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Objective:To report the application of our self-made Kirschner wire connecting rod combined with a conventional intramedullary nail extractor in difficult extraction of intramedullary devices.Methods:From January 2012 to August 2017, 10 patients with a hard-to-remove intramedullary device were treated at Department of Orthopaedics, The Fifth Hospital Affiliated to Xinjiang Medical University. They were 7 males and 3 females with a mean age of (40.0±9.0) years. In cases where no relevant extractor was available for the intramedullary device or it was impossible to connect the extractor connecting rod to the tail of the intramedullary device, the Kirschner wire was bent and pulled through the screw hole or the hole newly drilled at the tail of the intramedullary device to be tied or fixed with a conventional extractor connecting rod to form an effective connection. Next, our self-made Kirschner wire connecting rod was used to pull out the intramedullary device. In this cohort, 7 intramedullary nails in the tibia, 1 femoral intramedullary nail, 1 humeral intramedullary nail, and 1 tibial elastic nail were removed. The difficult extraction was due to "cold welding" of the tail cap of the intramedullary nail in 3 cases, mismatch between the screw rod of the extractor and the tail screw hole of the intramedullary nail in 4 cases, and unavailability of relevant removal tools in 3 cases. The time for intramedullary device removal, blood loss and postoperative adverse reactions were recorded.Results:Of this cohort, 9 patients underwent simple removal of the intramedullary device and 1 patient replacement of the intramedullary device. The total time for removal of an intramedullary device was (2.3±0.8) h, ranging from 1.0 to 3.2 h. The amount of blood loss was (159.0±61.0) mL, ranging from 80 to 250 mL. The follow-up was (14.5±2.2) months, ranging from 11 to 18 months. There was no infection or fracture associated with implant removal.Conclusion:Application of our self-made Kirschner wire connecting rod in combination with a conventional intramedullary nail extractor is an easy operation to successfully extract hard-to-remove intramedullary implants, requiring no more special instruments.
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Objective:To prospectively analyze the early clinical effects of 3D-printed porous metal cup with hip dual-mobility revision (HDR) system in treating severe acetabular bone defects.Methods:A total of 17 patients with severe acetabular defects (15 patients in Allan-Gross type 4 and 2 patients in type 5; 2 patients in Paprosky type 2B, 4 patients in type 3A and 11 patients in type 3B) who underwent revision hip arthroplasty between July 2019 and May 2020 were analyzed. There were 7 males and 10 females (mean age 67.3±9.3 years; range 42-80 years). The average body mass index was 22.2±3.8 kg/m 2 (range 17.7-33.3 kg/m 2). The preoperative mean leg length discrepancy (LLD) was 42.9±31.1 mm (range 10-160 mm) . One patient presented positive Trendelenburg sign. The follow-up duration was 12.1±3.0 months (range 6-16 months). The clinical and radiographic hip scores in all patients were evaluated. Results:The mean Harris Hip Score (HHS) was 31.2±11.3 points at preoperatively, 63.5±10.0, 68.7±10.4 and 70.2±10.1 points at 3 days, 7 days and 1 month postoperatively. At the latest follow-up, HHS was increased to 81.6±7.0 points. The outer cup mean abduction angle was 48.1°±10.6° and the mean inclination angle was 10.8°±6.0° postoperatively. The inner cup mean abduction angle was 45.0°±6.2° and the mean inclination angle was 10.8°±3.7°. The mean LLD decreased to 11.1±3.8 mm (range: 0-15 mm) after surgery. At the latest follow-up, all acetabular components were radiologically stable without displacement. No osteolysis or absorption was observed. There was no infection, loosening or nerve injury in all cases.Conclusion:During short-term follow-up, the 3D-printed porous metal HDR system can effectively enhance the stability of implants with satisfied quality of life. It can provide a good result for the revision of total hip arthroplasty with severe acetabular defects.
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Objective To meet the needs of public health emergency management in the new era, to improve the problems exposed in the public health emergency system after the outbreak of COVID-19, and to provide the government with a list of the gaps in the construction of the public health emergency system. Methods Several methods, including literature review, observation (discussion and questionnaire survey), and comparative and descriptive research, were used to conduct comprehensive analysis through the combination of induction and deduction. The evaluation questions were graded and were translated into some recognition indexes (averages). The golden section method was used for the recognition standard of evaluation problems, and U test method was used for statistical test. Results Five aspects of problem evaluation and suggestions were determined, including early warning, emergency plan, emergency management department, linkage between systems and epidemic situation judgment. The recognition indexes were 0.916, 0.905, 0.571, 1.000 and 1.190, respectively, all of which met the recognition standard, and there was no significant difference between them(P=0.357). The corresponding measures and suggestions were as follows: early warning trigger mechanism, modular emergency plan, government public health emergency agencies, collaborative emergency drill system of various industries, and expert epidemic situation judgment mechanism. Conclusion It is determined that the proposed measures to complement the weaknesses of public health emergency system in Suzhou are suitable for the locality and objectivity after the three steps of literature review, management staff discussion and professional questionnaire survey. The present study provides an objective basis for the health administrative department to propose the public health emergency system construction project to the government.
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From 1987 to 2017, cardiovascular disease (CVD) had been ranking the first cause of death in Suzhou, and the mortality rate showed an upward trend annual percentage changes (APC=0.62%, P=0.001), while the standardized mortality rate showed a downward trend (APC=-2.65%, P<0.001). The probability of premature death of CVD declined consistently from 7.06% in 1987 to 2.00% in 2017 (APC=-4.45%, P<0.001). When the life expectancy was set at 70, the potential years of life lost rate (PYLLR) decreased from 6.35‰ in 1987 to 3.30‰ in 2017, and the standardized PYLLR decreased from 7.30‰ to 2.68‰. When the life expectancy was set at 75, the PYLLR decreased from 10.12‰ to 5.19‰, and the standardized PYLLR decreased from 11.44‰ to 3.88‰. With the increase of years, all PYLLR and standardized PYLLR showed a significantly downward trend (APC=-2.51%--3.89%, P<0.001).
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Objective To study the relationship between the age of menarche and the nearterm/long-term obesity in adult women.Methods We analyzed the baseline data of 30 895 women with complete data on menarche and body measurement that was from the China Kadoorie Biobank (CKB) study from 2004 to 2008.The age of menarche was divided into three groups:≤12,13-16 and ≥ 17 years old.Prematurity was set at age ≤ 12 years.Multivariate logistic regression was used to analyze the effects of menarche age on the near/long-term obesity in female adults.Results The average menarche age of respondent appeared as (15.64 ± 1.92) years old,with prematurity number as 1 421,accounting for 4.6％ of the total numbers.Regarding the postponing of dates of birth,the age of menarche in women showed an advancing tendency.Among all the adult women under study,803 developed near-term obesity,with the prevalence as 2.6％,while the number of long-term obesity was 3 738,accounting for 12.1％.Refining factors of age,lifestyle,menopausal status,hypertension and diabetes showed that the menarche age was related to the risks of both short-term and long-term obesity in women and the ORs (95％CI) were 2.45 (1.74-3.45) and 1.99 (1.69-2.34),respectively.There was no multiplicative interaction shown between the menarche age and menopausal status on long-term obesity (P=0.324).Conclusion Premature menarche appeared a risk factor for near-term/long-term obesity in adult females.
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Objective To study the relationship between the age of menarche and the nearterm/long-term obesity in adult women.Methods We analyzed the baseline data of 30 895 women with complete data on menarche and body measurement that was from the China Kadoorie Biobank (CKB) study from 2004 to 2008.The age of menarche was divided into three groups:≤12,13-16 and ≥ 17 years old.Prematurity was set at age ≤ 12 years.Multivariate logistic regression was used to analyze the effects of menarche age on the near/long-term obesity in female adults.Results The average menarche age of respondent appeared as (15.64 ± 1.92) years old,with prematurity number as 1 421,accounting for 4.6％ of the total numbers.Regarding the postponing of dates of birth,the age of menarche in women showed an advancing tendency.Among all the adult women under study,803 developed near-term obesity,with the prevalence as 2.6％,while the number of long-term obesity was 3 738,accounting for 12.1％.Refining factors of age,lifestyle,menopausal status,hypertension and diabetes showed that the menarche age was related to the risks of both short-term and long-term obesity in women and the ORs (95％CI) were 2.45 (1.74-3.45) and 1.99 (1.69-2.34),respectively.There was no multiplicative interaction shown between the menarche age and menopausal status on long-term obesity (P=0.324).Conclusion Premature menarche appeared a risk factor for near-term/long-term obesity in adult females.
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Objective To explore the effect of salmon calcitonin on the receptor activator of NF-κB/receptor activator of NF-κB ligand/osteoprotegerin (RANK/RANKL/OPG) osteolysis pathway in human macrophages after particles induction.Methods The polyethylene wear particles were extracted from the periacetabular boundary membrane tissue of a patient with hip prosthesis loosening.The optimal reaction cell concentration of human macrophages to polyethylene wear particles (with a concentration of 0.1 mg/ml) was measured by methyl thiazolyl tetrazolium (MTT) assay.Particles were used to stimulate human macrophages,while salmon calcitonin with different drug concentrations was used for intervention.They were randomly divided into five groups,with six parts in each group:Group A,control group;Group B,particle group;Group C,particle + salmon calcitonin (10-8 mol/L) group;Group D,particle + salmon calcitonin (10-10 mol/L) group;Group E,particle+salmon calcitonin (10-12 mol/L) group.After cocultured for 48 hours,quantitative polymerase chain reaction (qPCR) assay was used to detect the mRNA expression of RANK,RANKL and OPG in macrophages.Results After induction with particles,Group B had a higher expression in RANK and RANKL,and lower OPG expression than Group A.After salmon calcitonin intervention,the expression of RANK and RANKL were significantly decreased,and OPG expression was significantly increased.Group B had the highest RANKL/OPG rate.After drug intervention,the RANKL/OPG rate in C,D,E group were reduced.Conclusions The particles can induce the transformation of macrophages into osteoclasts.In addition to directly inhibiting osteoclast activity,salmon calcitonin prevents macrophage from differentiating into osteoclasts through modulating RANKL/RANK/OPG signaling pathway.
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Objective To explore the relationship between sleep status and the risk of diabetes in adults.Methods The baseline data of 53 260 subjects who were aged 30-79 years and had been enrolled into China Kadoorie Biobank (CKB) study from Suzhou,Jiangsu province were analyzed.Multiple logistic regression models were used to investigate the association between sleep status and diabetes after adjusting for potential confounders.Results Among 53 260 subjects,5.3％ had diabetes.The proportions of difficultly falling asleep,early morning arousal and snoring frequently was 7.2％,10.0％ and 29.5％,respectively.There were 22.6％ of subjects reporting sleep duration ≤6 hours.After controlling for possible confounders,the subjects with difficulty falling sleep (OR=1.63 for male,95％ CI:1.30-2.05;OR=1.48 for female,95％ CI:1.27-1.73),early morning arousal (OR=1.37 for male,95％CI:1.12-1.68;OR=1.31 for female,95％CI:1.14-1.51) or snoring frequently (OR=1.16 for male,95％CI:1.00-1.34;OR=1.39 for female,95％CI:1.23-1.57) had a higher risk of diabetes.Using hypnotics regularly was associated with the risk of diabetes in females (OR=1.42,95％CI:1.06-1.92).Compared with 8 hours sleep duration daily,shorter sleep duration (≤ 6 hours) was associated with risk of diabetes in both males (OR=1.37,95％CI:1.17-1.60) and females (OR=1.24,95％ CI:1.08-1.41).No statistical significant association was found between longer sleep duration (≥9 hours) and the risk of diabetes.Conclusion Sleep problems,including difficulty falling asleep,early morning arousal,snoring frequently and shorter sleep duration,were associated with the risk of diabetes,but no statistical significant association was observed between longer sleep duration and the risk of diabetes.
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Objective To explore the relationship between sleep status and the risk of diabetes in adults.Methods The baseline data of 53 260 subjects who were aged 30-79 years and had been enrolled into China Kadoorie Biobank (CKB) study from Suzhou,Jiangsu province were analyzed.Multiple logistic regression models were used to investigate the association between sleep status and diabetes after adjusting for potential confounders.Results Among 53 260 subjects,5.3％ had diabetes.The proportions of difficultly falling asleep,early morning arousal and snoring frequently was 7.2％,10.0％ and 29.5％,respectively.There were 22.6％ of subjects reporting sleep duration ≤6 hours.After controlling for possible confounders,the subjects with difficulty falling sleep (OR=1.63 for male,95％ CI:1.30-2.05;OR=1.48 for female,95％ CI:1.27-1.73),early morning arousal (OR=1.37 for male,95％CI:1.12-1.68;OR=1.31 for female,95％CI:1.14-1.51) or snoring frequently (OR=1.16 for male,95％CI:1.00-1.34;OR=1.39 for female,95％CI:1.23-1.57) had a higher risk of diabetes.Using hypnotics regularly was associated with the risk of diabetes in females (OR=1.42,95％CI:1.06-1.92).Compared with 8 hours sleep duration daily,shorter sleep duration (≤ 6 hours) was associated with risk of diabetes in both males (OR=1.37,95％CI:1.17-1.60) and females (OR=1.24,95％ CI:1.08-1.41).No statistical significant association was found between longer sleep duration (≥9 hours) and the risk of diabetes.Conclusion Sleep problems,including difficulty falling asleep,early morning arousal,snoring frequently and shorter sleep duration,were associated with the risk of diabetes,but no statistical significant association was observed between longer sleep duration and the risk of diabetes.
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OBJECTIVE@#To investigate the clinical effect of total knee arthroplasty on patients with knee osteoarthritis combined with mild to moderate valgus knee deformity. @*METHODS@#A total of 15 patients received total knee arthroplasty for correcting mild (10°-15°) to moderate (15°-30°) valgus knee between January 2011 and February 2014 in Xiangya Hospital of Central South University. We adopted a stable prosthesis surgery through patellar medial approach, osteophytes cleaning, conventional osteotomy, a selective soft tissue release and balance technical correcting of knee valgus deformity. Then conventional anticoagulation and symptomatic rehabilitation was utilized. Preoperative and postoperative X-ray was conducted in patients with measuring femor-tibial angle (FTA) and inspecting the prosthesis position. FTA, visual analog scale (VAS) standard, and parallel knee scoring system (KSS) were used to evaluate the clinical effect. @*RESULTS@#Fifteen patients were followed up for 14 to 36 (22.40±11.88) months. The hospitalization time was 7-13 (7.73±1.58) d; operative time was 58-110 (81.8±16.85) min, the dominant blood loss was 140-600 (337.30±143.65) mL. Two cases had knee extension hysteresis, and the knee activity recovered after exercise. Leg power lines were normal. Three postoperative cases suffered anterior knee pain. They were subjected to celecoxib analgesic treatment and the pain gradually eased after 3 months. One postoperative case showed incision discharge and swelling, which was healed after change of dressing. During follow-up, review of X-ray film does not show prosthesis loose, subsidence and other complications. The knee valgus angle (8.1±1.8)°, knee motion range (107.33±9.61)°, KSS knee score (74.7±14.5, 75.3±2.7) and pain score (2.5±0.9) were significantly better than the preoperative (P<0.05). The clinical and function KSS scores showed that the improvement rate was 80%. @*CONCLUSION@#Total knee arthroplasty is an effective way to treat patients with knee osteoarthritis combined with mild to moderate valgus knee deformity. The correction of deformity and improvement of joint function can be achieved significantly. The clinical result is satisfactory and patients' quality of life is improved.
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Humans , Arthroplasty, Replacement, Knee , Methods , Blood Loss, Surgical , Knee Joint , Congenital Abnormalities , Knee Prosthesis , Operative Time , Osteoarthritis, Knee , General Surgery , Osteophyte , General Surgery , Osteotomy , Pain, Postoperative , Therapeutics , Patella , General Surgery , Quality of Life , Tibia , Treatment OutcomeABSTRACT
Objective To investigate the clinical effect of the treatment of osteoporotic vertebral compression fractures in the elderly populationthrough different surgical approaches.Methods 98 cases with a single-level osteoporotic vertebral compression fracture in the elderly population were randomly divided into two groups from February 201 1 to June 2013.48 patients were performed by percutaneous vertebroplasty (PVP)through unipedicular approach and 50 patients through bipedicular approachs.The clinical data of patients were prospectively analyzed and the clinical efficacy were compared between two groups using VAS (visual analogue scale method)and ODI (Oswestry disability index)in preoperative,postoperative 1 day and 1 year postoperatively .The data of age, gender,injury to the patients with operation time,postoperative follow-up time,operation time,bone cement injection,bone cement leakage and other complications were observed.Cobb angle,vertebral compression ration were observed by imaging data.Results All the cases were followed-up.There was no statistical difference in preoperative clinical data between the two groups (P >0.05).In unilateral group (48 cases),the data of operation time,bone cement injection,bone cement leakage,Cobb angle improve,vertebral compression ration improve were (34.87±5.91)min,(6.20±0.66)mL,1 6 cases(33%),(10.1 9±2.12)%,(13.23°±1.58°)and adjacent vertebral fractures was 10 cases (20.9%).VAS score was respectively improved (4.05 ± 0.12 ),(5.42 ± 0.12 ) in postoperative 1 day and 1 year than preoperative.VAS score was improved (1.40 ±0.1 1 )in postoperative 1 year than 1 day.ODI score was respectively improved (35.46 ± 1.89)%,(47.88 ±2.21 )% in postoperative 1 day and 1 year than preoperative.ODI score was improved (1 1.42±0.24)% in postoperative 1 year than 1 day.In bilateral group (50 cases).The data of operation time,bone cement injection,bone cement leakage,Cobb angle improve, vertebral compression ration improve were (41.66±6.90)min,(4.88±0.52)mL,9 cases(18.0%),(10.48±1.43)%,(13.04°±2.03°)and adjacent vertebral fractures was 6 cases(12.0%).VAS score was respectively improved (4.06±0.1 1),(5.30±0.10)in postoperative 1 day and 1 year than preoperative.VAS score was improved (1.34± 0.08)in postoperative 1 year than 1 day.ODI score was respectively improved (36.08±2.13)%,(47.54±1.97)%in postoperative 1 day and 1 year than preoperative.ODI score was improved (1 1.26 ± 0.54)% in postoperative 1 year than 1 day.There was no obvious clinical problems after occurred leakage in two groups.there was statistical difference in cement injection,bone cement leakage and postoperative adjacent vertebral fractures after operation between the two groups.there was no statistical difference in Cobb angle improve,vertebral compression ration improve,VAS score and ODI score between the two groups.Conclusion Both approaches are effective in the treatment of osteoporotic vertebral compression fractures in the elderly population ,but there is advantage of decrease the incidence of bone cement leakage and postoperative adjacent vertebral fractures through bilateral approach.
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Objective To evaluate the effect of chronic filariasis patients with lymphedema after comprehensive cared. Meth?ods A total of 386 chronic filariasis patients with lymphedema received the comprehensive care including soaking feet by TCM washing feet by single Chinese medicine or clear water preventing and eliminating invasive wound physical training raising the limb and wearing suitable shoes. The attack frequency of inflammation of lymphatic vessels the stage of lymphedema dis?ease and leg circumference were observed before and after the care. Results After the comprehensive care the attack rates of inflammation of lymphatic vessels decreased from 9.65%to 4.67% and there was a significant difference χ 2=7.34 P=0.006 7 . The proportion of the patients with high stage of lymphedema disease decreased significantly all P 0.01 and the average leg circumference decreased of 1.06 cm. The skin appearance improved significantly. Other signs such as pitting edema ulcer and skin folds also improved significantly all P 0.01 . Conclusion The comprehensive care for chronic filariasis patients with lymphedema has a remarkable effect and is worthy of further application.
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<p><b>OBJECTIVE</b>To explore the relationships between anthropometric measures as body mass index (BMI), percentage body fat, waist circumference (WC), hip circumference (HC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR) and the risks of diabetes.</p><p><b>METHODS</b>We analyzed the baseline data of 53 260 participants who were aged 30-79 years and had been enrolled into the China Kadoorie Biobank (CKB) study from Suzhou city,Jiangsu province. Unconditional logistic regression analyses were conducted with adjustment for potential confounders.</p><p><b>RESULTS</b>Overall, 5.3% of the participants had diabetes, with about a half of them being newly detected through on-site screening tests. The prevalence of diabetes increased with age, 61% higher (OR = 1.61, 95% confidence interval: 1.54-1.67) risk of diabetes, with 10 years increase of age. In both genders, all anthropometric measures were positively and significantly associated with diabetes, with the associations of measures in central adiposity stronger than those in general obesity, with WHR as the strongest. Each standard deviation (1- s) with greater WHR (<0.06 in men and 0.07 in women) was associated with 72% (61%-83%) higher risk of diabetes in men and 93% (83%-102%) in women. After adjusting for HC, each WC with 5 cm larger, showing 65% and 57% higher risks in men and women respectively. However, after adjusting for WC, every 5cm greater HC appeared and associated with respective 38% and 34% lower risks.</p><p><b>CONCLUSION</b>Measures on adiposity including BMI, percentage body, WC, WHR and WHtR fat were all positively associated with the prevalence of diabetes. Measures of central obesity, particularly WHR, were more strongly associated with diabetes than measures of general obesity. When WC was under control, HC appeared inversely associated with diabetes.</p>
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Adult , Female , Humans , Male , Adiposity , Biological Specimen Banks , Body Mass Index , China , Diabetes Mellitus , Epidemiology , Obesity , Epidemiology , Obesity, Abdominal , Prevalence , Risk , Risk Factors , Waist Circumference , Waist-Hip RatioABSTRACT
Objective: To evaluate the effect of standard management for hypertension in community population of Suzhou city. Methods: We conducted a prospective study of standard management for hypertension in community population of Suzhou city. The project included 3 groups: Standard group, the patients received standardized management,n=81 711, Control group, the patients received general management, n=38 944, and No-management group,n=1 644 249. The incidence rate of stroke and coronary artery disease (CAD) were compared among different groups according to 2010 chronic disease report of Suzhou city. Results: Compared with initial condition, the final average blood pressure drop in Standard group was (13.78/7.06) mmHg, which was better than that in Control group, X2=1852.91,P<0.01. The incidence rate of stroke in Standard group, Control group and No-management group were 1.72%, 2.41% and 3.59%, the incidence rate of CAD were 0.43%, 0.66% and 1.29% respectively. Conclusion: Standard management for hypertension was better than general management for preventing and controlling the incidence of stroke and CAD in community population.
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BACKGROUND:Surgical treatment for pigmented vil onodular synovitis can maximize the excision of synovial lesions and recovery of joint function. OBJECTIVE:To investigate the knee joint function and relapse rate fol owing treatment of pigmented vil onodular synovitis with total knee replacement and arthroscopic synovectomy. METHODS:We retrospectively analyzed 34 cases of knee pigmented vil onodular synovitis admitted for surgical treatment in the Department of Orthopedics, Xiangya Hospital of Central South University, China from December 2006 to December 2011. In these cases, 24 patients received arthroscopic synovectomy and 10 patients were subjected to total knee replacement. Adjuvant radiotherapy was conducted according to postoperative patient’s conditions. Lysholm scoring was employed in the arthroscopic synovectomy group, and American Knee Society scoring was used in the total knee replacement group. Knee function in two groups was compared before and after treatment. Fol ow-up observation was performed to compare knee function recovery and relapse rate between two groups. RESULTS AND CONCLUSION:Thirty-four patients were effectively fol owed up for 12-66 months, mean 41.3 months. Statistical analysis showed that in the arthroscopic synovectomy group, the postoperative Lysholm score was (86.3± 10.3) points, significantly higher than the preoperative score which was (55.5±13.2) points (t=3.81, P=0.016, P<0.05). In the total knee arthroplasty group, the American Knee Society score was increased from (40.7±2.2) points preoperatively to (90.2±1.1) points postoperatively (t=6.27, P<0.01). In the arthroscopic synovectomy group, the American Knee Society score was increased from (34.2±3.9) points preoperatively to (80.8±1.9) points postoperatively (t=16.58, P<0.01). Arthroscopic synovectomy combined with adjuvant radiotherapy can achieve better outcomes in pigmented vil onodular synovitis patients, while the total knee replacement for advanced with advanced knee diffuse pigmented vil onodular synovitis is better to restore knee function and the recurrence rate is low.
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OBJECTIVE@#To explore the difference in level of pain experienced by patients with total hip arthroplasty between aseptic loosening and periprosthetic infection, and to examine the correlation between C-reactive protein (CRP) and pain.@*METHODS@#Fifty-one patients (recruited from our hospital between March 2010 and November 2011) suffering aseptic loosening or periprosthetic infection after total hip arthroplasty were included in this study: 24 males and 27 females, with mean age 68.13 years. The patients were divided into an aseptic loosening group (n=31) and a periprosthetic infection group (n=20). Both the visual analog scale (VAS) and Harris pain score were used to estimate the level of pain experienced by the patients. CRP levels in serum were measured. The difference in assessment of pain by VAS and Harris pain score was compared between the two groups, and the correlation between pain and CRP was analyzed.@*RESULTS@#The mean VAS in the aseptic loosening group was 5.39 (2.10-8.13) compared with 5.48 (2.09-8.30) in the periprosthetic infection group; however, the difference was not statistically significant (P=0.85). The mean rank of Harris pain score was 26.23 in the aseptic loosening group and 25.65 in the periprosthetic infection group, but again there was no significant difference (P=0.88). The CRP level in the periprosthetic infection group (36.20-101.40 mg/L, mean 72.86 mg/L) was obvious higher than that in the aseptic loosening group (1.37-13.70 mg/L, mean 6.53 mg/L), and the difference was statistically significant (P<0.01). The VAS was related with the CRP level in the periprosthetic infection group (r=0.87, P<0.01), and the correlation between Harris pain score and CRP level was conspicuous (r=0.92, P<0.01) in this group. However, those correlations were not evident in the aseptic loosening group (r=0.25, P=0.17; r=0.19, P=0.65).@*CONCLUSION@#There is no difference in perception of pain in patients after total hip arthroplasty between those with aseptic loosening and those with periprosthetic infection. It is therefore unreliable to make a initial diagnosis only according to the level of pain. However, the level of CRP is a sensitive and effective way of differentiating the two conditions. The positive correlation between CRP and pian exists in patients with periprosthetic infection but not with aseptic loosening.
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Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Arthroplasty, Replacement, Hip , C-Reactive Protein , Pain Measurement , Prosthesis Failure , Prosthesis-Related Infections , BloodABSTRACT
Objective To explore the outcomes of surgery of hip fracture in elderly pafienta aged equal or greater than 80 years old.Method The data of totally 132 patients with hip fracture aged equal or greater than 80 years old were treated with surgery between January 2004 and December 2008 was analyzed retrospectively Results Of 132 cases,68 cases were femoral neck fracture,while 64 cases were intertroehanteric fracture.The average in.hospital time waft(17.2±4.6)d,and 2 cases died of cerebral embolism and respiratory dysfunction in perioperative period respectively.One hundred and eight cases were followed up for 6 months to 5 yeats,with an average of 3.2 years.According to Harris hip scores,the average score of femoral neck fracture at 1 year and at 2 years postoperatively were(77.6±10.2),(77.3±9.3)scores,respectively;while intertrochantefic fracture at 1 year and at 2 years postoperatively were(84.6±9.8),(83.9±10.1)scores,respectively.Conclusions Aged patients with hip fracture should receivesurgical treatment as early as possible.The reasonable perioperative treatment and operative method are the keys to gain good outcomes.
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Objective To observe the survival and reproduction of Oncomelania hupensis snails and their susceptibility to schistosome in schistosomiasis non-endemic area of the Yangtze River estuary in Southern Jiangsu.Methods The soil and water from the Yangtze River estuary of Southern Jiangsu were used for the experiment.The snails reproduced in the same year were collected from the upper reaches of the Yangtze River and raised in the laboratory.The snail survival and reproduction rates and schistosome infection of the snails were observed.The soil collected from schistosomiasis endemic area was used in the control group.Results There was no significant difference between the experimental and control groups for the snail survival rates both in 6 and 12 months (X~2= 0.727 8,P > 0.05 and X~2 = 0.416 1,P > 0.05).Each female snail reproduced 67.69 eggs in average (95 % CI:24.026 0-110.097 4).The average hatchability rate of snail eggs was 83.60%,and there was no significant difference between the 2 groups (X~2= 9.131 8,P > 0.05).The schistosome infection rate of the second generation snails was 1.40% (5/356) 60 days after the infection in the laboratory.Conclusions The snails collected from the upper reaches of the Yangtze River marshland can survival and reproduce in the soil and water from schistosomiasis non-endemic area of the Yangtze River estuary of Southern Jiangsu,and the second generation of the snails can be infected with schistosome in the laboratory.
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Both the snail number and the detection rate of living snails by means of snail screening in soil layer were higher than those of snail survey on soil surface. It is indicated that snail screening in soil layer can make up the shortage of survey on soil surface and improve the efficiency of snail control.
ABSTRACT
OBJECTIVE@#To measure the anatomic data of the proximal femur and to design an internal fixation instrument aiming at subtrochanteric fracture.@*METHODS@#We measured the anatomic data of 56 pairs of the matching proximal femur specimens: the diameter of femoral head (HD), the axis length of femoral head (HAL), 135 degree femoral head-neck axis length (HNAL), 135 degree femoral head-neck axis upper length (HNAUL), 135 degree femoral head-neck axis underside length (HNADL), the anterior-posterior axis diameter of femoral neck (NAPD), the upper-underside diameter of femoral neck (NUUD), femoral neck-shaft angle (NFA), femoral shaft lateral cortex-greater trochanter angle (SLGA), the medial-lateral diameter of lesser trochanter level's femoral shaft (LSMLD), the anterior-posterior diameter of lesser trochanter level's femoral shaft (LSAPD), the medial-lateral diameter of 5 cm below lesser trochanter femoral shaft (5 cm MLD), and the anterior-posterior diameter of 5 cm below lesser trochanter femoral shaft (5 cm APD). Part of the data was analyzed and compared.@*RESULTS@#HD was (46.69+/-3.73) mm, HAL was (39.22+/-4.17) mm, HNAL was (95.45+/-8.16) mm, HNAUL was (84.02+/-7.11) mm, HNADL was (99.95+/-9.34) mm, NAPD was (26.27+/-3.15) mm, NUUD was (32.24+/-3.31) mm, NFA was 126.21 degree+/-7.13 degree, SLGA was 16.38 degree+/-4.04 degree, LSMLD was (31.05+/-3.57) mm, LSAPD was (27.63+/-2.96) mm, 5 cm MLD was (26.36+/-3.22) mm, and 5 cm APD was (25.59+/-2.75) mm. NFA was positively correlated with SLGA (r=0.396, P=0.003).@*CONCLUSION@#It is necessary to design internal fixator to fit the anatomical feature of Chinese femur for the treatment of subtrochanteric fracture, and we should thoroughly consider the angle of the SLGA.