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Objective:To investigate the clinical efficacy of preoperative three-dimensional (3D) reconstruction planning in total hip arthroplasty for development dysplasia of the hip secondary to osteoarthritis.Methods:A total of 80 patients with osteoarthritis secondary to Crowe I-III developmental dysplasia of the hip who underwent primary unilateral total hip arthroplasty from October 2019 to March 2021 were retrospectively analyzed, including 18 males and 62 females and the mean age was 55.7±10.4 years (range 41-72 years). Forty patients in the 3D group, the prosthesis type and installation angle were planed on the 3D reconstruction software based on the full-length CT scan data of the lower limbs, and the length difference of the lower limbs and hip offset were calculated. Forty patients in the control group underwent preoperative planning using conventional film measurement, and lower limb length was judged based on the preoperative measurement data and intraoperative comparison of both lower limbs. The difference of postoperative leg length, hip offset, hip function score, operating time, intraoperative blood loss, and incidence of complications were compared between the two groups.Results:All 80 patients completed the surgery successfully and the follow-up time was up to 3 months after operation. The 3D group was better than the control group in operation time (70.9±7.7 min vs. 81.6±13.3 min, t=-4.91, P<0.001), the difference of postoperative lower limb length (2.78±1.31 cm vs. 5.35±2.15 cm, t=-5.74, P<0.001), and hip function score at 1 week after operation (75.67±3.35 vs. 67.35±4.21, t=12.33, P=0.002), with statistically significant differences. In the 3D group, 95% of acetabular prosthesis and 90% of femoral stem components were consistent with the planned model, while the rate were only 75% and 68% in the control group, and the difference was statistically significant (χ 2=7.51, P=0.023; χ 2=14.92, P=0.005). There were no intraoperative complications such as vascular and nerve injury, and no postoperative complications such as dislocation or periprosthetic infection in all 80 patients. Conclusion:3D preoperative planning assisted total hip arthroplasty in the treatment of Crowe I-III developmental dysplasia of the hip secondary to osteoarthritis can improve the accuracy of the operation, and has a good clinical effect on restoring the leg length and hip offset.
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Objective:To investigate the effect of live lactobacillus preparation in the treatment of postpartum vagina microenviro-ment dysbiosis. Methods:Totally 300 cases of postpartum women were selected in our hospital from February 2013 to November 2013, including those with normal delivery, cesarean section and vaginal delivery after lochia, and each was with 100 cases. The vaginal se-cretion was withdrawn from vagina and the microenvironment was assessed. The patients with dysbiosis were randomly divided into two groups, the observation group was treated with living lactobacillus preparation and the treatment group was without treatment. The effi-cacy and incidence of bacterial vaginosis(BV) were observed. Results:Totally 88 cases (29. 3%) occurred vaginal dysbiosis. There were significant differences in the dysbiosis incidence rate, pH, H2 O2 results, microscopic examination results and the distribution of flora between the two groups (P <0. 05). The effective rate of the observation group was 95. 5%, which was significantly higher than that of the control group (29. 5%). The incidence rate of BV was 4. 5% in the observation group, which was significantly lower than that in the control group [75%] (P<0. 05). Conclusion: The effect of the lactobacillus preparation in the treatment of postpartum vagina microenviroment dysbiosis is promising and safe.
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Objective To evaluate the value of MRI diffusion tensor imaging (DTI) on diagnosis of traumatic brain injury(TBI). Methods Twenty two patients with TBI 1 to 7 days post-injury and 14 healthy controls were studied with DTI and conventional MRI. The fractional anisotropy (FA) was quantified from different regions of interest (ROI) including the genu of corpus callosum (CC), the splenium of CC, the genu of internal capsule (IC) and the posterior limb of IC bilaterally. The FA value of the same ROI was compared between TBI group and control group, and FA value of the lesion side was compared with the mirror healthy side in TBI group. Correlations between the FA and Glasgow coma scale (GCS) in TBI patients were analyzed with Pearson linear correlation. Results Compared with control group, the FA value decreased significantly in each ROI (P<0.01). Compared with the healthy side, FA value was also significantly lower in lesion side in TBI group (P<0.01). The FA value in all the sites were not correlated with GCS in TBI group (P>0.01).Conclusion DTI is sensitive for detecting the acute traumatic injury of white matter and evaluate the degree of injury. It offers the possibility to diagnose TBI earlier and accurately.
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Objective To evaluate changes of regional cerebral metabolism by proton MR spectroscopy (~1H-MRS) in patients with minimal hepatic encephalopathy (MHE) and to correlate these changes with the neuropsychological test. Methods Fifty-four patients with cirrhosis including nine patients with hepatic encephalopathy (HE),23 patients with MHE,22 patients without HE and 13 controls underwent neuropsychological tests and ~1H-MRS scanning. The volumes of interest included occipital gray matter and left parietal white matter regions. Ratio of spectral peak areas of N-acetylaspartate (NAA),choline (Cho),myo-inositol (mI),and glutamine/glutamate (Glx) relative to creatine (Cr) were acquired. Statistical analysis was conducted using independent t test and one-way analysis of variance. The results of different groups were compared by using the nonparametric Mann-Whitney U test with Bonferroni correction. Correlations among the ~1H-MRS ratios, the grade of HE, neuropsychological test and ammonia data were calculated with Spearman correlation test. Results The ratios of NAA/Cr,Cho/Cr,mI/Cr,Glx/Cr of the occipital gray matter and left parietal white matter regions in patients with cirrhosis are 1.55±0.12,0.48±0.10,0.42±0.14,2.52±0.48 and 1.73±0.17,0.75±0.16,0.42±0.16,2.75±0.59respectively,and they are 1.53±0.10,0.48±0.09,0.51±0.11,2.20±0.39 and 1.69±0.15,0.82±0.14,0.53±0.12,2.40±0.40 in patients without HE,1.58±0.13,0.48±0.08,0.38±0.13,2.62±0.39 and 1.78±0.18,0.74±0.14,0.38±0.15,2.84±0.58 in patients with MHE,1.54±0.12,0.50±0.13,0.29±0.07,3.04±0.31 and 1.70±0.19,0.62±0.16,0.29±0.07,3.37±0.38 inpatients with HE.Compared with controls, decreased mI/Cr and Cho/Cr ratios and elevated Glx/Cr ratios were found in patients with cirrhosis (t=3.196,9.394,-6.527,P＜0.01,occipital gray matter. t=5.592,9.717,-6.681,P＜0.01,left parietal white matter＝ and in subgroup of patients without HE, with MHE and HE (F=5.097,25.896,20.204,P＜0.01,occipital gray matter.F=16.435,28.660,21.283,P＜0.01,left parietal white matter).Significant difference in these metabolic alterations was also found among the different groups of cirrhosis especially the ratios of Glx/Cr in occipital gray matter and left parietal white matter (P＜0.0084).The ratios of mI/Cr also significantly altered between patients without HE and with MHE (P＜0.0084).There was a significant negative correlation between the ratios of Cho/Cr,mI/Cr and the grade of HE (P＜0.01＝ and a significant positive correlation between the ratios of Glx/Cr and the grade of HE (r=0.709,P＜0.01,occipital gray matter; r=0.720,P＜0.01,left parietal white matter＝.NCT-A and DST of controls is (49±8) s and 39±6.They are (134±37),(83±26),(64±22) second and 15±2,25±9,35±8 in patients with HE,MHE and without HE respectively.The metabolic alterations of Cho/Cr,mI/Cr,Glx/Cr correlated significantly with neurepsychological tests in all subjects (P＜0.01＝.There was a significant positive and a negative correlation between the ratios of Glx/Cr and the data of NCT-A and DST respectively (r=0.570,-0.642,occipital gray matter; r=0.541,-0.632,left parietal white matter).The metabolic alterations of Glx/Cr had no correlation with ammonia data as well as other metabolic alterations.Conclusions ~1H-MRS study shows cerebral metabolic alterations of gray and white matter in patients with cirrhosis,especially the reduction in mI/Cr ratio and increase in Glx/Cr ratio. These changes correlate well with the neuropsychological tests and may be useful in predicting the presence of MHE.
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By analyzing 94 questionnaires of majors in medical imaging technology on medical ethics teaching,we found that some teaching models will help students realize the necessity of studying medical ethics and case teaching,including increasing the expansion of case teaching,selecting certain videos and short films into case teaching,expanding case-study model and case-exploration model,strengthening teachers' after-case-teaching summary to advance and further ethical themes.These models will also improve students' ability in ethical analysis and their sense of ethics,and will surely apply the theoretical principles into practice once they are interested in studying medical ethics.