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Objective To analyze the influence of total hip arthroplasty (THA) on the process of proximal femoral bone remodeling by using the Wolff bone remodeling theory. Methods According to control equation of bone remodeling, the program of bone remodeling was written in Python language. Preoperative femur model and postoperative femur and prosthesis finite element models were established respectively in ABAQUS software. The process of bone reconstruction before and after THA operation was compared to analyze the effect of prosthesis implantation on mechanical properties of the femur in the middle and long term after THA operation. Results The stress in proximal femur continued to decrease after prosthesis implantation, and the stress site was transferred from the femoral head to the prosthesis, resulting in an obvious stress shielding phenomenon. Bone loss in the stress shielding area was serious. The femoral shaft cortical bone became thinner and the stress shielding was relieved. The medial side at the bottom of the prosthesis was compressed, and the stress was significantly higher than that of the lateral side, where the bone was unevenly distributed. Conclusions After THA operation, obvious stress shielding occured at proximal medial side of the femur, leading to bone loss and prosthesis loosening. The difference in stress levels on both sides at the bottom of the prosthesis resulted in an uneven bone distribution, causing the discordance between the prosthesis and the femur, as well as postoperative pain in the middle part of the thigh.
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Objective:To investigate the infiltration and polarization of macrophages in mice during Chlamydia muridarum ( Cm) respiratory infection. Methods:C57BL/6 mice were intranasally infected with 1×10 3 inclusion-forming units (IFU) of Cm to establish the mouse model of Cm respiratory tract infection. The percentages of CD45 + F4/80 + cells and the macrophages expressing CD86, major histocompatibility complex Ⅱ (MHC), inducible nitric oxide synthase (iNOS) and CD206 were detected by flow cytometry. Expression of iNOS, CD206 and CCL2 at mRNA level was detected by real-time quantitative PCR. Results:Cm respiratory tract infection induced the increase of macrophages in mouse lung tissues. Compared with uninfected group, CD45 + F4/80 + macrophages were increased significantly from day 3 and reached the peak on day 7 after Cm infection. Moreover, the expression of CD86, MHCⅡ and CCL2 was increased, and the macrophages were polarized to M1 phenotype. However, the expression of M2 macrophage marker CD206 was decreased gradually. Further studies showed that iNOS expression, the indicator of M1 macrophage activation, was increased after Cm infection and reached to the top on day 7. Conclusions:Cm respiratory infection could induce the infiltration of macrophages in lung tissues and promote the polarization of macrophages to M1 phenotype.
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Objective To explore the safety and efficacy of different doses of enoxaparin combined with ticagrelor after percutaneous coronary intervention (PCI) in patients with non-ST elevation-acute coronary syndrome (NSTE-ACS) and complex coronary artery lesions and try to find out the best combination dose of enoxaparin. Methods A total of 345 NSTE-ACS patients with complex coronary artery lesions that had undergone percutaneous coronary intervention were recruited in Beijing Anzhen Hospital affi liated to Capital University from March 2015 to October 2016. All patients were treated with aspirin and ticagrelor during the trial and randomly assigned to three groups: no enoxaparin anticoagulation therapy (non-anticoagulation group), half dose of enoxaparin anticoagulation therapy (0.5 mg / kg, half-anticoagulation group) and full dose of enoxaparin anticoagulation therapy (1 mg / kg) (total-anticoagulation group).The primary endpoints were bleeding events during hospitalization and at 12 months after PCI and the secondary endpoints were major adverse cardiac and cerebrovascular events (MACCEs) during hospitalization and at 1, 3 and 12 months after PCI. Results (1) The primary endpoints: The incidences of total bleeding events in patients treated with full dose of enoxaparin were signifi cantly higher than those in the non-anticoagulation group(29.5%vs.13.6%,P=0.005)and the two groups had comparable rates of major bleeding(1.9%vs. 0,P>0.05),but minor bleeding rates were higher in the total-anticoagulation group(27.6% vs.13.6%, P=0.012).There were no significant differences in the incidence of major and minor bleeding events between the half-anticoagulation and the non-anticoagulation groups during hospitalization (all P>0.05). Trend test showed that the incidence of total bleeding and minor bleeding were increased with the increase of the dose of enoxaparin after PCI, and there was a linear correlation between bleeding events and dose of enoxaparin (total bleeding: trend for P=0.005; minor bleeding: trend for P=0.011). (2) The secondary endpoints: there was no signifi cant diff erence in the incidence of perioperative myocardial injury and MACCE at 1 month, 3 months and 12 months post-PCI between three groups (P>0.05).Conclusions For NSTE-ACS patients with complex coronary lesions, the combination of ticagrelor and enoxaparin after PCI did not bring additional benefi ts. Subcutaneous application of full dose of enoxaparin may increase patients' bleeding risk after PCI, while reduced dose of enoxaparin is relatively safe. These results suggest that routine anticoagulation therapy after PCI is not necessary for patients with NSTE-ACS and complex coronary lesions who were treated with ticagrelor. Reduced dose of enoxaparin could be applied subcutaneously post PCI after fully assessing the ischemia and bleeding risk of patients if it is necessary.
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Objective To investigate the clinical efficacy of combined use of beta blocker in the treatment of chronic severe congestive heart failure (CHF). Methods 78 patients with severe chronic congestive heart failure in patients from November 2015 to January 2017 were randomly divided into study group (n=39) and control group (n=39). The control group was treated with routine treatment of chronic severe congestive heart failure, and the study group was treated with beta blocker metoprolol on the basis of routine treatment. The changes of DBP, SBP, LVEF, LVEDD and the incidence of adverse reactions were recorded before and after treatment in two groups. Results After the analysis of the two groups before treatment, DBP, SBP, LVEF, LVEDD and other indicators compared no significant difference; after the treatment of DBP, SBP, LVEDD group index decline and increase of LVEF were better than the control group, comparing the data with significant difference (P<0.05); drug therapy in the treatment of severe chronic group occurred during the study period the rate of adverse reactions in patients with congestive heart failure and there is no significant difference compared with control group. Conclusion The use of routine regimen based on the use of beta blocker metoprolol can significantly improve the clinical efficacy of patients with chronic severe congestive heart failure, and is conducive to the protection of their prognosis and quality of life.
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Objective To investigate the clinical efficacy of combined use of beta blocker in the treatment of chronic severe congestive heart failure (CHF). Methods 78 patients with severe chronic congestive heart failure in patients from November 2015 to January 2017 were randomly divided into study group (n=39) and control group (n=39). The control group was treated with routine treatment of chronic severe congestive heart failure, and the study group was treated with beta blocker metoprolol on the basis of routine treatment. The changes of DBP, SBP, LVEF, LVEDD and the incidence of adverse reactions were recorded before and after treatment in two groups. Results After the analysis of the two groups before treatment, DBP, SBP, LVEF, LVEDD and other indicators compared no significant difference; after the treatment of DBP, SBP, LVEDD group index decline and increase of LVEF were better than the control group, comparing the data with significant difference (P<0.05); drug therapy in the treatment of severe chronic group occurred during the study period the rate of adverse reactions in patients with congestive heart failure and there is no significant difference compared with control group. Conclusion The use of routine regimen based on the use of beta blocker metoprolol can significantly improve the clinical efficacy of patients with chronic severe congestive heart failure, and is conducive to the protection of their prognosis and quality of life.
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<p><b>OBJECTIVE</b>To evaluate the bond strength and durability of a self-adhesive resin cement with a zirconia ceramic pretreated by a zirconia primer.</p><p><b>METHODS</b>Zirconia ceramic (Vita Inceram YZ) plates with a thickness of 2.5 mm were fired, polished, and then cleaned. Half of the polished ceramic plates were sandblasted with 50 μm alumina particles at 0.3 MPa for 20 s. The surface compound weight ratios were measured via X-ray fluorescence microscopy. The polished and sandblasted ceramic plates were directly bonded with self-adhesive resin cement (Biscem) or were pretreated by a zirconia primer (Z Primer Plus) before bonding with Biscem. The specimens of each test group were divided into two subgroups (n=10) and subjected to the shear test after 0 and 10,000 thermal cycles. The data were analyzed via three-way ANOVA.</p><p><b>RESULTS</b>After air abrasion, 8.27% weight ratio of alumina attached to the zirconia surface. Compared with air abrasion, primer treatment more significantly improved the primary resin bond strength of the zirconia ceramic. The primary resin bond strength of the zirconia ceramic with no primer treatment was not affected by thermocycling (P>0.05). However, the primary resin bond strength of the zirconia ceramic with primer treatment was significantly decreased by thermocycling (P<0.05).</p><p><b>CONCLUSION</b>Primer treatment can improve the primary resin bond strengths of zirconia ceramics. However, the bond interface of the primer is not stable and rapidly degraded during thermocycling.</p>
Subject(s)
Adhesives , Aluminum Oxide , Ceramics , Dental Bonding , Dental Porcelain , Dental Stress Analysis , Materials Testing , Resin Cements , Surface Properties , ZirconiumABSTRACT
Objective] To explore the early intervention mode for the community-based stroke re-habilitation . [ Methods] Thirty-two stroke patients who met the inclusion criteria were included in the study and intervened by doctor through home visit .The early rehabilitation intervention in community was assessed with Barthel Index ( BI ) and Berg Balanced Scale ( BBS ) . [ Results ] BI and BBS scores showed a gradual upward trend in patients as intervention went on and their differences between different in -tervention times were statistically significant (P<0.001). [Conclusion] Early community-based reha-bilitation intervention established the management mode for patients transferring from level III hospital to community , which played an important role in the recovery of balance function and activity of daily living for stroke patients .
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To discuss the application value of the Gail model in evaluation of breast cancer risk in Huangpu District , Shanghai. [Methods] Case-control study was adopted for 156 cases of breast cancer and 198 age-matched controls .From the subjects were collected information of age , history of breast disease , family history , age at menarche , age at first birth , breast biopsy and race .Gail model was used to evaluate the risk of breast cancer for these women 5 years before. [Results] A total of 72 cases and 11 controls had high risk of breast cancer within 5 years.As the evaluation results of the diagnos-tic test, the sensitivity of the Gail model was 50.3 percent and the specificity 92.0 percent.The positive predictive value was 86.7 percent and the negative predictive value 64.0 percent (The Chi square was 60. 09 and P value 0.000, The McNemar Chi square was 43.90 and P value 0.000).The Youden's index was 0.423.The total agreement was 70.7 percent. [ Conclusion] The Gail model did not achieve the de-sired results for assessment of population with high risk of breast cancer .The tool needs to be further studied as a tool for screening population with high risk of breast cancer .
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<p><b>OBJECTIVE</b>To explore the effect and mechanism of matrine (Mt.) on myocardial interstitial fibrosis induced by pressure overload.</p><p><b>METHODS</b>Pressure overloaded myocardial hypertrophy was produced by banding of aorta abdominalis in 67 male Sprague-Dawley rats weighing (200+/-15) g. The rats were assigned into one of the following groups: sham-operation control, operation control, operation group treated with matrine (15 mg/(kg.d)) and treated with carvedilol (Car.) (3.6 mg/(kg.d)) group. The rats were given drugs one day after operation. Five weeks after treatment, the left ventricular weight (LVW) was measured and the volume of myocardial cells was detected with Hematoxylin-Eosin (H-E) stain and Masson stain was used to assess the level of fibrosis of the myocardial matrix. Myocardial metalloproteinase activity was quantified with zymography, and survival rate was calculated.</p><p><b>RESULTS</b>Survival rate significantly decreased (P<0.05), LVW/BW (body weight), MMP-2 (matrix metalloproteinase-2) activity (P<0.05), size of cardiomyocytes and interstitial fibrosis obviously increased in the operation group compared with sham control group. Mt. and Car. treatment can significantly increase survival rate (P<0.05), decrease LVW/BW (P<0.05) and MMP-2 activity (P<0.05), decrease size of cardiomyocytes and interstitial fibrosis compared with operation group. But there was difference compared with sham group.</p><p><b>CONCLUSION</b>Matrine was shown to be able to prevent cardiac remodelling of hypertrophy cardium induced by pressure overload including myocardial hypertrophy and fibrosis which may be associated with the decrease in MMP-2 activity of heart.</p>