掺杂方法对W−1.0wt.%La2O3合金显微组织和力学性能的影响

对采用溶液燃烧合成法并结合不同掺杂方法(液-液(WL10)、液-固(WLNO)和固-固(WLO))制备的纳米尺度粉末及采用常压烧结法制备的超细晶W-1.0wt.%La2O3合金进行对比研究。与纯钨相比,W-1.0wt.%La2O3合金具有超细晶粒和优异的力学性能。烧结后,WLO样品的平均晶粒尺寸大于WL10和WLNO样品的平均晶粒尺寸;WL10和WLNO的显微硬度相差不大,但大于WLO的显微硬度。相对于其他样品,在1500℃烧结后的WL10样品中La2O3颗粒呈现最佳分布状态,均匀分布在晶界或晶粒内部,且平均尺寸最小,晶界和晶粒内部的La2O3颗粒平均尺寸分别为(57±29.7)和(27±13.1)nm。与传统方法制备的钨材料相比,采用液-液掺杂方法制备的W-1.0wt.%La2O3钨合金呈超细的显微组织和优异的性能。

Study on the correlation between early three-dimensional gait analysis and clinical efficacy after robot-assisted total knee arthroplasty

Purpose:Robot-assisted technology is a forefront of surgical innovation that improves the accuracy of total knee arthroplasty (TKA).But whether the accuracy of surgery can improve the clinical efficacy still needs further research.The purpose of this study is to perform three-dimensional (3D) analysis in the early postoperative period of patients who received robot-assisted total knee arthroplasty (RATKA),and to study the trend of changes in gait parameters after RATKA and the correlation with the early clinical efficacy.Methods:Patients who received RATKA in the Center of Joint Surgery,the First Hospital Affiliated to Army Military Medical University from October 2020 to January 2021 were included.The imaging parameters,i.e.,hip-knee-ankle angle,lateral distal femoral angle,medial proximal tibial angle,posterior condylar angle were measured 3 months post-TKA.The 3D gait analysis and clinical efficacy by Western Ontario Mac Master University Index (WOMAC) score were performed pre-TKA,3 and 6 months post-TKA.The differences in spatiotemporal parameters of gait,kinetic parameters,and kinematic parameters of the operated limb and the contralateral limb were compared.The correlation between gait parameters and WOMAC scores was analyzed.Paired samplet-test and Wilcoxon rank-sum test were used to analyze the difference between groups,and Spearman correlation coefficient was used to analyze the correlation.Results:There were 31 patients included in this study,and the imaging indexes showed that all of them returned to normal post-TKA.The WOMAC score at 3 months post-TKA was significantly lower than that pre-TKA,and there was no significant difference between at 3 and 6 months.The 3D gait analysis results showed that the double support time of the operated limb reduced at 3 and 6 months (allp < 0.05),the maximum extension and maximum external rotation of the knee joint increased at stance phase,and the maximum flexion angle,the range of motion and the maximum external rotation increased at swing phase.Compared with the preoperative data,there were significant improvements (allp < 0.05).Compared with the contralateral knee joint,the maximum external rotation of the knee joint at swing phase was smaller than that of the contralateral side,and the maximum flexion and extension moment was greater than that of the contralateral knee.The maximum external rotation moment of the joint was greater than that of the contralateral knee joint (p < 0.05).There was a negative correlation between the single support time pre-TKA and the WOMAC score at 3 months (p = 0.017),and the single support time at 3 months was negatively correlated with the WOMAC score at 6 months (p = 0.043).The cadence at 6 months was negatively correlated with the WOMAC score at 6 months (p = 0.031).The maximum knee extension at stance phase at 6 months was negatively correlated with the WOMAC score at 6 month (p = 0.048).The maximum external rotation at stance phase at 6 months was negatively correlated with the WOMAC score at 6 months (p = 0.024).Conclusion:The 3D gait analysis of RATKA patients is more sensitive than WOMAC score in evaluating the clinical efficacy.Trend of changes in gait parameters shows that the knee joint support,flexion and extension function,range of motion,external rotation and varus deformity moment of the patient were significantly improved at 3 months after surgery,and continued to 6 months after surgery.Compared with the contralateral knee,the gait parameters of the operated limb still has significant gaps in functionality,such as the external rotation and flexion and extension.The single support time,cadence,knee extension,and knee external rotation of the operated limb have a greater correlation with the postoperative WOMAC score.Postoperative rehabilitation exercises should be emphasized,which is of great value for improving the early efficacy of RATKA.

Anti-hemorrhoidal activity of Lian-Zhi-San,a traditional Chinese medicine,in an experimental hemorrhoidal model in rats

Objective:Hemorrhoidal disease(HD)is the most common proctological disease,with an estimated prevalence rate of 4.4%,and a peak in individuals between 45 and 65 years of age.This study was done to evaluate whether Lian-Zhi-San(LZS),a clinically used anti-hemorrhoidal ointment could alleviate the inflammatory injury,with its associated changes of inflammatory cytokines and morphology of anorectal tissues,in an experimental model of HD in rats.Methods:HD was induced by croton oil preparation(COP)applied to the anorectal region.Rats were then treated with cotton swabs soaked in LZS ointment,water or white vaseline,twice a day for 7 d.At the end of the experiment,HD was evaluated by measuring hemorrhoidal and biochemical parameters along with histopathological observations.Results:In this study,COP induced a significant increase in the macroscopic severity score,anorectal coefficient and Evans blue extravasation,compared to normal rats.Additionally,it greatly enhanced the expression and secretion levels of some important inflammation-related cytokines along with marked histological damage,compared to normal rats.Rats treated with LZS ointment experienced significantly ameliorated Evans blue extravasation(P<0.05),decreased macroscopic severity score(0.86±0.14 vs.1.65±0.16)and the anorectal coefficient(P<0.01);its use also attenuated tissue damage and inhibited the expression and secretion levels of inflammation-related cytokines(interleukin-1 b,interleukin-6 and tumor necrosis factor-a).Conclusion:This study validates a preliminary understanding of the use of LZS ointment to treat inflammatory factors and tissue damage in an experimental model of HD in rats.

Pulmonary deportation of hydatidiform mole:a 12-year,single tertiary center experience in China

Background:Pulmonary deportation of hydatidiform mole is an exceedingly rare entity.The underlying mechanisms and proper management strategies remain unclear based on sporadic case reports over the past six decades.This study aimed to investigate the clinical features and rational treatment of patients with benign molar pregnancies with pulmonary deportation based on our experience.Methods:Medical records of 20 cases of hydatidiform mole with pulmonary deportation were retrospectively reviewed at Peking Union Medical College Hospital from November 2006 to May 2019.The detailed information of all patients was recorded and analyzed.Patients were divided into different groups according to their characteristics and Mann-Whitney U test was used to compare the duration to achieve a normal b-human chorionic gonadotrophin(b-hCG)level after the first evacuation among groups.Results:Initial pulmonary computed tomography scans showed suspected bilateral,left and right chest deportation of hydatidiform mole in 12,four,and four patients,respectively,with the maximum nodular diameter ranging from 0.6 to 1.2 cm.Ten patients achieved lesion resolution while the remaining ten patients achieved decreases in the size of their pulmonary lesions.The median duration to achieve a normal b-hCG level after the first evacuation was 15.5(13.0,21.9)weeks.There was no significant difference in the duration to achieve a normal b-hCG level after the first evacuation between two groups based on age(≥40 years vs.<40 years:15.8[12.2,21.5]weeks vs.15.5[12.9,23.0]weeks,Z=0.094,P=0.925),type of antecedent mole(partial mole vs.complete mole:15.2[12.5,27.4]weeks vs.15.9[12.9,21.5]weeks,Z=0.165,P=0.869),distribution of pulmonary nodules(bilateral lungs vs.unilateral lung:15.2[12.8,22.5]weeks vs.15.9[13.2,22.2]weeks,Z=0.386,P=0.700),maximum size of pulmonary nodules(>0.5 cm vs.0.5 cm:13.0[11.3,17.2]weeks vs.16.0[14.5,23.8]weeks,Z=1.815,P=0.070),and number of uterine evacuations(once vs.twice or three times:15.0[13.0,16.3]weeks vs.16.0[12.8,23.9]weeks,Z=0.832,P=0.405).The post-molar cohort was followed up for 17 to 139 months,and no gestational trophoblastic neoplasia was observed.Conclusions:No surgeries other than uterine evacuation and no chemotherapy regimens are recommended for such patients if they achieve satisfactory decreases in the level of hCG and gradual decrease or disappearance of pulmonary deportation nodules.Patients should be informed about the necessity of long-term follow-up.More collaborative international studies on this exceedingly rare condition may guide decisions regarding optimal management strategies.

Unusual Ovarian Cancer Relapse Managed by Nivolumab in a Long-term Surviving Patient with PD-L1 Mutation

INTRODUCTION This report describes a case of ovarian cancer recurrent as sternal and costal metastasis long after initial treatment. The whole-exome sequencing suggested programmed death-ligand I （PD-L1） mutation. The patient responded well to nivolumab, an anti-PD-1 monoclonal antibody. We discuss the case and review the literature.

Facile synthesis of transition metal carbide nanoparticles embedded in mesoporous carbon nanosheets for hydrogen evolution reaction

Transition metal carbides(TMC)modified by mesoporous carbon nanosheets(MCNSs)with high activity,fast elec-tron/ion transfer and long durability are considered as promising electrocatalysts for hydrogen evolution reaction(HER).