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Comparison of clinical outcomes among total knee arthroplasties using posterior-stabilized,cruciate-retaining,bi-cruciate substituting,bi-cruciate retaining designs:a systematic review and network meta-analysis

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Chinese Medical Journal 2023年第15期136卷 1817-1831页

作者： Kaibo Sun yuangang wu Limin wu Bin Shen Department of Orthopedics Surgery Orthopedic Research InstituteWest China HospitalSichuan UniversityChengduSichuan 610041China

Background:Despite the advent of innovative knee prosthesis design,a consistent first-option knee implant design in total knee arthroplasty(TKA)remained *** study aimed to compare the clinical effects among posterior-stabilized(PS),cruciate-retaining(CR),bi-cruciate substituting(BCS),and bi-cruciate retaining designs for primary ***:Electronic databases were systematically searched to identify eligible randomized controlled trials(RCTs)and cohort studies from inception up to July 30,*** primary outcomes were the range of knee motion(ROM),and the secondary outcomes were the patient-reported outcome measures(PROMs)and complication and revision *** in evidence was assessed using Confidence in Network *** Bayesian network meta-analysis was performed for ***:A total of 15 RCTs and 18 cohort studies involving 3520 knees were *** heterogeneity and inconsistency were *** was a significant difference in ROM at the early follow-up when PS was compared with CR(mean difference[MD]=3.17,95%confidence interval[CI]0.07,7.18)and BCS was compared with CR(MD=9.69,95%CI 2.18,17.51).But at the long-term follow-up,there was no significant difference in ROM in any one knee implant compared with the *** significant increase was found in the PROMs and complication and revision rates at the final follow-up ***:At early follow-up after TKA,PS and BCS knee implants significantly outperform the CR knee implant in *** in the long run,the available evidence suggests different knee prostheses could make no difference in clinical outcomes after TKA with extended follow-up.

关键词： Total knee arthroplasty Knee implant Range of knee motion Patient-reported outcome measures

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软骨细胞线粒体氧化应激在骨关节炎发病机制中的研究进展

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中华骨与关节外科杂志 2024年第1期17卷 70-78页

作者：彭琳博斯海波吴元刚李明阳武立民周圣梁沈彬四川大学华西医院骨科骨科研究所成都610041

骨关节炎(OA)是老年人最常见的关节疾病之一,同时也是导致残疾的重要因素。软骨细胞是成熟软骨中唯一的细胞,软骨细胞的稳定和正常功能的维持对延缓OA进展有重要作用。近年来的研究发现,软骨细胞线粒体氧化应激与OA关系密切。本文综述... 详细信息

骨关节炎(OA)是老年人最常见的关节疾病之一,同时也是导致残疾的重要因素。软骨细胞是成熟软骨中唯一的细胞,软骨细胞的稳定和正常功能的维持对延缓OA进展有重要作用。近年来的研究发现,软骨细胞线粒体氧化应激与OA关系密切。本文综述了软骨细胞线粒体氧化应激在OA发病过程中的相关机制,为OA的相关研究提供一定参考。

关键词：线粒体氧化应激骨关节炎活性氧

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Virtual reality-based rehabilitation in patients following total knee arthroplasty:a systematic review and meta-analysis of randomized controlled trials

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Chinese Medical Journal 2022年第2期135卷 153-163页

作者： Linbo Peng Yi Zeng yuangang wu Haibo Si Bin Shen Department of Orthopedics Orthopedic Research InstituteWest China HospitalSichuan UniversityChengduSichuan 610041China

Background:Physical therapy is regarded as an essential aspect in achieving optimal outcomes following total knee arthroplasty(TKA).The coronavirus disease 2019(COVID-19)pandemic has made face-to-face rehabilitation *** reality(VR)is increasingly regarded as a potentially effective option for offering health care *** systematic review and meta-analysis investigate VR-based rehabilitation's effectiveness on outcomes following ***:From inception to May 22,2021,PubMed/Medline,Embase,Web of Science,the Cochrane Central Register of Controlled Trials,Scopus,PsycINFO,Physiotherapy Evidence Database,China National Knowledge Infrastructure,and Wanfang were comprehensively searched to identify randomized controlled trials(RCTs)evaluating the effect of VR-based rehabilitation on patients following TKA according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement and the Cochrane Handbook for Systematic Reviews of ***:Eight studies were included in the systematic review,and seven studies were included in the ***-based rehabilitation significantly improved visual analog scale(VAS)scores within 1 month(standardized mean difference[SMD]:−0.44;95%confidence interval[CI]:−0.79 to−0.08,P=0.02),the Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)within 1 month(SMD:−0.71;95%CI:−1.03 to−0.40,P<0.01),and the Hospital for Special Surgery Knee Score(HSS)within 1 month and between 2 months and 3 months(MD:7.62;95%CI:5.77 to 9.47,P<0.01;MD:10.15;95%CI:8.03 to 12.27,P<0.01;respectively)following TKA compared to conventional *** significant difference was found in terms of the Timed Up and Go(TUG)***:VR-based rehabilitation improved pain and function but not postural control following TKA compared to conventional *** high-quality RCTs are needed to prove the advantage of VR-based *** the COVID-19 pandemic continues,

关键词： Arthroplasty,Replacement,Knee Virtual Reality Virtual Reality Exposure Therapy Rehabilitation Systematic review Meta-analysis

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Eight-year trajectories of malalignment progression in symptomatic knee osteoarthritis

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Chinese Medical Journal 2022年第21期135卷 2570-2576页

作者： Mingyang Li Yong Nie Yi Zeng yuangang wu Limin wu Yuan Liu Bin Shen Department of Orthopedics Orthopedic Research InstituteWest China HospitalSichuan UniversityChengduSichuan 610041China.

Background: Although various therapies have been developed to treat malalignment in osteoarthritic knees, the pattern of malalignment progression is still unclear. This study aimed to identify homogeneous subgroups with distinct trajectories of malalignment progression in subjects with symptomatic knee osteoarthritis (KOA) and to determine corresponding risk ***: Eight-year follow-up (from 2004 to 2012) data on 1252 participants with symptomatic KOA from the Osteoarthritis Initiative were included. Varus/valgus angle progression was characterized by group-based trajectory models. Time-varying covariates were introduced into the model to investigate how they affected trajectories. Multinomial logistic regression for trajectory group membership was applied to ascertain risk ***: Five subgroups were identified. Participants in the varus worsening trajectory (n = 166) or valgus worsening trajectory (n = 118) proceeded to worsen malalignment over time. The neutral trajectory (n = 378), varus stable trajectory (n = 328), and valgus stable trajectory (n = 262) maintained close to the initial varus/valgus angle over 8 years. Higher baseline Kellgren and Lawrence grade (odds ratio [OR] = 4.35,P < 0.001 for varus;OR= 3.85,P < 0.001 for valgus) and "severe" baseline malalignment (OR = 13.57,P < 0.001 for varus;OR = 23.04,P < 0.001 for valgus) were risk factors for worsening trajectories. The cutoff point of the baseline varus/valgus angle to discriminate between stable or worsening trajectory was -4.5° for varus and 3.6° for ***: This study identified the malalignment progression pattern - minor malalignment (-4.5° to +3.6°) tends to remain stable, while major baseline malalignment is likely to progress. This provides a reference for therapy to prevent malalignment from deteriorating and emphasizes the necessity of determining the trigger factors for malalignment onset.

关键词： Malalignment Knee osteoarthritis Group-based trajectory modeling

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Influence of patellofemoral joint degeneration on clinical outcomes after medial unicompartmental knee arthroplasty

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Chinese Medical Journal 2023年第13期136卷 1539-1550页

作者： Limin wu Quan Chen Haibo Si yuangang wu Yi Zeng Mingyang Li Yuan Liu Bin Shen Department of Orthopedics Orthopedic Research InstituteWest China HospitalSichuan UniversityChengduSichuan 610041China

Background:Patellofemoral joint(PFJ)degeneration has traditionally been regarded as a contraindication to unicompartmental knee arthroplasty(UKA).More recently,some researchers have proposed that PFJ degeneration can be ignored in medial UKA,and others have proposed that this change should be reviewed in PFJ degenerative facets and *** study aimed to systematically evaluate the effect of PFJ degeneration on patient-reported outcome measures(PROMs)and revision rates after medial ***:Electronic databases(PubMed,Embase,Web of Science,etc.)were searched for studies assessing the influence of PFJ degeneration on medial UKA.A random-effects meta-analysis was conducted for the Oxford knee score(OKS),Knee society score(KSS),and revision rates and stratified by PFJ degenerative facets(medial/lateral/trochlear/unspecified),severe PFJ degeneration(bone exposed),and bearing type(mobile/fixed).Heterogeneity was assessed by the Cochran Q test statistic and chi-squared tests with the I-squared ***:A total of 34 articles with 7007 knees(2267 with PFJ degeneration)were included(5762 mobile-bearing and 1145 fixed-bearing and 100 unspecified).Slight to moderate degenerative changes in the medial and trochlear facets did not decrease the OKS and KSS,and only lateral facets significantly decreased the OKS(mean difference[MD]=-2.18,P<0.01)and KSS(MD=-2.61,P<0.01).The severity degree of PFJ degeneration had no additional adverse effect on the OKS,KSS,or revision *** mobile-bearing UKA,only lateral PFJ degeneration significantly decreased the OKS(MD=-2.21,P<0.01)and KSS(MD=-2.44,P<0.01).For fixed-bearing UKA,no correlation was found between PROMs/revision rates and PFJ ***:For medial mobile-bearing UKA,slight to moderate degenerative changes in the PFJ,except lateral facet,did not compromise PROMs or revision *** medial fixed-bearing UKA,although it might not be conclusive enough,PROMs or revision rates were not adversely affe

关键词： Unicompartmental knee arthroplasty Fixed-bearing Mobile-bearing Patellofemoral degeneration Clinical outcomes

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Trajectory and predictors of cartilage damage in three compartments of the knees at risk for osteoarthritis

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Chinese Medical Journal 2022年第23期135卷 2896-2898页

作者： Limin wu Yuan Liu Haibo Si Mingyang Li Yi Zeng yuangang wu Bin Shen Department of Orthopaedics Orthopedic Research InstituteWest China HospitalSichuan UniversityChengduSichuan 610041China

To the Editor:Osteoarthritis(OA)is a prominent disabling disease characterized by progressive articular cartilage damage coupled with deterioration in the subchondral bone and other structures of the joint,and is ranked as the 12th highest disease contributing to global disability.[1]The course of knee OA is considerably long and can affect three knee compartments(the patellofemoral joint[PFJ],medial tibiofemoral joint[MTFJ],and lateral tibiofemoral joint[LTFJ])alone or in combination,resulting in a large variation in the occurrence of cartilage damage in the three compartments.[2]We aimed to determine the baseline predictors associated with distinct tricompartmental trajectories of cartilage damage in knees at risk for OA.

关键词： damage knee cartilage

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Exosomes rewire the cartilage microenvironment in osteoarthritis:from intercellular communication to therapeutic strategies

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International Journal of Oral Science 2022年第3期14卷 259-274页

作者： yuangang wu Jiao Li Yi Zeng Wenchen Pu Xiaoyu Mu Kaibo Sun Yong Peng Bin Shen Orthopedic Research Institute Department of OrthopedicsWest China HospitalSichuan UniversityChengduChina Laboratory of Molecular Oncology Frontiers Science Center for Disease-related Molecular NetworkState Key Laboratory of Biotherapy and Cancer CenterWest China HospitalSichuan UniversityChengduChina

Osteoarthritis(OA)is a prevalent degenerative joint disease characterized by cartilage loss and accounts for a major source of pain and disability ***,effective strategies for cartilage repair are lacking,and patients with advanced OA usually need joint *** comprehending OA pathogenesis may lead to transformative *** studies have reported that exosomes act as a new means of cell-to-cell communication by delivering multiple bioactive molecules to create a particular microenvironment that tunes cartilage ***,exosome cargos,such as noncoding RNAs(ncRNAs)and proteins,play a crucial role in OA progression by regulating the proliferation,apoptosis,autophagy,and inflammatory response of joint cells,rendering them promising candidates for OA monitoring and *** review systematically summarizes the current insight regarding the biogenesis and function of exosomes and their potential as therapeutic tools targeting cell-to-cell communication in OA,suggesting new realms to improve OA management.

关键词： Exosomes rewire the cartilage microenvironment in osteoarthritis from intercellular communication to therapeutic strategies

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视神经萎缩因子1介导的线粒体动力学在骨骼系统疾病中的研究进展

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中国修复重建外科杂志 2023年第6期37卷 758-763页

作者：孙凯博吴元刚曾羿李明阳武立民沈彬四川大学华西医院骨科骨科研究所成都610041

目的对视神经萎缩因子1(optic atrophy 1,OPA1)介导的线粒体动力学在骨骼系统疾病中的研究进展进行综述。方法查阅近年关于OPA1介导的线粒体动力学相关文献,总结治疗骨骼系统疾病的生物活性成分及药物,为治疗骨关节炎提供新的思路。结果... 详细信息

目的对视神经萎缩因子1(optic atrophy 1,OPA1)介导的线粒体动力学在骨骼系统疾病中的研究进展进行综述。方法查阅近年关于OPA1介导的线粒体动力学相关文献,总结治疗骨骼系统疾病的生物活性成分及药物,为治疗骨关节炎提供新的思路。结果OPA1是参与线粒体动力学和能量学及维持线粒体基因组稳定的关键因子,越来越多证据表明OPA1介导的线粒体动力学在调控骨关节炎、骨质疏松、骨肉瘤等骨骼系统疾病方面有重要意义。结论OPA1介导的线粒体动力学在防治骨骼系统疾病方面提供了重要的理论依据。

关键词：线粒体质量控制线粒体动力学视神经萎缩因子1 骨骼系统疾病

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基于文献计量学和文本分析法的智能中医面诊分区方法系统性综述

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世界科学技术-中医药现代化 2024年第5期26卷 1132-1141页

作者：马圆港冯跃林卓胜李胜可吴欣刘启超徐红五邑大学智能制造学部维多利亚大学可持续工业与宜居城市研究院

面诊客观化研究通过近年来不断发展，已经成为多学科多领域交叉的研究主题之一。但大部分研究注重对面诊图像算法的调整与采集环境及设备的设计，缺乏对面诊分区方法的系统性研究。本文旨在对现阶段基于机器学习的智能中医面诊分区研究... 详细信息

面诊客观化研究通过近年来不断发展，已经成为多学科多领域交叉的研究主题之一。但大部分研究注重对面诊图像算法的调整与采集环境及设备的设计，缺乏对面诊分区方法的系统性研究。本文旨在对现阶段基于机器学习的智能中医面诊分区研究文献中存在的问题进行讨论并提出建议，为后续的相关研究提供参考。文章运用文献计量学方法和文本分析法进行梳理分析，整理归纳出目前智能中医面诊分区方法，主要包括基于面部特征点、基于面部特征块和基于完整面部；然后通过分析面诊分区研究的影响因素并对常用的机器学习算法进行归纳，得到不同机器学习算法的优缺点以及对应的常用面诊分区方法；最后对现阶段面诊分区研究中的数据集构建、深度学习的优势以及面诊理论的体现三个方面进行讨论。

关键词：文献计量学系统综述机器学习深度学习智能中医面诊分区

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等离子体熔融炉系统的设计与应用

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工业炉 2023年第5期45卷 49-53页

作者：张春飞吴远刚胡安宝西安航天源动力工程有限公司航天推进技术研究院西安航天发动机有限公司

介绍了一种用于危废处置的等离子体熔融炉工艺及设计原则。从等离子体熔融炉体、等离子体炬及电源、耐火材料及砌筑、熔渣液位控制、排渣系统多个方面对等离子体熔融炉系统进行了详细设计，并结合实践对其设计经验进行了总结。设计的等... 详细信息

介绍了一种用于危废处置的等离子体熔融炉工艺及设计原则。从等离子体熔融炉体、等离子体炬及电源、耐火材料及砌筑、熔渣液位控制、排渣系统多个方面对等离子体熔融炉系统进行了详细设计，并结合实践对其设计经验进行了总结。设计的等离子体熔融炉实际运行过程中处置能力达到了额度负荷，总体运行状态良好，达到了设计要求。

关键词：等离子体熔融炉设计应用

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