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Objective:To investigate the predictive value of neutrophil to lymphocyte ratio (NLR) for hemorrhagic transformation (HT) in patients with acute ischemic stroke (AIS).Methods:Consecutive patients with AIS without performing intravenous thrombolysis and mechanical thrombectomy admitted to the Cerebrovascular Disease Treatment Center, the Affiliated Brain Hospital of Nanjing Medical University from December 2015 to December 2020 were enrolled. The clinical, imaging and laboratory examination data were collected. HT was defined as the first imaging examination of AIS patients without finding bleeding signs, but the imaging reexamination after hospitalization found intracranial hemorrhage. Multivariate logistic regression analysis was used to determine the independent correlation between NLR and HT. The receiver operating characteristic (ROC) curve was used to analyze the predictive value of NLR for HT. Results:A total of 805 patients with AIS were included. The median age was 67 years (interquartile range, 63-71 years), the median National Institutes of Health Stroke Scale (NIHSS) score was 4 (interquartile range, 2-9), the median NLR was 3.84 (interquartile range, 2.66-5.30). Seventy-ywo patients (8.9%) had HT. There were significant differences in age, baseline systolic blood pressure, baseline NIHSS score, time from onset to admission, time from onset to blood collection, time from onset to imaging reexamination, NLR, atrial fibrillation, history of previous stroke and transient ischemic attack and stroke etiology between the HT group and the non-HT group (all P<0.05). Multivariate logistic regression analysis showed that NLR was an independent risk factor for HT in patients with AIS after adjusting for confounding factors (odds ratio 1.355, 95% confidence interval 1.099-1.672; P=0.005). The ROC curve analysis showed that the area under the curve of NLR predicting HT was 0.852, and the optimal cut-off value was 4.75. Its sensitivity and specificity of predicting HT were 88.3% and 71.8% respectively. Conclusion:High NLR is an independent risk factor for HT in patients with AIS during hospitalization, and had better predictive value for HT risk.
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Objective@#To understand the relations between high risk sexual behavior and HIV infection among MSM in ways of finding male partners in Ningbo.@*Methods@#A cross-sectional study was conducted in Ningbo between April and November in 2018. Data related to socio-demographics, ways of finding male partners, adoption of gay apps and sexual behaviors were collected by snowball method. Blood samples were drawn for HIV antibody testing. Classified data was evaluated by chi-square test. Related factors on HIV infection were analyzed by multivariate logistic regression.@*Results@#A total of 735 participants were included in this study. Ways of finding male partners would through gay apps (60.8%, 447/735), QQ/Wechat (32.3%, 237/735) and gay-places (6.9%, 51/735). Related information on high risk sexual behavior and HIV infection among gay apps users were found as: 16.8%(75) had sexual behavior once per week in the past 6 months, 41.8% (187/447) had multiple sexual partners, 12.1% (54/447) had unprotected anal intercourse in the last time, 52.3% (234/447) having had unprotected anal intercourse in the past 6 months. The overall HIV prevalence rate was 12.1%(54/447). Among the HIV cases who got infected within the two years, 68.6%(24/35) of them had used gay apps for less than two years. Results from the, multivariate logistic regression analysis showed that gay apps users were more susceptible to infected HIV than those who used the QQ/Wechat (OR=3.03, 95%CI: 1.30-7.07).@*Conclusions@#Gay apps was popularly known among the Ningbo MSM, and was associated with the high risk sexual behaviors and HIV infection. HIV control and prevention programs should be strengthened in the MSM population who used the gay apps. Related surveillance and intervention programs for MSM, who use the gay apps, need to be further reinforced.
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Objective To investigate the value of three-dimensional speckle tracking imaging (3D-STI) in quantitative evaluation of left ventricular global strain in patients with atrial septal defect (ASD) before and after transcatheter closure.Methods Totally 35 patients with secondary ASD who received successful transcatheter occlusion were selected.Routine echocardiography and 3D-STI examination were performed before the operation,2 days,1 month,3 months and 6 months after the operation.Routine echocardiography was used to obtain the parameters of left ventricular end diastolic diameter (LVEDD),left ventricular end systolic diameter (LVEDS),left ventricular end diastolic volume (LVEDV),left ventricular end systolic volume (LVESV),stroke volume (SV) and other parameters.The left ventricular global peak longitudinal strain (GPLS),left ventricular global peak circumferential strain (GPCS),left ventricular global peak radial strain (GPRS) and left ventricular global peak area strain (GPAS) were examined with 3D-STI.The preoperative and postoperative parameters at each time point were analyzed statistically.Results Routine echocardiography showed that LVEDD,LVEDS,LVEDV,LVESV and SV increased significantly after operation,but no significant difference was found to compare each other 2 days,1 month,3 months and 6 months after operation (all P＞0.05).3D-STI examination showed that left ventricular GPLS,GPCS,GPRS and GPAS increased after operation,and the most increase was noticed at the second day after transcatheter occlusion.GPLS,GPCS and GPAS 6 months after operation were larger than those 3 months after operation (all P＞0.05).Conclusion 3D-STI technique can evaluate the left ventricular global strain in patients with ASD before and after occlusion.Compared with conventional echocardiography,3D-STI technique can objectively and effectively evaluate the changes of left ventricular systolic function.
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Objective@#To explore the application of real-time three-dimensional ultrasound in locating the course, the brand and the blind end of internal opening of congenital preauricular fistula.@*Methods@#Congenital preauricular fistula patients from Changhai Hospital were studied. All the cases were evaluated using two-dimensional and three-dimensional ultrasound before surgeries. The surgery findings were utilized as the gold standard. The imaging features of 3D ultrasound were described to determine the accuracy of the blind end location, the course of the main fistula tract and the branch tracts. The diagnosis was compared with the surgery findings.@*Results@#In 89 cases, among which there were 21 branch fistulae. There were 68 bend fistulae without branch. The diagnostic accuracy of both two-dimensional ultrasound and three-dimensional ultrasound was 100%. The accuracy in locating the blind end of internal opening, the course of the branch tracts with 3D ultrasound was 92.1%(82/89), 85.7%(18/21) , compared to 80.9%(72/89), 57.1%(12/21) with 2D ultrasound. It was obvious that 3D ultrasound had more advantages. These differences were statistically significant (χ2=4.8, P<0.05; χ2=4.2, P<0.05).@*Conclusions@#Compared with 2D ultrasound, 3D ultrasound can accurately locate the blind end of internal opening, the course, and the branch of preauricular fistula, clearly display the morphology and the spatial structure of preauricular fistulaand its surroundings. It has high clinical application value in preoperative imaging examination.
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Objective To understand the epidemiology characteristics and survival status of HIV/AIDS patients with access to highly antiretroviral therapy (HAART) in Ningbo during 2004-2015.Methods A retrospective cohort study was conducted among HIV/AIDS patients diagnosed between 2004 and 2015.Life Tables were used to estimate survival rates,and Kaplan-Meier curve with Log rank test were used to describe the survival curves and the Cox proportional hazard model was used to determine predictors of mortality.Results Of the subjects,the median age when starting HAART was 35 years (IQR:27-45 years).Most of them were males,local residents,married,infected through heterosexual sexual transmission,and their baseline CD4 T cells counts were mainly ≤ 200 cells/μ 1,and most of them were at clinical stage Ⅰ (WHO).The cumulative survival rate was 96.75％ for the first year,92.36％ for the fifth year,91.87％ for the seventh year and 90.02％ for the tenth year.The risk of the mortality was 17.34 times higher for those aged ＞60 years compared with those aged ≤20 years (95％ CI:2.11-142.71),2.83 times higher for those at clinical stage ⅣV (WHO) compared with those at clinical stage Ⅰ (WHO) (95％CI:1.67-4.80) and 3.26 times higher for those with drug resistance compared with those without drug resistance (95％ CI:1.77-6.01).Blood transmission,lower CD4 + T cell level,BMI ＜ 18.5,unmarried were the risk factors for the mortality.Conclusions The effect of HAART was obvious in the HIV/AIDS patients in Ningbo,their survival rate was high.The finding indicated that it is necessary to strengthen the health care for old population and health education about AIDS prevention and control,and conduct large scale screening.Early discovery,early diagnosis,early treatment and improving treatment compliancy are still the effective ways to reduce the mortality.
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miRNA-204 is widely expressed in human body and also aberrantly expressed in almost all human cancers. It is proved that miRNA-204 plays an important role in the occurrence and development of cancers through regulating its target genes in human body. miRNA-204 is often used as a tumor suppressor to inhibit tumor invasion and metastasis through the related molecular mechanism. Meanwhile,miRNA-204 can also be used as potential molecular marker in the treatment of cancers. With a deeper study of miRNA-204,it is possible to provide new ideas for the prevention and treatment of cancers.
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Objective To study the variation of serum Hcy and UA of Parkinson's disease.Methods 46 pa-tients with Parkinson's disease in our hospital from April 2015 to March 2016 were selected as observation group,and 57 patients with other disease at the same time were selected as control group.The contents of serum Hcy and UA of the two groups were analyzed and compared.Results The contents of serum Hcy and UA of the observation group were (17.82 ±3.12)μmol/L,(321.42 ±79.42)μmol/L.Those of the control group were (10.12 ±3.05)μmol/L, (420.15 ±70.18)μmol/L.The content of serum Hcy of observation group was higher than the control group,the con-tent of serum UA of the observation group was lower than the control group(t =12.608,P <0.01).Hcy content of middle and late patients[(18.86 ±3.12)μmol/L]was higher than early patients[(16.16 ±3.04)μmol/L](t =2.378,P <0.05),serum Hcy level was positively correlated with UPDRS(r =0.462,P =0.037),the differences were significant.Conclusion Changes of serum Hcy and UA levels were related to the occurrence of Parkinson's disease.
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Objective To understand the epidemiology characteristics and survival status of HIV/AIDS patients with access to highly antiretroviral therapy (HAART) in Ningbo during 2004-2015.Methods A retrospective cohort study was conducted among HIV/AIDS patients diagnosed between 2004 and 2015.Life Tables were used to estimate survival rates,and Kaplan-Meier curve with Log rank test were used to describe the survival curves and the Cox proportional hazard model was used to determine predictors of mortality.Results Of the subjects,the median age when starting HAART was 35 years (IQR:27-45 years).Most of them were males,local residents,married,infected through heterosexual sexual transmission,and their baseline CD4 T cells counts were mainly ≤ 200 cells/μ 1,and most of them were at clinical stage Ⅰ (WHO).The cumulative survival rate was 96.75％ for the first year,92.36％ for the fifth year,91.87％ for the seventh year and 90.02％ for the tenth year.The risk of the mortality was 17.34 times higher for those aged ＞60 years compared with those aged ≤20 years (95％ CI:2.11-142.71),2.83 times higher for those at clinical stage ⅣV (WHO) compared with those at clinical stage Ⅰ (WHO) (95％CI:1.67-4.80) and 3.26 times higher for those with drug resistance compared with those without drug resistance (95％ CI:1.77-6.01).Blood transmission,lower CD4 + T cell level,BMI ＜ 18.5,unmarried were the risk factors for the mortality.Conclusions The effect of HAART was obvious in the HIV/AIDS patients in Ningbo,their survival rate was high.The finding indicated that it is necessary to strengthen the health care for old population and health education about AIDS prevention and control,and conduct large scale screening.Early discovery,early diagnosis,early treatment and improving treatment compliancy are still the effective ways to reduce the mortality.
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Aim To investigate the analgesic effect of tetrahydropalmatine on Cav1 . 2 expression in the dorsal root ganglion ( DRG) of mice with sciatic nerve chronic constriction injury ( CCI ) -induced neuropathic pain. Methods Forty male C57 BL/6 mice were randomly divided into 5 groups ( n =5 ): sham group ( group S) , CCI group ( group C ) and L-THP group ( group L) . Steady mice models of neuropathic pain were es-tablished by inducing CCI of sciatic nerve. According to development of neuropathic pain in mice, L group was divided into induction period, induction with ma-intenance period and long-term low-dose group. The mice were intraperitoneally administered with 45 mg · kg-1 tetrahydropalmatine in induction ( day 0~5 ) , in-duction with maintenance ( day 0~5 , 14~19 ) period of neuropathic pain state. From the instant after opera-tion, 15 mg · kg-1 tetrahydropalmatine was injected into the long-term low-dose group once per day for 19 days. Then, the behavior changes of mice were moni-tored. Moreover, the threshold of mechanical and ther-mal stimuli was tested. In addition, the expression of Cav1 . 2 protein was detected by Western blot and im-munohistochemical staining. Results The lowest ex-pression of Cav1 . 2 was observed in group C and the highest expression level of Cav1 . 2 was found in group S. Cav1. 2 expression was significantly up-regulated in induction period group, induction with maintenance period group and long-term low-dose group ( P0. 05 ) in long-term low-dose group. Conclusions High dose of tet-rahydropalmatine in induction period group, induction with maintenance period group and low-dose among the whole experiment process obviously relieves the neuro-pathic pain induced by nerve injury. The analgesic effect of tetrahydropalmatine on neuropathic pain may be due to the increased expression of Cav1 . 2 protein in DRG neurons.
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OBJECTIVE@#To explore the risk factors, the ciliary body anatomy structures, the therapeutic methods and the prognosis for malignant glaucoma through retrospectively collecting the clinical data from primary angle-closure glaucoma (PACG) patients.@*METHODS@#Clinical data in 1183 patients (1456 eyes) with PACG were collected between July, 2010 and May, 2014 from Xiangya Hospital, Central South University. Thirty patients (38 eyes) were diagnosed as malignant glaucoma. According to symptom, these patients were divided into a PACG group (1418 eyes) and a malignant glaucoma group (38 eyes); according to age, they were divided into a 3-40 years old group (171 eyes), a 41-70 years old group (1016 eyes) and a ≥71 years old group (269 eyes); according to therapeutic methods, they were divided into a drug therapy group (5 eyes), a lens extraction group (6 eyes) and a vitrectomy surgery group (27 eyes); according to the different method of surgery, they were divided into a vitrectomy group (27 eyes), a nonvitrectomy group (11 eyes). The age, sex, anterior chamber depth (ACD), axial length (AL), lens thickness (LT), visual acuity, intraocular pressure, therapeutic methods and surgery history were recorded. Meanwhile, the ciliary body thickness (CBT), trabecular ciliary process angle (TCA) and lens diameter were measured by ultrsound biomicroscopy (UBM).@*RESULTS@#Male and female ratio was 1:2 in the malignant glaucoma group. The average age [(51.87±12.92) years] in the malignant glaucoma group was less than that in the PACG group [(57.87±8.78) years](P<0.05). Malignant glaucoma was more likely to occur in the first 3 months after PACG trabeculectomy with a rate of 85.7%. The LT [(4.33±0.67) mm], AL[(21.44±1.18) mm] and ACD [(2.12±0.41) mm] in the malignant glaucoma group were less than those in the PACG group [(4.81±0.50), (22.17±0.97) and (2.49±0.48) mm, respectively](all P<0.05). The CBT0, CBT1, CBTmax, TCA and lens diameter in the malignant glaucoma group were less than those in the PACG group (all P<0.05).@*CONCLUSION@#Female PACG patients, with short axial length, shallow anterior chamber, thin lens, thin ciliary body, small trabecular ciliary process angle and short lens diameter, are more likely to suffer from malignant glaucoma. Vitrectomy can significantly reduce intraocular pressure.
Subject(s)
Adolescent , Adult , Aged , Child , Child, Preschool , Female , Humans , Male , Middle Aged , Young Adult , Ciliary Body , Glaucoma, Angle-Closure , Drug Therapy , General Surgery , Intraocular Pressure , Lens, Crystalline , Retrospective Studies , Risk Factors , Tonometry, Ocular , Trabeculectomy , Visual Acuity , VitrectomyABSTRACT
Objective To investigate the difference of IOL Master and A-ultrasound combined with corneal topography meas-urement in intraocular lens ( IOL) power calculation .Methods A total of 84 eyes of 60 cataract patients received phacoemulsification and intraocular lens implantation surgery were selected in Xiangya Hospital from March 2010 to September 2011.There were 57 eyes of 42 age-related cataract patients and 27 eyes of 18 complicated cataract patients .The patients were divided into IOL Master group and A ultrasound combined with corneal topography measurement group .Before surgery , in IOL Master group , axial length ( AL) and corneal curvature were measured with IOL Master , IOL power was calculated according to the Haigis , SRK/T formula and so on.At the same time the axial length ( AL) and corneal curvature were measured with A ultrasound combined with corneal topography respectively and IOL power was calculated by SRK/Ⅱ formula.In A ultrasound combined with corneal topography measurement group , axial length ( AL) and corneal curvature were measured with A ultrasound combined with corneal topography respectively , IOL power was calculat-ed according to the SRK/Ⅱformula.3 months postoperatively , all the patients were conducted refractive outcome and calculating mean absolute refractive error(MAE).Finally the data were analysed.Results ⑴In IOL Master group, before operation there was no sig-nificant difference in mean axial length between IOL Master and A-ultrasound measurement ( P >0.05 ) , while in the patients with AL>26 mm the axial length was (28.53 ±0.57)mm and (29.42 ±0.64)mm using IOL Master and A-ultrasound measurement respec-tively ( P <0.05).The mean corneal curvature was (42.12 ±0.31)D and (43.09 ±0.27)D using IOL Master and corneal topogra-phy measurement respectively ( P <0.01).The mean IOL power were (17.06 ±0.48)D and (16.37 ±0.56)D in IOL Master group and A ultrasound combined with corneal topography measurement group respectively ( P <0.05 ) .⑵3 months postoperatively , the MAE was (0.07 ±1.05)D and (0.16 ±0.81)D in IOL Master group and A-ultrasound combined with corneal topography measure-ment group( P <0.05) respectively.Conclusions In cataract patients with normal axial length , IOL Master and A-ultrasound com-bined with corneal topography have high consistency for axial length measurement and IOL power calculation .But in cataract patients with high myopia , IOL Master is more accurate for axial length measurement and IOL power calculation compared to A -ultrasound com-bined with corneal topography .
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BACKGROUND:Interlocking intramedul ary nail complications contain nail bent or broken, exit, re-fracture at spiketail or nail hole. Thus, our team designs a novel intramedul ary control ed dynamic nail. OBJECTIVE:To evaluate the rationality and safety of intramedul ary control ed dynamic nail design and strength, and to give rational proposal for its clinical application. METHODThe three-dimensional finite element models of composite femur, transverse fractures of the femoral shaft were constructed with intramedul ary control ed dynamic nailing. The stress and strain were detected under vertical loads and gait cycle. RESULTS AND CONCLUSION:The maximum stress of the intact femur under the compression load was at femoral neck and the medial and lateral aspects of the femoral shaft;while the stresses of fractured femur were at the interface between screw and screw hole. In gait cycle, in case of intact bone, large stresses were found in the distal 1/2 of anteriomedialis of femoral shaft;while the stress distribution in fractured femur was similar with the former. Intramedul ary control ed dynamic nailing has the ability of generating compression between fragments. These suggest that intramedul ary control ed dynamic nailing is rational and good at design and biomechanical properties.
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<p><b>OBJECTIVE</b>To describe the adherence and related determinants among HIV-positive methadone maintenance treatment(MMT)clients in Dali,Yunnan province from 2005 to 2013.</p><p><b>METHODS</b>Cases were selected from the "National MMT Information Management System". The main information included demographic, drug abuse behaviors prior to enrollment, MMT treatment and highly active antiretroviral therapy (HAART). Detailed medication records were collected to calculate the adherence to MMT. Multivariate unconditional logistic regression was conducted to analyze the impact factors of adherence.</p><p><b>RESULTS</b>The MMT adherence rate of 480 subjects is 58.11%. Data from the multivariate unconditional logistic regression indicated that among those HIV-positive MMT clients that on HAART program (OR = 1.52, 95% CI:1.03-2.24), related factors as:having stable job(OR = 1.69, 95% CI:1.11-2.56), having compulsory history prior to enrollment in MMT (OR = 1.78, 95% CI:1.04-3.04) were likely to have higher rate on MMT adherence, whereas clients who showed positive result in the last urine morphine test (OR = 0.38, 95% CI:0.24-0.59) were associated with lower rate on MMT adherence.</p><p><b>CONCLUSION</b>In order to improve the rate of adherence to MMT among those HIV-positive MMT clients, the coverage of HAART needed to be expanded and new approaches in combining MMT and HAART developed. Education and intervention efforts should be focused on clients who currently were jobless, those with last urine morphine testing as positive or had never received compulsory treatment.</p>
Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Female , Humans , Male , Middle Aged , Antiretroviral Therapy, Highly Active , China , Epidemiology , HIV Infections , Drug Therapy , Epidemiology , Psychology , HIV Seropositivity , Medication Adherence , Methadone , Therapeutic UsesABSTRACT
<p><b>OBJECTIVE</b>To describe club-based drug use and to explore the determinants on those HIV-positive methadone maintenance treatment (MMT) clients.</p><p><b>METHODS</b>This study was conducted in 5 MMT clinics in Yunnan province and 612 MMT clients who met the survey criteria were recruited for the study. Urine sample was tested as a biological marker to identify if heroin, methamphetamine, methylene-dioxy-methyl-amphetamine, buprenorphine or benzodiazepine had been used.</p><p><b>RESULTS</b>The average age among the 612 clients was 38.9 ± 6.3 years. Among these, 78.9% were males, with the average years of education as 8.0 ± 3.4 years. There were 60.5% clients who had good relationship with their families. 153 (25.0%) clients reported having used club-related drugs in the last 12 months. Results from the urine test showed that the positive rate on morphine was 14.4%, while the positive rate for club-related drugs was 26.6%. Factors as residential area, casual sexual partners, retention on MMT and occasionally use of heroin were associated with urine results on club-related drugs and the prevalence of self-reported club drug use (P < 0.05).</p><p><b>CONCLUSION</b>Club-related drug use was common among HIV-positive MMT clients. Inspection and supervision for club-related drugs and the education and intervention programs on related high risk behaviors should be strengthened.</p>
Subject(s)
Adult , Female , Humans , Male , Middle Aged , China , Epidemiology , HIV Seropositivity , Drug Therapy , Methadone , Therapeutic Uses , Opiate Substitution Treatment , Risk Factors , Substance-Related Disorders , EpidemiologyABSTRACT
OBJECTIVE@#To evaluate the surgical method and intraorbital foreign body extraction.@*METHODS@#Individualized plan was made based on radiology and foreign body extraction was performed in 27 cases (27 eyes). The outcome of extraction was analyzed. Visual acuity, eye movement, and ptosis were recorded before and after the operation.@*RESULTS@#Intraorbital foreign bodies in the 27 eyes were extracted successfully, 24 eyes (88.9%) extracted once and the other 3 eyes (11.1%) twice. The follow-up was 3-24(9.39±6.25) months. Visual acuity increased in 13 eyes (48.1%), and invariable in 13 eyes (48.1%) at the last follow-up. Disturbance of eye movement was found in 18 (66.7%) and 15 (55.5%) eyes before and after the extraction, respectively. Ptosis was found in 2 eyes (7.4%) and 1 eye (3.7%) before and after the extraction, respectively.@*CONCLUSION@#Individualized plan is helpful for the intraorbital foreign body extraction and eye recovery.
Subject(s)
Adolescent , Adult , Aged , Child , Female , Humans , Male , Middle Aged , Young Adult , Follow-Up Studies , Foreign Bodies , Diagnostic Imaging , General Surgery , Orbit , Diagnostic Imaging , General Surgery , Radiography , Visual AcuityABSTRACT
BACKGROUND: Human lower limb system under different motion statuses exhibits great difference in terms of kinetic characteristics and joint deformation magnitude. Total hip replacement has been shown to be the best method to solve the severe illness of hip joints today. A good understanding of the responses of human lower limb system, in particular the knee joint, following total hip replacement is significant for rehabilitation training of patients.OBJECTIVE: To analyze the effects of total hip replacement on knee joint deformation during motions by comparing the data collected from a patient who underwent total hip replacement 19 months ago and a healthy control subject under the same testing environment and method.METHODS: The patient was measured through the use of Optotrak Certus motion capture system (Northern Digital Inc.,California), and simultaneously measurements were performed in a healthy control subject presenting with similar body weight and body mass. Measurement indices included step length, step frequency, joint corner, and joint displacement curves. Speed and acceleration of each joint were calculated based on measured data.RESULTS AND CONCLUSION: Following total hip replacement, the structure of natural hip joint was destroyed. Although the gait did not change greatly, experimental data showed that knee joint deformed more greatly than normal gait, indicating the self-accommodation of human body, i.e., increasing the loading and deformation magnitude of knee joints can avoid the injuries caused by hip joint surgery.
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OBJECTIVE@#To evaluate the mid-term and long-term clinical effect and complication of micro-perforating trabecular surgery (MPTS) with amniotic membrane implants on open angle glaucoma (OAG).@*METHODS@#Thirty OAG patients (49 eyes) were treated with MPTS with amniotic membrane implants. Visual acuity, intraocular pressure, visual field, type of blebs, and complications were recorded pre-and post-operatively.@*RESULTS@#Patients were followed up for 6~24(15.93+/-2.35) months. The mean IOPs before the operation and 24 months after the operation were (36.84+/-11.02) mmHg and (18.24+/-1.34) mmHg, respectively (P=0.000). The mean numbers of anti-glaucoma drugs used before and after the operation were (2.76+/-0.69) and (0.59+/-0.89), respectively (P<0.05). The global index of the early to moderate glaucomatous visual field loss was significantly improved postoperatively (P<0.05), and no significant difference was found in aggressive glaucoma pre- and postoperatively. Functional filter bleb was formed in 70.8% patients 24 months after the operation. The complete success rate and quality success rate were 75.5% (37/49) and 93.9% (46/49), respectively. There was no significant change in visual acuity pre- and postoperatively and no severe complication was found.@*CONCLUSION@#Micro-perforating trabecular surgery with amniotic membrane implants is effective and safe for OAG, with reliable effect on lowering IOP in the mid-term and long-term.
Subject(s)
Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Amnion , Transplantation , Follow-Up Studies , Glaucoma, Open-Angle , General Surgery , Intraocular Pressure , Trabeculectomy , Methods , Treatment Outcome , Visual Acuity , Visual FieldsABSTRACT
BACKGROUND: There are two commonly used techniques of primary orbital implant placement, one is using sclera to cover hydroxyapatite prosthesis after evisceration and the other is using sclera to wrap around the hydroxyapatite prosthesisafter enucleation, which one is more efficient and safer.OB.IECTIVE: To compare the clinical safety of the two kinds of surgery for placing hydroxyapatite prosthesis in the orbit.DESIGN, TIME AND SETTING: A retrospective case analysis was performed.between June 2000 and June 2005 at Xiangya Hospital, Central South University, Changsha, Hunan Province, ChinaPARTICIPANTS: Fifty eyes of 50 cases who were admitted between June 2000 and March 2003 to accept enucleation implants, including 39 cases with atrophic eyeball, 6 cases with anterior scleral staphyloma, 1 case with absolute glaucoma, 4cases with eyeball rupture. Forty-nine eyes of 49 cases who were admitted between April 2003 and June 2005 to accept evisceration implants, including 36 cases with atrophic eyeball, 8 cases with anterior scleral staphyloma, I case with absolute glaucoma, 4 cases with eyeball rupture. All the operations performed by the same surgeon.METHODS: In enucleation implant group, autologous sclera-wrapped hydroxyapatite orbital implant was placed into the muscle cone after enucleation. In evisceration implant group, the bared hydroxyapatite orbital implant was placed into muscle cone after evisceration, and was covered by autologous sclera in anterior.MAIN OUTCOME MEASURES: Appearance improvements and complications of patients after orbital implant placement. RESULTS: There was no significant difference between the two groups in appearance improvement. In enucleation implant group, 7 patients experienced conjunctival dehiscence and 5 patients experienced orbital implant exposure. In evisceration implant group, no conjunctival dehiscence and orbital implant exposure occurred. There were significant differences between the two groups in conjunctival dehiscence ( x2 =7.380, P < 0.01) and orbital implant exposure( x2 =5.160, P < 0.01 ).CONCLUSION: Evisceration with sclera-covered orbital implant is more simple, safe, convenient and effective than enucleation with sclera-wrapped orbital implant.