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BACKGROUND: The best prevention strategy for venous thrombosis (VTE) is currently controversial, especially for patients with high risk of total knee arthroplasty. There are no fully safe, effective and inexpensive thrombus prevention drugs. OBJECTIVE: To study the efficacy and safety of aspirin in preventing venous thrombosis after total knee arthroplasty. METHODS: 300 patients undergoing primary unilateral total knee arthroplasty from September 2014 to December 2016 were randomly divided into two groups: conventional anticoagulation group and risk stratification group (n=150 per group), including 88 males and 212 females at the age of 49-85 years old. The conventional anticoagulation group received low molecular weight heparin for prevention and treatment. Risk stratification group was stratified according to the risk of venous thrombosis. 64 patients with low risk were treated with aspirin and 86 patients with high risk were treated with low molecular weight heparin. Complications were analyzed within 90 days after surgery, including deep venous thrombosis, pulmonary embolism, wound infection, bleeding and death. RESULTS AND CONCLUSION: (1) Complications occurred in 39 cases (13%) within 90 days after follow-up. The total incidence of symptomatic deep vein thrombosis complications was 2% in 6 cases, and 19 cases (6.33%) had wound complications. There were 3 cases (2%) of symptomatic deep vein thrombosis in conventional anticoagulation group and 3 cases (2%) in risk stratification group. (2) The incidence of symptomatic deep vein thrombosis, proximal deep vein thrombosis and distal deep vein thrombosis and pulmonary embolism were 1.56% (1 case), 1.56% (1 case), 4.68% (3 cases), and 0% respectively in patients treated with aspirin. The incidence of symptomatic deep vein thrombosis, proximal deep vein thrombosis and distal deep vein thrombosis and pulmonary embolism in patients receiving low molecular weight heparin were 2.12% (5 cases), 0.85% (2 cases), 5.08% (12 cases) and 0.42% (1 case), respectively. There was no significant difference between the two groups (P > 0.05). (3) There were 11 cases of wound complications in the conventional anticoagulation group and 8 cases in the risk stratification group (χ2 = 506, P = 0.318). (4) The incidences of wound-related complications (wound delayed healing, superficial wound infection and deep wound infection) were 1.56% (1 case), 0% and 1.56% (1 case) respectively in patients receiving aspirin, and 5.51% (13 cases), 1.27% (3 cases) and 0.42% (1 case) in patients receiving low molecular weight heparin. (5) Results suggested that aspirin and low molecular weight heparin can effectively prevent the occurrence of deep vein thrombosis. For low-risk patients, aspirin multi-mode thrombosis prevention is safe and effective.
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Objective To develop a series of surgical instruments to improve surgical treatment in field conditions with considerations on the characteristics of medical shelter and the requirements of surgical treatment in field conditions.Methods A series of surgical instruments was developed with considerations on the characteristics and requirements of surgical treatment in field conditions.Results The mask strap behaved well in structure,operation and fixation,and prevented the mask from unplanned extubation,dropping off and displacement.The sterilizing rack had high stability and safety and 150 kg bearing capability,and eliminated the needs for additional workload for patient carrying and traction during preoperative sterilization.The prone-position cushion exposed the operative field sufficiently and enhanced the success rate of surgical treatment.Conclusion The series of surgical instruments gains advantages in structure,operation,mobility,cleaning,sterilization,carrying,storage,loading and transport,and thus is applicable for field emergency rescue.
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Objective To develop an integrated prone position cushion to facilitate the operation and nursing of the patient.Methods The cushion was composed of outer and inner layers with considerations on gender and operative sites.The inner layer was made of plus hard high-density sponge,the outer layer was manufactured with polyurethane (PU),and the two layers were connected by Velcro.Results The cushion behaved well in shock proof and buffering,which could expose the operative field sufficiently and decrease the incidence rate of pressure sore during the operation.Conclusion The cushion gains advantages in simple structure,stability,safety,easy operation and disinfection,and is applicable for prone position surgery.
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Objective To design a flexible and convenient emergency tracheal intubation box for providing rapid artificial respiration support to critical and severe patients with sudden changes and implementing effective emergency rescue measures which enhance the success rate of emergency tracheal intubation in clinical departments.Methods The box had its size determined with considerations on the disadvantages of tracheal intubation by clinical departments and the requirements for difficult tracheal intubation,and then was customized by some specific plant.The items required for intubation were classified and placed according to proper sites,which were separated with boards adapting to their sizes.The boards divided the box into 7 compartments.Results The box gained advantages in size,carrying,structure and usage,and facilitated to establish artificial airway in emergency conditions.Conclusion The box is easy to manufacture,clean,sterilize,carry and store,and is applicable for emergency tracheal intubation in clinical departments and emergency conditions.
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Objective To develop a portable limb disinfection rack to set the medical personnel free from manual limb traction for preoperative disinfection and etc during limb surgery.Methods The disinfection rack was made of stainless steel with considerations on the requirements of limb surgery,which had the side bar extended for 300 to 600 mm.Results The disinfection rack had high stability and 150-kg bearing capability,and could be applied to preoperative preparation such as disinfection and sterile sheet laying to enhance the efficiency of medical personnel.Conclusion The disinfection rack gains advantages in structure,operation,performance,deployability,mobility,storage,transport and cleaning,and thus is worthy promoting clinically.
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Objective To develop a detachable upper limb operation table for facilitating field surgery and improve the utilization rate of surgical shelter in field hospital.Methods The operating table was composed of a rectangular frame made of stainless steel and a table top of insulation board.The width of the rectangular frame was quartered,and two elastic fasteners were placed respectively at the points of a quarter and 3 quarters.The operating table came into being after the two fasteners were connected.Results The table had its height regulated as required and facilitated intraoperative X-ray exposure,and enhanced the efficiency and satisfaction of the surgeon and nurse.Conclusion The table gains advantages in size,carrying,operation and structure,and thus is applicable for upper limb operation in field shelter.
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Objective To explore suitable pre-processing methods for the TCM clinical data based on prospective study on insomnia treated by syndrome differentiation. Methods Based on the TCM shared clinical and research information platform and by using man-machine combination method, data cleaning rules, physician review, rule revision, procedural import and batch processing were used to conduct pre-processing for data in prospective study on insomniac treated by syndrome differentiation of 8 TCM doctors. Results Totally 27534 rules for symptoms data of individual treatment of insomnia were made and 1036 rules for diagnostic data, 842 rules for therapeutic ways, 540 rules for formula data, 3785 rules for data of Chinese materia medica. Conclusion Different kinds of terminology concepts were normalized at different levels, at the same time, characteristics of individualized treatment based on syndrome differentiation were reserved. Appropriate pre-processing methods can be used in the reaserch of individualization and standardization of TCM syndrome differentiation clinical data and can provide support for data mining.
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Objective To develop a series of surgical instruments to improve surgical treatment in field conditions with considerations on the characteristics of medical shelter and the requirements of surgical treatment in field conditions.Methods A series of surgical instruments was developed with considerations on the characteristics and requirements of surgical treatment in field conditions.Results The mask strap behaved well in structure,operation and fixation,and prevented the mask from unplanned extubation,dropping off and displacement.The sterilizing rack had high stability and safety and 150 kg bearing capability,and eliminated the needs for additional workload for patient carrying and traction during preoperative sterilization.The prone-position cushion exposed the operative field sufficiently and enhanced the success rate of surgical treatment.Conclusion The series of surgical instruments gains advantages in structure,operation,mobility,cleaning,sterilization,carrying,storage,loading and transport,and thus is applicable for field emergency rescue.
ABSTRACT
Objective To develop an integrated prone position cushion to facilitate the operation and nursing of the patient.Methods The cushion was composed of outer and inner layers with considerations on gender and operative sites.The inner layer was made of plus hard high-density sponge,the outer layer was manufactured with polyurethane (PU),and the two layers were connected by Velcro.Results The cushion behaved well in shock proof and buffering,which could expose the operative field sufficiently and decrease the incidence rate of pressure sore during the operation.Conclusion The cushion gains advantages in simple structure,stability,safety,easy operation and disinfection,and is applicable for prone position surgery.
ABSTRACT
Objective To design a flexible and convenient emergency tracheal intubation box for providing rapid artificial respiration support to critical and severe patients with sudden changes and implementing effective emergency rescue measures which enhance the success rate of emergency tracheal intubation in clinical departments.Methods The box had its size determined with considerations on the disadvantages of tracheal intubation by clinical departments and the requirements for difficult tracheal intubation,and then was customized by some specific plant.The items required for intubation were classified and placed according to proper sites,which were separated with boards adapting to their sizes.The boards divided the box into 7 compartments.Results The box gained advantages in size,carrying,structure and usage,and facilitated to establish artificial airway in emergency conditions.Conclusion The box is easy to manufacture,clean,sterilize,carry and store,and is applicable for emergency tracheal intubation in clinical departments and emergency conditions.
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Objective To develop a portable limb disinfection rack to set the medical personnel free from manual limb traction for preoperative disinfection and etc during limb surgery.Methods The disinfection rack was made of stainless steel with considerations on the requirements of limb surgery,which had the side bar extended for 300 to 600 mm.Results The disinfection rack had high stability and 150-kg bearing capability,and could be applied to preoperative preparation such as disinfection and sterile sheet laying to enhance the efficiency of medical personnel.Conclusion The disinfection rack gains advantages in structure,operation,performance,deployability,mobility,storage,transport and cleaning,and thus is worthy promoting clinically.
ABSTRACT
Objective To develop a detachable upper limb operation table for facilitating field surgery and improve the utilization rate of surgical shelter in field hospital.Methods The operating table was composed of a rectangular frame made of stainless steel and a table top of insulation board.The width of the rectangular frame was quartered,and two elastic fasteners were placed respectively at the points of a quarter and 3 quarters.The operating table came into being after the two fasteners were connected.Results The table had its height regulated as required and facilitated intraoperative X-ray exposure,and enhanced the efficiency and satisfaction of the surgeon and nurse.Conclusion The table gains advantages in size,carrying,operation and structure,and thus is applicable for upper limb operation in field shelter.