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Objective:To investigate the feasibility and clinical efficacy of percutaneous anterior column screwing assisted by blocking screws for pelvic and acetabular fractures.Methods:A retrospective analysis was conducted of the 13 patients who had been admitted from July 2019 to April 2022 for pelvic and acetabular fractures. There were 8 males and 5 females with an age of (49.1±13.3) years, 7 acetabular fractures (6 on one side and 1 on both sides; by the Letournel-Judet classification: 5 anterior column fractures on 6 sides, and 2 transverse and posterior wall fractures on 2 sides), and 6 pelvic fractures (5 complicated with pelvic posterior ring fracture; by the Tile classification: 1 case of type B2, 3 cases of type C1, and 2 cases of type C2). According to the anatomic zones of the anterior column, 5 fractures were at zone Ⅲ, 3 ones at zone Ⅳ, and 6 ones at zone Ⅴ. The time from injury to surgery ranged from 3 to 14 days, averaging (8.2±2.9) days. Anterograde anterior column screwing assisted by blocking screws was performed for all the 13 patients; the posterior ring was fixated with percutaneous sacroiliac joint screws for the 5 patients complicated with pelvic posterior ring fracture. The surgical time, intraoperative fluoroscopy frequency, and intraoperative bleeding volume for insertion of anterior column screws, fracture reduction quality, and hip joint function at the last follow-up were recorded.Results:A total of 14 anterior column screws were inserted percutaneously in the 13 patients. For insertion of anterior column screws, the surgical time was (65.0±10.2) min, the intraoperative fluoroscopy frequency (63.5±14.5) times, and the intraoperative bleeding volume for each screw less than 30 mL. All the incisions healed primarily after surgery, without such complications as iatrogenic neurovascular injury or poor wound healing. All the 13 patients were followed up for (11.1±2.2) months after surgery. In the patient with bilateral acetabular anterior column fractures for which 2 anterior column screws had been inserted, one screw had to be removed due to its displacement at 1 month after surgery; no such complications as loosening of internal fixation or fracture re-displacement was found in the other patients. All fractures healed after (10.2±2.1) months. According to the Matta scoring for quality of fracture reduction, 7 sides were excellent, 5 sides good, and 2 sides poor; according to the Majeed scoring for the 6 patients with pelvic fracture at the last follow-up, the efficacy was rated as excellent in 4 cases and as good in 2 ones; according to the modified Merle d'Aubigné & Postel scoring for the 7 patients with 8 acetabular fractures at the last follow-up, the efficacy was rated as excellent in 4 hips, as good in 3 hips, and as fair in 1 hip.Conclusion:For pelvic and acetabular fractures, minimally invasive percutaneous anterior column screwing assisted by blocking screws can result in fine clinical efficacy, in addition to its easy procedures, safety and reliability.
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With the development of Internet medical service, the traditional peer-to-peer access mode is difficult to meet the rapidly growing business demand. By means of information technology, our hospital has built an Internet application access management platform, formed a " three platforms and one center" management model, formulated an application access standard management process based on integrated access documents, introduced a series of information security measures, and constructed a set of Omni-directional and standardized Internet application access management system. It has been proved that the system could realize unified design, standard access, centralized management, and security audit for application access, could effectively solve the problems of Internet application access, and could also provide powerful data support for hospital medical, teaching and research work.
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Objective:A multi-center and large sample volume study was conducted on the verification and improvement of the early established criteria for intelligent routine urinalysis validation (including the microscopic review rules and manual validation rules, referred to as intelligent criteria for short), in order to improve the clinical application of this intelligent criteria.Methods:A total of 31 456 urine specimens were collected from the inpatients and outpatients in six hospitals in China, from March to September 2019. Firstly, 3105 specimens were analyzed for preliminary verification and improvement of the intelligent criteria based on the results of the microscopic examination and manual validation. Secondly, 28 351 specimens were used to verify the clinical application of the improved intelligent criteria. All samples were manually validated as reference.Results:The approval inconsistency rate of the manual validation rules in the original intelligent criteria was 8.59% (202/2 352), and the interception inconsistency rate was 8.84% (208/2 352). The false negative rate and the microscopic review rate of the microscopic review rules were similar to the previous results. Based on an in-depth analysis of big data and the discussions by senior technicians from eight hospitals, one microscopic review rules and four manual validation rules were added, meanwhile two manual validation rule was deleted. The manual validation standards were unified. Finally, the intelligent criteria was improved. Based on the improved intelligent criteria, for microscopic review rules, the false positive rate, false negative rate (misdiagnosis rate), and microscopic review rate did not change significantly, which were 14.72% (457/3 105), 4.06% (126/3 105), and 24.73% (768/3 105), respectively. The approval inconsistency rate and the interception inconsistency rate of manual validation rules were both reduced to 0; the total manual validation rate of the intelligent criteria was 50.89% (1 580/3 105), and the auto-validation rate was 49.11% (1 525/3 105). The large sample volume verification results were consistent with the preliminary verification results of the improved intelligent criteria.Conclusion:This multi-center and large sample volume study had shown that the improved intelligent criteria had better clinical performance.
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Objective To shorten the stat test turnaround time (TAT) and improve the quality of service in clinical laboratory.Method Stat test TAT related data of clinical laboratory in Tongji hospital in Wuhan from August 1st to September 30th were collected by laboratory information system and hospital information system.EXCEL and SPSS were used for data analysis.Median and the 90th percentile were calculated for TATs from order to collection, collection to transfer, transfer to reception, reception to inspection and inspection to report.Outlier rates were calculated for TAT from collection to reception, reception to report, and collection to report using 2 h, 2 h, and 4h as target TAT value, respectively.Meanwhile descriptive statistics were calculated for TAT from order to collection in different clinical department, TAT from collection to reception during different collection time frames, and TAT from reception to report during different reception time frames.Results 32 235 stat biochemistry test data were included in this survey.Among three periods cut by collection and reception time, TAT from order to collection were the longest (P50: 681 min,P90:1261 min), followed by TAT from collection to reception(P50:94 min,P90:169 min) and TAT from reception to report(P50:68 min,P90:111 min).TATs from order to collection were longer in gynecological tumor department and organ transplantation department while shorter in infection department and cardiac vascular department.The TATs from collection to reception of specimen collected during 2:00 to 3:59 were longer than other collection time.While the TATs from reception to report of specimen received during 6:00 to 7:29 were longer than other reception time.There was no significant correlation between the amount of emergency specimens collected and TAT from collection to reception in different collection time period.However, the amount of emergency specimens collected was significantly correlated with the TAT from reception to report in different reception time period.Conclusions Analysis of TAT data can be used to identify existing problems and provide improved directions to shorten TAT in clinical laboratories.
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Objective To research the application of oral ambroxol in improving positive rate of sputum smear laboratory testing of Tuberculosis.Methods After immediate microscopic phlegm examination on 1 536 tuberculosis outpatients,them were divided into two groups alternatively and randomly.The referential group took oral placebo while the test group took oral ambroxol.Recheck would be conducted onmorning phlegm after three days,then comprated the positive rate of each group.Results The positive rates of immediate microscopic phlegm examination of the referential and test groups were 4.82％ and 4.56％ (x2 =0.058,P＞0.05) respectively.For the referential group,the positive rates before and after taking medicine were 4.82％ and 5.60％ respectively (x2 =0.475,P＞0.05).The differences had no statistic meaning.The positive rates of morning microscopic phlegm examination after taking medicine of the referential and test groups were 5.60％ and 8.59 ％ ()x2 =5.224,P＜0.05) respectively.The positive rates of the test group before and after taking medicine were 4.56 ％ and 8.59％ respectively (x2 =10.18,P＜0.05).It could be deemed that the difference had statistic meaning.Conclusion O-ral ambroxol can help raise the positive rate of microscopic phlegm examination of the patient with suspected tuberculosis.
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Objective To investigate the incidence of prozone phenomenon of rapid plasma reagin (RPR) test in syphilis serolog-ic testing and its correlation with the intensity of chemiluminescent microparticle immunoassay (CMIA) results.Methods A total of 101493 patients in our hospital from January 2014 to December 2015 were performed syphilis serologic testing by CMIA ,RPR and treponema pallidum particle agglutination (TPPA).The incidence rate of prozone phenomenon in RPR testing was evaluated.Its in-fluencing factors were investigated by using the Logistic regression.Results Among 101493 serum samples ,2180 cases were posi-tive by CMIA and 767 cases were positive by RPR ,the incidence rate of prozone phenomenon was 3.3% (26/767)in RPR.The Lo-gistic regression results indicated that the incidence of prozone phenomenon was significantly correlated with CMIA S /CO values and RPR titer ,but had no correlation with sex ,age and seasonality.Conclusion Although the incidence of prozone phenomenon is low in syphilis serologic testing ,but it is enough important.The patients with higher S/CO value in CMIA test have a higher inci-dence rate of RPR prozone phenomenon.
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Objective To study the clinical evaluation of Shenqi Fugan granule for chronic Hepatitis C and its effect on WBC and neutrophil count.Methods 135 patients with chronic hepatitis C from October 2014 to September 2016 were randomly divided into control group(n=68)and control group(n=68).The patients in control group were treated with reserpine.The patients in the observation group were treated with Shenqi Fugan Granule,and then the numbers of leukocytes and neutrophils were measured before and after treatment at 2,4 and 8 weeks after treatment.Meanwhile,the patients in both groups were treated before and after treatment.Liver function recovery,and to make a comprehensive evaluation of its clinical effect.Results There were significant differences between the two groups before and after treatment(P<0.05).The difference between the two groups was statistically significant(P<0.05),and the difference between the two groups was statistically significant(P<0.05).After treatment,the liver function(alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBIL))in the observation group was significantly better than that in the control group,and the total effective rate(91.18％)in the observation group was significantly greater than that in the control group Total effective rate(85.07％),the difference between the two groups was statistically significant(P<0.05).Conclusion The clinical effect of Shenqi Fugan Granule on chronic hepatitis C is significant,which can effectively inhibit the decrease of peripheral white blood cell count and middle cell count,and the safety is higher.
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Oral lichen planus (OLP) is considered a T cell-mediated autoimmune disease with unknown aetiology. T helper cells appear to play an important role in the pathogenesis of OLP. We investigated the possible role of T helper cells, Th1 and Th17, in the lesions and circulation of patients with OLP. Forty patients with OLP and 15 healthy volunteers were recruited. Double immunofluorescence staining was used to detect Th1 and Th17 cells in the OLP lesions, and intracellular cytokine staining and flow cytometry to evaluate the proportion of Th1 and Th17 cells in peripheral blood. The levels of serum interferon (IFN)-γ and interleukin (IL)-17 were assessed by using an enzyme-linked immunosorbent assay. It was found that Th17 cells, as well as Th1 cells, were present in OLP lesions. The proportion of peripheral Th1 and Th17 cells was significantly increased in patients with OLP. The proportion of Th17 cells in atrophic-erosive OLP was elevated as compared with that in reticular OLP. Serum IL-17 levels in OLP patients were significantly higher than in controls, and those in the atrophic-erosive OLP group were increased as compared with the reticular OLP group. However, the levels of serum IFN-γ were slightly decreased in OLP patients. Our data suggested that Th1 and Th17 cells in the local lesions and peripheral blood may be associated with the pathogenesis of OLP, and that IL-17 may be an important proinflammatory cytokine in OLP. These findings enhance our understanding of OLP pathogenesis.
Subject(s)
Child , Female , Humans , Male , Middle Aged , Interferon-gamma , Allergy and Immunology , Interleukin-17 , Allergy and Immunology , Lichen Planus, Oral , Allergy and Immunology , Pathology , Th1 Cells , Allergy and Immunology , Th17 Cells , Allergy and ImmunologyABSTRACT
Oral lichen planus (OLP) is considered a T cell-mediated autoimmune disease with unknown aetiology. T helper cells appear to play an important role in the pathogenesis of OLP. We investigated the possible role of T helper cells, Th1 and Th17, in the lesions and circulation of patients with OLP. Forty patients with OLP and 15 healthy volunteers were recruited. Double immunofluorescence staining was used to detect Th1 and Th17 cells in the OLP lesions, and intracellular cytokine staining and flow cytometry to evaluate the proportion of Th1 and Th17 cells in peripheral blood. The levels of serum interferon (IFN)-γ and interleukin (IL)-17 were assessed by using an enzyme-linked immunosorbent assay. It was found that Th17 cells, as well as Th1 cells, were present in OLP lesions. The proportion of peripheral Th1 and Th17 cells was significantly increased in patients with OLP. The proportion of Th17 cells in atrophic-erosive OLP was elevated as compared with that in reticular OLP. Serum IL-17 levels in OLP patients were significantly higher than in controls, and those in the atrophic-erosive OLP group were increased as compared with the reticular OLP group. However, the levels of serum IFN-γ were slightly decreased in OLP patients. Our data suggested that Th1 and Th17 cells in the local lesions and peripheral blood may be associated with the pathogenesis of OLP, and that IL-17 may be an important proinflammatory cytokine in OLP. These findings enhance our understanding of OLP pathogenesis.