reference for the formulation of prevention and control strategies and clinical practice of pancreatic cancer in China. MethodsWe collected and organized data on pancreatic cancer incidence cases, death cases, crude incidence, crude mortality, age-standardized incidence rate by world standard population (ASIRW), and age-standardized mortality rate by world standard population (ASMRW) from the GLOBOCAN database. Combined with socioeconomic parameters such as human development index (HDI) and national income levels, we conducted comparative analysis of the distribution characteristics of pancreatic cancer globally and in China across different regions, age groups, and genders. ResultsFrom 2018 to 2022, incidence number of global pancreatic cancer increased from 458 000 cases to 511 000 cases in 2022, with crude incidence rising from 5.4/100 000 to 6.5/100 000. Deaths increased from 432 000 cases to 467 000 cases, with crude mortality rising from 5.7/100 000 to 5.9/100 000, while ASMRW decreased from 4.4/100 000 to 4.3/100 000. In China, incidence number of pancreatic cancer increased from 116 000 cases in 2018 to 119 000 cases in 2022, accounting for 23.3% of global cases, with crude incidence maintained at (8–9)/100 000. Deaths decreased from 110 000 cases to 106 000 cases, with crude mortality declining from 7.8/100 000 to 7.5/100 000 and ASMRW decreasing from 4.9/100 000 to 3.9/100 000. In 2022, countries with very high HDI had pancreatic cancer ASIRW of 7.9/100 000 and ASMRW of 6.9/100 000, significantly higher than low HDI countries at 1.4/100 000 and 1.3/100 000. Pancreatic cancer incidence showed clear age-related patterns, with the ≥75 age group having 191 157 new cases globally (crude incidence of 63.3/100 000) and 37 722 cases in China (crude incidence of 51.2/100 000). Both globally and in China, males showed higher incidence and mortality than females. ConclusionsPancreatic cancer is becoming an important public health challenge globally and in China, with incidence and mortality likely to continue rising in the future. Comprehensive prevention and control measures including tobacco control, obesity management, and diabetes monitoring should be strengthened. Early screening and standardized diagnosis and treatment for high-risk populations are crucial for improving pancreatic cancer survival rates. Improving the national cancer registry system and integrating multidisciplinary collaborative models can lay a solid foundation for precision prevention and treatment of pancreatic cancer.
The present paper is aimed to investigate the effect of basic fibroblast growth factor (bFGF) on proliferation, migration and differentiation of endogenous neural stem cell in rat cerebral cortex with global brain ischemia-reperfusion. A global brain ischemia-reperfusion model was established. Immunohistochemistry was used to observe the pathological changes and the expression of BrdU and Nestin in cerebral cortex. RT-PCR was used to measure the NSE mRNA in brain tissue. The results of measurements indicated that in sham operation group, there was no positive cell in cerebral cortex, and the content of NSE mRNA did not change. In the operation group, the expression of BrdU and Nestin increased significantly at the end of the 3rd day, and peaked on the 7th day. NSE mRNA expression did not significantly increase. In bFGF group, compared with sham operation group and model group, the number of BrdU-positive and Nestin-positive cells increased significantly at each time point (P<0.05), and peaked at the end of the 11th day, and the content of NSE mRNA increased significantly (P<0.05). This research demonstrated that the proliferation of endogenous neural stem cells in situ could be induced by global cerebral ischemia and reperfusion, and could be promoted and extended by bFGF. In additiion, bFGF might promote endogenous neural stem cells differentiated into neurons.