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Objective:To analyze the risk factors for patellar clunk syndrome after total knee arthroplasty (TKA) without patellar surface replacement.Methods:Retrospectively analyzed were a total of 222 patients who had undergone TKA without patellar surface replacement at Department of Joint Surgery, The Second Hospital of Shanxi Medical University from June 2020 to June 2021. There were 43 males and 179 females, and 38 cases of rheumatoid arthritis and 184 cases of arthritis. They were divided into a patellar clunk syndrome group ( n = 56) and a non-patellar clunk syndrome group ( n = 166) according to the occurrence of patellar clunk after TKA. The incidence of early patellar clunk syndrome after TKA was 25.2% (56/222). The patient gender, arthritis type, prosthesis type, postoperative range of knee motion, postoperative patellar thickness, Insall-Salvati index, postoperative joint line height, lower extremity muscle strength, and the distance from the tibial plateau to the patellar tendon were recorded. The risk factors for patellar clunk syndrome were determined by univariate analysis and logistic analysis. Results:The univariate analysis showed significant differences between the 2 groups in prosthesis type, postoperative joint line height, postoperative lower extremity muscle strength, and the distance from the tibial plateau to the patellar tendon ( P < 0.05). The logistic analysis showed that the posterior cruciate substituting (PS) prosthesis was an independent risk factor compared with the cruciate-retaining (CR) prosthesis ( OR = 2.791, 95% CI: 1.411 to 5.521, P = 0.003), and the increased lower extremity muscle strength was an independent protective factor ( OR = 0.295, 95% CI: 0.148 to 0.587, P = 0.001). Conclusions:The incidence of patellar clunk syndrome is relatively high. The PS prosthesis may be an independent risk factor relative to the CR prosthesis. As the increased lower extremity muscle strength may be an independent protective factor, the recovery and strengthening of the muscle strength after TKA require more attention.
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@#Objective To explore the consistency of different intensity setting methods of aerobic exercise in order to provide the safe and effective strength setting method for patients with coronary heart disease (CHD).Methods From July, 2016 to July, 2017, CHD patients in our hospital were recruited. The basic data were collected. The patients received cardiopulmonary exercise test firstly to obtain anaerobic threshold, peak oxygen intake and other indicators. They underwent Six-minute Walk Test after a day off. The target heart rate was calculated using anaerobic threshold method (AT), peak oxygen uptake index method (PI), heart rate reserve method (HRR), age estimates method (AE) and quiet heart rate plus 20 method (HR20), respectively. The correlation and consistency of different methods were analyzed.Results There was no correlation (r=-0.131, P>0.05) and there was a very significant difference (P<0.001) between AE and AT on determining target heart rate. There was no correlation (r=0.372, P>0.05) between HR20 and AT. There was correlation (r=0.872, P<0.01) and there was no significant difference (P>0.05) between PI and AT on determining the target heart rate, and the Bland-Altman test showed a consistency between them. There was correlation (r=0.836, P<0.001) and there was no significant difference (P>0.05) between HRR and AT on determining the target heart rate, and Bland-Altman test demonstrated a consistency between them.Conclusion There was no correlation and consistency of AE and HR20 to AT on the target intensity of aerobic exercise. There was significant correlation and consistency between AT and HRR/PI.
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Objective To evaluate and compare the value of predicting diseases such as hypertension and arteriosclerosis of the body mass index(BMI) and percent body fat(PBF),so as to provide the basis for evaluation of obesity.Methods Totally 3149 common residents in Jiangsu province were surveyed using the method of stratified and cluster sampling.Effective data included height,weight,PBF,blood pressure and brachial-ankle pulse wave velocity(baPWV).Obesity was defined by percent body fat with the evaluation of WHO and ASBP.Areas under ROC curves(AUC)of BMI and PBF were estimated by the nonparametric test and then the two diagnostic tests were compared by predictive value of related diseases.Results(1)Predictive value of BMI to diagnose obesity(defined by PBF):AUC are respectively 0.949(for WHO standard)、0.906(for ASBP standard)in women and 0.864 in men.In age group,the 20-39 years have the highest AUC of BMI to predict obesity.P＜0.01 for above nonparametric tests.(2)According to ROC curves we got the adjusted cut-off points of BMI are respectively 26 kg/m2 in men and 25 kg/m2 in women for WHO standard or 26 kg/m2 in men and 23 kg/m2 in women for ASBP standard,while the specificity of predicting obesity decreased from 90％ ～ 99％ to 76％ ～87％,but the sensitivity significant increased from 17％ ～ 43％ to 78％ ～ 89％;After adjusting the cutoff points of BMI,the value of kappa of prevalence of obesity increased from 0.475 to 0.537 in men and 0.115 to 0.655 in women.(3)To predict hypertension,areas of BMI were 0.688(95％CI:0.656-0.720) in men and 0.745 (95％CI:0.708-0.782) in women,similarly,of PBF were 0.687 (95％CI:0.655-0.718) in men and 0.723(95％CI:0.681-0.764)in women;To predict arteriosclerosis there showed highly consistency that the areas of BMI were 0.613(0.586-0.641)in men and 0.692(95％CI:0.659-0.726)in women,meanwhile,for PBF they were 0.635 (95％CI:0.608-0.663) in men and 0.683 (95％CI:0.648-0.718) in women (P＜0.01).(4) Paired test of the two areas under ROC curves showed that PBF had higher diagnostic value than BMI in men to predict arteriosclerosis(u=2.05,P＜0.05),however,no statistical difference in women(u=0.75,P＞0.05)and in predicting hypertension(u=0.75 to men and u=1.26 to women,P＞ 0.05).Conclusions Using BMI and PBF can all predict hypertension and arteriosclerosis effectively,thus,obesity can be evaluated suitably by both BMI and PBF in large-scale population study,especially in women and youth.Relatively,WHO standard of PBF is more suitable for Chinese population to evaluate obesity than ASBP standard.
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Energy metabolism varies in different periods during the lifetime or in different pathological states. Resting energy expenditure (REE) may increase in some patients with malignant tumors, but may also show no significant difference when compared with healthy people or patients with benign tumors. The alteration of REE may be related to tumor site, pathologic stage, methods of treatment, and/or laboratory tests. The efficacy of a certain therapy may also affect REE in patients with malignant tumors: when a therapy is effective, the value of REE can return normal; however, when the treatment fails, REE will not be improved or become even higher.Mechanism governing the abnormalities of REE in patients with malignant tumors may be associated with the abnormal nutrition metabolism and the regulations of relevant cytokines.