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Objective To systematic evaluate the curative effect of total hip arthroplasty (THA) through direct anterior approach versus (DAA) posterolateral approach (PSA).Methods All the randomized controlled trial (RCT) articles and observational research articles about the curative effect of THA through direct anterior approach (DAA group) versus posterolateral approach (PSA group)for treatment of hip disease that published at home and abroad included from database establishing to December 2017 were retrieved from Cochrane Library,Pubmed,Web of Science,CBM and China national knowledge internet (CNKI) through computer.The articles were screened and the information was extracted independently by two authors.A Meta-analysis was performed utilizing the RevMan 5.3 software.Results Two hundred and forty-nine articles were searched out in the initial stage.After screening,7 Chinese articles and 2 English articles (942 cases)were included in the final analysis,including 8 RCT articles and 1 observational research article,and 463 patients in direct anterior approach and 479 patients in posterolateral approach.The results of Meta-analysis demonstrated that the incision length,operation time,intraoperative blood less,Harris hip function scores at 1 month after surgery,visual analogue scale (VAS) scores at 24 hours after surgery,postoperative bed rest time and the hospital stay were better in DAA group compared to PSA group (SMD =-2.51,95％ CI:-4.84,-0.19,P=0.03);(SMD=0.84,95％ CI:0.10,1.59,P=0.03);(SMD=-1.52,95％ CI:-2.98,-0.05,P=0.04);(SMD=2.58,95％ CI:0.65,4.51,P=0.009);(SMD=-0.65,95％ CI:-0.91,-0.38,P＜0.01);(SMD=-1.85,95％ CI:-3.00,-0.70,P=0.002);(SMD =-1.12,95％ CI:-1.62,-0.61,P ＜0.01).There were no statistical difference in drainage (SMD =-1.45,95％ CI:-3.40,0.49,P =0.14),Harris hip function scores at last follow-up (SMD =0.91,95％ CI:-0.31,2.14,P =0.15),VAS scores at 48 hours after surgery (SMD =-1.21,95％ CI:-3.03,0.61,P =0.19),acetabular anteversion angles (SMD =-0.50,95％ CI:-1.06,0.05,P =0.07),acetabular abduction angles (SMD =-0.01,95％ CI:-0.32,0.30,P =0.97) and incidence of complications (OR =1.10,95％ CI:0.59,2.07,P =0.77) between the 2 groups.The result of analysis of publication bias according to Harris hip function scores at last follow-up and incidence of complications showed that the funnel-plot was essentially bilateral symmetry.Conclusions THA through DAA can significantly reduce the soft-tissue damage,and it is beneficial for patient's quick recovery,also it conforms to the current concept of minimally invasive treatment that worthy of promotion.
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Objective:To analyze the value of maximum standardized uptake value (SUV max) of 18F-fluorodeoxyglucose (FDG) PET/CT in differentiating the malignant solitary pulmonary nodules (SPN) from benign ones. Methods:18F-FDG PET/CT imaging data of 84 patients (39 males, 45 females; age: 34-81(average: 61.1) years) with SPN in the First People′s Hospital of Lianyungang between September 2017 and June 2019 were retrospectively analyzed. The pathological results were taken as the gold standard. Differences of SUV max between benign and malignant SPN were analyzed with Mann-Whitney U test, and the best cut-off value for the diagnosis of benign and malignant SPN was measured by receiver operating characteristic (ROC) curve. The diagnostic efficacy was analyzed based on SUV max. Results:The pathological results confirmed 54 patients with malignant SPN, and 30 patients with benign SPN. SUV max of malignant group was significantly higher than that of benign group (5.48±4.08 vs 1.70(0.73, 3.33); U=443.50, P=0.001). The 84 SPN included 58 solid SPN and 26 subsolid SPN. SUV max of malignant subsolid SPN and benign ones were not significantly different ( U=56.00, P>0.05). The diagnostic value of SUV max in 58 cases of solid nodules were analyzed based on ROC curves, and the optimal cut-off value was 1.85. The corresponding diagnostic sensitivity, specificity, accuracy, negative predictive value and positive predictive value were 97.06%(33/34), 62.50%(15/24), 82.76%(48/58), 15/16, 78.57%(33/42), respectively. Conclusions:18F-FDG uptake of malignant SPN were higher than benign ones. The diagnosis of benign and malignant solid SPNs based on SUV max 1.85 has high sensitivity, negative predictive value and accuracy. SUV max has limited diagnostic value on subsolid SPN.
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BACKGROUND: The complicated localization of intramedullary nails and osteotomy more dependent on surgeons' experience limit the application of conventional total knee arthroplasty (TKA). The occurrence of three-dimensional (3D) printing technology can achieve precise localization and osteotomy in TKA.OBJECTIVE: To explore the effectiveness of 3D printing technology-aided TKA versus conventional TKA for genu varum.METHODS: Thirty-four patients with genu varum undergoing primary unilateral TKA were recruited and were then divided into two groups (n=17 per group) in accordance with the random number table. One group was treated with TKA with 3D printing guild plate (3D printing group), while the other group received the conventional TKA (conventional group).The intraoperative and postoperative blood loss, operation time, as well as the Hospital for Special Surgery score, range of motion, and lower limb mechanical alignment at 2 weeks postoperatively were compared between two groups.RESULTS AND CONCLUSION: (1) The range of motion of knee in the 3D printing group was larger than that in the conventional group, but had no significant difference at 2 weeks postoperatively (P=0.744). (2) There was no significant difference in the Hospital for Special Surgery scores between two groups at 2 weeks postoperatively (P= 0.532). (3) The postoperative lower limb mechanical alignment showed no significant difference between two groups (t=0.218, P=0.632).(4) The operation time in the 3D printing group was significantly shorter than that in the conventional group (P=0.000). (5) The blood loss in the 3D printing group was significantly less than that in the conventional group (P=0.000). (6) Our findings indicate that 3D printing technology-aided TKA exhibits similar results to the conventional TKA in the Hospital for Special Surgery scores, range of motion, and lower limb mechanical alignment, but it shortens the operation time,reduces the blood loss, and achieves precise osteotomy, which is available for the elderly with poor basic condition, and weak tolerance of surgery.
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A sensing method based on high-speed camera is proposed to recognize human arm motion in this paper. A sensing system for human arm motion was established. A fast image processing algorithm was developed to accurately extract marker positions in the image. Angle parameter results were further improved with the instantaneous joint center principle. The human motion information results can serve as the research references of medical treatment, gym, bionics, and so on. The sensing method can also be applied to other fields of the human motion recognition.