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BACKGROUND: Lateral single compartment knee osteoarthritis has a low incidence of degenerative diseases of the knee. Total knee arthroplasty in the treatment of lateral single compartment knee osteoarthritis has achieved considerable clinical efficacy. As a new technology, lateral monocondylar knee replacement has seldom been reported in terms of surgical strategy and clinical efficacy in the treatment of lateral single compartment knee osteoarthritis. OBJECTIVE: To compare the clinical efficacy of lateral unicompartmental knee arthroplasty and total knee arthroplasty for lateral unicompartmental knee osteoarthritis. METHODS: Clinical data of 39 patients with lateral unicompartmental knee osteoarthritis were retrospectively analyzed from October 2016 to October 2018 in the PLA 960 Hospital. According to the surgical plan, the patients were divided into two groups, including 20 patients in the lateral unicompartmental knee arthroplasty group and 19 patients in the total knee arthroplasty group. Perioperative incision healing and postoperative prosthesis survival were followed up. The changes of femorotibial angle of the affected knee were measured before and after operation. The patients’ acceptance of the two methods was statistically compared. The operation time, total blood loss, muscle strength of quadriceps femoris before operation, and the time of going to the ground after operation were compared between the two groups. Visual analogue scale score and Hospital for Special Surgery score were recorded before and after surgery. RESULTS AND CONCLUSION: (1) Perioperative situation: Intraoperative exploration found that a patient scheduled undergoing lateral unicompartmental knee arthroplasty to change the total knee arthroplasty due to anterior cruciate ligament rupture. One patient with diabetes in the lateral unicompartmental knee arthroplasty group had delayed healing of the incision, and one patient in the total knee arthroplasty group had delayed healing due to the liquefaction of fat. The remaining incisions healed normally. (2) Follow up after discharge: One patient in the total knee arthroplasty group died of lung cancer in the second year after operation, and the remainder was normal. The two-year survival rate was 97%. (3) Changes in femorotibial angle before and after surgery: The postoperative valgus angles of the two groups were between 5°-10°, and the lower extremity vertical line recovered well. There was no statistical difference in the femorotibial angle changes between the two groups before and after surgery (P > 0.05). (4) 54% of patients were more willing to undergo lateral unicompartmental knee arthroplasty, and 41% of patients respected the doctor’s suggestion that both surgical methods could be accepted. (5) The operation time, intraoperative and postoperative total blood loss and postoperative time of going to the ground in lateral unicompartmental knee arthroplasty group were better than those in total knee arthroplasty group (P < 0.05). There was no significant difference in preoperative muscle strength of quadriceps femoris, preoperative and postoperative visual analogue scale score, and Hospital for Special Surgery score between the two groups (P > 0.05). (6) Two surgical schemes have considerable clinical effects in the treatment of lateral compartment osteoarthritis. Compared with total knee arthroplasty, the lateral unicompartmental knee arthroplasty has less blood loss and shorter operation time, quick recovery and other advantages, so lateral unicompartmental knee arthroplasty is more suitable for the treatment of patients with osteoarthritis who meet the indications of lateral unicompartmental knee arthroplasty. [ABSTRACT FROM AUTHOR]

BACKGROUND: Heart transplantation is an important treatment for end-stage heart disease. The use of immunosuppressive drugs is indispensable for the maintenance of transplantation. Given the enormous side effects of immunosuppressive drugs, it may even have a significant impact on the quality of life of patients. People began to explore new ways to induce transplantation tolerance to avoid the use of immunosuppressive drugs. The immunomodulation characteristics of mesenchymal stem cells have attracted the attention of researchers and a large number of related researches have been carried out.OBJECTIVE: To summarize and investigate the characteristics of immune regulation of mesenchymal stem cells and immune tolerance induction in heart transplantation and their relationship. METHODS: We searched relevant literature in PubMed database. Key words were “stem cell; mesenchymal stem cells; MSC; MSCs; heart transplantation; cardiac allograft; heart allograft; immune tolerance; tolerance; immunological rejection”. The repetitive studies were excluded after screening, and the related literature was arranged and summarized. RESULTS AND CONCLUSION: On one hand, mesenchymal stem cells have different effects on a variety of immune cells. On the other hand, mesenchymal stem cells regulate or directly produce a large number of biological active factors so as to constitute a complex network, creating a microenvironment conducive to immune regulation. The application of mesenchymal stem cells in heart transplantation is limited to animal experiments, and the results are relatively optimistic. Researchers’ exploration of induction of immune tolerance in heart transplantation will help people to understand the field further and provide more inspiration to relevant clinicians. [ABSTRACT FROM AUTHOR]

BACKGROUND: Allogeneic organ transplantation is one of the most effective therapies to treat end-stage organ failure. However, it is an important problem to effectively overcome the transplantation reaction and induce the immune tolerance of transplantation. The current use of immunosuppressant drugs in clinical practice still has some problems such as limited effect on reducing chronic rejection and high toxicity, and causing chronic infection and tumor. In recent years, the immunomodulatory properties of mesenchymal stem cells have attracted attention in immune tolerance after organ transplantation. OBJECTIVE: To review the immunomodulatory properties of mesenchymal stem cells and their research progress in organ transplantation. METHODS: CNKI and PubMed databases were retrieved by using computer to search relevant articles about immunomodulatory properties of mesenchymal stem cells and their application in organ transplantation. The key words were “mesenchymal stem cells; immune regulation; organ transplantation; rejection reaction; immune tolerance” in Chinese and English, respectively. RESULTS AND CONCLUSION: Mesenchymal stem cells isolated from bone marrow, adipose tissue, umbilical cord, amniotic membrane and other tissues not only have self-replication and multidirectional differentiation potentials, but also have low immunogenicity and conspicuous immunomodulatory properties. Mesenchymal stem cells can inhibit the proliferation and activation of T cells and B cells, and inhibit the proliferation, cytotoxic effect and cytokine secretion of NK cells. Immune tolerance is induced by mesenchymal stem cells through regulating the function and activity of dendritic cells and macrophages. The basic and clinical researches have shown good long-term therapeutic effects and promising application prospect on the anti-rejection response to kidney, liver, heart and skin transplantation. [ABSTRACT FROM AUTHOR]

BACKGROUND: Traditional steel plate internal fixation, the common clinical standard procedure, is nothing new in treating fracture of tibia. The preoperative solid model, however, produced by 3D printing technology, works better in resetting the fracture, and is much safe, accurate and individualized, in contrast to classical approach. OBJECTIVE: To explore the clinical effect and application value of 3D printing technology in healing complex tibial fractures. METHODS: Two groups, 3D group and control group, were divided by 40 cases of unilateral tibial fractures that accepted surgical treatment at Qingdao Hospital of Shandong First Medical University from June 2017 to June 2019. Traditional surgical fixation method was applied to the control group, while the 3D group, however, received operations guided by the preoperative operation of 3D printed solid models, combining the model to perform preoperative simulated reduction and plate internal fixation to guide the actual surgical operation. All patients accepted a 12-month follow-up of comparing the operation time, intraoperative blood loss, intraoperative fluoroscopy times, knee Rasmussen radiology performance on the 3rd day after surgery, and knee HSS score 12 months later. RESULTS AND CONCLUSION: (1) All 40 patients were treated ideally and received an effective follow-up visit for more than 12 months. There were no complications such as vascular and nerve injury, and no rejection reactions related to internal fixation materials. (2) Outcomes, such as operation time, intraoperative blood loss, and intraoperative fluoroscopy were less in the 3D group than those in the control group (P < 0.05). Knee Rasmussen radiology performance on the 3rd day after surgery was higher in the 3D group than that of the control group (P < 0.05). There was no significant difference in knee HSS score between the two groups at 12 months (P > 0.05). (3) Results indicate that in terms of complex tibial fractures treatment, 3D printing shines on significantly shortening the operation time, reducing intraoperative blood loss and fluoroscopy times, and enhancing knee function. [ABSTRACT FROM AUTHOR]

BACKGROUND: At present, the alignment methods commonly used in knee arthroplasty include mechanical alignment and kinematic alignment. The imaging and functional evaluation of the two surgical methods have been studied to some extent, but the gait conditions of patients with the two surgical methods have been studied. OBJECTIVE: To explore the difference in kinematic alignment and mechanical alignment to guide gait analysis after total knee arthroplasty. METHODS: From January 2017 to June 2019, 50 hospitalized patients with inverted knee osteoarthritis were selected. According to the operation method, they were divided into kinematic alignment group (25 cases) and mechanical alignment group (25 cases). The patient’s knee Hospital for special surgery score, visual analogue scale score, and gait parameters (stride speed, stride frequency, stride length, stance and swing phase flexion angle, varus angle, internal and external rotation angle and adduction torque) were used as reference indicators. Follow-up time was 1 year. RESULTS AND CONCLUSION: (1) All patients successfully completed the follow-up, without incision infection, pulmonary embolism, joint dysfunction or other complications. (2) Compared with that before operation, visual analogue scale score and Hospital for special surgery score were significantly improved at 1 year after operation in both groups (P < 0.05). Hospital for special surgery score and visual analogue scale score were not significantly different between the two groups at 1 year after operation (P > 0.05). (3) Except swing phase varus or valgus angle, the gait parameters of the two groups were significantly improved at 1 year after operation compared with those before operation (P < 0.05). There was no statistical difference in stride frequency, standing phase, swing phase flexion and extension, internal and external rotation angle and swing phase varus or valgus angle (P > 0.05). There were significant differences in stride speed, stride length, varus or valgus angle and adduction torque in standing phase (P < 0.05). (4) It is concluded that both kinematic alignment-total knee arthroplasty and mechanical alignment-total knee arthroplasty can significantly improve the postoperative function and gait of the knee joint. However, some patients with kinematic alignment-total knee arthroplasty have residual physiological varus after surgery, but it can more effectively reduce the knee adduction torque, so as to obtain a good treatment effect. [ABSTRACT FROM AUTHOR]

BACKGROUND: Mesenchymal stem cells have the functions of inhibiting inflammation and cell apoptosis, promoting tissue repair, angiogenesis, and immune regulation in ischemic heart disease. OBJECTIVE: To review the latest research progress of mesenchymal stem cells in myocardial ischemia-reperfusion injury to provide ideas and basis for their further research and clinical application. METHODS: PubMed, Wanfang, and CNKI databases were searched for relevant literature. The key words were “mesenchymal stem cell, MSCs, myocardial ischemia-reperfusion injury, MIRI, exosomes, inflammation, tissue repair, vascular regeneration” in Chinese and English, separately. Finally, 48 articles were included and further summarized. RESULTS AND CONCLUSION: Myocardial ischemia-reperfusion injury is a common pathophysiological process in clinical heart diseases. It is common in ischemic cardiomyopathy, cardiopulmonary bypass and heart transplantation. Its mechanisms include free radical damage, calcium ion overload, energy metabolism disorders, and inflammation and so on. In recent years, the treatment of mesenchymal stem cell transplantation has attracted attention. Its exosomal function, myocardial tissue repair, reduction of myocardial cell apoptosis and inhibition of inflammation provide a new idea for treatment of myocardial ischemiareperfusion injury. Adult mesenchymal stem cells are currently the first choice for the treatment of myocardial ischemia-reperfusion injury. Therefore, a better understanding of the mechanism of mesenchymal stem cells in myocardial ischemia-reperfusion injury and the latest research progress are extremely important for their in-depth research and clinical application. [ABSTRACT FROM AUTHOR]

BACKGROUND: Numerous literatures have reviewed and analyzed acupuncture and moxibustion for stress urinary incontinence; however, there are some limitations, such as no comprehensive or targeted analysis of the individual efficacy of acupuncture and moxibustion on female patients. OBJECTIVE: To analyze the characteristics of clinical research regarding acupuncture for treating stress urinary incontinence to provide reference for acupuncture in clinical practice. METHODS: Randomized controlled trials (RCTs) related to acupuncture intervention on stress urinary incontinence published before March 15, 2020 were searched in PubMed, Embase, Cochrane Library, Clinical Evidence, CNKI, VIP, WanFang and SinoMed. Bibliometrics was used to extract data and information from the documents that met the inclusion criteria, and Cochrane was used to evaluate the quality of literature. We quantitatively analyzed acupuncture treatment for stress urinary incontinence from the number of publications, diagnostic criteria, treatment methods, selection of acupoints and meridians, frequency and duration of treatment, curative effect standards and outcome indicators, characteristics of acupuncture operation methods, and design of clinical research methods. RESULTS AND CONCLUSION: A total of 115 Chinese and English documents that met the requirements were screened out. The number of publications has been increasing year by year and tends to be stablely increased since 2012. The use of diagnostic criteria and efficacy criteria is not uniform and standardized; treatment methods are mainly acupuncture alone or in combination with other therapies (pelvic floor muscle training and biofeedback), moxibustion alone or in combination with other therapies, acupuncture combined with other therapies. Single acupuncture therapy is mostly body acupuncture and electric acupuncture. The top 10 acupoints used are Guanyuan (RN 4), Zhongji (RN 3), Sanyinjiao (SP 6), Qihai (RN 6), Shenshu (BL 23), Huiyang (BL 35), Zusanli (ST 36), Zhongliao (BL 33), Ciliao (BL 32), Baihui (DU 20). The BL, RN, GB and KI meridians are the most used. Subjective and objective indicators are combined with each other, and the effective rate is the most frequently used as the outcome indicator. Both clinical operation methods and the course of treatment are different in the documents. The quality of methodology and clinical reports are generally poor, and researches with high argumentation intensity are rare. Methods of acupuncture for stress urinary incontinence are various, mainly based on local selection of acupoints combined with acupoints selection along the meridian. The standards of design and method are different in the clinical researches, which need to be standardized and improved in the future. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The best surgical method for the treatment of multi-segment cervical spondylotic myelopathy is still controversial. In recent years, the application of posterior laminectomy/laminaplasty and fusion in the treatment of cervical spondylotic myelopathy has gradually increased. However, few comprehensive studies have compared the incidence of postoperative adverse events between anterior decompression and fusion and posterior laminectomy/laminaplasty and fusion. Therefore, we conducted a meta-analysis to observe the difference in postoperative adverse events of anterior and posterior cervical fusion for multiple-level cervical spondylosis. METHODS: PubMed, EMbase, Medline, The Cochrane Library, CBM, CNKI, and Wanfang Database were searched by computer for randomized controlled trials published before March 1, 2020 regarding anterior decompression and fusion and posterior laminectomy/laminaplasty and fusion for the treatment of multiple-level cervical spondylosis. The methodological quality of the included literature was evaluated using NOS scale, and then meta-analysis was performed using RevMan 5.3. Various adverse events were compared to evaluate the difference between anterior and posterior depression fusion surgery in various adverse events. RESULTS: (1) Two prospective cohort studies and nine retrospective cohort studies were included, with a total of 36 862 patients. The NOS quality assessment was above 5 points. (2) There was no significant difference between the two surgical methods in adverse events such as fixation failure and mortality (P > 0.05). (3) The incidence of new nerve dysfunction (OR=2.68, 95%CI:1.98-3.63, P < 0.000 01), incidence of cerebral fluid leakage (OR=1.73, 95%CI:1.18-2.54, P=0.005), infection rate at surgical site (OR=4.01, 95%CI:1.66-9.72, P=0.002), incidence of axial cervical pain (OR=7.27, 95%CI:3.04-17.40, P < 0.000 01), incidence of revision surgery (RR=3.14, 95%CI:2.80-3.15, P < 0.000 01), and incidence of chronic neck pain (OR=3.60, 95%CI:2.48-5.24, P < 0.000 01) were higher in the posterior laminectomy/laminaplasty and fusion group than those in the anterior decompression and fusion group. (4) The incidence of dysphagia and hoarseness was higher in the anterior decompression and fusion group than that in the posterior laminectomy/laminaplasty and fusion group (OR=0.23, 95%CI:0.12-0.42, P < 0.000 01). CONCLUSION: (1) Evidence from 11 cohort studies showed that regarding the incidence of postoperative adverse events, the incidences of new neurological dysfunction, cerebrospinal fluid leakage, surgical site infection, cervical axial pain, and revision surgery were less after anterior decompression and fusion. Dysphagia and hoarsenes were less after posterior laminectomy/laminaplasty and fusion. (2) However, limited by the quality of the included literature, above conclusions need to be validated by high-quality, multicenter and blinded randomized controlled trials. [ABSTRACT FROM AUTHOR]

BACKGROUND: With the continuous development of three-dimensional (3D) printing technology and bone tissue engineering, more and more studies have applied 3D printing technology to bone tissue engineering, but the main research status, hot spots and development trend are not clear enough. OBJECTIVE: To explore the current research status, hotspots and development trends of this field through the literature metrology and visual analysis of research hotspots of 3D printing and bone tissue engineering. METHODS: The CNKI database was searched under the theme of “3D printing and bone tissue engineering research”. Based on the quantitative visual analysis method of CNKI literature, the author made a statistical analysis on the trend of the number of publications, publishing institutions and journals of the application of 3D printing technology in bone tissue engineering. VOSviewer software was used to analyze the author collaboration and keyword co-occurrence network of the literature, and the hot research topic was interpreted based on the literature. RESULTS AND CONCLUSION: (1) A total of 469 effective articles related to 3D printing and bone tissue engineering were retrieved. Since 2014, the research on 3D printing and bone tissue engineering has shown a steady growth trend. Chinese Journal of Tissue Engineering Research and Jilin University are the most published journal and institution in this field, respectively. The authors of the literature form five major groups, but there is very little cooperation between the groups. (2) Keywords co-occurrence network shows that the contents revealed by keywords commonly clustering into four research topics (bone tissue engineering scaffold material, 3D printing technology and its application in orthopedics, 3D printing and joint replacement, and others) and the top 10 keywords (3D printing technology, computer aided technology, bone tissue engineering, tissue engineering, fracture, bone defect, hydroxyapatite, three-dimensional, replacement, titanium alloy) really reflect the present situation and the hotspots of current 3D printing and the bone tissue engineering research, which can provide a reference for researchers in this field when choosing a research direction. [ABSTRACT FROM AUTHOR]