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Objective@#To analyze the clinical characteristics of cases of novel coronavirus pneumonia and a preliminary study to explore the relationship between different clinical classification and liver damage.@*Methods@#Consecutively confirmed novel coronavirus infection cases admitted to seven designated hospitals during January 23, 2020 to February 8, 2020 were included. Clinical classification (mild, moderate, severe, and critical) was carried out according to the diagnosis and treatment program of novel coronavirus pneumonia (Trial Fifth Edition) issued by the National Health Commission. The research data were analyzed using SPSS19.0 statistical software. Quantitative data were expressed as median (interquartile range), and qualitative data were expressed as frequency and rate.@*Results@#32 confirmed cases that met the inclusion criteria were included. 28 cases were of mild or moderate type (87.50%), and four cases (12.50%) of severe or critical type. Four cases (12.5%) were combined with one underlying disease (bronchial asthma, coronary heart disease, malignant tumor, chronic kidney disease), and one case (3.13%) was simultaneously combined with high blood pressure and malignant tumor. The results of laboratory examination showed that the alanine aminotransferase (ALT), aspartate aminotransferase (AST), albumin (ALB), and total bilirubin (TBil) for entire cohort were 26.98 (16.88 ~ 46.09) U/L and 24.75 (18.71 ~ 31.79) U/L, 39.00 (36.20 ~ 44.20) g/L and 16.40 (11.34- ~ 21.15) mmol/L, respectively. ALT, AST, ALB and TBil of the mild or moderate subgroups were 22.75 (16.31- ~ 37.25) U/L, 23.63 (18.71 ~ 26.50) U/L, 39.70 (36.50 ~ 46.10) g/L, and 15.95 (11.34 ~ 20.83) mmol/L, respectively. ALT, AST, ALB and TBil of the severe or critical subgroups were 60.25 (40.88 ~ 68.90) U/L, 37.00 (20.88 ~ 64.45) U/L, 35.75 (28.68 ~ 42.00) g/L, and 20.50 (11.28 ~ 25.00) mmol/L, respectively.@*Conclusion@#The results of this multicenter retrospective study suggests that novel coronavirus pneumonia combined with liver damage is more likely to be caused by adverse drug reactions and systemic inflammation in severe patients receiving medical treatment. Therefore, liver function monitoring and evaluation should be strengthened during the treatment of such patients.
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Objective To collect domestic and foreign literatures on mini-invasive total hiparthroplasty (THA) and conventional THA so as to assay the clinical outcomes of the two treatments usingMeta analysis.Methods Randomized controlled trials (RCTs) of mini-invasive THA and conventionalTHA that met the inclusion criteria were collected in the computer-based retrieval combined with manualretrieval of databases such as MEDLINE,EMBASE,OVID,and ScienceDirect.Methodological qualityassessment of the included literatures was performed using Cochrane risk evaluation tool and Meta analysisof those literatures was made by employing RevMan 5.1 software.Two surgical approaches were comparedin regard of indices including postoperative Harris hip score,operation time,intraoperative blood loss andcomplications.Results The study involved 17 related articles (18 RCTs containing 1 560 patients),including 774 patients treated by mini-invasive THA and 786 by conventional THA.The study showedsignificant differences between mini-invasive THA and conventional THA in aspects of incision length[WMD=-5.93,95％ CI (-7.29,-4.57)],blood loss [SMD =-0.45,95％ CI (-0.77,-0.13)] and postoperative visual analog scale (VAS) [MD =-19.58,95％ CI (-26.38,-12.78)],whereas there were no significant differences regarding the postoperative Harris score [WMD =0.85,95％ CI (-3.50,5.20)],operation time [WMD=-0.99,95％ CI (-5.36,3.39)],blood transfusion volume [WMD =-66.29,95％ CI (-241.31,108.72)] and complication incidence rate [RR =1.01,95％ CI (0.61,1.66)].Conclusions Mini-invasive THA offers advantages of smaller incision,less intraoperative blood loss and milder postoperative pain over conventional THA but has similar effect with conventional THA in aspects of Harris hip score,operation duration,blood transfusion volume and complications.Moreover,high quality,multicenter and large scale RCTs are required to confirm the outcomes.
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Objective To compare the biomechanical property of original and new dynamic sleeve three-wing screws.Methods Twelve artificial polymethylmethacrylate (PMMA) femoral models and twelve adult cadaver femurs were selected,and then adduction-type femoral neck fracture models were prepared.The specimens were divided randomly into 2 groups,and each group had 6 specimens.According to the operative approach,the fractures were fixed with original dynamic sleeve three-wing screw (DSTS) or new DSTS after anatomic reduction.Then the specimens were fixed in simulated uniped standing position with an instron-8874 servo-hydraulic mechanical testing machine.Ten key points at the proximal femurs and two key points at the femoral shaft were selected to be the positions at which the strain was recorded.The continuous load (PMMA group:0-1200 N; cadaver femur group:0-800 N) was put to the specimens at the rate of 10 mm/min.The strain values under the maximum load,the femoral head sinking displacement and the strain values of No.8 gauge under different loads were recorded.Results There was a peak at the No.8 resistance strain gauge under 1200 N in PMMA group,and the strain values of original and new DSTS were (-2744±35) and (-718±14) με,respectively.There was a peak at the No.8 resistance gauge under 800N in cadaver femur group,and the strain values of original and new DSTS were (-2813±38) and (-2032±22) με,respectively.The differences of strain values above were significant.The femoral head sinking displacement of the new DSTS was much less than that of original DSTS under the same load.Conclusion The new DSTS has better biomechanical properties,using which the femoral neck fracture can be fixed more stably.
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Objective To observe the biomechanieal properties of tendons repaired by five suture techniques in different stage of healing process.Methods After establishing the zone Ⅱ FDP transection model in 2nd,3rd,4th too of both feet in female fowls,the ruptured tendons were repaired with Modified Kessler ( M K ),Kessler plus running ( K +R ),double-strand Kessler ( DK ),double loop (DT) and modified double loop (MT) methods,respectively.Passive and active mobilizations were applied on the 3rd day and 21st day postoperatively.Animals were executed postoperatively,on the 14th,21st and 35th days,respectively and both feet were harvested for biomechanical test.Results Anatomical findings included: The breakage incidence of K+R group was smaller than that of MK group.The excellent and good results of K+R and DK groups were higher compared with that of MK group.Biomechanical results showed: The MK group had the poorest biomechanical results in every stage of tendon healing (P＜0.05) except that the results from MK group on the 35th showed no statistical difference compared with that of MT and DT in extreme load;K+R group exbited the greatest extreme load and tensile strength (P＜0.05);Biomechanical test results from all groups showed significant differences on different testing point: 35th day＞21st day＞14th day(P＜0.05 );No significant differences were found in all groups between the immediate postoperative results onlst day and that from 14th day.ConclusionDuring the recovery of tendon,biomechanical properties returned to the immediate postoperative level on the 14th day and increased along with time.K+R group shows the superiority to the other methods in biomechanical properties as well as low breaking incidence ratein every stage of tendon healing.Kessler plus running is an effective method with high strength against breakage and great resistance to adhesion formation.
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Objective To compare the biomechanical effect of several commonly used internal fixators in treating the femoral neck fractures so as to provide clinical basis for the selection of ideal internal fixation.Methods Twelve artificial PMMA femoral models were selected,and the central neck of the specimens was sawn with an electric saw at Pauwels angle of 70° to form adduction type femoral neck fracture models.After anatomic reduction,the specimens were fixed with dynamic hip screw ( DHS),three hollow screws,proximal femoral nail (PFN) and dynamic sleeve three-wing screw according to the operative approach,respectively.Instron-8874 servo-hydraulic mechanical testing machine was used to fix the specimens which simulated uniped standing.Fifteen key points on proximal femur were selected as test points and were given gradation loading at speed of 10 mm/min with linear load 0-1 200 N.The strain of each point under 1200 N load,head sink displacement under different loads and the strain of eight points on principal pressure side were measured.Results There was a peak at the eight resistance strain gage at 1200 N load and the strain values of the DHS,three hollow screws,PFN and dynamic sleeve three-wing screw were (700 ±35) μεz,(756 ± 14) με,( 1362 ± 136) με and (3024 ± 127) με,with statistical significance (P ＜ 0.01 ).Under the same load,the head sink displacement in the group of dynamic sleeve three-wing screw was greater than that of the hollow screws group and the PFN group ( P ＜0.01 ),but smaller thau that of the DHS group ( P ＜ 0.01 ).The strain values at the eight resistance strain gage in the group of dynamic sleeve three-wing screw was larger than that of the other three groups under the same load (P ＜ 0.01 ),and the strain values increased with the increase of load at the same fixation group.Conclusion Dynamic sleeve three-wing screw has good biomechanical stability for treatment of femoral neck fracture,which can be applied in the clinical practice.