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Objective:To compare the clinical efficacy of robot-assisted and simple arthroscopic reconstruction of anterior cruciate ligament (ACL).Methods:A retrospective cohort study was conducted to analyze the clinical data of 37 patients with ACL tear admitted to Honghui Hospital of Xi′an Jiaotong University from January 2020 to September 2020. There were 24 males and 13 females, aged 16-45 years［(30.7±9.8)years］. A total of 17 patients were treated by robot-assisted ACL reconstruction (robot-assisted group), and 20 patients by simple arthroscopic ACL reconstruction (simple arthroscopy group). The operation time, number of guide wire drilling, positional accuracy of bone tunnel (distance between the central point of bone tunnel and ideal anatomical point) and perioperative complications were compared between the two groups. Knee stability was evaluated by Lachman test and KT-2000 measurement, and knee function by Lysholm score, International Knee Documentation Committee (IKDC) score and range of motion of joint flexion and extension before operation, at 4 months after operation and at the last follow-up.Results:All patients were followed up for 12-18 months［(13.1±4.1)months］. The operation time in robot-assisted group was (83.8±11.3)minutes, significantly longer than (50.4±9.1)minutes in simple arthroscopy group ( P<0.01). The number of guide wire drilling in robot-assisted group was (2.2±0.5)times, less than (2.5±0.4)times in simple arthroscopy group ( P<0.05). The distance between the central point of bone tunnel and ideal anatomical point was (1.3±0.3)mm in robot-assisted group, not significantly different from (1.4±0.3)mm in simple arthroscopy group ( P>0.05). There were no perioperative complications in both groups. The two groups showed no significant differences in Lachman test, KT-2000 measurement, Lysholm score, IKDC score and range of motion of joint flexion and extension before operation, at 4 months after operation and at the last follow-up (all P>0.05). The above indices in both groups were significantly improved at 4 months after operation and at the last follow-up as compared with those before operation (all P<0.01), and both groups showed no significant difference in the above indexes at 4 months after operation and at the last follow-up as compared with those before operation (all P>0.05). Conclusion:Compared with simple arthroscopic ACL reconstruction, robot-assisted ACL reconstruction can prepare a bone tunnel once with good location and direction in one time and achieve similar results in stability and functional recovery of the joint except for slightly longer operation time.
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Objective:To investigate risk factors for infection of biofilm-forming Klebsiella pneumonia and prognosis of patients. Methods:The clinical data of 125 patients with Klebsiella pneumoniae bloodstream infection admitted in Tianjin Medical University General Hospital from January to December 2019 were analyzed retrospectively. According to the presence of Klebsiella pneumoniae biofilm, patients were divided into biofilm positive group ( n=81) and biofim negative group ( n=44). In biofilm positive group 17 patients died (fatal group) and 64 survived (survival group) during 3-month follow-up. The antimicrobial resistance of the strains was analyzed, and multivariate logistic regression analysis was used to investigate the risk factors of biofilm-forming Klebsiella pneumoniae infection and the risk factors of death in biofilm positive group. Results:A total of 125 strains of Klebsiella pneumoniae were isolated from 125 patients, of which 81(64.80%) strains were biofilm positive. Antimicrobial resistance analysis showed that the resistance rate of biofilm positive group to aztreonam, amikacin, ciprofloxacin and levofloxacin was significantly higher than that in the biofilm negative group ( χ2=5.94, 4.03, 5.05 and 4.15, P<0.05). Multivariate logistic regression analysis showed that endotracheal intubation ( OR=3.460, 95% CI 2.890-14.445, P<0.05) and administration of immunosuppressants ( OR=6.945, 95% CI 1.160-21.567, P<0.05) within 3 months before infection were independent risk factors for biofilm-forming Klebsiella pneumoniae bloodstream infection. The use of tegacycline ( OR=4.886, 95% CI 1.123-21.263, P<0.05) within 3 months before death was independent risk factors for the death of biofilm-positive Klebsiella pneumoniae bloodstream infection. Conclusions:In order to reduce the incidence and fatality of biofilm-forming Klebsiella pneumoniae bloodstream infection, antibiotics should be used rationally and invasive procedures should be minimized.
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OBJECTIVE@#To evaluate the early clinical effects of direct anterior approach (DAA) versus anterolateral approach (ALA) on safety and functional recovery following total hip arthroplasty (THA).@*METHODS@#Between January 2015 and May 2016, a randomized clinical trial was performed at Guizhou Provincial People's Hospital. A total of 50 patients who underwent THA were allocated for either the DAA (n=25) or ALA (n=25). DDA group had 25 patients (25 hips), including 16 males and 9 females, with the mean age of (62±2) years, BMI of (23.26 ±4.95) kg/m2(range: 19.6 to 29.5), and preoperative Harris score of (33.4 ±15.5) (range: 17.9 to 48.9). Eleven cases were diagnosed as primarily hip osteoarthritis, 4 were developmental dysplasia of the hip (DDH, Crowe 2) and 10 were hip avascular necrosis (AVN, Stages 3 to 4). ALA group had 25 patients (25 hips), including 18 males and 7 females, with the mean age of (59±3) years, BMI of (25.35 ±5.8) kg/m2(range: 18.2 to 29.8), and preoperative Harris score of (38.6 ± 16.7) (range: 23.1 to 56.5). Ten cases were diagnosed as primarily hip osteoarthritis, 3 were developmental dysplasia of the hip (DDH, Crowe 2) and 12 were hip avascular necrosis (AVN, Stages 3 to 4). Operation time, incision length, intra-operative blood loss and functional recovery of hip postoperatively were compared between the two groups.@*RESULTS@#The surgical incision of both groups were stage I healing. The mean follow-up was 6 months. There was no significant difference regarding operation time, incision length, and intra-operative blood loss between the two groups. However, we also found that there was no significant difference in the Harris score 3 months and 6 months postoperatively. In addition, two patients in ALA group suffered claudication (physical examination: abduction dysfunction of hip). We also found that DAA group resulted in better recovery of abductor strength and gait than ALA group during early follow-up.@*CONCLUSION@#Both DAA and ALA could obtain good results of early curative effect following THA. Moreover, DAA resulted in better gait than ALA during early follow-up.
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Female , Humans , Male , Middle Aged , Antiviral Agents , Arthroplasty, Replacement, Hip , Hepatitis C, Chronic , Osteoarthritis, Hip , Treatment OutcomeABSTRACT
Objective To discuss the clinical application value of serum procalcitonin(PCT) in patients with Candida bloodstream infection.Methods The data of 783 hospitalized patients of Tianjin Medical University General Hospital including blood culture and serum PCT test were retrospectively analyzed,and the medical records of patients with Candida or bacterial bloodstream infection were evaluated by univaxiate and multivariate logistic regression analysis.The comparison of PCT value were carried out among the different blood culture groups using the Mann-Whitney U test.A receiver operating characteristic(ROC) curve was used to determine the diagnostic performance of the PCT.Results The PCT was 0.21 (0.06,1.02) ng/mL in the 510 patients with negative blood culture,but in 121 patients with Candida infection and 152 patients with bacteria infections,the PCT levels were 1.15 (0.38,6.85) ng/ mL and 2.34 (0.77,15.12) ng/mL,respectively.There were statistically significant differences in PCT levels among three groups(P＜0.05).According to ROC,when the value of PCT was 0.355 ng/mL,the sensitivity was 76.9％,and the specificity was 60.8％ with 0.726 area under the curve (AUC) (P＜0.01) for the identification of Candida infection by blood cultures.Conclusions Serum PCT levels have a certain diagnostic value for Candida bloodstream infection.In critically ill patients with factors associated with candidemia,the combination of clinical symptoms with PCT as an adjuvant diagnostic marker and other laboratory findings can be used to make a prompt and effective initiation of antifungal therapy.
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Tissue-type plasminogen activator (tPA) belongs to the serine protease family, which is expressed in most organs, including the brain and spinal cord.tPA plays an important role in the removal of intravascular fibrin deposition and has been approved for thrombolytic therapy for acute cerebral ischemia .In the central nervous system (CNS), tPA displays many important functions, such as neuronal survival or death , synaptic plasticity, and learning and memory processes .tPA can be synthesized by many types of cells, so it has additional functions besides the blood vessels and CNS .In this review, we provide the structural features , the role in cerebral ischemia, and other functions of tPA.
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Objective To explore the clinical significance of early biomarkers in neonatal asphyxia diagnosis with myocardial damage by detection of ischemia modified albumin in neonatal serum(IMA) and glycogen phosphorylase isoenzyme BB(GPBB) for screening sensitive markers with direct myocardial injury.Methods 166 neonates were selected in our hospital as the research object,in which 136 cases with myocardial injury dividend into the experimental group and 30 cases into the control group.The experimental group were divided into mild group and severe group according to the degree of asphyxia.All the children were tested for GPBB and IMA 1 h after admission.Results The levels of GPBB in neonatal asphyxia myocardial injury group and severe asphyxia group were significantly higher than those in the control group,the difference was statistically significant(P<0.05).The sensitivity of GPBB in diagnosis of asphyxia was higher than that of IMA,the difference was statistically significant(P<0.05).Conclusion The degree of asphyxia is closely related to serum IMA,GPBB level in neonatal asphyxia complicated with myocardial injury.The sensitivity and specificity of GPBB in diagnosis asphyxia is better than IMA in children complicated with myocardial damage.
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Objective To explore the effect of timing for removing the catheter on prognosis in elderly patients with catheter-related bloodstream infection(CRBSI)and on the death-relevant risk factors.Methods 166 elderly patients with vein detaining catheter and a suspected CRBSI in General Hospital of Tianjin Medical University from 2010 to 2015 were retrospectively analyzed.The patients were divided into a group(n=80)of removing the catheter immediately and a group(n=86)of temporarily not removing the catheter.Mortality rate within 30 days was compared between two groups and mortality-related factors were analyzed.Results In patients with CRBSI,pathogen culture results showed that the detection rate of gram-positive bacteria(G+)was 40.4％ (n=67),the rate of gram-negative bacteria(G)was 40.4％(n=67),and the rate of fungi infection were 19.3％ (n =32).The mortality rate within 30 days was 17.5 ％ in group of removing the catheter immediately,and 31.4％ in group of temporarily not removing catheter.The incidence rate of CRBSI in elder patients was also lower in group of removing the catheter immediately versus not immediately(x2 =4.303,P =0.038).Multiple Logistic regression analysis showed that tumor and diabetes were independent risk factors for death in elder patients with CRBSI (OR =2.805,2.502;P =0.017,0.019).Tumor was a relative risk factor for patients who died after removal of catheter immediately (x2=4.033,P =0.045).Conclusions Removing the vein detaining catheter immediately is an urgent need when the suspected CRBSI symptoms such as chill and hyperpyrexia appear in elderly patients with vein detaining catheter.Nephrotic syndrome,hypoalbuminemia,tumor,diabetes and antibiotic usage＞7 days are risk factors for mortality in CRBSI patients.
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Objective To verify the indicator reference value ranges of blood cells analytic report by quoting the WS/T 405-2012 industry standard in Changsha area and to establish the reference value ranges of research parameters suitable for local area.Methods The blood cells analytic results in 3138 cases of reference group were analyzed according to the program of the Formulation of Reference Intervals in Clinical Laboratory Detection Items and the results were compared with the WS/T 405-2012 industry standard.Results WBC,Neu#,Mon%,MCHC,PLT,MPV,PCT,P-LCC,P-LCR and InR‰ in the report parameters and WBC-D,PDW-SD in the research parameters had no statistical differences between males and females(P>0.050);WBC,Neu#,Mon%,MCHC and PLT had no difference between genders,the indicators were narrowed compared with the reference value ranges in standard;the reference value ranges of Neu%,RBC,HGB,MCV and MCH in the male blood cells analytic indicators were narrowed,the lower limits of Bas%,Lym#,Mon# and HCT reference value ranges were elevated,the upper limits of Bas%,Lym#,Mon# and HCT reference value ranges were elevated,while the upper limits of Eos# and Eos% reference value ranges were decreased,the Lym% lower limit was decreased;Neu%,Lym#,Mon# and RBC in the female blood cells analytic indicators were narrowed,the lower limits of Bas# and Bas% were increased,the lower limits of Eos%,Lym%,HGB,MCV and MCH were decreased,the upper limits of Eos#,Eos%,Lym%,HGB,MCV and MCH were decreased and the HCT upper limit was elevated.Conclusion The Changsha area should have the reference value ranges of selective quoted standards and establishes the reference value ranges suitable for local area or laboratory.
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Objective To compare the the curative effect of laparoscopy and open operation in surgical repair of gastric perforation.Methods The clinical data of 68 patients with gastric perforation were analyzed.According to different operation method,the patients were diviede into laparoscopic group and laparotomy group,34 cases in each group.The patients in the two groups were given laparoscopy or laparotomy,respectively.ResultsThe operation time between the two groups had no statistically significant difference (P＞0.05).The intraoperative blood loss,postoperative exhaust time,length of hospital stay in the laparoscopic group were (24.9±7.3)mL,(31.9±10.5)h,(7.4±2.9)d,respectively,which were significantly less than those in the laparotomy group,the differences were statistically significant (t=9.953,5.226,7.441,all P＜0.05).The incidence rate of postoperative complications of the laparotomy group was 32.35％,which was significantly higher than 8.82％ of the laparoscopic group,the difference was statistically significant(χ2=5.757,P=0.016).Conclusion The curative effect of laparoscopic downward gastric perforation repair is superior to laparotomy,patients have rapid recovery,less complications,it is worthy of clinical popularization and application.
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Objective The epidemiology of Acinetobacter baumannii isolates from bloodstream infections,their antibiotic resistance profiles and virulence-associated factors were studied.Methods A total of 90 isolates from 17 hospitals were collected from the patients with bloodstream infections during July 2013 and July 2014.Vitek-2 Compact system was used for identification of the strains and antibiotic susceptibility testing.The epidemiology was studied by pulsed-field gelectrophoresis(PFGE).Drug-resistant genes and associated virulence genes were amplified by PCR.Results According to antimicrobial susceptibility testing,75 isolates are multi-drug resistant Acinetobacter baumannii.PFGE results showed that 75 multi-drug resistant Acinetobacter baumannii isolates belonged to eight clone types(A to H),with the A (n=51)and B (n=14)clone being the dominant PFGE clone types.Different clone isolates spread in different hospitals.Most of the hospitals were given priority to with clone A.Clone A only maintaining high sensitive rate to cefoperazone/sulbactam、amikacin and tigecycline.Virulence gene abaI,cusE,ompA,bap,bfms detection rates are 93.3% (84/90),92.2% (83/90),100.0% (90/90),84.4% (76/90),92.2% (83/90),respectively.There were 7 mucoid isolates,which are all multi-drug resistant Acinetobacter baumannii,all belong to clone B and all associated virulence genes can be detected.Conclusions The dominant clone type of multi-drug resistant Acinetobacter baumannii from bloodstream infections is clone A.The abaI-,bap-and bfms-positive strains are associated with a higher incidence of antibiotic resistance in most types of antimicrobials.The acquisition of mucous type may indicate the emergence of virulent strains,which should be paid attention to during clinical treatment.
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Objective To compare the therapeutic effects and side effects of cisplatin-S-1 (CS) program and docetaxel-cisplatin-S-1(DCS) program on patients with malignant gastric tumor who were treated by laparoscopic gastrectomy.MethodsA total of 67 patients in our hospital from January 2010 to June 2013 were included in this study,of which 33 cases accepted cisplatin-S-1 program (CS group),34 cases accepted DCS program (DCS group).The related side effects including diarrhea,nausea and acute upper respiratory infection,change of routine blood tests,blood biochemical index,and death caused by chemotherapy were analyzed.The related index of surgery including operation time,blood loss,recovery time of gastrointestinal function,pain incidence,hospital stay,lymph nodes resection success rate,postoperative infection,obstruction,intestinal emptying delays were recorded.Meanwhile,the 3-year survival rate after operation and postoperative 3-year recurrence rate between the two groups were compared.Results There was no significant difference in operation time,intraoperative blood loss,postoperative recovery time of gastrointestinal function,the lymph nodes resection success rate,the incidence of postoperative pain,as well as the length of hospital stay,postoperative infection rate,and complications such as obstruction and intestinal emptying delays between the two groups(P>0.05).And there was no significant difference in chemotherapy-related complications between the two groups(P>0.05).But the postoperative 3-year survival rate and postoperative 3-year recurrence rate of DCS group was better than those of the CS Group(P<0.05).Conclusion There is no significant difference in complications and surgery-related index between the two preoperative chemotherapy.However,the DCS programs have more advantages in therapeutic effects.
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Objective To evaluate the performance of parallel test in detecting malaria infection for returned person from malaria endemic area.Methods The blood samples of 484 returnees from malaria endemic area were analyzed and detected by thick blood smear,rapid diagnostic test (RDT) and nest PCR in four companies involving the African labor dispatching.Results The sensitivi ty of thick blood smear and RDT was 0.628 and 0.744 respectively,which of the parallel test was 0.930.On the other hand,the area under the curve (AUC) of parallel test was 0.930 (95％CI:0.895-0.986),which was higher than thick blood smear[0.814 (95％CI:0.724-0.904)]and RDT[0.847 (95％CI:0.769-0.926)].Conclusion Thick blood smear and RDT,which consist of parallel test,could improve the detection sensitivity and accuracy for returnees from malaria epidemical area effectively.This approach is worthy of popularization and application.
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Objective To explore the significance of combined detection of tumor markers cancer embryo antigen (CEA) ,alpha fetoprotein (AFP ) ,carbohydrate antigen 19-9 (CA19-9 ) and carbohydrate antigen 72-4 (CA72-4 ) in digestive tract tumors . Methods The electrochemical luminescence method was adopted to detected the CEA ,AFP ,CA19-9 and CA72-4 levels in 106 cases of digestive tract malignant tumor confirmed by pathological examination (malignant tumor group) ,110 cases of digestive tract be-nign diseases (benign disease group) and 60 persons undergoing the healthy physical examination (control group) in our hospital from January to December 2015 .The differences were compared among various groups and the positive detection rates of 4 markers in the patients with digestive tract tumors were compared .Results The serum levels of CEA ,AFP ,CA19-9 and CA72-4 levels in the malignant tumor group were significantly higher than those in the benign disease group and control group(P0 .05) .In the single indicator detection of ser-um CEA ,AFP ,CA19-9 and CA72-4 ,AFP had the highest detection rate in hepatocellular carcinoma (HCC) ,which was 74 .19% ;the positive detection rate of CA 72-4 in gastric cancer was highest ,which was 60 .71% ;the positive detection rate of CA 19-9 in pan-creatic cancer was highest ,which was 75 .00% ;the positive detection rate of CEA was not high without specificity in various tumor diseases .The positive detection rate of 4-item combined detection was significantly higher than that of single item detection (P<0 .05) .Conclusion The detection of tumor markers CEA ,AFP ,CA19-9 and CA72-4 is conducive to the identification of tumor types ,meanwhile they can improve the detection rate of gastrointestinal cancer and conduces to early diagnosis and early treatment for the patients .
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Objective To understand the situation of eosinophils absolute value and percentage in the population of occupational health examination in Changsha City ,and to analyze the distribution situation of physical examination abnormal results of eosino‐phils absolute value(EOS) and percentage(EOS% ) .Methods The blood cell analysis results and physical examination abnormal manifestations in 22 135 cases of occupational health examination were statistically analyzed .Results Among cases of EOS absolute value and EOS% increase ,the majority had the changes of EKG abnormality ,fatty liver ,etc .the minority were reactive and clonal increase ,meanwhile the cases of unknown cause eosinophils increase also accounted for a large proportion .Conclusion It is sugges‐ted that a large number of experiments and clinical studies should be carried out for further investigate the significance of eosino‐phils increase in the occupational health examination .
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Objective To evaluate the clinical application of the whole blood interferon γ(IFN-γ) release assay of QuantiFERON TB Gold in tube (QFT-GIT) in diagnosis of tuberculosis. Methods From October 2014 to October 2015, 109 patients with tuberculosis (45 cases of confirmed patients and 64 cases of clinically diagnosed patients) and 70 patients with non-tuberculosis were enrolled in Tianjin Medical University General Hospital. In order to evaluate diagnosis value between two kinds of tests, and to compare the differences between two groups, QFT-GIT test and colloidal gold anti tuberculosis antibody (TB-Ab) were employed to detect in two groups of patients. The ROC curve of IFN-γrelease quantity was analyzed in two groups. Results The sensitivity and specificity of QFT-GIT were 93.58% and 85.71% respectively. The positive rate was significantly higher in QFT-GIT than that of TB-Ab (χ2=43.68,P<0.01). The sensitivity of combined detection of the two methods decreased to 52.3% (57/109), but the specificity increased to 90.0% (63/70). The release quantity of IFN-γwas significantly higher in tuberculosis group than that in the non-tuberculosis group (U=330,P<0.05). The area under the ROC curve of IFN-γrelease quantity was 0.913 (95%CI:0.864-0.963). Conclusion The whole blood IFN-γrelease assay of QFT-GIT is a sensitive and specific assay for detecting tuberculosis infection. The combination QFT-GIT with TB-Ab can improve the specificity further, which could be a useful tool for the diagnosis of tuberculosis .
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Objective To investigate the resistance mechanism and virulence genes of clinical strains of carbapenem-resistant Klebsiella pneumonia ( CRKP ) .Methods Twenty clinical CRKP strains were collected from Tianjin Medical University General Hospital during May 2014 and May 2015.Vitek-2 Compact system was used for identification of the strains and antibiotic susceptibility test .Modified Hodge Test and EDTA double disk phenotypic test were performed for screening of drug -resistant phenotypes .Drug-resistant genes , capsular serotypes and associated virulence genes were amplified by PCR , and positive products were sequenced and analyzed by DNA sequencing .Results Resistance to beta-lactam antibiotics including cephalosporins and carbapenems was observed in 80.0%and above strains , but more than 70.0%strains were sensitive to tigecycline , amikacin and levofloxacin .KPC gene and NDM gene were found in 7 strains (35.0%) and 8 strains (40.0%), respectively.SHV, the most common extended-spectrumβ-lactamases ( ESBLs ) gene, was found in 16 strains ( 80.0%). DHA plasmid-mediated AmpCβ-lactamase was found in 2 strains (10.0%).Deletions of porin-coding genes OmpK35 and OmpK36 were found in 8 stains ( 40.0%) and 13 strains ( 65.0%), respectively.Carbapenem-resistant genes in combination with ESBLs genes and/or variation of porin was found in 14 strains (70.0%), and ESBLs genes in combination with variation of porin was found in 4 strains (30.0%).Three strains were of capsular serotype K1 and 1 was of K57, and all of them carried KPC genes .Virulence gene rmpA was found in 8 strains and all carried carbapenemases , among which 5 strains with KPC, 2 strains with NDM, 1 strain with both KPC and NDM .Six strains were aerobactin gene positive , among which 4 strains carried KPC genes . FimH-1 was positive in all strains .Conclusions KPC and NDM genes mainly account for resistance in CPKP, and ESBLs with OmpK gene deletion may also be an important cause .Strains with capsular serotypes K1 and K57 carrying KPC genes are common .
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<p><b>OBJECTIVE</b>To investigate whether plasma from patients with systemic lupus erythematosus (SLE) inhibits the suppressive effects of mesenchymal stem cells (MSCs) on lupus B lymphocytes.</p><p><b>METHODS</b>MSCs isolated and expanded from the bone marrow of healthy donors were co-cultured with B cells purified from the peripheral blood of SLE patients in the presence of fetal bovine serum or pooled plasma from SLE patients, and the proliferation and maturation of the B lymphocytes were analyzed.</p><p><b>RESULTS</b>s Co-culture with normal MSCs obviously inhibited the proliferation of lupus B cells and suppressed the maturation of B lymphocytes, which showed lowered expressions of CD27 and CD38. The pooled plasma from SLE patients significantly inhibited the suppressive effects of normal MSCs on B cell proliferation and maturation.</p><p><b>CONCLUSION</b>Plasma from SLE patients negatively modulates the effects of normal MSCs in suppressing lupus B cell proliferation and maturation to affect the therapeutic effect of MSC transplantation for treatment of SLE. Double filtration plasmapheresis may therefore prove beneficial to enhance the therapeutic effects of MSC transplantation for SLE.</p>
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Humans , B-Lymphocytes , Pathology , Cell Proliferation , Coculture Techniques , Lupus Erythematosus, Systemic , Blood , Lymphocyte Activation , Mesenchymal Stem Cells , Cell Biology , PlasmaABSTRACT
<p><b>BACKGROUND</b>The conventional method cannot guarantee the precise osteotomies required for a perfect realignment and a better prognosis after total knee arthroplasty (TKA). This study investigated a customized guide plate for osteotomy placement in TKAs with the aid of the statistical shape model technique using weight-bearing lower-extremity X-rays and computed tomography (CT) images of the knee.</p><p><b>METHODS</b>From October 2014 to June 2015, 42 patients who underwent a TKA in Guizhou Provincial People's Hospital were divided into a guide plate group (GPG, 21 cases) and a traditional surgery group (TSG, 21 cases) using a random number table method. In the GPG group, a guide plate was designed and printed using preoperative three-dimensional measurements to plan and digitally simulate the operation. TSG cases were treated with the conventional method. Outcomes were obtained from the postoperative image examination and short-term follow-up.</p><p><b>RESULTS</b>Operative time was 49.0 ± 10.5 min for GPG, and 62.0 ± 9.7 min in TSG. The coronal femoral angle, coronal tibial angle, posterior tibial slope, and the angle between the posterior condylar osteotomy surface and the surgical transepicondylar axis were 89.2 ± 1.7°, 89.0 ± 1.1°, 6.6 ± 1.4°, and 0.9 ± 0.3° in GPG, and 86.7 ± 2.9°, 87.6 ± 2.1°, 8.9 ± 2.8°, and 1.7 ± 0.8° in TSG, respectively. The Hospital for Special Surgery scores 3 months after surgery were 83.7 ± 18.4 in GPG and 71.5 ± 15.2 in TSG. Statistically significant differences were found between GPG and TSG in all measurements.</p><p><b>CONCLUSIONS</b>A customized guide plate to create an accurate osteotomy in TKAs may be created using lower-extremity X-ray and knee CT images. This allows for shorter operative times and better postoperative alignment than the traditional surgery. Application of the digital guide plate may also result in better short-term outcomes.</p>
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Aged , Female , Humans , Male , Middle Aged , Arthroplasty, Replacement, Knee , Methods , Knee , Diagnostic Imaging , Osteotomy , Methods , Surgery, Computer-Assisted , Methods , Tomography, X-Ray Computed , MethodsABSTRACT
Objective To assess the risk factors of carbapenem -resistant Acinetobacter baumannii (CRAB) infection.Methods Clinical data of patients with positive bacterial culture in Tianjin Medical University General Hospital during January 2011 and December 2015 were retrospectively analyzed, including 68 patients with carbapenem resistant Acinetobacter baumannii (CRAB) bacteremia, 68 patients with carbapenem sensitive Acinetobacter baumannii ( CSAB) bacteremia, and 68 patients with positive culture of other bacteria (control group).The risk factors of Acinetobacter baumannii infection were analyzed by univatiate and multivariate Logistic regression analyses .Results Univariate analysis showed that bacteremia /sepsis,use of carbapenems,β-lactamase inhibitor compound,tigecycline,combined antibiotics, glucocorticoids,surgery within one month, mechanical ventilation, central venous catheters ( CVCs ), arteriopuncture,indwelling catheter≥3 days and indwelling gastric tube were risk factors of CRAB infection (CRAB vs.control: χ2 =4.96,15.56,7.64,9.22,5.89,6.80,17.00,11.83,18.22,8.24,25.24 and 7.70, P <0.05 or P <0.01, respectively); while use of third-generation cephalosporin,CVCs,length of hospital stay were risk factors of CSAB infection (CSAB vs.control: χ2 =11.93 and 6.94,U =1555, P <0.05).Multivariate logistic analysis showed that bacteremia /sepsis (OR =4.01, 95%CI:1.13 ~14.20), use of carbapenems (OR =4.17, 95%CI :1.79 ~9.73), CVCs (OR =2.93, 95% CI: 1.22 ~7.08), indwelling catheter≥3 days (OR =6.08,95%CI:2.39 ~15.46) were independent risk factors of CRAB infection; use of third-generation cephalosporin (OR =3.98, 95% CI :1.88 ~8.43 ),CVCs(OR =3.40, 95% CI:1.48 ~7.81) were independent risk factors of CSAB infection .Conclusions Long-term use of carbapenems and invasive procedures are associated with CRAB infection , strict control of invasive procedures and rational use of antibiotics may reduce CRAB infection .
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Objective To explore the size changes of erythrocytes infected with Plasmodium malariae,so as to improve the basic?level experimenters’microscopy capabilities for P. malariae identification in thin blood smears. Methods The micro?scopic features of erythrocytes infected with P. malariae in thin peripheral blood smears were observed,and a microscope image processing software was used to measure and analyze the diameter changes of the erythrocytes infected with P. malariae. Re?sults The diameter of erythrocytes infected with P. malariae decreased significantly compared with that of the normal erythro?cytes. The three parameters in this study:the diameter of erythrocytes,the value of diameter variation,and the ratio of diameter variation varied at different developmental stages of P. malariae,and the differences were statistically significant(all P<0.01). The variances of the three parameters grouped by different cases or different developmental stages in different cases were ana?lyzed,all showing statistically significant differences(all P<0.01). Conclusion All the developmental stages of P. malariae will cause the decrease of the diameters of infected erythrocytes in peripheral blood smears,but the influence on the diameter of erythrocytes,value of diameter variation,and ratio of diameter variation varies at different developmental stages in different cases.