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1.
Article in Chinese | WPRIM | ID: wpr-1023204

ABSTRACT

Objective:To investigate the efficacy of transcatheter arterial embolization (TAE) in treating postoperative hemorrhage in the gallbladder-pancreas-duodenum(GPD) region.Methods:The clinical data of 39 patients with postoperative hemorrhage in the GPD region who underwent digital subtraction angiography (DSA) examination in Peking Union Medical College Hospital from July 2018 to August 2022 were analyzed retrospectively, clinical regression was compared between TAE-treated and non-TAE-treated patients, and the concordance between DSA and enhanced CT for bleeding indications was analyzed using the Kappa test.Results:Among 39 patients, DSA examination suggested bleeding in 26 patients (66.7%), which were gastroduodenal artery hemorrhage in 4 cases, common hepatic artery and branches in 6 categories, superior mesenteric artery and branches in 6 cases, pancreaticoduodenal artery and branches in 4 cases, pancreatic aorta in 3 cases, splenic artery in 2 cases, and gastric left artery in 1 case. Positive DSA signs manifested as contrast spillage alone in 18 cases (69.2%), pseudoaneurysm alone in 7 cases (26.9%), and pseudoaneurysm with contrast spillage in 1 case (3.8%). 26 patients underwent TAE with a technical success rate of 96.2% (25/26), a clinical success rate of 88.5% (23/26) and a rebleeding rate of 7.7% (2/26). 13 patients didn't undergo TAE and the rebleeding rate was 30.8%(4/13). 14 patients underwent enhanced CT in the same period of DSA, showed low concordance with DSA in determining the presence or absence of bleeding, with a Kappa value of 0.462.Conclusions:TAE is a safe and effective treatment for postoperative hemorrhage in the GPD region. Patients without TAE treated should be alert for rebleeding. When postoperative hemorrhage is suspected, the consistency between enhanced CT and DSA examination results is limited, and DSA examination should be preferred.

2.
Chinese Journal of Trauma ; (12): 193-205, 2024.
Article in Chinese | WPRIM | ID: wpr-1027024

ABSTRACT

Osteoporotic proximal humeral fracture (OPHF) is one of the common osteoporotic fractures in the aged, with an incidence only lower than vertebral compression fracture, hip fracture, and distal radius fracture. OPHF, secondary to osteoporosis and characterized by poor bone quality, comminuted fracture pattern, slow healing, and severely impaired shoulder joint function, poses a big challenge to the current clinical diagnosis and treatment. In the field of diagnosis, treatment, and rehabilitation of OPHF, traditional Chinese and Western medicine have accumulated rich experience and evidence from evidence-based medicine and achieved favorable outcomes. However, there is still a lack of guidance from a relevant consensus as to how to integrate the advantages of the two medical systems and achieve the integrated diagnosis and treatment. To promote the diagnosis and treatment of OPHF with integrated traditional Chinese and Western medicine, relevant experts from Orthopedic Expert Committee of Geriatric Branch of Chinese Association of Gerontology and Geriatrics, Youth Osteoporosis Group of Orthopedic Branch of Chinese Medical Association, Osteoporosis Group of Orthopedic Surgeon Branch of Chinese Medical Doctor Association, and Osteoporosis Committee of Shanghai Association of Integrated Traditional Chinese and Western Medicine have been organized to formulate Expert consensus on the diagnosis and treatment of osteoporotic proximal humeral fracture with integrated traditional Chinese and Western medicine ( version 2024) by searching related literatures and based on the evidences from evidence-based medicine. This consensus consists of 13 recommendations about the diagnosis, treatment and rehabilitation of OPHF with integrated traditional Chinese medicine and Western medicine, aimed at standardizing, systematizing, and personalizing the diagnosis and treatment of OPHF with integrated traditional Chinse and Western medicine to improve the patients ′ function.

3.
Chinese Journal of Geriatrics ; (12): 228-233, 2024.
Article in Chinese | WPRIM | ID: wpr-1028266

ABSTRACT

Objective:To investigate the characteristics of cognitive frailty and its influencing factors in older patients with chronic heart failure.Methods:In this cross-sectional study, 300 older patients hospitalized for chronic heart failure in a tertiary hospital in Shandong Province between September 2021 and September 2022 were selected.A general information questionnaire, the mini-nutritional assessment scale-short form(MNA-SF), the athens insomnia scale(AIS), the ulca loneliness scale, the geriatric depression scale-5 item version(GDS-5), and the social support rating scale(SSRS)were used for assessment and influencing factors were identified by univariate and Logistic regression analysis.Results:Among 300 older patients with chronic heart failure, the prevalence of cognitive frailty was 75.3%(226 cases). Logistic regression analysis showed that age between 70-79 years( OR=0.543, 95% CI: 0.299-0.987), education level( OR=3.644, 95% CI: 1.780-7.461), weekly intellectual activity( OR=2.168, 95% CI: 1.082-4.334)and loneliness( OR=1.101, 95% CI: 1.032-1.175)were factors influencing cognitive frailty in older patients with chronic heart failure. Conclusions:The prevalence of cognitive frailty in older patients with chronic heart failure is high, and age, education level, weekly intellectual activity and loneliness are influencing factors, with education level having the greatest impact on older patients with chronic heart failure.

4.
China Modern Doctor ; (36): 82-85, 2024.
Article in Chinese | WPRIM | ID: wpr-1038228

ABSTRACT

@#Objective To evaluate the effect of sodium-dependent glucose transporters 2(SGLT-2)inhibitors on carotid artery elasticity in patients with diabetes mellitus type 2 by applying the ultrafast pulse wave velocity(UFPWV).Methods A total of 82 patients with diabetes mellitus type 2 admitted to the First Affiliated Hospital of Jinzhou Medical University from January to June 2022 were selected and randomly divided into control group(n=41)and observation group(n=41),and both groups were treated with conventional hypoglycemic therapy,and patients in observation group were combined with the treatment of SGLT-2 inhibitor on the basis of control group,and the patients of both groups were treated for 1 year.Systolic blood pressure(SBP),diastolic blood pressure(DBP),body mass index(BMI),fasting blood glucose(FPG),2-hour postprandial blood glucose(2hPG),glycosylated hemoglobin(HbA1c),carotid intima-media thickness(CIMT),and UFPWV technique was used to measure the common carotid artery pulse wave velocity-beginning of systole(PWV-BS)and pulse wave velocity-end of systole(PWV-ES).Results ①The comparison between SBP,DBP,BMI,FPG,2h PG,HbA1c,CIMT,PWV-BS,PWV-ES indexes of the two groups of patients before treatment,the difference was not significant(P>0.05);② After receiving treatment,SBP,DBP,BMI,FPG,2hPG,HbA1c,CIMT,PWV-BS,PWV-ES of patients in observation group were lower than those of control group before treatment,and the differences were statistically significant(P<0.05);③ FPG,2hPG,HbA1c,SBP,DBP,BMI,CIMT,PWV-BS,PWV-ES indexes of observation group were lower than those of control group after treatment,and the difference was statistically significant(P<0.05).Conclusion UFPWV can effectively assess the value of SGLT-2 inhibitors in improving carotid artery elasticity in patients with diabetes mellitus type 2 with high accuracy and simplicity.

5.
China Pharmacy ; (12): 1320-1326, 2024.
Article in Chinese | WPRIM | ID: wpr-1031707

ABSTRACT

OBJECTIVE To optimize the steaming and processing technology of wine-steamed Taxillus chinensis, and to characterize its quality. METHODS Using the content of avicularin, quercitrin, quercetin and appearance traits as evaluation indicators, the analytic hierarchy process (AHP)-entropy weight method was used to determine the weights of each indicator, and the comprehensive scores of those indicators were used as response values. Box-Behnken response surface method was used to investigate the effects of solid-liquid ratio (g/mL), soaking time, and steaming time on the processing technology of wine-steamed T. chinensis, optimize the best processing technology, and verify it. Fifteen batches of T. chinensis decoction pieces from different origins were used to prepare wine-steamed T. chinensis using the best processing technology, and their qualities were characterized. RESULTS The optimal processing technology for wine-steamed T. chinensis was to take 100 g of T. chinensis decoction pieces, add 20 mL of yellow wine, seal and moisten for 2 h, steam at normal pressure for 1 h, take out and dry at 50 ℃. The surface of wine-steamed T. chinensis prepared by the optimal processing technology was reddish brown or brownish, and its powder was dark brown, with a hard or brittle texture that was easy to break, and had a slight aroma of alcohol, and an astringent taste. Results of microscopic and thin-layer identification for the stem cross-section of wine-steamed T. chinensis were the same as those of raw T. chinensis. The contents of moisture, total ash and acid-insoluble ash were 3.92%-8.75%, 2.27%-5.08%, and 0.19%-0.82%, respectively; the contents of water-soluble extract were 11.28%-18.56%, and the contents of alcohol-soluble extract were 3.36%-8.58%; the contents of avicularin, quercitrin, and quercetin were 0.22-1.64, 0.26-2.45, and 0.01-0.38 mg/g, respectively. CONCLUSIONS This study successfully optimized the processing technology of wine-steamed T. chinensis and preliminarily characterized its quality, which can provide reference for the standardized processing and establishment of quality standards for wine-steamed T. chinensis decoction mail:wyl@sxtcm.edu.cn pieces.

6.
China Pharmacy ; (12): 1320-1326, 2024.
Article in Chinese | WPRIM | ID: wpr-1031729

ABSTRACT

OBJECTIVE To optimize the steaming and processing technology of wine-steamed Taxillus chinensis, and to characterize its quality. METHODS Using the content of avicularin, quercitrin, quercetin and appearance traits as evaluation indicators, the analytic hierarchy process (AHP)-entropy weight method was used to determine the weights of each indicator, and the comprehensive scores of those indicators were used as response values. Box-Behnken response surface method was used to investigate the effects of solid-liquid ratio (g/mL), soaking time, and steaming time on the processing technology of wine-steamed T. chinensis, optimize the best processing technology, and verify it. Fifteen batches of T. chinensis decoction pieces from different origins were used to prepare wine-steamed T. chinensis using the best processing technology, and their qualities were characterized. RESULTS The optimal processing technology for wine-steamed T. chinensis was to take 100 g of T. chinensis decoction pieces, add 20 mL of yellow wine, seal and moisten for 2 h, steam at normal pressure for 1 h, take out and dry at 50 ℃. The surface of wine-steamed T. chinensis prepared by the optimal processing technology was reddish brown or brownish, and its powder was dark brown, with a hard or brittle texture that was easy to break, and had a slight aroma of alcohol, and an astringent taste. Results of microscopic and thin-layer identification for the stem cross-section of wine-steamed T. chinensis were the same as those of raw T. chinensis. The contents of moisture, total ash and acid-insoluble ash were 3.92%-8.75%, 2.27%-5.08%, and 0.19%-0.82%, respectively; the contents of water-soluble extract were 11.28%-18.56%, and the contents of alcohol-soluble extract were 3.36%-8.58%; the contents of avicularin, quercitrin, and quercetin were 0.22-1.64, 0.26-2.45, and 0.01-0.38 mg/g, respectively. CONCLUSIONS This study successfully optimized the processing technology of wine-steamed T. chinensis and preliminarily characterized its quality, which can provide reference for the standardized processing and establishment of quality standards for wine-steamed T. chinensis decoction mail:wyl@sxtcm.edu.cn pieces.

7.
Article in Chinese | WPRIM | ID: wpr-1020575

ABSTRACT

An adult female presented with severe closed overbite,class Ⅱ skeletal and dental malocclusion,low angle and straight face.Helped with the clear aligners,the class Ⅱ dental malocclusion was corrected by maxillary molars distalization,the occlusion of anterior teeth were opened by posterior teeth extention and anterior teeth intrusion,and finally a balanced occlusion and an ideal smile line were obtained.

8.
Article in Chinese | WPRIM | ID: wpr-1018133

ABSTRACT

The ABRACL protein, the regulator of actin and cell motility, belongs to the HSPC280 family, and its conserved hydrophobic groove can interact with other proteins to facilitate actin motility and cellular activity. ABRACL is upregulated in tumor tissues and is closely linked with the proliferation and migration of tumor cells. A deeper understanding of the role of ABRACL in tumorigenesis and development may provide new ideas and insights for ABRACL to prevent or reverse tumor progression.

9.
Article in Chinese | WPRIM | ID: wpr-981776

ABSTRACT

OBJECTIVE@#To explore the genetic basis for a fetus with severe heart defect and mosaic trisomy 12, and the correlation between chromosomal abnormalities and clinical manifestations and pregnancy outcome.@*METHODS@#A 33-year-old pregnant woman who presented at Lianyungang Maternal and Child Health Care Hospital on May 17, 2021 due to abnormal fetal heart development revealed by ultrasonography was selected as the study subject. Clinical data of the fetus were collected. Amniotic fluid sample of the pregnant women was collected and subjected to G-banded chromosomal karyotyping and chromosomal microarray analysis (CMA). The CNKI, WanFang and PubMed databases were searched with key words, with the retrieval period set as from June 1, 1992 to June 1, 2022.@*RESULTS@#For the 33-year-old pregnant woman, ultrasonography at 22+6 gestational weeks had revealed abnormal fetal heart development and ectopic pulmonary vein drainage. G-banded karyotyping showed that the fetus has a karyotype of mos 47,XX,+12[1]/46,XX[73], with the mosaicism rate being 1.35%. CMA results suggested that about 18% of fetal chromosome 12 was trisomic. A newborn was delivered at 39 weeks of gestation. Follow-up confirmed severe congenital heart disease, small head circumference, low-set ears and auricular deformity. The infant had died 3 months later. The database search has retrieved 9 reports. Literature review suggested that the liveborn infants with mosaic trisomy 12 had diverse clinical manifestations depending on the affected organs, which had included congenital heart disease and/or other organs and facial dysmorphisms, resulting in adverse pregnancy outcomes.@*CONCLUSION@#Trisomy 12 mosaicism is an important factor for severe heart defects. The results of ultrasound examination have important value for evaluating the prognosis of the affected fetuses.


Subject(s)
Infant, Newborn , Child , Pregnancy , Female , Humans , Adult , Trisomy/genetics , Amniocentesis/methods , Chromosome Disorders , Mosaicism , Fetus , Heart Defects, Congenital/genetics
10.
Article in Chinese | WPRIM | ID: wpr-981795

ABSTRACT

OBJECTIVE@#To carry out prenatal genetic testing for a fetus with de novo 46,X,der(X)t(X;Y)(q26;q11).@*METHODS@#A pregnant woman who had visited the Birth Health Clinic of Lianyungang Maternal and Child Health Care Hospital on May 22, 2021 was selected as the study subject. Clinical data of the woman was collected. Peripheral blood samples of the woman and her husband and umbilical cord blood of the fetus were collected and subjected to conventional G-banded chromosomal karyotyping analysis. Fetal DNA was also extracted from amniotic fluid sample and subjected to chromosomal microarray analysis (CMA).@*RESULTS@#For the pregnant women, ultrasonography at 25th gestational week had revealed permanent left superior vena cava and mild mitral and tricuspid regurgitation. G-banded karyotyping analysis showed that the pter-q11 segment of the fetal Y chromosome was connected to the Xq26 of the X chromosome, suggesting a Xq-Yq reciprocal translocation. No obvious chromosomal abnormality was found in the pregnant woman and her husband. The CMA results showed that there was approximately 21 Mb loss of heterozygosity at the end of the long arm of the fetal X chromosome [arr [hg19] Xq26.3q28(133912218_154941869)×1], and 42 Mb duplication at the end of the long arm of the Y chromosome [arr [hg19] Yq11.221qter(17405918_59032809)×1]. Combined with the search results of DGV, OMIM, DECIPHER, ClinGen and PubMed databases, and based on the guidelines from the American College of Medical Genetics and Genomics (ACMG), the deletion of arr[hg19] Xq26.3q28(133912218_154941869)×1 region was rated as pathogenic, and the duplication of arr[hg19] Yq11.221qter(17405918_59032809)×1 region was rated as variant of uncertain significance.@*CONCLUSION@#The Xq-Yq reciprocal translocation probably underlay the ultrasonographic anomalies in this fetus, and may lead to premature ovarian insufficiency and developmental delay after birth. Combined G-banded karyotyping analysis and CMA can determine the type and origin of fetal chromosomal structural abnormalities as well as distinguish balanced and unbalanced translocations, which has important reference value for the ongoing pregnancy.


Subject(s)
Humans , Child , Pregnancy , Female , Vena Cava, Superior , In Situ Hybridization, Fluorescence , Chromosome Aberrations , Karyotyping , Translocation, Genetic , Fetus , Prenatal Diagnosis/methods
11.
Article in Chinese | WPRIM | ID: wpr-1020282

ABSTRACT

Objective:To explore the mediating roles of family resilience and perceived social support between fear of progression and quality of life in patients with adult pulmonary hypertension, so as to provide guidance for grassroots medical staff to deeply understand and improve the long-term quality of life of adult pulmonary hypertension patients.Methods:Using a convenience sampling method, 219 adult pulmonary hypertension patients who attended Qilu Hospital, Shandong University from July 2021 to February 2022 were selected for a cross-sectional study using the World Health Organization Quality of Life Questionnaire Abbreviated Version (WHOQOL-BREF), Perceived Social Support Scale (PSSS), Shortened Chinese version of the Family Resilience Assessment Scale (FRAS-C) and Chinese version of Fear of Progression Questionnaire-Short Form (FoP-Q-SF) for investigation. A structural equation model was established to evaluate the mediating effect of family resilience and perceived social support on fear of progression and quality of life.Results:The scores of WHOQOL-BREF, PSSS, FRAS-C, and FoP-Q-SF were (45.85 ± 10.22), 66(56, 75), 94(89, 97) and 39(32, 46) points in adult pulmonary hypertension patients. The total scores of WHOQOL-BREF were negatively correlated with FoP-Q-SF ( r = -0.63, P<0.01), and positively correlated with FRAS-C and PSSS ( r=0.54, 0.46, both P<0.01). Family resilience played a partial mediating role between fear of progression and quality of life, accounting for 13.43% of the total effect. Family resilience and perceived social support played a chain mediating role between fear of progression and quality of life, accounting for 2.71% of the total effect. Conclusions:Family resilience-perceived social support play mediating roles between fear of progression and quality of life, healthcare workers can alleviate fear of progression and improve quality of life by promoting the levels of family resilience and perceived social support of adult pulmonary hypertension parents.

12.
Organ Transplantation ; (6): 585-2023.
Article in Chinese | WPRIM | ID: wpr-978502

ABSTRACT

With gradual maturity of surgical technique of heart transplantation, extensive use of immunosuppressants and the improvement of organ distribution system, the shortage of donor heart has become a bottleneck issue restricting the development of heart transplantation in clinical practice. How to expand the donor pool for heart transplantation remains to be urgently solved. In recent years, with the development of science and technology and the application of new technology, groundbreaking progresses have been made on how to expand the donor pool for heart transplantation within the transplantation community. Multiple research results have been gradually translated into clinical practice, driving the development of heart transplantation in clinical settings. In this article, the latest technologies and strategies to expand the donor pool for heart transplantation were reviewed, the roles of organ preservation technology, use of marginal donor heart, xenotransplantation, artificial heart and bioartificial heart in alleviating the shortage of donor heart were investigated, and existing challenges and future directions to expand the donor pool for heart transplantation were summarized, aiming to provide reference for subsequent development of heart transplantation in clinical practice.

13.
Chinese Journal of Trauma ; (12): 289-298, 2023.
Article in Chinese | WPRIM | ID: wpr-992601

ABSTRACT

Periarticular fracture of the shoulder is a common type of fractures in the elderly. Postoperative adverse events such as internal fixation failure, humeral head ischemic necrosis and upper limb dysfunction occur frequently, which seriously endangers the exercise and health of the elderly. Compared with the fracture with normal bone mass, the osteoporotic periarticular fracture of the shoulder is complicated with slow healing and poor rehabilitation, so the clinical management becomes more difficult. At present, there is no targeted guideline or consensus for this type of fracture in China. In such context, experts from Youth Osteoporosis Group of Chinese Orthopedic Association, Orthopedic Expert Committee of Geriatrics Branch of Chinese Association of Gerontology and Geriatrics, Osteoporosis Group of Youth Committee of Chinese Association of Orthopedic Surgeons and Osteoporosis Committee of Shanghai Association of Chinese Integrative Medicine developed the Chinese expert consensus on the diagnosis and treatment of osteoporotic periarticular fracture of the shoulder in the elderly ( version 2023). Nine recommendations were put forward from the aspects of diagnosis, treatment strategies and rehabilitation of osteoporotic periarticular fracture of the shoulder, hoping to promote the standardized, systematic and personalized diagnosis and treatment concept and improve functional outcomes and quality of life in elderly patients with osteoporotic periarticular fracture of the shoulder.

14.
Chinese Journal of Orthopaedics ; (12): 687-696, 2023.
Article in Chinese | WPRIM | ID: wpr-993492

ABSTRACT

Objective:To investigate the clinical outcomes of minimally invasive lateral lumbar interbody fusion (LLIF) and the necessity to perform LLIF plus posterior direct decompression in the treatment of severe degenerative lumbar spinal stenosis (DLSS).Methods:In this prospective randomized, controlled trial, we assigned 71 patients, who were 50 to 80 years old, and diagnosed with severe DLSS (Schizas Classification grade C on magnetic resonance imaging), in a 1∶1 ratio to undergo either one-stage LLIF plus posterior internal fixation (treatment group) or CLIF plus posterior internal fixation with laminectomy (control group). Demographic and perioperative data were collected and compared. The clinical outcome measures included Oswestry Disability Index (ODI), Zurich Claudication Questionnaire (ZCQ) score as well as visual analogue scale (VAS). Patients were followed up for at least 1 year.Results:The treatment group included 36 patients with 46 surgical levels, while the control group included 35 patients with 46 surgical levels. The baseline demographic data of the 2 groups were equivalent in preoperative central canal areas, spinal canal anteroposterior diameter, disc height, ODI, ZCQ score for symptom severity and physical function, as well as VAS scores for back and leg pain. The mean operative time, blood loss, drainage volume and hospital stay of the treatment group are significantly less than the control group (157.2±29.1 min vs. 180.6±26.8 min, 75.6±39.1 ml vs. 108.6±43.3 ml, 136.9±73.9 ml vs. 220.5±121.3 ml, 5.3±1.1 d vs. 6.6±2.3 d). There were 2 cases with dura tear and 1 case with wound infection in control group. Thus, the surgical trauma and complications of the control group were more than the treatment group. At 1-year follow-up, the mean ODI score of treatment group improved from 42.24%±10.70% preoperatively to 18.21%±11.49%, the mean ZCQ symptom severity from 2.89±0.38 to 1.61±0.41, the mean ZCQ physical function from 2.31±0.45 to 1.50±0.37, the mean VAS for back from 5.56±1.19 to 1.97±1.13 and the mean VAS for leg from 4.44±1.81 to 0.94±1.26. At 1-year follow-up, the mean ODI score of the control group improved from 43.65%±14.93% preoperatively to 17.36%±12.15%, the mean ZCQ symptom severity from 2.92±0.52 to 1.65±0.39, the mean ZCQ physical function from 2.37±0.52 to 1.55±0.39, the mean VAS for back from 5.63±1.40 to 2.34±1.47, and the mean VAS for leg from 4.37±2.14 to 0.83±1.20. The ZCQ satisfactory score of both groups were not significant different (1.25±0.45 vs. 1.26±0.43, t=0.07, P=0.944). The mean improvement rate of both groups for ODI, ZCQ symptom severity, ZCQ physical function, VAS back and VAS leg at 1-year follow-up were not significant different (55.43%±27.74% vs. 58.36%±25.06%, 43.07%±17.22% vs. 42.66%±12.95%, 32.25%±23.65% vs. 31.71%±23.24%, 62.65%±21.25% vs. 58.37%±22.44%, 78.94%±26.41% vs. 85.45%±20.53%). One adjacent segment disease was found in each group at 1 year follow-up. Conclusion:CLIF+ posterior internal fixation in the treatment of Schizas Grade C DLSS has satisfactory clinical outcome at 1-year follow-up. Laminectomy increases surgical trauma, but does not significantly improve the clinical outcome at 1-year follow-up.

15.
Chinese Journal of Orthopaedics ; (12): 1022-1030, 2023.
Article in Chinese | WPRIM | ID: wpr-993535

ABSTRACT

Objective:To assess the early clinical outcomes of Oxford cementless unicompartmental knee arthroplasty (UKA) in the management of anteromedial osteoarthritis of the anterior medial knee (AMOA).Methods:A retrospective review was conducted on a cohort of 90 patients who underwent primary UKA for AMOA at the Fuzhou Second Hospital between January 2020 and June 2021. The patients were divided into two groups based on the type of prosthesis used: the cementless UKA group and the cemented UKA group. The cementless UKA group included 45 patients (22 males and 23 females), with a mean age of 65.6±7.0 years (ranging from 52 to 81 years). The cemented UKA group consisted of 45 patients, including 21 males and 24 females, with a mean age of 67.9±6.1 years (ranging from 55 to 79 years). The study compared various parameters between the two groups, including the duration of surgery, amount of blood loss, length of hospitalization, pain visual analogue scale (VAS) scores, Hospital for Special Surgery (HSS) scores, and forgotten joint score (FJS). Additionally, radiolucency around the prosthesis, medial proximal tibial angle (MPTA), and mechanical axis deviation (MAD) were observed and measured before and after surgery to assess prosthesis stability, improvement of knee deformity, and knee joint mobility, respectively.Results:Both groups were followed up for a minimum of 18 months. No statistically significant differences were found in demographic data such as gender, age, and body mass index between the two groups. The cementless UKA group demonstrated superior results in terms of shorter duration of surgery (97.8±21.1 min) and less blood loss (70.8±37.6 ml) compared to the cemented UKA group ( P<0.05). However, no significant difference in length of stay was observed between the groups. Postoperative VAS scores, HSS scores, MPTA, and MAD were significantly improved compared to preoperative values in both groups ( P<0.05). The median VAS scores for the cementless UKA group at 6, 12, and 18 months postoperatively were 4.0(3.0, 5.0), 2.0(2.0, 3.0), and 2.0(1.0, 3.0) respectively. The corresponding median HSS scores for the cemented UKA group were 78(75, 82), 85 (80, 89), and 86(82, 90) preoperatively and at 6, 12, and 18 months postoperatively, respectively. The median FJS scores for the cementless UKA group were 73.0(70.5, 76.0), 76.0(74.0, 78.0), and 66.0(63.0, 68.0) preoperatively and at 6, 12, and 18 months postoperatively, respectively. There was no statistically significant relationship between preoperative VAS scores and preoperative FJS scores ( P>0.05). However, there was a significant difference in VAS scores between the two groups at 6 months postoperatively ( P<0.05). The cementless UKA group consistently exhibited better VAS scores and HSS scores compared to the cemented UKA group at 6, 12, and 18 months postoperatively ( P<0.05). The median MPTA values for the cementless UKA group were 85.41°(84.22°, 86.54°), 85.80°(84.74°, 87.41°), 86.51°(85.47°, 88.14°), and 86.80°(86.09°, 88.27°) preoperatively and at 6, 12, and 18 months postoperatively, respectively. The median MAD values for the cementless UKA group were 2.29(1.79, 2.65) cm, 1.11(0.69, 1.75) cm, 1.02(0.65, 1.66) cm, and 0.91(0.61, 1.63) cm preoperatively and at 6, 12, and 18 months postoperatively, respectively. There were no significant differences in MPTA and MAD between the two groups at all time points, except for the preoperative MPTA and postoperative MAD at 6 and 12 months. The incidence of physiological radiolucency around the prosthesis was significantly lower in the cementless UKA group 3 than in the cemented UKA group 28 ( P<0.05). However, no complete radiolucency was observed in either group. Conclusion:Oxford cementless UKA is a highly effective treatment for relieving joint pain and correcting knee deformity in patients with knee AMOA. It offers the advantages of shorter surgical duration, reduced blood loss, and improved subjective outcomes for patients after the operation.

16.
Article in Chinese | WPRIM | ID: wpr-991268

ABSTRACT

Through the comparison of the residency training system between China and the United States in pre-training educational background, training policy and post-training career path, it is concluded that the cardiothoracic surgery residency training in the United States has a high admission threshold, long training cycle and high education cost, but it also has the advantages of professional management, outstanding specialty characteristics and perfect evaluation system, which are suitable for the training of cardiothoracic surgeons. However, the current residency training of cardiothoracic surgery in China needs to be further improved. Learning from the advantages of the United States residency training system, we can formulate a more reasonable and professional residency training program according to Chinese own characteristics, so as to train excellent cardiothoracic surgeons for our country.

17.
Article in Chinese | WPRIM | ID: wpr-932802

ABSTRACT

Objective:To investigate the influence of different degrees of facet joint arthropathy on the indirect decompression effect of crenel lumbar interbody fusion (CLIF), and the clinical outcomes of CLIF for the treatment of lumbar spinal stenosis with severe facet joint arthropathy (grade 3).Methods:This study reviewed a total of 269 surgical segments in 156 patients with lumbar spinal stenosis treated with CLIF technique from November 2016 to February 2020. According to preoperative CT images, the facet joint was graded according to Pathria classification. There are 19 segments with grade 0, 156 segments with grade 1, 67 segments with grade 2, and 27 segments with grade 3. Radiographic parameters included disc angle, anterior and posterior disc height, and bilateral intervertebral foramen height on CT, and the midsagittal canal diameter and axial central canal area. In 30 patients with at least one segment of grade 3, the clinical efficacy was assessed using visual analogue scale (VAS) and Oswestry disability index (ODI).Results:The average the anterior and posterior intervertebral space height, intervertebral space angle, height of bilateral intervertebral foramina, spinal canal sagittal diameter and spinal canal area were significantly improved after the operation of grade 3 facet joint degeneration segment compared to preoperation. The preoperative mean spinal canal sagittal diameter and spinal canal area of grade 3 facet joint degeneration segment were significantly less than grade 1 and grade 2. The average change of spinal canal area after grade 3 articular degeneration was significantly less than that of grade 1 and 2, but there was no significant difference with that of grade 0. The posterior decompression rate was 55.56% (15/27) for grade 3, 35.82% (24/67) for grade 2, 16.03% (25/156) for grade 1, and 21.05% (4/19) for grade 0. The posterior decompression rate of grade 3 articular process degeneration was significantly higher than that of other grades ( P<0.001). Severe lateral recess stenosis and 24.24% of severe intervertebral foraminal stenosis were found in 81.48% of grade 3 degenerative segment. The 23 patients were followed up with an average of 21.62±6.52 months, and the average improvement of ODI was 24.10%±11.09%; the average VAS for leg pain and back pain were improved significantly. Conclusion:The degrees of facet joint degeneration do not prevent intervertebral space distraction of CLIF. However, because segments with severe facet joint arthropathy were usually associated with severe spinal canal stenosis, CLIF had a high rate of second-stage posterior decompression in the treatment of lumbar spinal stenosis with severe facet joint arthropathy.

18.
Article in Chinese | WPRIM | ID: wpr-939979

ABSTRACT

ObjectiveTo explore the effect of kinematic alignment on postoperative knee function for patients after total knee arthroplasty (TKA). MethodsFrom June, 2020 to October, 2021, 200 patients undergoing primary TKA in Beijing Chaoyang Hospital were divided into mechanical alignment (MA) group (n = 100) and kinematic alignment (KA) group (n = 100). All the patients accepted comprehensive rehabilitation after operation. They were assessed with Keen Society Score (KSS) before and three months after operation, with Visual Analogue Scale for pain (VAS) before, and three days and three months after operation. The time of first standing, the time of first straight-leg raising more than 30°, and the active range of motion (AROM) of knee before, and one, two and three days, and one and three months after operation were recorded, as well as where to go after discharge. ResultsA total of 96 patients in MA group and 98 in KA group finished the research. The AROM of knee improved more in the KA group than in the MA group after operation (Fgroup = 8.816, P = 0.017), and the incidence going to the rehabilitation institutes was less (χ2 = 6.542, P = 0.011). ConclusionKA may promote the rapid recovery of AROM of knee for patients after TKA, and reduce the needs of institute-based rehabilitation after discharge, to save medical costs.

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Article in Chinese | WPRIM | ID: wpr-933343

ABSTRACT

Objective:To evaluate the effect of hydrogen-rich saline (HRS) on mitochondrial biogenesis and dynamics in hippocampus of mice with sepsis-associated encephalopathy (SAE).Methods:One hundred and twenty-eight male C57BL/6J mice, aged 6-8 weeks, weighing 20-25 g, were divided into 4 groups ( n=32 each) using a random number table method: sham operation group (Sham group), sham operation plus HRS group (Sham+ HRS group), SAE group and SAE plus HRS group.Sepsis was developed by cecal ligation and puncture (CLP) in anesthetized mice.HRS 10 ml/kg was intraperitoneally injected at 1 and 6 h after CLP in Sham+ HRS and SAE+ HRS groups.Twenty mice were randomly selected from each group to record the 7-day survival after operation.The working memory of the mice was observed by Y-maze test on days 3, 5 and 7 after CLP.The hippocampal tissues were obtained at 24 h after CLP for determination of the content of tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6) and high-mobility group box 1 protein (HMGB1) (by enzyme-linked immunosorbent assay), activities of superoxide dismutase (SOD) and catalase (CAT) (by spectrophotometry), and expression of peroxisome proliferator-activated receptor gamma coactivator 1α (PGC-1α), nuclear respiratory factor 2 (NRF2), mitochondrial transcription factor A (Tfam), dynamin-related protein 1 (Drp1) and mitochondrial fusion protein mitofusin 2 (Mfn2) (by Western blot). Results:Compared with group Sham, the postoperative 7-day survival rate was significantly decreased, the time spent in novel arm was shortened, the contents of TNF-α, IL-6 and HMGB1 were increased, the activities of SOD and CAT were decreased, the expression of PGC-1α, NRF2 and Tfam was up-regulated, the expression of Drp1 was up-regulated, and the expression of Mfn2 was down-regulated in group SAE ( P<0.05). Compared with group SAE, the postoperative 7-day survival rate was significantly increased, the time spent in novel arm was prolonged, the contents of TNF-α, IL-6 and HMGB1 were decreased, the activities of SOD and CAT were increased, the expression of PGC-1α, NRF2 and Tfam was up-regulated, the expression of Drp1 was down-regulated, and the expression of Mfn2 was up-regulated in group SAE+ HRS ( P<0.05). Conclusions:The mechanism by which HRS alleviates SAE may be related to promotion of mitochondrial biogenesis, regulation of dynamics, and reduction of oxidative stress in hippocampus of mice.

20.
Zhonghua Nei Ke Za Zhi ; (12): 603-606, 2022.
Article in Chinese | WPRIM | ID: wpr-933472

ABSTRACT

A young male patient with abdominal pain and fever was diagnosed as acute hyper-triglyceridemicpancreatitis is clear. During the recovery of pancreatitis, the patient developed acute acalculous cholecystitis, as well as carbapenem-resistant Enterobacter infection and Cytomegaloviremia, and had anaphylaxis for several times after the use of antibiotics, which cannot be completely explained by drug allergy. This paper analyzes the possible causes of multiple diseases in the same patient in detail.

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