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Objective:To explore the role of post competency oriented interactive teaching in clinical teaching of blood purification.Methods:A total of 80 interns from the blood purification center of our hospital were selected from May 2019 to August 2020, and they were randomly divided into two groups. The control group ( n=40) were taught by routine clinical teaching, and the observation group ( n=40) was taught by interactive teaching based on the post competency. They were both taught for 3 months. The theoretical and practical assessment results of the two groups after teaching, the post competency before and after the teaching, and the satisfaction with the teaching were compared. SPSS 22.0 was used for t test and chi-square test. Results:The theoretical and practical assessment scores of the observation group after teaching were higher than those of the control group, and the difference was statistically significant (theoretical assessment: t=4.01, P<0.05; practical assessment: t=3.94, P<0.05). There was no statistically significant difference in effective communication ability score ( t=1.31, P=0.193), adaptability and coping ability ( t=1.25, P=0.216), autonomous learning and self-improvement ability ( t=0.93, P=0.356), and management ability score ( t=0.76, P=0.451). After teaching, the competency scores of the above-mentioned positions in the two groups were improved compared with those before teaching, and the scores of the observation group were higher than those of the control group, and the differences were statistically significant (effective communication ability: t=12.60, 6.63, P<0.05; adaptability and coping ability: t=11.21, 6.44, P<0.05; autonomous learning and self-improvement ability: t=10.80, 5.78, P<0.05; management ability score: t= 12.42, 6.79, P<0.05). There were significant differences in the distribution of satisfaction with teaching ( t=6.90, P=0.007) of the two groups of interns, and the total satisfaction rate of the observation group was higher than that of the control group ( t=6.49, P=0.011). Conclusion:The application of post competency oriented interactive teaching in clinical teaching of blood purification internship can not only improve the appraisal results of interns, enhance their post competency, but also improve the teaching satisfaction.
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Objective:To investigate the current status of knowledge expectation satisfaction of orthopedic patients during hospitalization, and to analyze the main influencing factors.Methods:From March 2021 to July 2021, a total of 320 orthopedic inpatients from Affiliated Hospital of Qingdao University were selected by convenient sampling method, who were investigated by the general information, Patient Participation Ability Questionnaire, Excepted Knowledge of Hospital Patients and a self-designed questionnaire of actual accepted knowledge on the basis of this scale.Results:The highest level of knowledge expectation satisfaction in the functional dimension (-0.40 ± 0.32), and the lowest level in the economic dimension (-1.27 ± 0.38) ( t=22.45, 59.64, both P<0.01). Knowledge expectation difference was positively correlated with information acquisition ability ( r=0.802, P<0.01) and emotion management ability( r=0.671, P<0.01). Multiple linear regression analysis showed that education level, hospitalization experience, information acquisition ability and ability to manage emotions were the main influencing factors for this difference ( t values were -6.40-13.17, all P<0.05). Conclusions:The level of knowledge expectation satisfaction of orthopedic patients′ needs to be further improved. According to the level of education, hospitalization experience, information acquisition ability and emotion management ability of patients, nurses should formulate measures to improve the level of knowledge expectation satisfaction.
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Objective To study influencing factors of renal blunt impact injury by using finite element (FE) method. Methods Based on CT images of the kidney, the kidney FE models for different age groups were constructed. The renal blunt impact test was reconstructed, and the influence of kidney material constitutive parameters, kidney tissue structure, kidney size, impact position and impact velocity on injury severity were analyzed. Results Under the same impact condition, the stress of renal cortex decreased with the kidney mass increasing, and increased with the impact velocity of the hammer increasing. The renal capsule had a certain energy absorption effect, so as to reduce the kidney stress. When the kidney was impacted, the stress of renal cortex under side impact was significantly higher than that under frontal impact. Conclusions Compared with viscoelastic constitutive model, Mooney Rivlin material constitutive model is more suitable for FE evaluation on renal injury severity. The renal injury decreases with the kidney mass increasing. The increase of impact velocity will intensify the renal injury severity. Renal capsule will reduce renal injury to a certain extent, so the existence of renal capsule structure must be considered in FE modeling of the kidney. Compared with frontal and rear impact, the renal injury severity is greater when the kidney is impacted from the lateral side.
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Objective:To explore the scientific and technological innovation environment faced by hospitals in the context of great health, and the measures to promote the sustainable development of the independent innovation capacity of the third class hospitals.Methods:Combined with the development trend of scientific and technological innovation in the new era, this paper illustrates the practice of using existing resources to improve the level of clinical diagnosis and treatment technology and release the vitality of scientific and technological innovation, and puts forward some thoughts and suggestions for the work in combination with practice.Results:According to the measurements of " platform building, talent supporting and mechanism development" , the hospital integrated its internal resources, strengthened the integrated development of clinical disciplines within the platform resources, and strengthened the construction of hospital innovation connotation and the improvement of scientific research strength in many aspects.Conclusions:It is suggested to further clarify the development mode and direction of discipline innovation, continue to expand the construction of full-time scientific research teams, broaden and deepen the construction of public platforms, improve the multi-dimensional evaluation mechanism, and promote the establishment of a sustainable development system of scientific and technological innovation.
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Objective:To explore the protective effects of breastfeeding on behavioral problems at 4 years in children born to mothers with gestational diabetes mellitus (GDM).Methods:Based on the Ma' anshan Birth Cohort (MABC) study, 305 GDM women and their children were recruited in this study from Ma' anshan Maternal and Child Health Care Hospital from May 2013 to September 2014. Total breastfeeding duration was followed up at 42 d, 3, 6, 12, and 18 months postpartum as well as the breastfeeding intensity within 6 months. All the subjects were divided into breastfeeding group ( n=256, including exclusive breastfeeding and mixed feeding) or bottle feeding group ( n=49). Internalizing and externalizing behavioral problems at age 4 were assessed using Achenbach Child Behavior Checklist (CBCL/1.5~5) and their association with breastfeeding were analyzed using robust Poisson regression. Controlling false discovery rate was applied for multiple test correction. Results:Compared with bottle feeding, breastfeeding was a protective factor for depression in children ( RR=0.23, 95% CI: 0.05-0.98, q=0.048) when the duration was 4-5 months; for somatic complaints ( RR=0.36, 95% CI: 0.14-0.95, q=0.047) and anxiety ( RR=0.19, 95% CI: 0.06-0.62, q=0.010) with a breastfeeding duration of 6-11 months; and for depression ( RR=0.46, 95% CI: 0.25-0.83, q=0.039) and anxiety ( RR=0.12, 95% CI: 0.03-0.49, q=0.006) with a breastfeeding duration of 12 months and above. Compared with bottle feeding within 6 months, mixed feeding had a protective effect on somatic complaints ( RR=0.29, 95% CI: 0.13-0.64, q=0.026) and anxiety ( RR=0.18, 95% CI:0.07-0.52, q=0.002). Conclusions:The findings suggested that breastfeeding had a protective effect on behavioral problems at age 4 in children exposed to GDM. Women with GDM should be encouraged to breastfeed.
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Objective:To evaluate the data quality of Shenzhen Type 1 Diabetes Alliance (SZT1D), and to provide a basis for evaluation and improvement for the continuous improvement of data quality.Methods:From December 2018 to July 2021, 697 first-visit type 1 diabetes (T1DM) patients (including 501 in Shenzhen and 196 out-of-Shenzhen) and 120 re-visited T1DM patients (including 113 in Shenzhen and 7 out-of-Shenzhen) who were registered by SZT1D in collaborative research platform network of China Type 1 Diabetes Alliance (hereinafter referred to as China T1D). The data quality was evaluated from three dimensions: data completion, accuracy and revisit. The data completion degree was evaluated by the overall data completion degree and the key indicator completion degree; the data accuracy was evaluated by the probability of abnormal blood glucose value; the patient′s return visit was evaluated by the return visit rate.Results:The main characteristics of T1DM in SZT1D were young and middle-aged adults [age: (34.4±17.1)years] with thin body [BMI: (19.80±3.52)kg/m 2)], half of male and female patients [proportion of male: 52.4%(365/697)]; the main types of diagnosis were classical T1DM [65.22%(150/230)] and latent autoimmune diabetes in adults(LADA) [26.08%(60/230)], and the fasting blood glucose (FPG) [(10.93±6.98)mmol/L] and glycosylated hemoglobin (HbA 1c) [(10.63±3.01)%] were high. The average completion rate of the overall data of the first diagnosed patients in SZT1D was only 60% [(62.9±31.5)%]: the number of patients with overall data completion ≥80% in SZT1D was only 50.2%(350/697); the number of patients with overall data completion ≥80% in Shenzhen was less than that outside Shenzhen [44.3%(222/501) vs 65.3%(128/196), P<0.001]. The key indicators with better completion rate of first-visit were disease course [76.2%(531/697)], age of onset [75.8%(528/697)], family history of diabetes [74.9%(522/697)], etc., but none of them had a completion rate of more than 80%, and the diabetes self-management behavior assessment questionnaire and scale score were completely missing; the frequency of daily blood glucose monitoring [46.1%(231/501) vs 64.3%(126/196), P<0.001], current insulin regimen [44.3%(222/501) vs 63.3%(124/196), P<0.001], number of diabetic ketoacidosis (DKA) since the onset of the disease [45.7%(229/501) vs 64.8%(127/196), P<0.001] and the number of symptomatic hypoglycemia in the past 1 month [39.3%(197/501) vs 63.8%(125/196), P<0.001] were higher in Shenzhen than those reported outside Shenzhen. In addition, the probability of abnormal FPG and postprandial glucose (PPG) [5.2%(24/466); 3.8%(19/236)] were low. The revisit rate was not high [17.2%(120/697)], and the revisit rate in Shenzhen was higher than that outside Shenzhen [22.6%(113/501) vs 3.6%(7/196), P<0.001]. The first revisit rate was 16.2%(113/697) and the second revisit rate was seriously insufficient [1.0%(7/697)]. Conclusions:The data quality of T1DM patients recorded by SZT1D needs to be further improved. Improving the information interconnection between China-T1D and SZT1D, employing quality control personnel and building a systematic data quality evaluation analysis and feedback mechanism are methods to promote the comprehensive, accurate and efficient input of T1DM data and continuously improve the evaluation methods to improve the overall data quality.
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Objective @#To investigate the serum levels of antibodies against SARS-CoV-2 after inoculation of an inactivated SARS-CoV-2 vaccine, so as to provide insights into the evaluation of the vaccine immunogenicity. @*Methods @#In this single-arm Objective performance criteria trial, residents aged 18 to 59 years and inoculated with an inactivated SARS-CoV-2 vaccine in Xihu District, Hangzhou City from October to December of 2020 were selected using a cluster sampling method. Blood samples were collected prior to inoculation, 14 and 28 days post-inoculation of the first dose, and 28 days post-inoculation of the second dose. Serum levels of anti-SARS-CoV-2 IgM and IgG antibodies were detected using the magnetic particle-based chemiluminescence immunoassay. The seroconversion of antibodies and dynamic changes of antibody levels were analyzed.@*Results @#Totally 310 participants were enrolled, including 133 subjects on day 14 post-inoculation of the first dose, 97 subjects on day 28 post-inoculation of the first dose and 254 subjects on day 28 post-inoculation of the second dose. The seroconversion rates of anti-SARS-CoV-2 IgG antibody were 6.02%, 28.87% and 98.43%, and the median IgG antibody levels were 1.76 ( interquartile range, 3.25 ), 5.69 ( 9.95 ) and 52.05 ( 47.60 ) AU/mL ( P<0.05 ), respectively, while the seroconversion rates of anti-SARS-CoV-2 IgM antibody were 9.02%, 11.34% and 12.99%, and the median IgG antibody levels were 1.89 ( 3.28 ), 2.06 ( 4.71 ) and 2.65 ( 4.01 ) AU/mL ( P>0.05 ), respectively. In addition, higher serum levels of anti-SARS-CoV-2 IgG and IgM antibodies were detected post-inoculation relative to pre-inoculation ( P<0.05 ), and higher serum IgG antibody levels were found in subjects aged 18 to 39 years than in those aged 40 to 59 years ( P<0.05 ). @*Conclusions @#Inoculation of two doses of the inactivated SARS-CoV-2 vaccine achieves a high immunogenicity among residents aged 18 to 59 years 28 days post-inoculation, and the anti-SARS-CoV-2 IgM antibody is detectable in some residents following inoculation of the first dose.
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Objective:To identify the core genes related to the disease severity of respiratory syncytial virus (RSV) bronchiolitis in children using RNA sequencing (RNA-seq) and weighted gene co-expression network analysis (WGCNA), aiming to provide reference for predicting the condition of RSV infection.Methods:Twenty-two patients admitted to the Second Affiliated Hospital of Wenzhou Medical University with RSV bronchiolitis from October 1, 2019 to February 29, 2020 were enrolled as the case group. They were divided into three groups based on the severity of the disease: mild group, moderate group and severe group. Twenty-two healthy children were selected as the control group. Total RNA was extracted from whole blood leukocytes and analyzed by RNA-seq to compare the differentially expressed genes (DEGs) between children with RSV bronchiolitis and healthy children. The gene co-expression modules related to disease severity and biological indicators for disease severity assessment were identified.Results:The median age of the 22 patients (19 males and 3 females) was 3 months. The median age of the 22 healthy children (14 males and 8 females) was 4 months. There was no significant difference in age or gender between the two groups. There were 8 cases in the mild group, 7 cases in the moderate group and 7 cases in the severe group. Through significance analysis, 416 DEGs were found in the mild group, 586 in the moderate group and 846 in the severe group. According to WGCNA analysis, 10 co-expression modules were found, among which brown module ( r=0.62, P<0.001) was significantly correlated with disease severity. The protein-protein interaction network of DEGs in brown module was constructed and the top 30 core genes were selected according to the connectivity of gene nodes, among which the genes with high correlation were RBX1 and PSMA7. The expression of RBX1 and PSMA7 genes was up-regulated in the severe group, but their expression in the mild and moderate groups was not significantly different from that in the control group. Conclusions:RBX1 and PSMA7 genes might be biological predictors of disease severity in RSV bronchiolitis.
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Objective:To detect the serum levels of SARS-CoV-2-specific IgM and IgG antibodies in patients infected with SARS-CoV-2 and recipients of inactivated vaccine in different periods for understanding their variation patterns in vivo. Methods:Chemiluminescence immunoassay was used to detect the levels of SARS-CoV-2-specific IgM and IgG antibodies in 144 serum samples of 44 COVID-19 patients, 381 serum samples of 118 asymptomatic infected cases and 398 serum samples of 273 inactivated vaccine recipients collected at different periods. The results were statistically analyzed together with basic characteristics and vaccination status.Results:The positive rates of IgM antibody in COVID-19 patients, asymptomatic infected cases and inactivated vaccine recipients were 52.27% (23/44), 23.73% (28/118) and 14.29% (39/273). The positive rate of IgM antibody was higher in COVID-19 patients than in asymptomatic infected cases and vaccine recipients (χ 2=12.106, P=0.001; χ 2=34.755, P<0.001). The positive rates of IgG antibody in the three populations were 100.00% (44/44), 97.46% (115/118) and 98.81% (166/168), and the differences were not statistically significant (χ 2=2.944, P=0.229). In COVID-19 patients, the concentration of IgM antibody in <40 years old group was lower than that in ≥40 years old group (Waldχ 2=6.609, P=0.010), and the concentration of IgG antibody in patients with vaccination was higher than that in patients without vaccination (Waldχ 2=12.402, P<0.001). In asymptomatic infected cases, the concentration of IgG antibody was higher in people with vaccination than in those without vaccination (Waldχ 2=4.530, P=0.033). In SARS-CoV-2 vaccine recipients, the concentration of IgG antibody in <40 years old group was higher than that in ≥40 years old group (Waldχ 2=9.565, P=0.002). Dynamic analysis of antibody levels showed that from week 1 to week 9, the concentrations of IgM and IgG antibodies in COVID-19 patients were higher than those in asymptomatic infected cases and vaccine recipients. Conclusions:The concentrations of IgM and IgG antibodies in COVID-19 patients were higher than those in asymptomatic infected cases and inactivated vaccine recipients. COVID-19 patients aged ≥40 years had higher level of IgM antibody. COVID-19 patients and asymptomatic infected cases who had received vaccination had higher concentration of IgG antibody. Inactivated vaccine showed good immunogenicity after whole course of immunization, and the IgG antibody level in <40 years old group was higher.
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ObjectiveTo observe the effect of Kinesio taping on salivation after stroke. MethodsFrom October, 2019 to January, 2021, 40 patients with salivation after stroke were randomly divided into control group (n = 20) and experimental group (n = 20). Both groups received routine medicine, routine rehabilitation for dysphagia and rehabilitation nursing, while the experimental group received Kinesio taping in addition, for three weeks. They were assessed with Functional Oral Intake Scale (FOIS), Water Swallow Test (WST) and Teacher Drooling Scale (TDS) before and after treatment. ResultsOne case dropped in the experimental group. The scores of FOIS, TDS and WST improved in both groups after treatment (|Z| > 2.000, P < 0.05), and improved more in the experimental group than in the control group (|Z| > 3.045, P < 0.01). ConclusionKinesio taping may relieve the salivation of patients with dysphagia after stroke.
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ObjectiveTo investigate the effects of upper limb robot-assisted training on cognitive function, upper limb motor function and activity of daily living for subacute stroke patients. MethodsFrom September, 2019 to September, 2020, 65 subacute stroke hemiplegic patients with cognitive impairment were randomly divided into control group (n = 32, two cases dropped) and experimental group (n = 33, three cases dropped). Both groups accepted conventional occupational therapy; and then, the control group accepted conventional cognitive training, while the experimental group accepted upper limb robot-assisted training, for four weeks. They were assessed with Montreal Cognitive Assessment (MoCA), Mini-Mental State Examination (MMSE), Fugl-Meyer Assessment-Upper Extremities (FMA-UE) and modified Barthel Index (MBI) before and after treatment. ResultsThe scores of MoCA, MMSE, FMA-UE and MBI improved after treatment in both groups (t > 22.11, Z > 4.79, P < 0.001), the MoCA total score and some item-scores, MMSE total score and some item-scores, FMA-UE total score and the score of arm, and score of MBI improved more in the experimental group than in the control group (t > 2.06, Z > 3.19, P < 0.05). ConclusionUpper limb robot-assisted training could facilitate to improve the cognitive function, upper limb motor function and activities of daily living in subacute stroke patients.
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The finite element method is a new method to study the mechanism of brain injury caused by blunt instruments. But it is not easy to be applied because of its technology barrier of time-consuming and strong professionalism. In this study, a rapid and quantitative evaluation method was investigated to analyze the craniocerebral injury induced by blunt sticks based on convolutional neural network and finite element method. The velocity curve of stick struck and the maximum principal strain of brain tissue (cerebrum, corpus callosum, cerebellum and brainstem) from the finite element simulation were used as the input and output parameters of the convolutional neural network The convolutional neural network was trained and optimized by using the 10-fold cross-validation method. The Mean Absolute Error (MAE), Mean Square Error (MSE), and Goodness of Fit ( R 2) of the finally selected convolutional neural network model for the prediction of the maximum principal strain of the cerebrum were 0.084, 0.014, and 0.92, respectively. The predicted results of the maximum principal strain of the corpus callosum were 0.062, 0.007, 0.90, respectively. The predicted results of the maximum principal strain of the cerebellum and brainstem were 0.075, 0.011, and 0.94, respectively. These results show that the research and development of the deep convolutional neural network can quickly and accurately assess the local brain injury caused by the sticks blow, and have important application value for understanding the quantitative evaluation and the brain injury caused by the sticks struck. At the same time, this technology improves the computational efficiency and can provide a basis reference for transforming the current acceleration-based brain injury research into a focus on local brain injury research.
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Humans , Brain , Brain Injuries , Computer Simulation , Finite Element Analysis , Neural Networks, ComputerABSTRACT
Objective To predict and assess biomechanical responses and injury mechanisms of the thorax and abdomen for small-sized females in vehicle collisions. Methods The accurate geometric model of the thorax and abdomen was constructed based on CT images of Chinese 5th percentile female volunteers. A thoracic-abdominal finite element model of Chinese 5th percentile female with detailed anatomical structure was developed by using the corresponding software. The model was validated by reconstructing three groups of cadaver experiments (namely, test of blunt anteroposterior impact on the thorax, test of bar anteroposterior impact on the abdomen, test of blunt lateral impact on the chest and abdomen). Results The force-deformation curves and injury biomechanical responses of the organs from the simulations were consistent with the cadaver experiment results, which validated effectiveness of the model. Conclusions The model can be used for studying injury mechanisms of the thorax and abdomen for small-sized female, as well as developing small-sized occupant restraint systems and analyzing the forensic cases, which lays foundation for developing the whole body finite element model of Chinese 5th percentile female.
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The study analyzed the application of failure mode and effect analysis(FMEA)in the emergency management of emergent infectious diseases. In February 2020, optimization of emergency management procedures for emergent infectious diseases was identified as the research theme. Subsequently, FMEA was applied to study the emergency management process of emergent infectious diseases and analyze corresponding potential failure modes in an infectious disease hospital. The appraisal identified four prioritized risk exposures to correct, including non-standardized personnel protection, delayed personnel arrival, unqualified specimens and inadequate ward preparation. Accordingly pertinent countermeasures were formulated. Three months after measures were taken, the risk priority numbers of the above four risks were decreased significantly. On the other hand, evident increase was found in the on-duty rate of emergency personnel, the rate of standard protection, the qualification rate of sample collection and disposal, as well as the serviceability rate of respirators, ECG monitors and protective equipment in emergency wards. The application of FMEA is conducive to optimizing the emergency response process of emergent infectious diseases, and to upgrading emergency management at large.
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Objective:To investigate the influence of joint line alteration on the mid-term clinical effects of primary medial pivot total knee arthroplasty (MP-TKA).Methods:Data of a total 189 patients (233 knees) with 30 males (30 knees) and 159 females (203 knees) with age 66.42±6.12, diagnosed as knee osteoarthritis and underwent primary MP-TKA from January to December 2015, were retrospectively analyzed. All cases were followed up for at least 4 years. The patients were divided into four groups according to the extent of alteration, namely <-4 mm, -4- mm, 0- mm and >4 mm. Range of motion (ROM), Knee Society's Knee Scoring System (KSS), the Western Ontario and McMaster University (WOMAC) osteoarthritis index score were compared preoperatively and at 4 years postoperatively.Results:The postoperative follow-up duration was 52.20± 2.94 months (48-59 months). A total of 133 knee (57%) had joint line raised and 100 cases (43%) joint line distal shifted. The overall height of joint line before surgery was 16.56±3.54 mm (7.33-25.32 mm) and 17.34±2.92 mm (7.25-25.43 mm) postoperatively. The average alteration was 0.78±3.17 mm (-6.00-9.91 mm) with statistically significant difference ( t=-2.596, P=0.010). There was no statistical difference among the four groups in terms of gender, body mass index, pre-operative tibia slope and post condylar offset. The overall preoperative ROM of the all groups was 90.45°±20.44°, which increased from baseline to 108.95°±12.55° at 4 years postoperatively ( t=-22.381, P<0.001). There was statistical difference in term of ROM among each group ( F=7.101, P<0.001). The ROM in group 0- mm and >4 mm was significantly higher than that in group <-4 mm and -4- mm ( P<0.05). The KSS function score and clinic score at 4 years postoperatively were significantly higher that those before surgery, the WOMAC score was statistically lower at 4 years postoperatively ( F=0.723, P<0.001; F=1.138, P<0.001; F=2.502, P<0.001). There was no significant difference among the four groups in terms of KSS score and WOMAC ( P>0.05). One case in >4 mm group had gasket prolapse at 6 month after surgery and 3 cases with immediate anterior knee pain occurred in <-4 mm group. Conclusion:MP-TKA can lead to significant joint line alteration. The overall ROM after surgery is positively correlated with the quantity of joint line alteration. However, there was no correlation between quantity of joint line alteration and the joint function scores. Thus, MP-TKA can achieve good mid-term clinical effects.
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Objective:To summarize the clinical characteristics of 102 children with protracted bacterial bronchitis in Qingdao area.Methods:One hundred and two children with protracted bacterial bronchitis treated at respiratory clinic of Women and Children′s Hospital affiliated to Qingdao University from January 2016 to March 2021 were included in this study.The clinical data, age and seasonal distribution, etiology, clinical manifestations, high-resolution CT of the lungs, characteristics of lung function, bronchoscopy and treatment prognosis were retrospectively analized.Results:The top three pathogens of protracted bacterial bronchitis in 102 children (55 boys, 47 girls, median age: 1.7 (0.8, 4.2)years were Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis, with frequency of 12.75%, 10.78%, and 6.86%, respectively.The onset season was mainly autumn and winter, with a total of 73 (71.57%) cases.The main clinical manifestations were wet cough and (or) wheezing, and the cough was not divided between day and night.CT of the lungs showed thickening of the bronchial wall in 16(15.69%) cases and uneven ventilation in 5(4.90%) cases.Twenty-three (22.55%) cases had abnormal lung function.Fifty-two (50.98%) cases underwent bronchoscopy, of which 33(32.35%) cases had multiple lung segmental purulent changes under the microscope.After standard anti-infection, bronchoscopy and alveolar lavage, expectorant and physical therapy, the prognosis was mostly good.Conclusion:The clinical manifestations of protracted bacterial bronchitis in children have no obvious specificity.Early diagnosis, identification of the cause and comprehensive management are critical to its prognosis.
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Objective:To investigate the body composition and sarcopenia in patients with stable chronic obstructive pulmonary disease (COPD) and to analyze the influencing factors.Methods:A total of 220 patients with stable COPD were enrolled in the study from China-Japan Friendship Hospital during July 2018 to December 2019; 220 age and sex-matched healthy subjects (control group 1) and 220 healthy young adults aged 20-40 years (control group 2) were enrolled from the community. The body composition was measured by bioelectrical impedance method. The demographic characteristics, disease conditions, living background and other related factors were collected by questionnaire. T test or one-way ANOVA were used for comparison between groups, and non parametric test was used for non normal distribution data.Results:Compared with the control group 1 and control group 2, the body fat rate ( Z=-10.037, t=-8.411), the fat free mass index ( Z=-8.165, t=-7.856), and appendicular skeletal muscle index (ASMI) ( t=-7.158, t=-11.989) were significantly lower in stable COPD patients ( P<0.05). Among 220 patients with stable COPD, 51 (23.2%) were diagnosed as sarcopenia; the prevalence of sarcopenia was 18.3% (24/131) in men and 30.3% (27/89) in women (χ2=4.297, P=0.038). The decreased ASMI and grip strength in COPD patients with sarcopenia were significantly associated with age≥75 (χ2= 15.746, F= 14.048), female sex ( Z=5.805, t=2.672), low income ( Z=-4.291, t=-4.789), Global Initiative for Chronic Obstructive Lung Disease (GOLD) grade Ⅳ (χ2=22.644, F=3.905), Modified British Medical Research Council (mMRC) Dyspnea Scale grade 4 (χ2=12.475, F=4.369), not receiving systematic health education ( Z=-4.239, Z=-2.474), no exercise (χ2=14.786, F=3.402), insufficient nutrition intake (χ2=40.531, F=10.529). The range of 6-min walking distance was (110-268) m, that was even shorter for patients with mMRC dyspnea scale grade 4 ( F=3.468, P<0.05). Conclusion:The impairment of body composition is common in COPD patients, which will further affect the body function. It is suggested that the routine evaluation of COPD should include the measurement of body composition.
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Objective To study the constitutive model of adipose tissue at medium strain rate and its parameter inversion. Methods Based on experiments of adipose tissue mechanical properties, the compression experiment of adipose tissues was reconstructed by finite element method, and the parameters for characterizing constitutive models of adipose tissues were screened. Combined with the method of feasible direction (MFD) in optimization method, the reverse calculation for parameters of fat tissue constitutive model at medium strain rate was conducted. ResultsCompared with Ogden constitutive model, the viscoelastic constitutive model was more suitable for characterizing the mechanical response at medium strain rate (260 s-1). The parameters of the constitutive model suitable for simulation were obtained using the reverse method. Conclusions The viscoelastic constitutive model was more suitable for characterizing the mechanical response at medium strain rate. The results provide references for studying the influence of human adipose tissues on body injury in finite element simulation of vehicle collisions.
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Objective To study the influence of skull thickness on intracranial biomechanical parameters by finite element method. Methods The female head at 5th percentile was selected for CT scanning to construct finite element model of the head with high biofidelity,and the model was verified by reconstructed cadaver test. The finite element model of the head with different skull thickness was established, and multiple groups of tests were carried out to compare the intracranial mechanical parameters. Results The negative value of intracranial pressure was significantly affected by the decrease in skull thickness under the same head size, while the negative value of intracranial pressure was slightly affected, with an increasing trend. The shear stress and von Mises stress of brain tissues were significantly increased with skull thickness increasing. Conclusions Under the same head size, the skull thickness will affect head injury to a certain extent, and people with small skull thickness are more likely to be injured than those with large skull thickness.
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Objective To explore the influence of child head injury under different impact angles by applying the finite element model of six-year-old child pedestrian as specified in the European New Car Assessment Programme (Euro NCAP). Methods Based on the finite element model of 6-year-old pedestrian with detailed anatomical structure as specified by the Euro NCAP (TB024), four groups of simulation experiments were set up to explore the mechanism of head injury in children under different impact angles. The initial position for head mass center was on the longitudinal center line of the car. The initial speed of the car was 40 km/h. The car contacted with the model from the direction of the right (0°), the front (90°), the left (180°) and the back (270°). The kinematics differences and head impact responses were compared, and injuries of the facial bone and skull were analyzed. Results Through the analysis of head contact force, acceleration of head mass center, resultant velocity of head mass center with the vehicle, head injury criterion (HIC15), facial bone fracture and skull stress distribution, it was found that the risk of head fracture and brain contusion under back impact and front impact was higher than that under side impact. The risk of head fracture and brain contusion was highest under back impact, while the lowest under side impact. Conclusions Child pedestrian head injury was the largest under back impact. The results have important application values for the assessment and development of car-pedestrian collision protection device.