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Osteoarthritis is a chronic inflammatory disease characterized by non inflammatory degeneration of articular cartilage and the formation of osteophytes at the edge of the joint, caused by complex causes. Its pathology is complex, and its pathogenesis is not yet clear, ultimately leading to joint stiffness and functional activity disorders. At present, the treatment for osteoarthritis is limited to alleviating symptoms and improving function, with varying degrees of side effects. Ferroptosis is a new type of programmed cell death discovered in recent years, which is related to the pathological and physiological processes of osteoarthritis and plays an important regulatory role in the occurrence and development of osteoarthritis. Its main characteristics include iron metabolism imbalance and accumulation of reactive oxygen species. Therefore, ferroptosis inhibitors targeting ferroptosis have shown great application prospects in the treatment of osteoarthritis. In this review, the author summarizes the relevant mechanisms of ferroptosis in the occurrence and development of osteoarthritis, outlines a large number of specific therapeutic drugs and their corresponding targets, with the aim of delaying and reversing the progression of osteoarthritis by regulating chondrocyte ferroptosis, which has certain clinical guiding significance.
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Objective:To investigate the clinical and imaging features of population receiving opportunistic screening for lung cancer and in convalescent stage of COVID-19.Methods:Cross-sectional study and analysis was performed on the patients who underwent chest low-dose CT examination for cancer prevention in Cancer Hospital of Chinese Academy of Medical Sciences from December 28, 2022 to January 19, 2023. All the patients completed the COVID-19 questionnaire. A total of 334 questionnaires were sent out, all of which were recovered, and 321 valid questionnaires were collected, among them, 293 questionnaires were included in the analysis. Statistical analysis was conducted according to the questionnaire information, clinical symptoms and chest CT imaging results. The potential influencing factors of COVID-19 infection were explored, and the imaging characteristics of COVID-19 infection and early stage of lung cancer were compared.Results:A total of 293 patients underwent lung cancer screening during the convalescent stage of COVID-19 infection. A total of 231 (78.8%) cases had cough and 228 (77.8%) cases had fever. 214 (73.0%) cases still had clinical symptoms within 2 weeks after nucleic acid or antigen test showing negative, especially for cough in 171 (58.4%) cases, fatigue in 79 (25.3%) cases and sputum in 73 (24.9%) cases. There were 54 (18.4%) cases with positive chest CT changes. The main imaging findings showed that there were 46 cases with new patchy shadows, 25 cases with linear opacities, 10 cases with ground-glass opacities, 10 cases with nodular like shadows and 2 cases with consolidation, and most lesions were in the subpleural area of both lungs. Univariate analysis showed that positive CT findings were correlated with the time from positive detection of COVID-19 to screening ( P=0.026), age ( P<0.001) and underlying diseases ( P=0.006). Multivariate analysis showed that age≥65 years old ( OR=6.425, 95% CI: 2.688-15.358; P<0.001) and underlying diseases ( OR=2.292, 95% CI: 1.120-4.691; P=0.023) were risk factors for pulmonary imaging changes of COVID-19 infection. For lung cancer opportunistic screening, 36 (12.3%) cases showed ground-glass opacities in bilateral or unilateral lung lobes, among which 4 cases were suspected to be atypical adenomatous hyperplasia and 2 cases s were suspected to be early stage of lung cancer. Conclusions:Abnormal clinical symptoms and chest CT findings are still observed in the patients during the convalescent stage of COVID-19 infection. Age≥65 years, underlying diseases were the high-risk factors for the changes in chest CT imaging after COVID-19 infection. Attention should be paid to the differential diagnosis of chest CT findings between changes in the convalescent stage of COVID-19 and early stage of lung cancer.
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Objective:To observe the effect of ultrasound probe fixation bracket assisted ultrasound-guided venipuncture in difficult intravenous access.Methods:A total of 105 inpatients with difficult intravenous access from November 2017 to May 2019 were selected by convenient sampling method. From November 2017 to May 2018, 39 patients as the control group were treated with ultrasound-guided peripheral venous indwelling needle puncture technique. From June 2018 to May 2019, 66 patients as the experimental group were treated with ultrasound probe fixation bracket assisted ultrasound-guided peripheral vein indwelling needle puncture technique. The success rate of one needle puncture, the times of puncture and the degree of pain were compared between the two groups.Results:The success rate of one needle puncture was 92.4% (61/66) in the experimental group and 66.7% (26/39) in the control group ( χ2 value was 11.450, P<0.01); The puncture times in the experimental group and the control group were 1.08±0.27 and 1.44 ±0.72, and the difference was statistically significant ( Z value was -3.435, P<0.01). The pain scores of the experimental group and the control group were 2.00 ± 0.95 and 3.08±1.37, and the difference was statistically significant ( Z value was -4.159, P<0.01). Conclusions:The application of ultrasound probe fixation bracket assisted ultrasound-guided peripheral venipuncture technique in patients with difficult intravenous access can improve the success rate of one needle puncture, reduce the number of puncture and reduce the degree of pain.
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Objective@#To determine the screening and early detection reference age for individuals with family history of cancer in either one of the parents.@*Methods@#We examined the family history of 33 200 subjects who visited the Department of Cancer Prevention, National Cancer Center and Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College between January 2008 and March 2018 for cancer screening and early detection. The age differences between the subjects in the research population were analyzed using an independent t-test. All statistical analysis was performed using IBM SPSS Statistics for Windows version 24.0 (IBM Corp., Armonk, NY, USA).@*Results@#We documented 480 families in which fathers and one or more of their children were diagnosed with malignancies, attributing to 614 father-child pairs. We also documented 476 families with mothers and one or more of their children diagnosed with malignancies, attributing to 614 mother-child pairs. In total, we included 956 families in our study with a total of 505 sons and 723 daughters diagnosed with cancer during the study period. In the father-child group the average age at diagnosis for fathers, sons, and daughters were 66.6±10.8, 56.6±11.7, and 51.7±11.7 years, respectively. Sons and daughters were diagnosed with malignancy 10.0 and 14.9 years earlier than their fathers, respectively (P<0.001). Daughters developed malignancies approximately 5 years earlier than sons in the father-child group (P<0.001). In the mother-child group, the average age at diagnosis for mothers, sons, and daughters were 65.8±12.2, 57.8±12.2, and 52.3±12.4 years, respectively. Mothers were diagnosed with malignant disease 8 years later than their sons (P<0.001) and 13.5 years later than their daughters (P<0.001). Interestingly, daughters developed malignant diseases 5.5 years earlier than sons even in this group (P<0.001). Average age at diagnosis for subjects whose fathers and mothers developed malignancy before 50 years was 4.8 years and 4.4 years earlier than those whose fathers and mothers developed malignancy after 50 years old (P<0.05, P<0.001). Sons and daughters were diagnosed with lung cancer 9.3 and 12.6 years earlier than the fathers, and 10.2 and 13.6 years earlier than the mothers, respectively (P<0.001).The daughters in the mother-children group and the father-daughter group were diagnosed with breast cancer 10.5 and 11.1 years earlier than the mothers in the mother-child group (P<0.001).@*Conclusions@#Children develop malignancy earlier than their parents in families with cancer in parents and children. Hence, individuals with a family history of cancer in either of their parents should undergo interventions for cancer screening and early detection at a relatively earlier age compared to the initial screening age recommended by conventional screening guidelines for certain cancers.
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Objective To investigate the role and significance of opportunistic screening in cervical cancer screening for elderly women aged≥65 years old. Methods The screening data of 1 304 elderly women (≥65 years old) who underwent opportunistic screening for cervical cancer at the Cancer Hospital, Chinese Academy of Medical Sciences, between January 1, 2010, and December 31 st, 2018, were analyzed retrospectively. Women who underwent cervical cytology tests and human papillomavirus (HPV) testing were divided into two groups according to age as following 65-69 and ≥70 years old. Women with abnormal cytology or who were hrHPV-positive were followed up. The cervical cytological abnormalities and high-risk HPV infection rates in women aged≥65 years in opportunistic screening were analyzed. Results Of all cases, 175 had abnormal cytology or were hrHPV-positive. Among the 1 304 women, 69 were TCT-positive, with a positivity rate of 5.3%, including 17 cases (24.6%) of high-degree squamous intraepithelial neoplasia and 3 cases (4.4%) of squamous cell carcinoma. The total abnormality rate of TCT in the 65-to 69-year age group (6.7%, 43 cases) was significantly higher than that in the≥70 age group (3.9%, 26 cases), and the difference was statistically significant between the two groups (P=0.024). The overall prevalence of hrHPV infection was 10.7% (139/1 304). HPV58 (31/174, 17.9%) was identified as the most common high-risk HPV type, followed by HPV16, HPV52, HPV33, and HPV31. Follow-up showed that 50.3% of the women had never been screened in the past 10 years, and no statistically significant difference in TCT abnormality and hrHPV infection positivity rate were found between those who had been screened (80 cases) and those who had not been screened at least once in 5 years (87 cases) (P>0.05). Conclusion Attention should be paid to the screening for cervical cancer in elderly women aged ≥65 years old. Opportunistic screening is a supplement to the population-based organized cervical cancer screening. The termination age of cervical cancer screening for elderly women may be appropriately extended.
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Objective To investigate the mechanism of homocysteine-induced microglia (BV-2 cells) expression of interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α).Methods The BV-2 cells were divided into blank control group,cysteine (Cys) group,homocysteine (Hcy) group and homocysteine and glutathione (Hcy+GSH) group,and the BV-2 cells in these groups were incubated with cysteine or homocysteine or homocysteine and glutathione together for 72 h.The mRNA expressions of IL-1β and TNF-α were assessed by RT-qPCR.The protein expressions of IL-1β and TNF-α in supernatant were detected by enzyme linked immunosorbent assay (ELISA).Western blot was used to observe the changes of NF-κB/p65 expression.Results There were significant differences in mRNA and protein expressions of IL-1β and TNF-α and NF-κB/p65 protein expression between groups (F=48.63,130.76,702.91,293.69,212.06,respectively,all P=0.000).The secretions of IL-1β and TNF-α were significantly improved by homocysteine (P＜0.05),and were reversed by the treatment with glutathione (P＜0.05).Western blot assay result showed that NF-κB/p65 was elevated after treatment with homocysteine (P＜0.05).Conclusions Homocysteine can induce microglia expression of interleukin-1β and tumor necrosis factor-α,and NF-κB signaling pathway may be involved in this process.
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BACKGROUND:Periprosthetic joint infection is a complication that is difficult to deal with after joint arthroplasty. Early diagnosis is the key to treatment. To find a fast response, high-sensitivity and high-specificity molecular biomarker can significantly optimize the diagnosis process of periprosthetic joint infection. OBJECTIVE:To monitor blood procalcitonin, interleukin-6 and lipopolysaccharide binding protein levels, to compare with blood leukocyte count and C-reactive protein levels, to identify above indexes, and to distinguish sensitivity and specificity of periprosthetic joint infection. METHODS: A total of 81 patients with pain after arthroplasty who were treated in Affiliated Hospital of Jining Medical Colege from January 2008 to December 2013 were enroled in this study. The repair surgery of al patients was divided into two stages. In the first stage, complete debridement and the instalation of temporary occupancy device were conducted. After 3 months averagely, two-phase reconstruction was performed. At 1 day before surgery, venous blood was colected. Calcitonin, interleukin 6, lipopolysaccharide binding protein, leukocyte count and C- reactive protein levels were detected. During the operation, synovial membrane and sample of false envelope around the prosthesis were colected. Bacterial and histological examinations were performed. The sensitivity and specificity were calculated using receiver operating characteristic curve. RESULTS AND CONCLUSION: One-way analysis of variance results showed that the receiver operating characteristic curve of lipopolysaccharide binding protein was bigger, 0.962; 95 confidence interval 0.924-1.000. Diagnostic value was optimal, and the critical value was 23.5 μg/L. These data suggested that when lipopolysaccharide binding protein exceeded 23.5 μg/L before surgery, periprosthetic joint infection would be identified. The receiver operating characteristic curve of C-reactive protein was 0.871. The receiver operating characteristic curve of leukocytes was close to 0.5. The diagnostic value of leukocyte count on periprosthetic joint infection was not great. These findings indicate that lipopolysaccharide binding protein has good application prospect in the diagnosis of periprosthetic joint infection after joint replacement, and shows high positive predictive rate and negative predictive rate of periprosthetic joint infection.
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BACKGROUND:Lateral retinacular release is effective to treat anterior knee pain, but it has not been confirmed through the parameters of the knee joint. OBJECTIVE: To analyze the relevant parameters on the axial X-ray films of the patela before and after lateral retinacular release and then to find out the efficient parameters for patelofemoral joint disorders on the axial X-ray film of the patela, which are of most clinical significance. METHODS: Fifty patients with anterior knee pain were included randomly who admitted at the Department of Joint Surgery, Affiliated Hospital of Jining Medical University from February 2009 to December 2013, including 45 cases of Outerbridge I-III undergoing arthroscopic lateral retinacular release+articular cartilage repair and 5 cases of Outerbridge IV undergoing lateral retinacular release+knee joint surface replacement. RESULTS AND CONCLUSION:After lateral retinacular release, the congruence angle, patelofemoral index and tilt angle were al reduced significantly (P 0.05). The patelar trajectory restored to the corresponding central position of the femoral condyle, and meanwhile, no joint hematoma, deep vein thrombosis and patelar subluxation occurred. These findings indicate that the lateral retinacular release is of great significance for treatment of anterior knee pain induced by lateral patelofemoral compression.
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Objective To identify risk factors for wound complications related to internal fixation of distal tibial fracture.Methods A total of 125 patients undergone open reduction and internal fixation of the distal tibial fracture between January 2008 and December 2011 were enrolled.There were 72 men and 53 women with mean age of 41.46 years.Factors contributing to operative wound complications assessed were demographic characteristics (age,gender,and smoking history),types of fracture,operative time,time from injury to operation,and concomitant diseases (diabetes and peripheral vascular disease).Patients with wound complications were defined as those requiring dressing care and oral or intravenous antibiotics or those requiring further surgical treatment.Results At follow-up,wound complications were recorded including 1 patient (0.8％) had surgical debridement and 10 patients (8.0％) had dressing care and oral or intravenous antibiotic therapy.Logistic regression analysis identified risk factors for wound complications were open fracture (OR =23.077,95％ CI 2.672-199.342,P ＜0.01) and age (OR =1.078,95％ CI 1.011-1.150,P ＜ 0.05).Otherwise,following factors exhibited no significant correlation with wound complications:age,body mass index,smoking history,types of fracture,multiple injury or not,and operative time.Conclusion Patients with older age or open fracture present an increased risk of wound complications after operation and need special concern.
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Objective To explore the influence of drug dosage, solvent and other main influencing factors on the successful establishment of alloxan-induced hyperglycemia mouse model and the effect on the stability of this model. Methods 160 6-8-week-old Kunming mice ofSPF grade, (male:female=1:1) were used in this study.The influences of different dosages of alloxan and solvent combinations on the successful establishment rate of the model, survival rate, body weight, fasting blood glucose, blood glucose area under curve, serum insulin level and their stabilities were dynamically observed for six weeks.Results By single intraperitoneal injection of 160 mg/kg bw alloxan ( pH 4.5 citrate sodium as solvent) , we were able to obtain a stable experimental hyperglycemic mouse model with higher levels of successful establishment rate (70%), survival rate (75%), fasting blood glucose (15-20 mmol/L), glucose area under the curve (55-65 mmol/L) and a lower but not loss of serum insulin levels (21 mIU/L).Conclusions In the present study we have carefully considered the influence of main factors such as drug dosages, solvent, etc., on the alloxan-induced experimental hyperglycemic mouse model, and successfully established this model after 6-week period observation of its stability.This model may provide a useful tool in the research of experimental diabetes and hypoglycemic functional studies.
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Objective To evaluate the biomechanical effect of horizontal, vertical, and cruciate suture repairs and partial meniscectomy on contact mechanics. Methods Control group (complete meniscus), buckethandletear group and suture repaired group were recorded. The contact map of the control group was firstly recorded; simulated bucket handle medial meniscal tears were then created. Tears were treated with 1 of 3 suture repair techniques or partial meniscectomy. The 24 samples were treated randomly and thus there were 6 samples evaluated for every operation method. Instantaneous contact area (CA), mean contact pressure (MCP), and peak contact pressure (PCP) measurements were recorded with a pressure sensing system. CA, MCP, and PCP for intact stifles (control), stifles with simulated tears, and stifles after treatment were recorded and compared using 1-way repeated measures ANOVA. Results Stifleswithbuckethandletearshadsignificantlydecreased CA, increased MCP and increased PCP when compared with control group. All meniscal repair techniques reestablished normal contact mechanics. When comparing meniscal repair and partial meniscectomy, stifles with partial meniscectomy had lower CA, higher MCP and PCP than stifles undergoing repair (P = 0.851 and 0.987, respectively). Conclusions Contact mechanics obtained from each repair technique were mechanically superior to partial meniscectomy. Performing meniscal repair instead of partial meniscectomy with select meniscal tears may mitigate the development of degenerative joint disease.
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BACKGROUND:Failure of anterior cruciate ligament reconstruction can be caused by multiple factors, which requires a revision surgery. However, there are few studies about the revision of anterior cruciate ligament. OBJECTIVE:To investigate the primary cause, indication, methods and effectiveness of revision after the failure of anterior cruciate ligament reconstruction. METHODS: Thirty patients with instability undergoing anterior cruciate ligament reconstructions were subjected to revision under arthroscopy. After revision, a systemic analysis was performed based on KT-2000 examination, the International Knee Documentation Committee (IKDC) scale, Lysholm and Tegner scores. RESULTS AND CONCLUSION:Of the 30 cases, 9 cases were reconstructed with bone-patelar tendon-bone autograft, 14 cases with hamstring tendon autograft, 7 cases with hamstring tendon alograft. Twelve cases had a femoral tunnel in the front of the predicted one, 1 case had knee stiffness, 8 cases had a tibial tunnel in the front of the predicted one, and 8 cases had both the femoral and tibial tunnels in the front of the predicted ones. One case had a malposited interference screw which reconstructed with bone-patelar tendon-bone autograft; one case complicated by posteromedial corner injury was not reconstructed. The reconstructed anterior cruciate ligament was absolutely ruptured and absorbed in 12 cases, and 18 cases had obviously loosen but stil partly linked reconstructed ligament. None had severe incompletion of spongy bone. Al cases received primary revision. Ten cases reconstructed with ipsilateral hamstring tendon, 14 cases reconstructed with contralateral hamstring tendon, and 6 cases with LARS ligament. The mean side-to-side difference of KT-2000 examination at 90° and 30°, the mean IKDC, Tegner and Lysholm scores were significantly improved after revision. There were many reasons leading to failure of anterior cruciate ligament reconstruction, such as malposition of the bone tunnel, invalid fixation, adhesion, compound ligament injuries, and ankylosis. The functional results and objective stability could be obtained through revision folowing anterior cruciate ligament reconstruction.
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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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Objective To explore the establishment method of virtual three-dimensional model of the virtual artery and interven-tional devices,and its application value.Methods The virtual models including virtual artery system,catheter,guide wire,stent and coil were established by using the three-dimensional moulding software of 3D Studio MAX R3.The study about interventional preoperative simulation and assistant instruction were run in personal computer.Results ①All the virtual instruments and real in-struments were highly similar shape,the arterial system in the visual display was similar to realistic system.②All arteries branches had own name,could be arbitrarily adjusted curvature,diameter and established the lesion morphology.③The reference value of preoperative simulation results to guide the actual surgery included following aspects:to guide the reasonable shaping of micro-cathe-ter and micro-guide wire tip,to plan the coil and stent deployment location,number and size.④In training and teaching,the preop-erative simulation could assist doctors in learning and remembering the artery branch and establishing the concept of three-dimen-sional space,and enhanceing the intention understanding of surgery.Conclusion The establishment method of virtual model of the virtual artery and interventional devices is reliable.The preoperative simulation results can be used to guide practical operation with relatively high accuracy,and it has an important supporting role for the teaching and training of medical students.
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Objective To investigate the prevalence of human papilloma virus (HPV) infections among gynecological patients and to identify the risk factors associated with high-risk HPV (HR-HPV)infection.Methods HPV DNA genotyping was performed in 391 HPV infected gynecological patients admitted in Weifang People's Hospital during January 2010 and December 2012.HPV negative patients (controls,n =356) were matched to HR-HPV positive patients (cases,n =356) with a 1 ∶ 1 ratio.All the participants took part in a questionnaire survey with 50 items,including demographic characteristics,pregnancy and reproductive history,living conditions,sexual behavior,family history,etc.Stepwise Logistic regression analysis was used to determine the risk factors of HR-HPV infection.Results Among 391 HPV positive patients,318 (81.3％) were infected with one type of HR-HPV,35 (9.0％) were infected with one type of low-risk HPV,and 38 (9.7％) were infected with mixed types.Logistic regression analysis showed that married women,age of sexual debut ＜ 20,multiple sexual partners,oral sex,commercial sexual activity,and vaginal douching more than once a week were risk factors of HR-HPV infection (OR =4.053,1.861,1.587,2.420,5.125 and 1.943,respectively,all P ＜ 0.01).Conclusions Unprotected sex may be associated with HR-HPV infection.Healthy sexual behavior should be encouraged,and the detection,prevention and control of HR-HPV infection should be strengthened.
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Objective To explore virtual three-dimensional (3D)model for intravascular interventional devices,the method of preoperative simulation and its value in clinical work.MethodsThe virtual models including catheter,guide wire,stent and coil were established by using the 3D moulding software of 3D Studio MAX R3. The interventional preoperative simulation was performed on personal computer including 21 patients of cerebral aneurysm embolization ( anterior communicating artery 5,posterior communicating artery 10,middle cerebral artery 3,internal carotid artery 2,and vertebral artery 1 ),during interventional procedures,the surgeon relied on the simulation results for plastic micro-guide wire,catheter and the release of micro-coils and stents.Results( 1 ) All the virtual instruments and real instruments had similar shape,the overall tine for constructing virtual model was about 20 hours.The preoperative simulation took 50 to 80 minutes. (2) The simulation result of catheter insertion in the 18 cases had relevant value to guide micro-catheter,molding micro-guide wire tip,and shortened the operating time.For embolization,the simulation results of filling coil and releasing stent were similar to surgical results in 76％ of the patients (16/21).(3)For teaching and training,93％ (38/41) of doctors in training believed that preoperative simulation facilitated the understanding of surgery. ConclusionsThe method of virtual model of intravascular interventional devices was reliable.The preoperative simulation results could be used to guide practical clinical operation with relatively high degree of similarity,and could play a role in promoting researches on interventional virtual operations.
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Objective To explore the effective perioperative nursing measures for congenital cleft lip and palate children.Methods 43 cases of congenital cleft lip and palate children treated in our hospital from January 2010 to December 2011 were given perioperative nursing measures.Results The wound healing time was 6～7 days,with an average time of 6.6 d.After operation,a survey was carried out to investigate the satisfaction degree of the parents,the results showed that postoperative satisfaction degree of the parents reached 100％.Conclusions Nursing intervention is of great significance on the efficacy of cleft lip and palate surgery,the implementation of comprehensive nursing interventions can obtain desirable clinical effect,and increase the satisfaction degree of children's parents.
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Objective To explore.the effect of operative treatment for more than 70-year-old patients with osteoporotic hip fracture,and analyze the clinical feature,perioperative management and choices of operative treatment.Methods One hundred and fifty-nine patients of more than 70-year-old with osteoporotic hip fracture were operated from June 2007 to October 2010.Fracture type:38 cases with intertrochanteric fracture while femoral neck fracture in 121 cases.Results One hundred and thirty-five cases were followed up after operation ranging from 3 to 43 months.There were 2 cases by proximal femur nail internal fixation,13 cases by proximal femur locked plate internal fixation,15 cases by dynamic hip screwinternal fixation,48 cases by bipolar femoral head arthroplasty and 57 cases by total hip arthroplasty.The Harris scores of various surgical method above respectively were 100.0％ (2/2),76.9％ ( 10/13 ),80.0％(12/15),89.6％ (43/48),96.5％ (55/57).Conclusions The operation plays an important role in the treatment of elderly osteoporotic hip fracture,having so many advantages as earlier mobilization,less complications and better life quality.But it is important to pay attention to perioperative management and choose reasonable surgical approach according to classification of fracture.
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OBJECTIVE: To study the curative efficacy of Shuxuetong injection for vascular dementia(VD).METHODS: A total of 60 patients with VD were randomized to receive Shuxuetong injection(6 mL) added into normal saline(250 mL)q.d by drip infusion for 21 days(treatment group) or citicoline injection(250 mg) added into 250 mL normal saline q.d by drip infusion for 21 days(control group).In addition,both groups received basic treatment and nursing care,and the antihypertensive,hypoglycemic and hypolipidemic therapies were adopted based on the patients' severity of disease and complications.The efficacy was evaluated before and after treatment by using mini-mental state examination(MMSE),activities of daily living(ADL),transcranial Doppler(TCD) and P300 test.RESULTS: Compared to control group,the treatment group had significantly higher MMSE score and ADL score(P
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BACKGROUND: Lung protective ventilation strategies and positive endexpiratory pressure (PEEP) have been widely used as an effective ventilation pattern in clinical practice of administration of acute respiratory distress syndrome (ARDS) in recent years, but there arestill great arguments on the therapeutic effects.OBJECTIVE: To observe the changes of oxygenation index and inflammatory transmitters in peripheral blood and bronchoalveolar lavage fluid(BALF) of different lung areas [superior area of lung (upper lobe), ventral side of inferior lung (heart lobe), and dorsalis inferior lung (diaphragm lobe)] of ARDS dogs caused by pulmonary and extrapulmonary insults under lung protective ventilation treatment.DESIGN: A randomized control animal study.SETTING: Department of Respiratory Medicine, the General Hospital of Chinese PLA.MATERIALS: Twenty-four adult healthy male mongrel dogs were randomly divided into four groups with 6 dogs in each: pulmonary ARDS experimental group, pulmonary ARDS control group, extrapulmonary ARDS experimental group and extrapulmonary ARDS control group.METHODS: Models of extrapulmonary ARDS were induced by intravenous injection of oleic acid (0.1-0.15 mg/kg), and the pulmonary ARDS models were established by intratracheal administration of diocty sulfosuccinate sodium salt. After lung injury, the experimental groups received lung protective ventilation treatment (tidal volume: 8 mL/kg, PEEP: 0.981 kPa)for 3 hours, and the control groups also received ventilation of large tidal volume (tidal volume: 14-17 mL/kg, PEEP: 0 kPa).MAIN OUTCOME MEASURES: ① changes of oxygenation index in each group; ② dynamically observed the changes of the inflammatory transmitters [tumor necrosis factor alpha (TNF-α), interleukin-1 beta (IL1β) and interleukin-6 (IL-6)] in pe. Ripheral blood and BALF of different lung areas (upper lobe, heart lobe and diaphragm lobe) of ARDS dogs under lung protective ventilation treatment.RESULTS: All the 24 dogs were involved in the analysis of results. ①After lung injury, the oxygenation indexes were significantly decreased in all the groups, and the oxygenation indexes after lung protective ventilation in the experimental groups were obviously higher than those in the control groups (P ＜ 0.05). At 2 and 3 hours after lung protective ventilation, the oxygenation indexes in the extrapulmonary ARDS experimental group were markedly higher than those in the pulmonary ARDS experimental group (P＜ 0.05). ② After lung injury, the levels of the inflammatory transmitters in peripheral blood were all obviously increased in all the groups, which were decreased to different extent after the lung protective ventilation treatment,but the therapeutic effect in the pulmonary ARDS experimental group was not as good as that in the extrapulmonary ARDS experimental group. ③The levels of inflammatory transmitters in BALF of lung upper lobe and heart lobe were obviously higher in pulmonary ARDS dogs than in extrapulmonary ARDS dogs.CONCLUSION: The ameliorations of the release of inflammatory transmitters and oxygenation index at different areas are obviously different between ARDS dogs caused by pulmonary and extrapulmonary insults, and lung protective ventilation has good effect on extrapulmonary ARDS dogs,but has bad effect on pulmonary ARDS ones.