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Objective:To develop an total knee arthroplasty(TKA) enhanced recovery after surgery information management system based on "cloud + terminal" data-drivene technology, which can be used in the perioperative interaction between doctors and patients and rehabilitation management of TKA, and evaluate its implementation effect.Methods:The clinical data of 96 patients with unilateral TKA from Qilu Hospital Shandong University were analyzed retrospectively. Forty eight patients in the control group from February to August, 2018 were treated with traditional management. From February to August, 2019, 48 patients in the research group adopted the accelerated rehabilitation information management system based on data-driven technology, which can automatically match, interact and push the information between medical and patient.Results:The Self-rating Anxiety Scale(SAS) score of the intervention group on hospitalization day was 41.52±4.65, which was better than that of the control group (52.60±4.84). The difference between the two groups was statistically significant ( F value was 11.446, P<0.05). The scores of Hospital for Special Surgery(HSS), Visual Analogue Scale(VAS) and SAS in the intervention group 3 days after operation were 56.31±5.81, 2.79±0.68, 38.69±3.81, which were better than those of the control group (51.31±5.20, 4.31±0.78, 46.02±3.86). The difference between the two groups was statistically significant ( F value was 4.44, 10.19, 9.37, all P<0.05); the HSS, VAS, and SAS scores of the intervention group one week after operation were 71.35±3.59, 1.98± 0.67, 36.81±4.03, better than the control group (67.15±3.67, 2.60±0.87, 39.48±4.04), the difference between the two groups was statistically significant ( F value was 5.683, 3.951, 3.237, all P<0.05); the postoperative hospital stay in the intervention group was (3.98±0.84) days, which was less than (6.00±0.80) days in the control group, the difference was statistically significant ( F value was 146.286, P<0.05); The patients′ satisfaction score in the intervention group during medical treatment was 97.46±1.73, which was higher than the control group (94.35±2.04), the difference was statistically significant ( F value was 64.911, P<0.05). Conclusions:TKA enhanced recovery management system based on "cloud + terminal" data-drivene can improve the management level of TKA patients, reduce the length of stay and improve satisfaction of patients.
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Objective@#To report a case of rat poison with multiple hemorrhage after trauma.@*Methods@#The clinical data of a case of rodenticide poisoning with hemorrhage as the first symptom admitted to a third-class a hospital in July 2018 were analyzed and summarized.@*Results@#This patient is a rodent drug poisoning patient with hemorrhage as the first symptom.The disease was diagnosed as bromohamelin and bromadiolone poisoning through the analysis of poison detection because the rodent drug was taken in the market and the history of taking poison was concealed. The patient was given active comprehensive treatment of vitamin K1 and other drugs for clinical cure.@*Conclusion@#For patients with clinically unexplained hemorrhage, the possibility of rodenticide poisoning should be considered and the toxicant detection should be improved actively.
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Objective To evaluate the effect of integrated service platform of extensional care based on the combined internet and extensional care model in the orthopedics nurse care. Methods Two hundred and eighty six hospitalized patients in the orthopedic department were randomly divided into two groups including experimental group (144 cases) and control group (142 cases) according to the random number table method. Patients in the control group received extensional care by traditional telephone follow-up, patients in the experimental group received extensional care by using the integrated service platform combing internet and extensional care. All the patients were evaluated using the self-made extensional care satisfaction questionnaire and Short Form 36 Questionnaire. Results The extensional care satisfaction scores of experimental group using internet plus extended care mode were respectively ( 74.4 ± 5.3) points and (76.2 ± 8.1) points at the time points of 3 months and 6 months after discharge from hospital;The extensional care satisfaction scores of control group were respectively (69.4±9.9) points and (70.1±12.2) points at the time points of 3 months and 6 months after discharge from hospital;The two groups had statistically comparative difference (t=7.40, 6.37, P<0.01). There was a statistically significant improvement of extensional care satisfaction and physical function score and role-physical score and social function score in the experimental group compared with the control group both at the time points of 3 months and 6 months after discharge from hospital. There was a statistically significant improvement of vitality score and role-emotion score in the experimental group compared with the control group both at the time points of 1 month and 3 months after discharge from hospital (t=2.366-8.211, P<0.05). Conclusions The effect of integrated service platform of extensional care based on the combined internet and extensional care model is better than traditional telephone follow-up, patients′satisfaction is higher. This new mode of service platform could greatly deepen the connotation of quality nursing, intensify the effect of extensional care, and reduce the working strength of nurse who did extensional care as while.
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To evaluate the validity of osteoarthritis model induced by bilateral ovariectomy in guinea pig, 32-month-old female guinea pigs were randomly divided into two groups: a sham operation group (control group) and an ovariectomized group (OVX group). The animals were killed 6 or 12 weeks after the operation and the degeneration of the knees were assessed microscopically and histologically by scanning electron microscope (SEM), transmission electron microscope (TEM) and light microscope. The serum levels of estrogen and gestone were detected by immune contest assay.The scoring of articular cartilage histopathology of tibial plateau was performed by histopathological examination. The blood serum levels of estrogen and gestone were decreased significantly in the OVX group as compared with the control group 6 or 12 weeks after the operation. Joint cartilage degeneration as detected by SEM and TEM could be found at the 6th week, but severe degenerative lesions were observed at the 12th week in the OVX group as compared with the control group (P＜0.01).The histopathological score of articular cartilage in tibial plateau in OVX group was higher than that of control group, which was coincident with the changes of estrogen and the ultrastructure (P＜0.01).The findings suggested that bilateral ovariectomy in guinea pig can induce the severe osteoarthritis that is similar to the aging-induced OA in human. Therefore, the model of the osteoarthritis by bilateral ovariectomy in guinea pig in this study is valid.
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To evaluate the validity of osteoarthritis model induced by bilateral ovariectomy in guinea pig, 32-month-old female guinea pigs were randomly divided into two groups: a sham operation group (control group) and an ovariectomized group (OVX group). The animals were killed 6 or 12 weeks after the operation and the degeneration of the knees were assessed microscopically and histologically by scanning electron microscope (SEM), transmission electron microscope (TEM) and light microscope. The serum levels of estrogen and gestone were detected by immune contest assay. The scoring of articular cartilage histopathology of tibial plateau was performed by histopathological examination. The blood serum levels of estrogen and gestone were decreased significantly in the OVX group as compared with the control group 6 or 12 weeks after the operation. Joint cartilage degeneration as detected by SEM and TEM could be found at the 6th week, but severe degenerative lesions were observed at the 12th week in the OVX group as compared with the control group (P<0.01). The histopathological score of articular cartilage in tibial plateau in OVX group was higher than that of control group, which was coincident with the changes of estrogen and the ultrastructure (P<0.01). The findings suggested that bilateral ovariectomy in guinea pig can induce the severe osteoarthritis that is similar to the aging-induced OA in human. Therefore, the model of the osteoarthritis by bilateral ovariectomy in guinea pig in this study is valid.
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To investigate the estrogen receptor(ER) expression in cartilage cell in the development of osteoarthritis induced by bilateral ovariectomy in guinea pig and to find their relationship. 30two-month-old female guinea pigs were randomly divided into two groups (n= 15 each): sham operation (control)group and ovariectomized group (OVX); Scanning electorne microscope (SEM) and transmission electron microscope (TEM) were obtained to analysis the cartilage degeneration of the hind limb knee joint after 6 and 12 weeks of ovariectomy. Dextran-Coated Charcoal (DCC) was taken to quantitively detect the expression of ER. The serum levels of estrogen and gestone were deteeted by immune contest assay. The results showed that ER do exist in the cartilages of the guinea pigs, with higher expression in the control group than in OVX group at the same time point (P＜0. 05). It was increased also at 12 th week after operation than that of preoperation. The blood serum levels of estrogen and gestone showed a similar tendency to the expression of ER. Joint cartilage degeneration detected by SEM and TEM could be found at 6 th week, but severe degenerative lesions at 12 th week in the OVX group compared with the control group (P＜0.01). The data suggested that bilateral ovariectomy in guinea pig lead to severe osteoarthritis which mighgt be related to the lower serum level of estrogen and the downregulation of the expression of ER in the cartilage also.
ABSTRACT
To investigate the estrogen receptor (ER) expression in cartilage cell in the development of osteoarthritis induced by bilateral ovariectomy in guinea pig and to find their relationship. 30 two-month-old female guinea pigs were randomly divided into two groups (n = 15 each): sham operation (control) group and ovariectomized group (OVX); Scanning electorne microscope (SEM) and transmission electron microscope (TEM) were obtained to analysis the cartilage degeneration of the hind limb knee joint after 6 and 12 weeks of ovariectomy. Dextran-Coated-Charcoal (DCC) was taken to quantitively detect the expression of ER. The serum levels of estrogen and gestone were detected by immune contest assay. The results showed that ER do exist in the cartilages of the guinea pigs, with higher expression in the control group than in OVX group at the same time point (P < 0.05). It was increased also at 12 th week after operation than that of preoperation. The blood serum levels of estrogen and gestone showed a similar tendency to the expression of ER. Joint cartilage degeneration detected by SEM and TEM could be found at 6 th week, but severe degenerative lesions at 12 th week in the OVX group compared with the control group (P < 0.01). The data suggested that bilateral ovariectomy in guinea pig lead to severe osteoarthritis which mighgt be related to the lower serum level of estrogen and the downregulation of the expression of ER in the cartilage also.