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BACKGROUND: With the prevalence of total knee arthroplasty, periprosthetic joint infection as a serious complication has been an issue of concern.OBJECTIVE: To summarize the advances in the diagnosis and treatment of infection after total knee arthroplasty.METHODS: The first author searched the PubMed and CNKI databases for the literatures related to the diagnosis and treatment of infection after total knee arthroplasty using the keywords of total knee arthroplasty,infection in English and Chinese, respectively. The repetitive articles were excluded, and the risk factors,diagnosis, classification and treatment of infection after total knee arthroplasty were summarized.RESULTS AND CONCLUSION: (1) The infection after artificial knee replacement is closely related to the patient's preoperative condition, operation skills and postoperative status. (2) Diagnosis of infection is based on the detailed understanding of the patients' situation and complete auxiliary examinations. (3) The treatment methods include antibiotics, debridement and retention, reversion, arthrodesis, as well as amputation. (4) Periprosthetic infection is a serious complication after total knee arthroplasty, and early diagnosis and treatment are critical. Furthermore,choosing an appropriate individualized treatment scheme for different patients is important.
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Objective To investigate and analyze the clinical application of washed red blood cells in Quzhou in 2014-2015 years,and to provide evidence for the rational and effective use of washed red blood cells in clinical practice.Methods the amount of washed red blood cells,the distribution of diseases and the serological detection before transfusion were analyzed retrospectively in 8 hospitals of grade two and over in Quzhou during the past 2014-2015 years.Results the amount of washed red blood cells in 2015 increased by 39.07％ compared with 2014,an increase of 24.4 times the amount of red blood cells increase,increase mainly in 3 hospitals;Diseases of the blood system,malignant tumors and chronic kidney disease is the main diagnosis of transfusion cases,accounted for 63.49％,19.05％,12.70％.There were different standards for the development of serological testing items before transfusion Conclusion the advantages of washed red blood ceils gradually recognized by clinicians,but also don't rely on experience,hospitals should pay attention to the comprehensive evaluation of clinical blood transfusion and standardize the serological detection of blood transfusion department,which is the key to improve the cost performance of this component.
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Objective To standardize the job training and improve the basic professional quality and induction ability of practitioners in Blood Services by setting up job training assessment standardized model.Methods Using the standardize model to carry out the application of standardized model of job training assessment for the practitioners in Blood Services.July 2016-June 2017,focusing on the standardize training materials and training standards to carry out the centralized training,establishing a unified teacher library of the province and the centralized training will be taught by those teachers,evaluating result by standardize theoretical test and the conformity standard,then evaluating and supervising the assessment results.Results 356 practitioners participated in centralized training,379 practitioners participated in the theoretical test,and 339 practitioners were qualified of the actual operation during these two years.The total qualified rate is 89.4％.There was no significant difference in the qualified rate between two years (P＞0.05).Among them,the qualified rate of category Ⅰ personnel was 85.1％,category Ⅱ personnel was 98.7％,category Ⅲ personnel was 94.8％,and the qualified rate of category Ⅱand Ⅲ was higher than that of category Ⅰ (P＜0.05).Conclusion Through the application of the standardized model to promote the standardization of education and training resource standard,and carry on standardized training evaluation as well as strictly grasp the examination and evaluation standards,it will be conducive to improving the quality of education and training,will also be conducive to improving the professional quality of employees and supply institutions.
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Objective To discuss the effect of quick freezer equipment and quick freezing time on the preparation of cryoprecipitate.Methods The cryoprecipitate,already prepared,was placed into the MBF21 freezer and minus 30℃ SANYO refrigerator for 30-minute and 50-minute storage.The activity of coagulation factor VⅧ,and the content of fibrinogen in different equipment were detected by automatic coagulation analyzer,in order to make sure whether it met the quality requirements.Results The content of fibrinogen in the cryoprecipitates from both of the equipment after 30-minute storage met the requirement,with the qualification rate of 100％.As to the activity determination of coagulation FⅧ,low temperature refrigerator showed a qualification rate of 62.5％,which was significantly lower than that of quick freezer with a qualification rate of 97.5％ (P＜0.01).The cryoprecipitates from both of the equipment after 50-minute storage,with part of fibrin precipitation,had a qualification rate of fibrinogen content lower than 50％ (P＞0.05).The qualification rate of quick freezer and low temperature refrigerator was 35％ and 12.5％,respectively,with significant difference.Conclusion Quick freezer can make the cryoprecipitate quick-frozen,which can ensure the quality.The coagulation factor VⅧ is unstable,whose activity decreased with the increase of temperature.We should try our best to shorten the time off the cold chain.
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BACKGROUND:Unicompartmental knee arthroplasty has become mainstream operation for treatment of unicompartmental osteoarthritis of the knee, but unicompartmental knee arthroplastystil has some problems, such as excessive bleeding-induced postoperative blood transfusion, increased blood transfusion rate, hospitalization expense and complication of blood transfusion. As tranexamic acid for total knee arthroplasty has achieved good effects. It is significant to investigate whether local application of tranexamic acid can effectively reduce blood loss in unicompartmental arthroplasty. OBJECTIVE:To investigate the efficacy and safety of the intra-articular tranexamic acid injection in treating perioperative blood loss in patients undergoing unicompartmental knee arthroplasty. METHODS:122 patients with knee osteoarthritis undergoing unicompartmental knee arthroplastyinthe Department of Orthopedics, the Second Affiliated Hospital ofDalian Medical University from January 2014 to August 2015wereenroled in this study. Al patients were randomly divided into two groups. Patients in the tranexamic acid group were injected with 10 mL of tranexamic acid (containing 1000 mg) + 10 mL of sodium chloride injection in the articular cavity before loosening the tourniquet. Patients in the control group received 20 mL of sodium chloride injection in the articular cavity. In both groups, the drainage tube was clipped for 3 hours after injection.At 48 hours after replacement, the drainage tube was puled out. We compared and analyzed hemoglobin levels and hematocrit at 2 days and 1 month postoperatively, total blood loss and drainage volume at 2 days postoperatively, the number of patients receiving blood transfusion, Hospital for Special Surgery scores of knee function at 1 week and 1 month postoperatively, and thrombosis at 1 week postoperatively, and evaluated effects of tranexamic acid on blood loss after unicompartmental knee arthroplasty. RESULTS AND CONCLUSION:(1) Hemoglobin levels and hematocrit were significantly higher in the tranexamic acid group than in the control group at 2 days postoperatively (P 0.05). (2) Drainage volume and total blood loss were significantly less in the tranexamic acid group than in the control group at 2 days postoperatively (P< 0.05). (3) The number of patients receiving blood transfusion was significantly less in the tranexamic acid group (0 case) than in the control group (6 cases) (P< 0.05). (4) Scores of Hospital for Special Surgery were significantly higher in the tranexamic acid group than in the control group at 1 week postoperatively (P< 0.05). No significant difference in above socres was identified between the two groups at 1 month postoperatively. (5) No venous thrombosis was found at 1 week postoperatively in both groups. (6) These results confirm that during knee medial unicompartmental arthroplasty, intra-articular injection of tranexamic acid combined with 3 hours of blood occlusion can effectively reduce drainage volume, perioperative blood loss, blood transfusion, is beneficial to the early recovery of knee jointfunction after replacement, and does not increase the risk of lower extremity deep venous thrombosis.
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Objective:To observe the effect of NGF on the expression of BMP-2 in rabbit model and explore the molecular mechanism of NGF which might promote the healing of mandibular fracture with nerve injury. Method:The 48 New-Zealand white rabbits were randomly divided into the experimental group (mandibular fracture+to cut off the nerve bundle+NGF by GS), the control group (mandibular fracture+to cut off the nerve bundle+NS by GS), the blank group (mandibular fracture+to cut off the nerve bundle) and the full-set group (mandibular fracture+retains the nerve bundle). After 2 weeks, 4 weeks, 6 weeks and 8 weeks, 3 rabbits were sacrificed in each group for HE staining and RT-PCR, respectively. Result:HE staining showed the osteogenesis phenomenon: the experimental group was clearer than control group, the full-set group was clearer than the blank group and the control group is similarly to the blank group. RT-PCR results revealed that there was a statistically significance in the early stage. The expression of BMP-2 peaked in 2 weeks and decreased later with time. Conclusion:The local application of NGF can prompt BMP-2 expression in the early stages of the mandibular fracture with partial nerve injury healing and this may be one of the molecular mechanisms.
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<p><b>OBJECTIVE</b>To evaluate the clinical value of three-dimensional pseudo-continuous arterial spin labeling (3D pCASL) perfusion magnetic resonance imaging (MRI) and dynamic susceptibility contrast (DSC) enhanced perfusion MRI in the diagnosis of transient ischemic attack (TIA).</p><p><b>METHODS</b>Thirty-nine consecutive patients with suspected TIA underwent multi-modal MRI scans including DSC, magnetic resonance angiography (MRA), diffusion-weighted imaging (DWI) and 3D pCASL (post-labeling delay, PLD=1.5 s and 2.5 s) within 24 h of symptom onset. Cerebral blood flow (CBF) from ASL and the time to the maximum of tissue residual function (Tmax) map from DSC were calculated using AW workstation. DWI and MRA were applied to detect acute cerebral infarction and intracranial artery stenosis. Two neuroradilogists who were blinded to the patients' clinical data assessed the presence of perfusion deficit, ischemic lesion and the lesion sites both from 1.5 s, 2.5 s PLD ASL-CBF and DSC-Tmax independently, and then graded them. The differences in the ranking grades between 1.5 s, 2.5 s PLD ASL and DSC were analyzed, and the frequency of lesion detection was compared between ASL-CBF, Tmax and MRA combining DWI method.</p><p><b>RESULTS</b>No significant differences was found in hypoperfusion grades detected by 3D pCASL (including PLD1.5 s and 2.5 s) CBF and Tmax maps, while significant differences were detected between 1.5 s PLD ASL-CBF and MRA combining DWI method; ASL with PLD 1.5 s CBF detected ischemic lesions and lesion site significantly more frequently than MRA combining DWI method.</p><p><b>CONCLUSION</b>s Three dimensional pCASL is a non-invasive perfusion method free of radiation exposure, and short PLD ASL is more sensitive than long PLD ASL for detecting ischemic lesions and lesion sites.</p>
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Humanos , Arterias , Encéfalo , Infarto Encefálico , Diagnóstico , Isquemia Encefálica , Diagnóstico , Circulación Cerebrovascular , Imagen de Difusión por Resonancia Magnética , Angiografía por Resonancia Magnética , Perfusión , Imagen de Perfusión , Marcadores de SpinRESUMEN
<p><b>OBJECTIVE</b>To study the effect of perioperative immunomodulatory therapy on postoperative recurrence of rectal cancer.</p><p><b>METHODS</b>This prospective study was conducted among 238 rectal/anal cancer patients undergoing intersphincteric resection at our center between January, 2010 and January, 2011, among whom 150 were eligible to be included and completed the study. The 150 patients were randomized in a double-blinded fashion into 3 equal groups to receive immunomodulatory therapy with 8 mg/kg celecoxib (group A), 0.4 mg/kg Sou-Medrol (group B), or placebo (group C), given daily from 5 days before surgery to 5 days after surgery, and the postoperative cancer recurrence were compared.</p><p><b>RESULTS</b>At 3 days after the operation, the 3 groups showed significantly different C-reactive protein (CRP) levels, which decreased obviously in all the 3 groups compared with those at 1 day following the operation (P=0.022), especially in group B. The levels of interleukin-6 (IL-6) at 3 days after the operation also differed significantly between the 3 groups but were lower in all the 3 groups than those at 1 day after the operation (P=0.046), and this reduction was the most obvious in group A. COX-2 expression differed significantly between the 3 groups (P=0.017), among which group A showed the most obvious suppression of COX-2 expression. During the follow-up for a mean of 45 months, no significant difference in the recurrence rate was found between the 3 groups (P=0.549).</p><p><b>CONCLUSION</b>With a lower efficacy than Sou-Medrol in decreasing postoperative inflammation, celecoxib produces a better effect in inhibiting COX-2 expression, but it does not lower postoperative recurrence rate of rectal cancer.</p>
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Humanos , Proteína C-Reactiva , Metabolismo , Celecoxib , Inhibidores de la Ciclooxigenasa 2 , Usos Terapéuticos , Inmunomodulación , Inflamación , Interleucina-6 , Sangre , Recurrencia Local de Neoplasia , Periodo Posoperatorio , Estudios Prospectivos , Pirazoles , Usos Terapéuticos , Neoplasias del Recto , Cirugía General , Terapéutica , Sulfonamidas , Usos TerapéuticosRESUMEN
Objective To investigate the therapeutic effect of ginkgo-damole combined with prostaglandin E1 and explore its influences on clinical evaluation and hemorheology paramaters in treatment of diabetic patients with peripheral arterial disease(PAD). Methods 64 patients were randomly divided into two groups: the therapeutic group was given conventional therapy adding ginkgo-damole combined with prostaglandin E1, while the control group was given ginkgo-damole only. To compare ankle-brachial index(ABI) and hemorheology changes before and after the use of ginkgo-damole combined with prostaglandin E1 in diabetic patients with PAD. Result The total effective rate was 91.2% in therapeutic group, and the significant efficiency in therapeutic group was higher than that in control group ( 67.6% vs 36.7% ) ( P ＜ 0. 05 ). Compared with before the treatment , ABI increased significantly and hemorheological parameters improved significantly in two groups after the treatment( P ＜ 0. 05 or P ＜ 0. 01 ), and the difference were more significant in therapeutic group than in control group( P ＜ 0. 05 or P ＜ 0. 01 ). Conclusion Ginkgo-damole combined with prostaglandin E1 was effective and safe in treatment of diabetic patients with PAD.
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<p><b>OBJECTIVE</b>To determine the clinical value of C-reactive protein(CRP), fibrinogen (FIB), or serum amyloid A protein (SAA) combined with 64 multi-slice computed tomography (MSCT) for preoperative staging and operative strategy in colon cancer.</p><p><b>METHODS</b>Patients with colon cancer were prospectively enrolled at the West China Hospital of Sichuan University from November 2007 to July 2009,and were equally randomized into 3 groups undergoing different preoperative evaluation: MSCT combined with CRP(CRP group), MSCT combined with FIB (FIB group), and MSCT combined with SAA (SAA group). The agreement between preoperative staging and postoperative pathologic staging and that between expected surgical procedure and procedure adopted were compared.</p><p><b>RESULTS</b>Baseline characteristics among three groups were similar(P>0.05). In CRP group, the accuracies of preoperative staging T, N, M and TNM were 65.7%, 72.4%, 100% and 66.7%, respectively. In FIB group, the accuracies of preoperative staging T, N, M and TNM were 71.4%, 74.3%, 99.0% and 65.7%, respectively. In SAA group, the accuracies of preoperative staging T, N, M and TNM were 60.0%, 55.2%, 96.2%and 51.4%, respectively. The accuracies of N and TNM staging in CRP group and FIB group were significantly higher than those in SAA group(P<0.05). However, there were no significant differences between FIB and CRP group(P>0.05). There were no significant differences in accuracy of predicting surgical procedures among three groups(93.3%, 92.3% and 87.6%, P>0.05).</p><p><b>CONCLUSION</b>Combined assessment of MSCT and CRP or FIB may improve the accuracy of preoperative staging and procedure prediction, and is superior to MSCT combined with SAA.</p>
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Femenino , Humanos , Masculino , Persona de Mediana Edad , Proteína C-Reactiva , Metabolismo , Neoplasias del Colon , Sangre , Diagnóstico , Patología , Fibrinógeno , Metabolismo , Inflamación , Estadificación de Neoplasias , Proteína Amiloide A Sérica , Metabolismo , Tomografía Computarizada EspiralRESUMEN
<p><b>OBJECTIVE</b>To investigate the infection of HEV in Quzhou area of Zhejiang Province.</p><p><b>METHODS</b>All sera from blood donors in the central blood bank of Quzhou from April 2006 to April 2007 were used. Anti-HEV IgG and anti-HEV IgM were measured by EIA. RT-PCR was also performed to the samples with positive anti-HEV IgM. Genotype and sequence homology were analyzed after sequencing.</p><p><b>RESULTS</b>The positive ratio of anti-HEV IgG was 40.60%, in which the male infection ratio was higher than the female significantly (43.09% VS 36.09%; chi2=22.6; P < 0.01). The infection ratio was increased with age. The positive ratio of anti-HEV IgM was 0.43%. The positive ratio of anti-HEV IgG and the titers of antibody were higher in the inferior clinical infectors with positive anti-HEV IgM than the negative ones (P < 0.05). Two samples were positive in HEV PCR among 21 samples with positive anti-HEV IgM. The toxemia ratio was 0.4% of all the donors. And the genotype of the two samples with toxemia were both HEV-IV.</p><p><b>CONCLUSION</b>The HEV infection was correlation with age and sex significantly and the infection occurred in the adults mainly in Quzhou area. HEV toxemia was not infrequency in the blood donors.</p>
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Adolescente , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Factores de Edad , Anticuerpos Antivirales , Alergia e Inmunología , Donantes de Sangre , China , Epidemiología , Genotipo , Hepatitis E , Epidemiología , Alergia e Inmunología , Virología , Virus de la Hepatitis E , Genética , Alergia e Inmunología , Inmunoglobulina G , Alergia e Inmunología , Inmunoglobulina M , Alergia e Inmunología , Análisis de Secuencia de ADN , Homología de Secuencia , Factores Sexuales , Toxemia , Epidemiología , VirologíaRESUMEN
Objective To design and implement the implantable part of cochlear implants, i.e. multi-channel implantable neural stimulator. Methods Based on programmable logic device (PLD), the design of hardware circuit utilized hardware description language through PDM decoding and ETC controlling precept. Results The multi-channel implantable neural stimulator could provide as more as eight outputs of the channel, and the resolution of the outputs were high. Conclusion The miniature stimulator which is portable and efficient, contains perfect error correcting system, and the stimulating waveforms produced by the stimulator accord with the charge balance, current limit and charge limit.
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Objective To design a circuitry for the indication of the remaining capacity of battery.The circuitry can remind the user of charging in time for normal operation of instruments and prevention of early invalidation due to the over-discharge of battery.Methods The circuitry was designed totally based on hardware which used general electronic components.Results The circuitry functions was dependable and reliable with accurate indication in radar based non-contact life detecting devices.Conclusion The whole design is simple and needs no programming technology.The PCB is small,and the debugging is simple.Moreover,it can be applied to indication of various capacity and voltage.