Objective To observe the posterior condylar offset (PCO) changes and anteroposterior femorotibial translation, to investigate the influence of them on the maximum knee range of flexion (ROF) in patients with posterior cruciatesacrificingself al ignment bearing total knee arthroplasty (TKA). Methods The cl inical data were analyzed retrospectively from 40 patients (40 knees) undergoing primary unilateral TC-PLUSTM SB posterior cruciate-sacrificing self al ignment andbearing TKA for osteoarthritis between January 2007 and June 2009. There were 18 males and 22 females with an average age of 70.6 years (range, 56-87 years). The disease duration was 5-14 years (mean, 9.1 years). The locations were the left side in 11 cases and the right side in 29 cases. Preoperative knee society score (KSS) and ROF were 48.0 ± 5.5 and (77.9 ± 9.0)°, respectively. The X-ray films were taken to measure PCO and anteroposterior femorotibial translation. Multi ple regression analysis was performed based on both the anteroposterior femorotibial translation and PCO changes as the independent variable, and maximum knee flexion as the dependent variable. Results All incisions healed by first intention. The patients were followed up 12-19 months (mean, 14.7 months). At last follow-up, there were significant differences in the KSS (91.9 ± 3.7, t=— 77.600, P=0.000), the ROF [(102.0 ± 9.3)°, t=— 23.105, P=0.000] when compared with preoperative values. Significant difference was observed in PCO (t=3.565, P=0.001) between before operation [(31.6 ± 5.5) mm] and at last follow-up [(30.6 ± 5.9) mm]. At ast follow-up, the anteroposterior femorotibial translation was (— 1.2 ± 2.1) mm (95%CI: — 1.9 mm to — 0.6 mm); femoral roll forward occurred in 27 cases (67.5%), no roll in 1 case (2.5%), and femoral roll back in 12 cases (30.0%). By multiple regression analysis (Stepwise method), the regression equation was establ ished (R=0.785, R2=0.617, F=61.128, P=0.000). Anteroposterior femorotibial translation could be introducted into the equation (t=7.818, P=0.000), but PCO changes were removed from the equation (t=1.471, P=0.150). Regression equation was y=25.587+2.349x. Conclusion Kinematics after TC-PLUSTM SB posterior cruciate-sacrificing self al ignment bearing TKA with posterior cruciate l igament-sacrificing show mostly roll forwardof the femur relative to the tibia, which have a negative effect on postoperative range of motion. There is no correlation between PCO changes and postoperative change in ROF in TC-PLUSTM SB posterior cruciate-sacrificing self al ignment bearing TKA.
As evidence-based practice (EBP) continues to be valued, the guideline implementation has become an important field for research and practice in health care. In order to better guide the guideline implementation in the field of health care, this paper combines the EBP experience gained from several EBP programs carried out in our hospital those years, in aim of exploring and sharing the methodology of guideline implementation in domestic clinical settings.
Objective To investigate the effectiveness of slope-reducing tibial osteotomy and anterior cruciate ligament (ACL) revision in the treatment of patients with primary ACL reconstruction failure and abnormally increased posterior tibial slope (PTS). Methods The clinical data of 9 patients with primary ACL reconstruction failure and abnormally increased PTS (≥17°) who met the selection criteria between January 2018 and January 2020 were retrospectively analyzed. There were 8 males and 1 female; the age ranged from 21 to 42 years, with a median age of 30 years. Lachman test was positive in 9 patients. Pivot-shift test was negative in 6 cases, degree Ⅰ positive in 2 cases, and degree Ⅱ positive in 1 case. The PTS was (17.78±1.09)° and the anterior tibial translation (ATT) was (11.58±1.47) mm. The International Knee Documentation Committee (IKDC) score was 51.0±3.8, Lysholm score was 49.7±4.6, and Tegner score was 3.7±0.7. The time from primary reconstruction to revision was 12-33 months, with an average of 19.6 months. Slope-reducing tibial osteotomy and ACL revision were performed. The improvement of knee function was evaluated by IKDC score, Lysholm score, and Tegner score; Lachman test and Pivot-shift test were used to evaluate the stability of knee joint. PTS and ATT were measured to observe the morphological changes of knee joint. Results All the incisions healed by first intention, and there was no complication such as incision infection, fat liquefaction, necrosis, deep vein thrombosis of lower extremities, and neurovascular injury. All 9 patients were followed up 12-36 months, with an average of 25.8 months. At last follow-up, Lachman test and pivot-shift test were negative. IKDC score was 85.0±4.0, Lysholm score was 87.7±2.8, Tegner score was 6.8±0.7, PTS reduced to (9.89±0.60)°, and ATT shortened to (0.91±0.29) mm, which were significantly improved when compared with those before operation (P<0.05). ConclusionSlope-reducing tibial osteotomy and ACL revision in the treatment of patients with primary ACL reconstruction failure and abnormally increased PTS has a satisfactory short-term effectiveness. It can improve the stability of knee joint and maintain the normal shape of knee joint.
Testing Treatments is a book to help the public understand how to validate the efficacy of testing treatments and the possible bias and error in clinical trial, as well as to call for help to promote good study thus to improve the quality of health care. No matter for the first or the second edition, this book is very popular around the world, and its second edition has been translated into more than ten languages. To help the readers understand the content of the book, we established a website (www.testingtreatments.org) and other sibling sites in different languages. The website not only provided the full-texts to download, but also collected various popular science resources (videos, audios and cartoons) to help the readers assimilate more knowledge. The editors of all the different language websites have established an TTi Editorial Alliance to share experience and provide each other with mutual support, thus to promote health professionals, patients and public around the world to use reliable research to inform their health decisions.
In recent years, 3D-printed porous titanium scaffold has become a focus of research in bone defect repair due to their controllable pore structure and good biocompatibility. Its main strategies include pore design to optimize mechanics and bone ingrowth, surface functionalization modification to enhance osseointegration and anti-infection ability, and loading of bioactive molecules to achieve temporal release and promote vascular osteogenic coupling. Individualized precise reconstruction is gradually being carried out in clinical applications, but long-term safety, manufacturing accuracy, and cost-effectiveness remain challenges. This article reviews the research progress of 3D-printed porous titanium scaffold in bone defect repair, summarizes their application advantages and limitations, and looks forward to directions such as intelligent coatings, immune regulation, and artificial intelligence, in order to provide a reference for their clinical translation.
The Clearinghouse plays an important role in knowledge translation in western developed countries. It consistently provides the latest evidence to target customers according to its strict criteria in the specific fields. Clearinghouse is objectively and scientifically designed to assess the scientific nature and the practical applicability of evidence to provide the best current evidence to different service practitioners. It emphasizes much on the process from "knowledge production" to "knowledge utilization", which effectively fills the gap between scientific research and practice. It will play an increasing important role in the knowledge translation in the future. This article specifically introduces its history of development, characteristics and application and sets the construction of Chinese Clearinghouse for Evidence Translation in Child & Aging Health (CCET) as an example, fully elaborating the application status of Clearinghouse and providing assistance for evidence informed decision making.
In recent years, scholars from diverse fields have initiated explorations into the integration of multimodal data, leveraging the unique advantages of various data types to enhance the perceptual and cognitive capabilities of models. Storyboarding is a visual tool for presenting stories. It has been introduced into the field of evidence-based medicine as an analytical technique for qualitative evidence synthesis (QES), which helps researchers organize and present research results and facilitates the interaction of evidence between doctors and patients. By integrating visual, textual, and other multimodal elements, storyboarding effectively communicate intricate and multifaceted qualitative information. Storyboarding, as an innovative approach to evidence synthesis and presentation, has yet to gain widespread adoption in the field. This paper introduces storyboarding within the context of qualitative evidence synthesis, detailing its methodology and process. Through case analysis, it demonstrates how storyboarding can facilitate multimodal data analysis, thereby enhancing the readability and dissemination of evidence. It offers new methodologies for evidence synthesis, promoting knowledge translation and evidence communication. Storyboarding is particularly well-suited as a premier tool for evidence transformation and application in healthcare research. By refining information presentation, it significantly improves content readability, enabling users to more effectively understand and apply information in stakeholders. Although storyboarding technology remains underutilized in evidence-based medicine, its potential will likely be increasingly recognized as multimodal evidence grows and the demand for effective evidence transformation rises. In the future, this method promises to play a pivotal role in advancing evidence-based medicine.
Protein post-translational modifications (PTMs) are critical for modulating protein structure and function. Among these, lysine lactylation (Kla) has garnered significant attention in recent years as a newly discovered PTM. Although Kla has been thoroughly investigated in eukaryotic systems, its study in prokaryotes, especially bacteria, remains comparatively limited. Emerging research highlights that bacterial Kla, operating through dynamic modification mechanisms, is pivotal in processes such as growth and metabolism, virulence control, pathogenicity, and host-pathogen interactions. This article provides a comprehensive overview of the latest progress in bacterial Kla research, emphasizing its historical discovery, distinct modification features, and underlying molecular regulatory mechanisms. We further explore the regulatory roles of this modification in bacterial physiological processes and pathogenesis, concluding with a discussion of current research challenges and prospective future developments.
Objective By summarizing the latest research progress of circRNA translation mechanism and reviewing the research progress of circRNA translation in various digestive system tumors, this paper is aiming to forecast the clinical application prospect of circular RNA translation and provide ideas for the diagnosis and treatment of digestive system neoplasms. Method The literatures on the translation of circRNA and its role in digestive system neoplasms were searched and reviewed. Results As a member of the non-coding RNA family, circRNAs are generally considered to be difficult to encode proteins as translation templates. With the rapid development of bioinformatics, next-generation sequencing, proteomics and translation omics, it has been found that many kinds of circRNAs can encode proteins or peptides in a cap-independent manner and play a critical role in the development of digestive system neoplasms, including gastric cancer, liver cancer and colorectal cancer. Conclusions The translation function of circRNA plays an important role in the development and progression of digestive system tumors, and its translation products may become new diagnostic or therapeutic targets for digestive system tumors, with great clinical transformation potential.
Parkinson’s disease is a common neurodegenerative disorder with continuously rising incidence rates. Existing pharmacological treatments have complications and cannot halt disease progression. Transcranial focused ultrasound stimulation (tFUS), as a novel neuromodulation technology, demonstrates unique advantages in Parkinson’s disease treatment. tFUS exerts multiple effects through mechanical mechanisms at multiple levels, including protecting dopaminergic neurons, regulating neurotransmitter systems, and improving neural circuit function. Preclinical studies have confirmed its potential in improving both motor and non-motor symptoms, and early clinical studies have shown good safety profiles. However, the clinical translation of tFUS still faces challenges such as parameter optimization and individualized treatment protocols, requiring validation of long-term efficacy through large-scale clinical trials.