Publications by authors named "Yixin Zhou"

128 Publications

Malposition of components and Femorotibial mechanical Axis changes on pressure distribution in Total knee arthroplasty.

Clin Biomech (Bristol, Avon) 2022 May 6;96:105659. Epub 2022 May 6.

Department of Orthopaedic Surgery, Beijing Jishuitan Hospital, Fourth Clinical College of Peking University, Beijing 100035, China. Electronic address:

Background: To the best of our knowledge, no report has analyzed the postoperative results of poor prosthesis position, particularly when the femoral and tibial components are abnormally positioned relative to neutral lower limb alignment. We aimed to investigate pressure distribution in the knee at different lower limb alignments with diverse positions of femoral and tibial components.

Methods: We established a three-dimensional model of the lower limb using computed tomography and simulated total knee arthroplasty. Tibial and femoral components were changed to 7°, 5°, and 3° of valgus and neutral and 3°, 5°, and 7° of varus positions in the coronal plane. Finite element analysis was performed after applying pressure to simulate weight-bearing, and pressure distribution on the tibial surface was analyzed. We also conducted biomechanical testing using a weight-bearing rig with six cadavers. We measured the pressure at the tibial surface with the position of different components and lower limb alignment.

Findings: Peak pressure on the medial or lateral side of the tibia was determined by the mechanical axis. When tibial components are in 3°,5° and 7° of valgus/varus and femoral components are in 3°,5° and 7° of varus/valgus correspondence, no peak pressure was detected with normal alignment, despite malpositioned components.

Interpretation: Lower limb alignment is more critical than the position of the component. Medial and lateral tibial compartment pressures were evenly distributed if the alignment was neutral. Malpositioned femoral or tibial components changed the femorotibial mechanical axis, and peak pressure of the proximal tibia was positively related to alignment.
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http://dx.doi.org/10.1016/j.clinbiomech.2022.105659DOI Listing
May 2022

[Midterm follow-up outcomes of total hip arthroplasty in treatment for patients with juvenile-onset ankylosing spondylitis].

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2022 May;36(5):548-554

Department of Orthopedics, Beijing Jishuitan Hospital (Fourth Clinical College of Peking University), Beijing, 100035, P. R. China.

Objective: To assess the midterm follow-up outcomes of total hip arthroplasty (THA) for the treatment of patients with juvenile-onset ankylosing spondylitis (JAS).

Methods: The clinical data of 81 patients (127 hips) with JAS (age≤16 years, JAS group) and 267 patients (391 hips) with adult onset ankylosing spondylitis (AAS) (age>16 years, AAS group) between January 2004 and March 2018 were retrospectively analysed. The baseline demographics, clinical, radiographic, and laboratory parameters were collected. Before operation and at last follow-up, the overall disease activity [Bath ankylosing spondylitis disease activity index (BASDAI)] and function status [Bath ankylosing spondylitis functional index (BASFI)], hip subjective score [Harris hip score (HHS)] and objective score [12-item short form health survey (SF-12), including physical component score (PCS) and mental component score (MCS)], and patient satisfaction for THA were reviewed. The major orthopedic complications, including periprosthetic infection, dislocation, periprosthetic fractures, and poor incision healing, were also recorded during the follow-up period.

Results: The comparison of preoperative baseline parameters showed that the body mass, body mass index, age of onset, age of surgery, disease duration, and the proportion of combined smoking history in the JAS group were significantly lower than those in the AAS group ( <0.05), the proportion of bilateral surgeries, proportion of uveitis, proportion of combined family history, C-reactive protein, albumin, and preoperative BASFI were significantly higher than those in the AAS group ( <0.05). Both groups were followed up. The follow-up time in the JAS group was 29-199 months, with an average of 113 months; in the AAS group was 35-199 months, with an average of 98 months. Incisions in both groups healed by first intention. During the follow-up period, there were 1 case of periprosthetic fracture, 1 case of dislocation, and 1 case of ceramic fragmentation in the JAS group, 1 case of periprosthetic infection and 6 cases of periprosthetic fracture in the AAS group. There was no significant difference in the incidence of complications between the two groups ( >0.05). At last follow-up, the BASDAI, BASFI, SF-12 MCS, SF-12 PCS, and HHS score of the two groups were significantly improved when compared with those before operation ( <0.05); but there was no significan difference in the difference of the above parameters before and after operation and the patient satisfaction between the two groups ( >0.05).

Conclusion: The midterm follow-up outcomes of THA for the treatment of JAS patients were reliable. A low age at disease onset did not exert a significant negative effect on THA reconstruction for the treatment of ankylosing spondylitis.
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http://dx.doi.org/10.7507/1002-1892.202111062DOI Listing
May 2022

A CT-based radiomics model to predict subsequent brain metastasis in patients with ALK-rearranged non-small cell lung cancer undergoing crizotinib treatment.

Thorac Cancer 2022 Apr 18. Epub 2022 Apr 18.

State Key Laboratory of Oncology in South China, Guangzhou, China.

Background: Brain metastasis (BM) comprises the most common reason for crizotinib failure in patients with anaplastic lymphoma kinase (ALK)-rearranged non-small cell lung cancer (NSCLC). We hypothesize that its occurrence could be predicted by a computed tomography (CT)-based radiomics model, therefore, allowing for selection of enriched patient populations for prevention therapies.

Methods: A total of 75 eligible patients were enrolled from Sun Yat-sen University Cancer Center between June 2014 and September 2019. The primary endpoint was brain metastasis-free survival (BMFS), estimated from the initiation of crizotinib to the date of the occurrence of BM. Patients were randomly divided into two cohorts for model training (n = 51) and validation (n = 24), respectively. A radiomics signature was constructed based on features extracted from chest CT before crizotinib treatment. Clinical model was developed using the Cox proportional hazards model. Log-rank test was performed to describe the difference of BMFS risk.

Results: Patients with low radiomics score had significantly longer BMFS than those with higher, both in the training cohort (p = 0.019) and validation cohort (p = 0.048). The nomogram combining smoking history and the radiomics signature showed good performance for the estimation of BMFS, both in the training (concordance index [C-index], 0.762; 95% confidence interval [CI], 0.663-0.861) and validation cohort (C-index, 0.724; 95% CI, 0.601-0.847).

Conclusion: We have developed a CT-based radiomics model to predict subsequent BM in patients with non-brain metastatic NSCLC undergoing crizotinib treatment. Selection of an enriched patient population at high BM risk will facilitate the design of clinical trials or strategies to prevent BM.
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http://dx.doi.org/10.1111/1759-7714.14386DOI Listing
April 2022

Safety, Tolerability, and Pharmacokinetics of the Novel Hepatitis B Virus Expression Inhibitor GST-HG131 in Healthy Chinese Subjects: a First-in-Human Single- and Multiple-Dose Escalation Trial.

Antimicrob Agents Chemother 2022 May 11;66(5):e0009422. Epub 2022 Apr 11.

Phase I Clinical Trial Unit, First Hospital, Jilin University, Changchun, China.

GST-HG131, a novel dihydroquinolizinone (DHQ) compound, has been shown to reduce circulating levels of HBsAg in animals. This first-in-human trial evaluated the safety, tolerability, and pharmacokinetic profile of GST-HG131 in healthy Chinese subjects. This was a double-blind, randomized, placebo-controlled phase Ia clinical trial that was conducted in two parts. Part A was a single-ascending-dose (SAD; GST-HG131 10 30, 60, 100, 150, 200, 250 or 300 mg or placebo) study, which also assessed the food effect of GST-HG131 100 mg. Part B was a multiple-ascending-dose (MAD; GST-HG131 30, 60 or 100 mg or placebo BID) study. Tolerability assessments included adverse events, vital signs, 12-lead electrocardiogram, physical examination, and clinical laboratory tests. PK analyses were conducted in blood, urine, and fecal samples. Single doses of GST-HG131 ≤ 300 mg and multiple doses of GST-HG131 ≤ 60 mg were generally safe and well tolerated; however, multiple dosing was stopped at GST-HG131 100 mg, as pre-defined stopping rules specified in the protocol were met (Grade II drug related AEs of nausea and dizziness in >50% of subjects). In the SAD study, median t of GST-HG131 was 1-6 h, and t ranged from 3.88 h to 14.3 h. PK parameters were proportional to dose. Exposure was reduced after food intake. In the MAD study, steady-state was attained on day 4, and there was no apparent plasma accumulation of GST-HG131 on day 7 (R < 1.5). In conclusion, GST-HG131 exhibited an acceptable safety profile in healthy subjects at single doses ranging from 10-300 mg and multiple doses (BID) ranging from 30-60 mg, and the MAD doses (30 mg and 60 mg BID) that potentially meet the therapeutic AUC requirements. These findings imply GST-HG131 has potential as a therapeutic option for CHB infection. (This study has been registered at ClinicalTrials.gov under identifier NCT04499443.).
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http://dx.doi.org/10.1128/aac.00094-22DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9112976PMC
May 2022

Study on the Macroeconomic Model Based on the Genetic Algorithm.

Appl Bionics Biomech 2022 30;2022:9448895. Epub 2022 Mar 30.

Logistics Management, Wuhan Business School, 430056 Wuhan, China.

In order to design a more reliable general push time cycle prediction software for macroeconomic indicators, a set of general software is used to serve financial transactions, bulk material transactions, international trade, macro-control and other fields, so as to improve the prediction of macroeconomic indicators. Because the macro data is one-dimensional array data, the essence of the mutation algorithm is to obtain the movement direction of the mutation of data nodes, obtain the distance between the linear programming result and the original data through the least square method, and calculate the average value in the original data, After binary -correction, it refers to the binary -correction results of the one-dimensional matrix before the final evaluation output factor and the one-dimensional matrix after the final evaluation output factor. In this study, genetic algorithm is introduced as the core algorithm. In the algorithm efficiency verification test, the calculation model based on genetic algorithm is constructed in Matlab environment, and the data space construction mode and genetic variation mode of genetic algorithm are explored. Finally, a high-throughput macroeconomic timing prediction scheme based on genetic algorithm is designed. This scheme is more accurate than the paid full-function 10jqka software, and has a higher prediction cycle for stock price and stock index. The simulation software composed of this algorithm has the prediction function that 10jqka software cannot complete.
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http://dx.doi.org/10.1155/2022/9448895DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8986447PMC
March 2022

Patient-perceived knee enlargement after total knee arthroplasty: prevalence, risk factors, and association with functional outcomes and radiological analysis.

Int Orthop 2022 Jun 29;46(6):1305-1312. Epub 2022 Mar 29.

Department of Orthopaedic Surgery, Beijing Jishuitan Hospital, Fourth Clinical College of Peking University, No. 31 Xinjiekou East Street, Xicheng District, Beijing, 100035, China.

Purpose: In clinical practice, many patients complained that their knees became larger after total knee arthroplasty (TKA), yet no studies have described this phenomenon. We named this as "patient-perceived enlargement of knee" (PPEK). This study aimed to investigate the prevalence of PPEK after TKA; assess the association between PPEK and demographics, surgical options, or component size; assess the influence of PPEK on patient satisfaction and functional outcomes; and determine whether there was radiological difference between patients with or without PPEK.

Methods: We reviewed patients that underwent unilateral primary TKA between May 2018 and April 2019. We investigated the prevalence of PPEK and acquired functional scores and satisfaction. Patients were divided into two groups according to whether they complained of PPEK. In radiological evaluation, we measured anterior and posterior condyle offset (ACO and PCO) of the femur, tibial coverage lines, tibial overhanging lines, and femoral overhanging lines.

Results: A total of 389 patients were enrolled and 101 patients felt their knee became "larger" after TKA. Patients with PPEK had significantly shorter height and lower weight, yet component size distribution showed no statistical difference. Patients with PPEK had significantly lower functional scores and satisfaction. Patients with PPEK had significantly larger ACO, shorter postoperative PCO, more ACO increase, and less anterior underhang of the tibia.

Conclusion: PPEK is common in TKA patients, especially in individuals with smaller height and weight. PPEK is associated with poor satisfaction and lower functional scores. In radiology, post-operative ACO, PCO, and anterior underhang of the tibial component were correlated with PPEK.
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http://dx.doi.org/10.1007/s00264-022-05388-zDOI Listing
June 2022

Optimizing the tumor shrinkage threshold for evaluating immunotherapy efficacy for advanced non-small-cell lung cancer.

J Cancer Res Clin Oncol 2022 Mar 18. Epub 2022 Mar 18.

State Key Laboratory of Oncology in South China, Guangzhou, China.

Purpose: The rise of immune checkpoint inhibitors (ICIs) in recent years has coincided with unusual clinical response patterns. Modification of the sum of longest diameters (SLD)-based threshold that reflecting dynamic change of the tumor burden and predicting response to ICIs, may markedly improve current treatment regimens.

Methods: The baseline and post-treatment SLD of target lesion was recorded and the maximum percent change of the SLD from baseline was designated as SLD-change score. The optimal cut-off value was obtained using the X-tile program. The relationship between SLD-change score and survival outcome (PFS, OS) was evaluated.

Results: 10% cut-off value of SLD-change score was found to be most distinctive for PFS. Responders defined according to this cut-off value showed a significant improvement for PFS and OS. Bone metastasis and brain metastasis were also two independent prognostic factors of PFS and OS, respectively.

Conclusions: 10% SLD change score could discriminate for ICIs treatment response, which holds great promise in promoting the development of precise immunotherapeutic strategy.
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http://dx.doi.org/10.1007/s00432-022-03978-3DOI Listing
March 2022

Association of China's two-child policy with changes in number of births and birth defects rate, 2008-2017.

BMC Public Health 2022 03 4;22(1):434. Epub 2022 Mar 4.

Department of Bioinformatics and Biostatistics, School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, Shanghai, China.

Background: In October 2015, China's one-child policy was universally replaced by a so-called two-child policy. This study investigated the association between the enactment of the new policy and changes in the number of births, and health-related birth outcomes.

Methods: We used difference-in-difference model to analyse the birth record data in Pudong New Area, Shanghai.The design is descriptive before-and-after comparative study.

Results: The data covered three policy periods: the one-child policy period (January 2008 to November 2014); the partial two-child policy period (December 2014 to June 2016); the universal two-child policy period (July 2016 to December 2017). There was an estimate of 7656 additional births during the 18 months of the implementation of the universal two-child policy. The trend of monthly percentage of births to mothers aged ≥35 increased by 0.24 percentage points (95% confidence interval 0.19 to 0.28, p < 0.001) during the same period. Being a baby boy, preterm birth, low birth weight, parents with lower educational attainment, and assisted delivery were associated with a higher risk of birth defects.

Conclusions: The universal two-child policy was associated with an increase in the number of births and maternal age. Preterm birth, low birth weight, and assisted delivery were associated with a higher risk of birth defects, which suggested that these infants needed additional attention in the future.
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http://dx.doi.org/10.1186/s12889-022-12839-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8895506PMC
March 2022

Conversion of the Sagittal Functional Safe Zone to the Coronal Plane Using a Mathematical Algorithm: The Reason for Failure of the Lewinnek Safe Zone.

J Bone Joint Surg Am 2022 Feb 9. Epub 2022 Feb 9.

Department of Orthopaedic Surgery, Beijing Jishuitan Hospital, Fourth Clinical College of Peking University, Beijing, People's Republic of China.

Background: Ante-inclination (AI) of the cup is a key component of the combined sagittal index (CSI) for predicting joint stability after total hip arthroplasty (THA). We aimed to (1) validate a mathematical algorithm relating AI to radiographic anteversion (RA), radiographic inclination (RI), and pelvic tilt (PT); (2) convert the AI criterion of the CSI into the coronal functional safe zone (CFSZ) and explore the influences of standing-to-sitting pelvic motion (PM) and pelvic incidence (PI) on the CFSZ; and (3) attempt to locate a universal cup orientation that always fulfills the AI criterion of the CSI for all patients.

Methods: In the first phase, a phantom pelvis was designed to simulate a range of PT values, and an acetabular cup was implanted with different RA, RI, and PT settings using a robot-assisted technique and scanned using the EOS imaging system. The second phase involved patient radiographs. We enrolled 100 patients who underwent robot-assisted THA from April 2019 to December 2019, and EOS images before THA and at the 12-month follow-up were recorded. The AI was measured on a lateral radiograph; this angle was used as the reference and compared with the calculated AI to assess the accuracy of the algorithm. Linear regression was conducted to explore the relationship between the size of the CFSZ and the values of PM and PI. We calculated the intersection of the CFSZs of the patients to find a universal cup orientation (RA and RI) for the CSI.

Results: The algorithm was accurate according to both the phantom study and patient radiographs using PT at the time of follow-up, with mean absolute errors (MAEs) of 1.5° (width of 95% confidence interval [CI], 2.2°) and 2.8° (width of 95% CI, 3.0°), respectively. However, the preoperatively predicted AI had an MAE of 9.0° (width of 95% CI, 10.5°). In patient subgroups with lower PM or PI, the sizes of the CFSZ and of its intersection with the Lewinnek safe zone were significantly smaller (p < 0.017). No universal cup orientation existed to fulfill the CSI criteria for all patients or for any of the PM or PI subgroups.

Conclusions: The target orientation for the cup in THA should be individualized. Our validated algorithm may serve as a quantitative tool for the patient-specific optimization of cup AI on the basis of the functional safe zone.

Clinical Relevance: The Lewinnek safe zone fails because it cannot predict the functional orientation of the cup. The concept of a universal safe zone of cup orientation should be abandoned and replaced by a patient-specific surgical target.
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http://dx.doi.org/10.2106/JBJS.21.00840DOI Listing
February 2022

Assessment of sarcopenia as a predictor of poor overall survival for advanced non-small-cell lung cancer patients receiving salvage anti-PD-1 immunotherapy.

Ann Transl Med 2021 Dec;9(24):1801

State Key Laboratory of Oncology in South China, Guangzhou, China.

Background: Sarcopenia, which is defined as the loss of skeletal muscle mass, has been identified as a poor prognostic factor for cancer patients. This study sought to elucidate the effects of sarcopenia on the outcomes of advanced non-small cell lung cancer (NSCLC) patients receiving salvage anti-programmed death-1 (PD-1) immunotherapy.

Methods: In total, 105 NSCLC patients receiving second-line anti-PD-1 immunotherapy at the Sun Yat-sen University Cancer Center between January 2015 and December 2017 were enrolled in this study, and detailed patient data were collected. Available lumbar computed tomography images of the patients were analyzed to determine the total skeletal muscle cross-section area. The efficacy of the predictive and prognostic role of sarcopenia in progression-free survival (PFS) and overall survival (OS) was analyzed using the Kaplan-Meier method, and the risk factors were analyzed using Cox analyses.

Results: We found that patients with sarcopenia receiving salvage anti-PD-1 immunotherapy had significantly worse PFS (2.67 . 7.96 months; P<0.001) and OS (9.08 . 21.84 months; P<0.001) than their non-sarcopenic counterparts. We also found that sarcopenia was associated with the neutrophil-to-lymphocyte ratio (NLR) (P=0.041), and that the NLR acts as a predictor of OS.

Conclusions: Sarcopenia was associated with a poor prognosis in advanced NSCLC patients receiving salvage anti-PD-1 immunotherapy. Further research needs to be conducted to identify more biomarkers and the patients most likely to benefit from immunotherapy.
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http://dx.doi.org/10.21037/atm-21-6578DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8756219PMC
December 2021

Reducing number of target lesions for RECIST1.1 to predict survivals in patients with advanced non-small-cell lung cancer undergoing anti-PD1/PD-L1 monotherapy.

Lung Cancer 2021 Dec 31;165:10-17. Epub 2021 Dec 31.

State Key Laboratory of Oncology in South China, Guangzhou, China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, China; Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China. Electronic address:

Objectives: The Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 provides conventional and standardized response assessment for multiple solid tumors. We investigated the smallest number of target lesions that can be measured without compromising response categorization and survival prediction in patients with advanced non-small-cell lung cancer (aNSCLC) undergoing anti-PD-1/PD-L1 monotherapy.

Material And Methods: 125 aNSCLC patients with at least two measurable lesions undergoing PD-1/PD-L1 inhibitor treatment were retrospectively studied. Tumor measurements allowing up to two lesions per organ and five lesions in total were reviewed. Inter-individual agreement and κ values for inter-method concordance on response status were evaluated based on up to five target lesions versus the largest one through four lesions. C-index was calculated to evaluate the prognostic accuracy of response categorization based on the selected number of target lesions for predicting overall survival (OS). Cox regression analysis was conducted for survival analysis.

Results: The highly consistent response assignment (99.2%) could be obtained when measuring the largest two lesions versus up to five lesions. Using the largest two through four lesions produced κ values of 0.986, 1.000 and 1.000 for response assessment, values significantly higher than those obtained when measuring the largest single lesion (κ = 0.850). C-index for overall survival (OS) was similar when assessing the largest one through five lesions, ranging from 0.646 to 0.654. Cox regression analyses showed that radiological response significantly predicted OS, irrespective of the number of target lesions selected.

Conclusions: Reducing the number of target lesions does not affect OS prediction in aNSCLC patients treated with anti-PD-1/PD-L1 therapy. Considering the high intra-individual and inter-method concordance, using the largest two lesions in total is proposed to assess response.
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http://dx.doi.org/10.1016/j.lungcan.2021.12.015DOI Listing
December 2021

The correlation between volumetric bone mineral density and morphological parameters of the proximal femur and clinical outcomes in ankylosing spondylitis patients with hip involvement.

BMC Musculoskelet Disord 2022 Jan 3;23(1):24. Epub 2022 Jan 3.

Department of Orthopedic Surgery, Beijing Jishuitan Hospital, Fourth Clinical College of Peking University, No. 31 Xinjiekou East Street, Xicheng District, Beijing, 100035, China.

Background: To measure volumetric bone mineral density (vBMD) with quantitative computed tomography (QCT) in the proximal femur of ankylosing spondylitis (AS) patients with hip involvement and analyze their correlations with radiographic and clinical parameters.

Methods: Sixty-five AS inpatients were enrolled in this study. The bone mineral density was measured by QCT and dual-energy x-ray absorptiometry (DXA), respectively. The morphological parameters of the proximal femur were measured on digital anteroposterior (AP) radiographs of the pelvis. The correlations between them were analyzed by SPSS software.

Results: The average trabecular vBMD measured at the femoral neck was 136.38 ± 25.58 mg/cm. According to the BASRI-Hip score, group A consisted of 39 hips (0-2 score) and group B consisted of 26 hips (3-4 score). There were significant differences regarding trabecular CTXA equivalent T-score between group A and B at the femoral neck (p = 0.004); intertrochanteric region (p < 0.001) and greater trochanter (p = 0.001). The trabecular CTXA equivalent T-score at femoral neck had a negative correlation with disease duration (r = - 0.311, p = 0.012) and with CBR (r = - 0.319, p = 0.010).

Conclusions: The low trabecular bone density at the site of the hip was associated with the duration of disease progression and degree of hip involvement. Meanwhile, it had a correlation with hip function status although we failed to confirm a significant relationship between hip vBMD and disease activity.
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http://dx.doi.org/10.1186/s12891-021-04912-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8725399PMC
January 2022

Deoxyribonucleic Acid 5-Hydroxymethylation in Cell-Free Deoxyribonucleic Acid, a Novel Cancer Biomarker in the Era of Precision Medicine.

Front Cell Dev Biol 2021 10;9:744990. Epub 2021 Dec 10.

Department of Surgical Oncology, Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou, China.

Aberrant methylation has been regarded as a hallmark of cancer. 5-hydroxymethylcytosine (5hmC) is recently identified as the ten-eleven translocase (ten-eleven translocase)-mediated oxidized form of 5-methylcytosine, which plays a substantial role in DNA demethylation. Cell-free DNA has been introduced as a promising tool in the liquid biopsy of cancer. There are increasing evidence indicating that 5hmC in cell-free DNA play an active role during carcinogenesis. However, it remains unclear whether 5hmC could surpass classical markers in cancer detection, treatment, and prognosis. Here, we systematically reviewed the recent advances in the clinic and basic research of DNA 5-hydroxymethylation in cancer, especially in cell-free DNA. We further discuss the mechanisms underlying aberrant 5hmC patterns and carcinogenesis. Synergistically, 5-hydroxymethylation may act as a promising biomarker, unleashing great potential in early cancer detection, prognosis, and therapeutic strategies in precision oncology.
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http://dx.doi.org/10.3389/fcell.2021.744990DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8703110PMC
December 2021

Contact-Resistance-Free Stretchable Strain Sensors with High Repeatability and Linearity.

ACS Nano 2021 Dec 17. Epub 2021 Dec 17.

State Key Laboratory of Nonlinear Mechanics, Institute of Mechanics, Chinese Academy of Sciences, Beijing 100190, China.

Most of the existing stretchable strain sensors are based on the contact-resistance mechanism, where the stretchability and resistance variation depend on the change of the contact relationship of the conductive microstructures. These sensors usually exhibit large sensing ranges and gauge factors but unsatisfactory repeatability and linearity of the electrical responses because the contact is unstable. Here, we report a completely different design for stretchable strain sensors based on a contact-resistance-free structure, i.e., the off-axis serpentine sandwich structure (OASSS), with the mechanism of the stretch-bending-stretch transformation (SBST). Neither unstable contact resistance nor nonlinear constitutive and geometric behaviors occur for the OASSS while the sensor undergoes a large applied strain (50%), which guarantees high repeatability (repeatability error = 1.58%) and linearity (goodness-of-fit >0.999). Owing to such performances, the present sensors are not only applied to monitoring human activities and medical surgery but also to the ground tests of Tianwen-1, China's first Mars exploration mission.
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http://dx.doi.org/10.1021/acsnano.1c07645DOI Listing
December 2021

[Long-term effectiveness of total hip arthroplasty for Crowe type developmental dysplasia of the hip].

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2021 Dec;35(12):1531-1536

Department of Orthopedics, Beijing Jishuitan Hospital (Fourth Clinical College of Peking University), Beijing, 100035, P.R.China.

Objective: To investigate the long-term effectiveness of primary total hip arthroplasty (THA) in treatment of Crowe type Ⅳ developmental dysplasia of the hip (DDH).

Methods: A clinical data of Crowe type Ⅳ DDH patients treated with primary THA between January 2002 and August 2008 and followed up more than 13 years was retrospectively analyzed. Forty-two patients (45 hips) met the selection criteria and were enrolled in this study. There were 13 males and 29 females with an average age of 43.5 years (range, 18-65 years). There were 39 patients of unilateral hip and 3 of bilateral hips. The preoperative Harris score was 38.3±10.7 and leg length discrepancy of the patients treated with unilateral THA was (50.52±24.51) mm. During operation, 19 hips underwent subtrochanteric shortening osteotomy, with an average length of 25 mm (range, 15-35 mm). The Harris score, subjective satisfaction, prosthesis survival rate, complications, and related imaging indicators were summarized.

Results: All patients were followed up 13.0-19.6 years (mean, 15.0 years). The complications included 1 hip of femoral nerve palsy, 2 hips of dislocation, 1 hip of periprosthetic fracture, 1 hip of periprosthetic joint infection. At last follow-up, the Harris score was 82.1±9.3, which significantly improved when compared with preoperative one ( =-21.885, =0.000). The subjective satisfaction was evaluated as very dissatisfactory in 3 hips, dissatisfactory in 1 hip, generally in 4 hips, satisfactory in 17 hips, and very satisfactory in 20 hips. X-ray films showed that the height of the greater trochanter of affected side was 3.01-51.60 mm (mean, 23.22 mm); the descending distance of greater trochanter was 3.95-98.06 mm (mean, 48.20 mm); the affected limb lengthened 3.95-61.63 mm (mean, 34.92 mm); the leg length discrepancy of patients treated with unilateral THA was (12.61±8.56) mm, which was significantly shorter than that before operation ( =11.721, =0.000). The vertical distance between the center of rotation of the affected side and the teardrop line was (14.65±6.16) mm, and the difference was not significant when compared with (15.60±4.99) mm of the healthy side ( =-0.644, =0.525); the horizontal distance was (22.21±5.14) mm, and the difference was significant when compared with (34.48±5.63) mm of the healthy side ( =-12.973, =0.000). Except for the non-union of 1 hip subtrochanteric shortening osteotomy, the other subtrochanteric osteotomies healed well. During follow-up, all the femoral stems obtained bone ingrowth fixation without radiolucent line or radiopaque line. With any reoperation and aseptic loosening as the endpoint, the prosthetic survival rates were 88.64% [95% (63.73%, 96.82%)] and 89.19% [95% (65.61%, 96.94%)], respectively.

Conclusion: For Crowe type Ⅳ DDH patients, primary THA combined with subtrochanteric shortening osteotomy if necessary, can obtain satisfactory long-term effectiveness and prosthetic survival rate.
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http://dx.doi.org/10.7507/1002-1892.202107100DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8669183PMC
December 2021

Correction to: Hepatotoxicity associated with PD-1 blockade antibodies in cancer patients co-infected with hepatitis B virus.

Cancer Immunol Immunother 2022 May;71(5):1257

Department of Medical Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, China.

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http://dx.doi.org/10.1007/s00262-021-03112-1DOI Listing
May 2022

Different Deformity Origins and Morphological Features in Subtypes of Valgus Knees: A Radiological Classification System.

Orthop Surg 2022 Jan 6;14(1):96-103. Epub 2021 Dec 6.

Department of Orthopaedic Surgery, Beijing Jishuitan Hospital, Fourth Clinical College of Peking University, Jishuitan Orthopaedic College of Tsinghua University, Beijing, China.

Objective: To analyze the deformity origins and distribution among valgus knees to individualize their morphological features.

Methods: Radiographic images of 105 valgus knees were analyzed. Long-film radiographs and computed tomography were collected for every knee. A malalignment test was performed on standing long-film radiographs. The hip-knee-ankle angle (HKA), the anatomical lateral distal femoral angle (aLDFA), and the anatomical medial proximal tibial angle (aMPTA) were measured on long-film radiographs. The distal condylar angle and posterior condylar angle on distal femur were further measured on computed tomography scans. The tibial bone varus angle was measured on long-film radiographs as well. All the valgus knees were sorted into different subtypes according to the origins of bony deformity, and the prevalence of each subtype was reported. Finally, to examine the inter-observer reproducibility of this classification system, two observers measured the deformities and did the classification for all the 105 knees independently and then the intraclass correlation coefficient (ICC) was calculated.

Results: Among the 105 knees, 48 knees (45.7%) had apparent deformity from the tibial plateau, and 62 knees (59.0%) had apparent deformity from the supracondylar region of the femur. Eighteen knees (17.1%) had distal condylar angle >7°, among which 11 knees had posterior condylar angle >3° simultaneously. Valgus knees had five subtypes of bone deformity origins-the supracondylar part of the femur, the distal aspect of the lateral femoral condyle, both distal and posterior aspects of the lateral femoral condyle, the tibial plateau, or the metaphyseal segment of the tibia. A valgus knee could be labeled as only one subtype, or a combination of two or more subtypes. Labeling 105 knees with origin of the most severe deformity, the prevalence of each subtype was 40.0%, 5.7%, 9.5%, 28.6%, and 16.2%, respectively. The intra-observer and inter-observer ICC of this classification system was 0.992 and 0.976, respectively.

Conclusions: Valgus knees can be classified into different subtypes according to deformity origins. This radiological classification system has satisfactory reproducibility. It helps surgeons better individualize morphological features of valgus knees.
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http://dx.doi.org/10.1111/os.13178DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8755874PMC
January 2022

PD-1/PD-L1 inhibitor plus chemotherapy versus bevacizumab plus chemotherapy in first-line treatment for non-squamous non-small-cell lung cancer.

J Immunother Cancer 2021 11;9(11)

State Key Laboratory of Oncology in South China, Guangzhou, Guangdong, China

Anti-PD-1)/programmed cell death-ligand 1 (PD-L1) antibody plus platinum-based chemotherapy (PBC) has replaced PBC as first-line treatment for patients with non-squamous (sq) non-small cell lung cancer (NSCLC) lacking targetable driver mutations. However, few studies have directly compared immune checkpoint inhibitor (ICI) plus chemotherapy with bevacizumab plus chemotherapy (beva +chemo) in this setting. Herein, we conducted an indirect comparison for anti-PD-1/PD-L1 antibody plus chemotherapy (ICI +chemo) versus beva +chemo in non-sq NSCLC using the frequentist methods. The main outcomes analyzed include progression-free survival (PFS), overall survival (OS), and objective response rate (ORR). Data were subtracted from randomized trials comparing ICI +chemo or beva +chemo against PBC. Fourteen trials involving 6165 patients were included. Direct meta-analyses showed that both ICI +chemo (PFS: HR 0.58, OS: HR 0.73, ORR: relative risk (RR) 1.66) and beva +chemo (PFS: HR 0.74, OS: HR 0.89, ORR: RR 1.62) improved clinical outcomes compared with PBC. Indirect comparison showed that ICI +chemo reduced the risk of disease progression (HR 0.78, 95% CI 0.60 to 1.00) and death (HR 0.82, 95% CI 0.71 to 0.94) compared with beva +chemo. The PFS benefits with ICI +chemo over beva +chemo were non-significant in those with negative PD-L1 expression and non-smokers. In conclusion, ICI +chemo is superior to beva +chemo in first-line treatment for non-sq NSCLC.
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http://dx.doi.org/10.1136/jitc-2021-003431DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8576478PMC
November 2021

Reconstruction of severe acetabular bone defects with porous metal augment in total hip arthroplasty: A finite element analysis study.

Proc Inst Mech Eng H 2022 Feb 22;236(2):179-187. Epub 2021 Oct 22.

School of Mechanical Engineering, Southwest Jiaotong University, Sichuan, Chengdu, China.

This study aims to evaluate the reconstructive stability for Paprosky III acetabular defects after total hip arthroplasty using three different reconstruction strategies with trabecular metal (TM) augments. The acetabular bone defects examined were located in the ilium, the sciatic ramus and the pubic ramus. Different scenarios of acetabular reconstructions were simulated, including the non-reconstruction model (NRM), the complete reconstruction model (CRM), the two-point reconstruction model (TRM) and the superior edge reconstruction model (SRM). A primary hip replacement model (HRM) was also investigated to compare the initial stability with different reconstruction models. The gait cycle was incorporated in the model to investigate the dynamic variation within the contact mechanics parameters. By comparing the SRM and the TRM, the acetabular cup translation was more pronounced when the superior defect on the acetabulum remained unfixed. Comparison of the acetabular cup displacement and the interface micromotion of both HRM and CRM demonstrated that the prosthetic implant provided good support for the reconstructed acetabulum. With the use of a press-fit cup, the cup displacement was reduced remarkably, while its Von-Mises stress increased significantly. The results show that the CRM was the best reconstruction option. In terms of acetabular defects, future improvements should focus on the reconstructive stability in stress concentration areas, to ensure no significant stress-shielding or other factors contributing to loosening of the prosthesis.
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http://dx.doi.org/10.1177/09544119211052377DOI Listing
February 2022

Effect of Weather Aging on Viscoelasticity and Fatigue Performance of Asphalt Mastic.

Materials (Basel) 2021 Oct 18;14(20). Epub 2021 Oct 18.

National Demonstration Center for Experimental Road and Traffic Engineering Education, School of Transportation, Southeast University, 2 Sipailou, Nanjing 210096, China.

The long-term effect of climate factors, such as sunlight, oxygen, and water, leads to the performance degradation of the asphalt mastic, which is the binding part in the asphalt mixture. It is not conducive to satisfy the long-term performance requirements of long-life asphalt pavement. In this study, five kinds of base asphalt mastic and styrene-butadiene-styrene (SBS) modified asphalt mastic were prepared with the filler-asphalt ratio of 0.6, 0.8, 1.0, 1.2, and 1.4. The indoor simulated weather aging tests were carried out considering multi-factors including sunlight, oxygen, and water. The master curves of the complex shear modulus and phase angle of the asphalt mastic with different aging degrees were obtained by the frequency sweep test. The curves of fatigue damage characteristics and fatigue life were fitted based on the viscoelastic continuum damage (VECD) model. The influence of weather aging on the viscoelasticity and fatigue performance of asphalt mastic were analyzed. Results indicated that the effect of weather aging increases the elastic component and decreases the viscous component. The fatigue performance of SBS modified asphalt mastic was better than that of base asphalt mastic. As the aging degree deepens, the brittle failure characteristics of asphalt mastic with a higher filler-asphalt ratio were more obvious. The base asphalt mastic becomes more sensitive to the strain level due to weather aging, and its fatigue life increased under the low strain loading and decreased under the high strain loading. The fatigue performance of SBS modified asphalt mastic was less sensitive to the strain level. The fatigue life reduced after aging under low and high strain load. Taking the impact of weather aging on the fatigue performance into consideration, the optimal filler-asphalt ratios of the base asphalt mastic SBS modified asphalt mastic are 1.0 and 1.2, respectively.
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http://dx.doi.org/10.3390/ma14206163DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8539027PMC
October 2021

Unsatisfied Reporting Quality of Clinical Trials Evaluating Immune Checkpoint Inhibitor Therapy in Cancer.

Front Immunol 2021 5;12:736943. Epub 2021 Oct 5.

State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-Sen University Cancer Center, Guangzhou, China.

Background: More and more immune-oncology trials have been conducted for treating various cancers, yet it is unclear what the reporting quality of immune-oncology trials is,and characteristics associated with higher reporting quality.

Objective: This study aims to evaluate the reporting quality of immune-oncology trials.

Methods: The PubMed and Cochrane library were searched to identify all English publications of clinical trials assessing immunotherapy for cancer. Reporting quality of immune-oncology trials was evaluated by a quality score with 11 points derived from the Trial Reporting in Immuno-Oncology (TRIO) statement, which contained two parts: an efficacy score of 6 points and toxicity score of 5 point. Linear regression was used to identify characteristics associated with higher scores.

Results: Of the 10,169 studies screened, 298 immune-oncology trial reports were enrolled. The mean quality score, efficacy score, and toxicity score were 6.46, 3.61, and 2.85, respectively. The most common well-reported items were response evaluation criteria (96.0%) and toxicity grade (98.7%), followed by Kaplan-Meier survival analyses (80.5%). Treatment details beyond progression (12.8%) and toxicity onset time and duration (7.7%) were poorly reported. Multivariate regression revealed that higher impact factor (IF) (IF >20 vs. IF <5, < 0.001), specific tumor type ( = 0.018 for lung, = 0.021 for urinary system, vs. pan cancer), and a certain kind of immune checkpoint blocking agent ( < 0.001 for anti-PD-1 or multiagents, vs. anti-CTLA-4) were independent predictors of higher-quality score. Similar independent predictive characteristics were revealed for high-efficacy score. Only IF >20 had a significant high-toxicity score ( < 0.001).

Conclusion: Immune-oncology trial reports presented an unsatisfied quality score, especially in the reporting of treatment details beyond progression and toxicity onset time and duration. High IF journals have better reporting quality. Future improvement of trial reporting was warranted to the benefit-risk assessment of immunotherapy.
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http://dx.doi.org/10.3389/fimmu.2021.736943DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8524036PMC
December 2021

Comparison of the success rate after debridement, antibiotics and implant retention (DAIR) for periprosthetic joint infection among patients with or without a sinus tract.

BMC Musculoskelet Disord 2021 Oct 21;22(1):895. Epub 2021 Oct 21.

Department of Orthopedic Surgery, Beijing Jishuitan Hospital, Fourth Clinical College of Peking University, No.31 Xinjiekou East Road, Xicheng District, Beijing, 100035, China.

Background: The relevance between the presence of a sinus tract and the failure risk after debridement, antibiotics and implant retention (DAIR) for periprosthetic joint infection (PJI) after hip or knee arthroplasty is still unclear. This study aimed to compare the success rate of DAIR between patients with or without a sinus tract and to explore the possible risk factors for failure after DAIR in patients with a sinus tract.

Methods: Consecutive DAIR cases for PJI after hip or knee arthroplasty between January 2009 and June 2019 with a minimum 1-year follow-up in two tertiary joint arthroplasty centers were included. Patients were classified into the sinus tract group and the non-sinus tract group according to the presence of a sinus tract. The success rate after DAIR were compared using Kaplan-Meier survival analysis. Potential risk factors for failure in the sinus group were also explored.

Results: One hundred seven patients were included. At a median 4.4 years of follow-up, 19 of 52 (36.5%) cases failed in the sinus tract group, while 15 of 55 (27.3%) cases failed in the non-sinus tract group. The 1-year and 5-year cumulative success rates were 71.2% (95% confidence interval (CI): 59.8-84.6%) and 56.8% (95% CI: 42.6-75.7%) in the sinus tract group, respectively, which were similar to the counterparts in the non-sinus tract group (P = 0.214). Among patients with a sinus tract, DAIR with the exchange of modular components showed a higher success rate (75.8% versus 47.4%, P = 0.038).

Conclusions: The presence of a sinus tract does not affect the success rate of DAIR. Modular component exchange in DAIR was proposed for patients with a sinus tract for an improved infection control rate.
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http://dx.doi.org/10.1186/s12891-021-04756-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8532350PMC
October 2021

[Short-term effectiveness of novel computer navigation system assisted total knee arthroplasty].

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2021 Oct;35(10):1281-1285

Department of Orthopaedic Surgery, Beijing Jishuitan Hospital, Fourth Clinical College of Peking University, Beijing, 100035, P.R.China.

Objective: To investigate the short-term effectiveness of novel computer navigation system (Knee 3 software; Brainlab, Germany) assisted total knee arthroplasty (TKA).

Methods: Between July 2020 and December 2020, 19 patients underwent unilateral TKA assisted with Knee 3 software. There were 4 males and 15 females. The mean age was 66.3 years (range, 52-79 years). Eighteen patients were diagnosed with osteoarthritis and 1 patient with rheumatoid arthritis. Sixteen patients had varus knees and 3 patients had valgus knees. Preoperative Western Ontario and McMaster University Osteoarthritis Index (WOMAC) pain, stiffness, function, and total scores were 12.4±3.4, 2 (1, 4), 22 (18, 29), and 37 (29, 43), respectively. Intraoperatively, the medial and lateral gaps in knee extension and in 90° of knee flexion were recorded. The operation time, intraoperative blood loss, blood transfusion, and complications were recorded. The hip-knee-ankle angle (HKA), lateral distal femoral angle, and medial proximal tibial angle were measured to evaluate lower limb alignment and prostheses's alignment using X-ray films at 6 weeks after operation. Patient's satisfaction rate and WOMAC pain, stiffness, function, and total scores were investigated.

Results: Eighteen patients (94.7%) had medial- lateral gap balancing in knee extension, 18 patients (94.7%) had medial-lateral gap balancing in 90° of knee flexion, 19 patients (100%) had medial gap balancing between knee extension and 90° of knee flexion, and 18 patients (94.7%) had lateral gap balancing between knee extension and 90° of knee flexion. The mean operation time was 126 minutes (range, 100-200 minutes). The mean intraoperative blood loss was 205 mL (range, 100-400 mL). Patients were followed up 4-8 months, with an average of 6.2 months. Postoperative complications included 1 deep vein thrombosis of lower extremities and 1 cerebral infarction. X-ray films showed that the mean HKA, lateral distal femoral angle, and medial proximal tibial angle were 179.8° (range, 178°-182°), 83.5° (range, 80°-87°), and 89.5° (range, 87°-93°), respectively. At last follow-up, WOMAC pain, stiffness, function, and total scores were 3.6±1.9, 0 (0, 2), 4 (2, 6), and 9 (5, 10), respectively, which improved when compared with preoperative scores ( <0.05). Twelve patients were very satisfied with the operation results and 7 patients were satisfied with the operation results. The overall satisfaction rate was 100%.

Conclusion: Knee 3 software can help to obtain good gap balancing and optimal lower limb alignment, with high patient's satisfaction and good short-term effecectiveness.
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http://dx.doi.org/10.7507/1002-1892.202105114DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8505941PMC
October 2021

[Early effectiveness of robot-assisted total hip arthroplasty via direct superior approach].

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2021 Oct;35(10):1240-1245

Department of Orthopaedic Surgery, Beijing Jishuitan Hospital, Fourth Clinical College of Peking University, Beijing, 100035, P.R.China.

Objective: To evaluate the early effectiveness of the robot-assisted total hip arthroplasty (THA) via direct superior approach (DSA).

Methods: Between March 2021 and April 2021, 11 patients (11 hips) were treated with a robot-assisted THA via DSA. There were 7 males and 4 females, with an average age of 55 years (range, 26-73 years). There were 5 patients of osteoarthritis secondary to hip dysplasia and 6 patients of osteonecrosis of femoral head. Preoperative hip Harris score was 55.8±6.3. The operation time, volume of blood loss, length of incision, postoperative blood transfusion and hospital stay, and the incidence of surgical complications were recorded. The visual analogue scale (VAS) score and Harris score were used to evaluate hip joint pain and function. The leg length discrepancy (LLD) was measured on the X-ray films. The inclination angle and anteversion angle of the acetabular component were also measured, and the difference between the planned and actual values were compared.

Results: One THA was performed via conventional posterolateral approach finally because of poor exposure. The rest of 10 THAs were performed with assistance of robotic arm via DSA. The average operation time was 89 minutes (range, 65-120 minutes); the average length of incision was 10.5 cm (range, 9-13 cm); and the average blood loss was 400 mL (range, 110-740 mL). One patient was given a blood transfusion for 2 unit. All incisions healed by first intention and no neurovascular injury, deep vein thrombosis, or fracture occurred. The length of hospital stay after operation was 2-6 days (mean, 4.4 days). The duration of follow-up was 1-3 months (mean, 2.1 months). The VAS score was 0 in 9 patients and 2 in 1 patient at the day of discharge. At last follow-up, the hip Harris score was 84.9±6.7, showing significant difference when compared with that before operation ( =-8.717, =0.000). The inclination and anteversion angles were (37.4±2.0)° and (17.1±4.5)°, respectively, and there was no significant difference when compared with the planned values [(38.2±1.6)°, (16.6±3.7)°] ( =1.809, =0.104; =-1.103, =0.299). The LLD ranged from -2 to 4 mm. No complication such as dislocation, aseptic loosening, or periprosthetic joint infection occurred.

Conclusion: The robot-assisted THA via DSA has encouraged early effectiveness.
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http://dx.doi.org/10.7507/1002-1892.202105115DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8505947PMC
October 2021

Hepatotoxicity associated with PD-1 blockade antibodies in cancer patients co-infected with hepatitis B virus.

Cancer Immunol Immunother 2022 May 14;71(5):1247-1255. Epub 2021 Oct 14.

Department of Medical Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, China.

The use of anti-programmed cell death-1 (PD-1) antibodies in treating malignancies is increasing; however, most registered clinical trials on anti-PD-1 antibodies exclude patients infected with hepatitis B virus (HBV). This retrospective study aimed to assess hepatotoxicity in cancer patients infected with HBV undergoing anti-PD1 antibody therapy and identify the associated risk factors. A total of 301 cancer patients positive for hepatitis B core antibodies (HbcAb) (negative or positive hepatitis B surface antigen [HBsAg]) who received PD-1 inhibitors were enrolled. The primary and secondary endpoints were the incidence rate of hepatotoxicity related to PD-1 inhibitor treatment, and risk factors associated with hepatic toxicity, respectively. Of the enrolled analyzed, 16.9% (n = 51) developed any grade and 4.7% (n = 14) developed grade 3-4 hepatotoxicity, respectively. Higher risk for any-grade hepatotoxicity development was associated with sero-positive HBsAg (OR = 6.30; P = 0.020), existence of liver involvement (OR = 2.10; P = 0.030), and detectable baseline HBV DNA levels (OR = 2.39; P = 0.012). Patients with prophylactic antiviral therapy decreased hazard for the incidence of grade 3-4 hepatotoxicity (OR = 0.10; P = 0.016). Our results suggested chronic (HBsAg-positive)/resolved (HBsAg-negative and HBcAb-positive) HBV-infected cancer patients are at an increased risk of hepatotoxicity following PD-1 inhibitor therapy. Cancer patients should be tested for HBsAg/HBcAb prior to the commencement of immune checkpoint inhibitor therapy. For patients with chronic/resolved HBV infection, ALT/AST and HBV DNA should be closely monitored during the whole immunotherapy period.
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http://dx.doi.org/10.1007/s00262-021-03082-4DOI Listing
May 2022

Reliability and validity of commonly used patient-reported outcome measures (PROMs) after medial unicompartmental knee arthroplasty.

Orthop Traumatol Surg Res 2021 Oct 1:103096. Epub 2021 Oct 1.

Department of Orthopaedic Surgery, Beijing Jishuitan Hospital, Fourth Clinical College of Peking University, No. 31 Xinjiekou East Street, Xicheng District, Beijing 100035, China.

Introduction: Many patient-reported outcome measures (PROMs) have been utilized to assess outcomes after unicompartmental knee arthroplasty (UKA). However, most are not specifically designed for UKA and the measurement properties of these PROMs have never been elucidated in the setting of UKA. This study aimed to evaluate the reliability and validity of commonly used PROMs after UKA, which includes the Oxford knee score (OKS), Knee Society Score (KSS)-function score, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Knee Injury and Osteoarthritis Outcome Score (KOOS).

Hypothesis: The four commonly used PROMs after UKA are of good reliability and validity, but with different floor/ceiling effect.

Material And Methods: Prospectively collected postoperative follow-up PROMs scores of patients after medial UKA cases for osteoarthritis between May 2015 and June 2018 were retrospectively analyzed. All of the PROMs were finished on the same electronic questionnaires. Reliability (internal consistency, test-retest reliability, measurement error), construct validity and floor/ceiling effects were assessed.

Results: The whole cohort was composed of 207 cases, with a median age of 62.0 years and a male ratio of 59/207 (28.50%). Internal consistency was high in the OKS, weak in the KSS-function score and with redundancy in the WOMAC and KOOS scores (Cronbach alpha=0.915, 0.610, 0.953, 0.961, respectively). Each of the four PROMs had a high test-retest reliability (all intraclass correlation coefficient (ICC) >0.97). Convergent validity of the four PROMs with the physical component score of the 12-Item Short Form Health Survey (SF-12 PCS) were proven (all r>0.5; p<0.001). While no ceiling effect occurred in the OKS, one was detected in the KSS-function score with 19.81% of patients achieving the best possible score, as well as in the WOMAC sub-score for pain (54.11%) and stiffness (50.72%), in addition to the KOOS sub-score for symptoms (27.54%) and pain (38.16%).

Discussion: The four commonly used PROMs after UKA showed good test-retest reliability and construct validity. The OKS is more recommended for its better performance in internal consistency and ceiling effect than the KSS-function score, the WOMAC and KOOS scores.

Level Of Evidence: III; Diagnostic study.
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http://dx.doi.org/10.1016/j.otsr.2021.103096DOI Listing
October 2021

Entrepreneur-Region Fit and Entrepreneurial Success in China: The Effect of "Confucian" Personality.

Front Psychol 2021 10;12:724939. Epub 2021 Sep 10.

CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.

The personality of entrepreneurs is associated with their entrepreneurial success, and the regional personality plays a crucial role in the entrepreneurial ecosystem. Recently, scholars have called for an indigenous personality perspective and combining the personality of entrepreneurs with the regional personality. The current study aimed to investigate the indigenous Confucian personality (e.g., interpersonal relatedness [IR]) and taking an entrepreneur-regional personality fit perspective, allowing testing how entrepreneurs interact with the local ecosystem. Using the personality data of entrepreneurs ( = 1,386) from a representative sample across 42 major cities in China, we found that (1) city-level IR is curvilinearly correlated with the annual income of entrepreneurs, with moderate IR associates with the highest income; and (2) the entrepreneur-regional fit analysis further revealed substantial interplay between an entrepreneur and the city. Specifically, entrepreneurs who have moderate IR and run their business in the city also with moderate IR are most likely to have the highest income. This study highlights the usefulness of investigating indigenous personality and the fit perspective in entrepreneurship research.
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http://dx.doi.org/10.3389/fpsyg.2021.724939DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8460871PMC
September 2021

A Modeling Study of a Patient-specific Safe Zone for THA: Calculation, Validation, and Key Factors Based on Standing and Sitting Sagittal Pelvic Tilt.

Clin Orthop Relat Res 2022 01;480(1):191-205

Department of Orthopaedic Surgery, Beijing Jishuitan Hospital, Fourth Clinical College of Peking University, Beijing, China.

Background: Lumbar-pelvic stiffness and sagittal imbalance have been reported to increase the risk of dislocation and wear after THA. One potential way to approach this concern is by identifying patient-specific safe zones for THA components based on the standing and sitting sagittal pelvic tilt. However, there is no algorithm to integrate the standing and sitting pelvic tilt into the surgical plan of component orientations.

Questions/purposes: We established a new mathematical algorithm for determining a patient-specific safe zone for THA by integrating the impingement-free ROM requirements of standing and sitting while preventing edge loading while standing. We aimed to determine (1) the accuracy of this new method for predicting the impingement-free ROM for a given component orientation, (2) the sensitivity and specificity of detecting an impingement-free acetabular cup position for standing and sitting, and (3) the influences of key factors including pelvic tilt while standing and pelvic tilt while sitting and implant parameters on patient-specific safe zones.

Methods: A strategy for calculating the intersection of standing and sitting impingement-free safe zones and the zone of a standing radiographic inclination of ≤ 45° was used to develop patient-specific safe zones. We conducted a computer simulation study including the pelvis and THA prosthesis to answer the three study questions. We enrolled 10 patients who underwent robot-assisted THA for avascular necrosis of the femoral head (mean age 49 ± 19 years; five were women) from October 2019 to December 2019. We used a prosthesis model with a conical stem neck and a non-hooded liner, with the femoral head diameter ranging between 28 mm and 40 mm, and the corresponding head-neck ratio ranging between 2.33 and 3.33. We tested 1680 movements for the accuracy of impingement-free ROM (Question 1), and 80 marginal points and 120 non-marginal points of the comprehensive impingement-free safe zone, which combines the standing and sitting postures (Question 2). For Question 3, we explored the influences of standing and sitting pelvic tilt, femoral head diameter, and ROM criteria on the size of the patient-specific safe zone.

Results: With the simulation method as a reference for detecting impingement, the mean absolute error (arithmetic mean of all the absolute errors) of the calculated impingement-free ROM was 1.4° ± 2.3°, and the limit of agreement of errors was between -3.6° and 3.7°. The sensitivity of detecting a safe cup orientation within the comprehensive impingement-free safe zone for a given ROM criterion was 98.9% (95% CI 93.6% to 99.9%), and specificity was 97.1% (95% CI 91.0% to 99.2%). There were no impingement-free safe zones for 29% (pelvic tilt combinations without an impingement-free safe zone and all tested combinations) and no patient-specific safe zones for 46% (pelvic tilt combinations without a patient-specific safe zone and all tested combinations) of the tested combinations of standing and sitting pelvic tilt. The patient-specific safe zone was sensitive to changes in standing and sitting pelvic tilt, femoral head diameter, stem version, and ROM criteria. Stem anteversions beyond 10° to 20° dramatically reduced the size of the patient-specific safe zone to 0 within a change of 10° to 20°.

Conclusion: The patient-specific safe zone algorithm can be an accurate method for determining the optimal orientation for acetabular cups and femoral stems in THA. The patient-specific safe zone is sensitive to changes in standing and sitting pelvic tilt, stem version, ROM criteria, and the femoral head diameter. A narrow zone of 10° to 20° for stem anteversion is recommended to maximize the size of the patient-specific safe zone.

Clinical Relevance: This study suggests the potential of a mathematical algorithm to optimize the orientation of THA components and illustrates how key parameters affect the patient-specific safe zone.
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http://dx.doi.org/10.1097/CORR.0000000000001923DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8673979PMC
January 2022

Research on Intelligent Solution of Service Industry Supply Chain Network Optimization Based on Genetic Algorithm.

Authors:
Yixin Zhou Zhen Guo

J Healthc Eng 2021 19;2021:9429872. Epub 2021 Aug 19.

School of Economics, Harbin University of Commerce, Harbin 150000, Heilongjiang, China.

With the advent of the era of big data (BD), people"s living standards and lifestyle have been greatly changed, and people's requirements for the service level of the service industry are becoming higher and higher. The personalized needs of customers and private customization have become the hot issues of current research. The service industry is the core enterprise of the service industry. Optimizing the service industry supply network and reasonably allocating the tasks are the focus of the research at home and abroad. Under the background of BD, this paper takes the optimization of service industry supply network as the research object and studies the task allocation optimization of service industry supply network based on the analysis of customers' personalized demand and user behavior. This paper optimizes the supply chain network of service industry based on genetic algorithm (GA), designs genetic operator, effectively avoids the premature of the algorithm, and improves the operation efficiency of the algorithm. The experimental results show that when  = 8 and  = 40, the average running time of the improved GA is 54.1 s. The network optimization running time of the algorithm used in this paper is very fast, and the stability is also higher.
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http://dx.doi.org/10.1155/2021/9429872DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8390170PMC
March 2022

A Novel Endosteal Reconstruction of the Femur from Distal Femoral Remnant Using 3D-Printed Titanium Rings: A Two-Case Report.

JBJS Case Connect 2021 08 27;11(3). Epub 2021 Aug 27.

Department of Orthopaedics, Beijing Jishuitan Hospital, Fourth Clinical College of Peking University, Beijing, China.

Case: Femur reconstruction with only the distal femoral remnant is challenging because of poor bone volume required for stem fixation. Although proximal femoral replacement, total femur replacement, allograft prosthesis composite, and custom porous tantalum implants are options, hybrid fixation enhanced by endosteal reconstruction with three-dimensional (3D)-printed porous titanium rings to reconstruct the femur without supporting isthmus has not been described. We report 2 cases with satisfactory 34- and 22-month follow-up results of hybrid fixation enhanced by endosteal reconstruction with 3D-printed porous titanium rings.

Conclusion: This novel method provides a solution to revise loosened femoral endoprosthesis with only distal femoral remnant.
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http://dx.doi.org/10.2106/JBJS.CC.20.01038DOI Listing
August 2021
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