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With the acceleration of the aging process of the population, the demand for joint replacement continues to increase. Under the background of enhanced recovery after surgery, outpatient joint replacement has become a safe, economic and effective model to shorten the average length of stay and reduce the cost of hospitalization. It has been widely used in foreign countries, but there are still some limitations in the development and promotion in China. Therefore, this study intends to review the perioperative management plan and implementation effect of joint replacement in foreign countries, in order to provide reference for the implementation and improvement of the concept of fast track surgery for bone and joint in China.
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Objective To analyze the epidemiological characteristics and spatiotemporal clustering of scarlet fever in Jinan, from 2014-2019, and to provide a basis for scarlet fever prevention and control. Methods The case data of scarlet fever in Jinan during 2013-2019 were extracted from the Chinese National Notifiable Infectious Disease Reporting System. Descriptive epidemiology and spatiotemporal rearrangement scanning methods were used to analyze the epidemiological characteristics and spatiotemporal distribution of scarlet fever. The RR values of scarlet fever in different towns (streets) were calculated, and the contour map of RR value was drawn. Results A total of 9 715 cases of scarlet fever were reported in Jinan from 2014 to 2019. During this period, the number of cases and the incidence rate showed a gradual increase, with two seasonal peaks in the winter and spring each year. Spatiotemporal clustering analysis detected a total of eight spatiotemporal aggregation areas, and the strongest one was in Licheng and Lixia Districts, from March 2017 to December 2019 (RR=3.45, LLR=577.88, P<0.001). The relative risk maps in each year from 2014 to 2019 were similar, and the areas with the highest risk were located in the central area of Jinan. Conclusion From 2014 to 2019, scarlet fever is highly prevalent in the central area of Jinan, with obvious spatial and temporal clustering. There are clustering areas in the central, southwest and eastern areas of Jinan, and there was a tendency for the disease to spread to Zhangqiu in the east and Pingyin in the southwest.
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Objective To investigate the changes of serum inflammatory mediators in septic rats. Methods Thirty male SD rats were randomly divided into sham operation group(10 rats)and sepsis group (20 rats). The model of sepsis was made by cecal ligation and puncture. Carotid artery blood samples were taken from the sham operation group,and from sepsis group at 0,24,48,72 h after model establishment. Enzyme linked immunosorbent assay(ELISA)was applied to detect the content of serum tumor necrosis factor alpha(TNF α), interleukin 1(IL-1),interleukin element 6(IL-6). Results Serum TNF-α content in the sham operation group was(9. 27 ± 3. 12)ng/ L,and(9. 26 ± 8. 01),(32. 01 ± 4. 52),(55. 22 ± 7. 61),(83. 31 ± 8. 57)ng/ L respectively at 0,24,48,72 h after model establishment in sepsis group. There were significant difference between sham operation group and sepsis group at different time points(P < 0. 01). Serum IL-1in sham operation group was(8. 93 ± 1. 26)ng/ L,lower than that in sepsis group model at 0,24,48,72 h after model establishment ((20. 01 ± 3. 51),(25. 51 ± 2. 79),(59. 67 ± 3. 26),(87. 86 ± 11. 51)ng/ L respectively),and the differences were significant(P < 0. 01). The serum IL-6 level in sepsis group at 0,24,48,72 h after model establishment were(11. 52 ± 2. 32),(31. 59 ± 12. 12),(57. 27 ± 13. 53),(71. 59 ± 12. 67)ng/ L,respectively,different from that of sham operation group((12. 36 ± 3. 25)ng/ L,(P < 0. 01)). Conclusion The serum transmitter levels in septic rats significantly increase,which suggest that a lot of inflammatory mediators are released,and it may be one of the factors for the occurrence of sepsis.
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Objective To investigate the effects of physical exercises on cardiac function and plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) levels in hypertensive patients combined with diastolic cardiac dysfunction.MethodsA total of 66 essential hypertension patients who had abnormal left ventricular relaxation and normal systolic function were assigned to the intervention group ( n =33 ; doing physical exercises once a day,5 days a week) or control group (n =33 ).All the patients received standard treatment.At 6 months,body weight,blood pressure,heart rate,NT-proBNP,and echocardiography were measured.ResultsAt 6 months,body weight [ (68 ± 7 ) kg vs (72 ± 8 ) kg ],systolic blood pressure [ (135.4 ±5.1) mm Hg (1 mm Hg =0.133 kPa) vs (141.9 ±5.2) mm Hg ],diastolic blood pressure [ (81.1 ±4.0) mm Hg vs (84.7 ±4.6) mm Hg],New York Heart Association class (1.4 ±0.3 vs 1.8 ±0.4),NT-proBNP level [ (526 ± 126 ) ng/L vs (741 ± 189 ) ng/L] were significantly decreased in the intervention group when compared with the control group ( all P ＜ 0.05 ) although left ventricular ejection fraction (LVEF) (62.9 ±6.7 vs 59.0 ±5.6) and E/A ratio ( 1.1 ±0.3 vs 0.9 ±0.3) were significantly increased ( both P ＜ 0.05).ConclusionPhysical exercises could play a role in reduced blood pressure and body weight and improved cardiac function in hypertensive patients with diastolic cardiac dysfunction.