Résumé
Objective To compare predictive power for deep vein thrombosis among hip and knee joint replacement patients using Autar scale and Wells scale.Methods Convenience sampling method was used.Totally 331 patients from ten tertiary hospitals receiving hip and knee joint replacement were recruited.General information questionnaire,Autar scale and Wells scale were used to collect data.Telephone follow-up was performed at 2 weeks,1 month and 3 months after hospital discharge.The primary endpoint of follow-up was occurrence of DVT,and the secondary endpoint was no occurrence of DVT within 3 months after hospital discharge.Results The Cronbach's α coefficients of Autar scale ranged from 0.716 to 0.762 for scores 24h before operation,24h after operation and at the day of discharge,and those of Wells scale ranged from 0.580 to 0.603.The area under the ROC curve of Autar scale ranged from 0.726 to 0.798.The area under the ROC curve of Wells scale ranged from 0.568 to 0.628.Conclusion The predictive power of Autar scale was higher than that of Wells scale which enabled Autar scale to better predict deep vein thrombosis for patients receiving hip and knee joint replacement.
Résumé
Objective To study the effect of fast tract surgery (FTS) used in patients undergoing total knee arthroplasty (TKA). Methods For the experimental group, 341 inpatients with TKA in the Joint Surgery Department of Shandong Provincial Hospital from June 2014 to June 2015 were treated with FTS nursing measures. For the control group, 355 inpatients with TKA of the same department from January 2013 to May 2014 were treated with conventional nursing measures. The effects of FTS nursing measures, the parameters of patients′ postoperative complications, average hospitalization days and the function recovery of knee joint were evaluated respectively. Results After implementing the FTS nursing measures , the incidence of deep venous thrombosis of lower limbs reduced from 8.45%(30/355) to 2.35%(8/341) (χ2=2.340, P<0.05). The average hospitalization days treated without/with FTS nursing measures were:unilateral knee (14.49±3.62) days (without FTS) vs. (11.95±4.53) days (with FTS), bilateral knees (15.80± 3.01) days (without FTS) vs. (13.19±4.08) days (with FTS)(t=3.166, P<0.05). Two weeks after surgery, the HSS scores in the experimental group was 65.72 ± 5.54, while the HSS scores in the control group was 52.43 ± 7.32 (t=2.452, P < 0.05). Three months after surgery, the HSS scores in the experimental group was 88.72 ± 7.10, while the HSS scores in the control group was 72.14 ± 8.73 (t=2.528, P < 0.05). Conclusions FTS nursing measures could significantly reduce the incidence of deep venous thrombosis of lower limbs, shorten the hospitalization days of inpatients, and promote the functional recovery of knees.
Résumé
Objective To evaluate the effect of early exercise intervention on deep venous thrombosis (DVT) after joint replacement.Methods 100 patients with joint replacement were divided into observation group including 50 cases and control group including 50 cases by random number table method.Early exercise intervention was used in observation group and usual nursing was used in control group.The hemodynamic index (femoral vein blood flow peak velocity and average velocity) and DVT incidence were compared between the two groups.Results After the intervention for 3 days,the femoral vein blood flow peak velocity and average velocity of observation group respectively were (43.5±4.1) cm/s and (27.3±3.2) cm/s,those of control group respectively were(36.6±3.7) cm/s and (20.2±2.8) cm/s.The difference between the two groups was statistically significant (t=2.987,2.895,P ＜ 0.05).After the intervention for 7 days,the femoral vein blood flow peak velocity and average velocity of observation group respectively were (56.1±4.7) cm/s and (32.1±3.9) cm/s,those of control group respectively were (41.3±3.9) cm/s and (22.4±4.3) cm/s.The femoral vein blood flow peak velocity and average velocity of observation group significantly higher than control group(t=3.675,2.929,P ＜ 0.05).The DVT incidence of control group and observation group respectively were 40.0％(20/50) and 14.0％(7/50),showed significant differences between the two groups(x2=8.574,P=0.003).Conclusions Using the early exercise intervention on patients with joint replacement can effectively improve the lower limb venous blood flow velocity and prevent DVT.
Résumé
ObjectiveTo study the epidemiological characteristics of diabetes mellitus and awareness rate in Zhejiang adults.MethodA total of 17 437 adults from 15 counties were randomly selected with stratified multi-stage cluster sampling method from July to November,2010.Each participant was required to complete a set of standardized questionnaire,physical examination,and blood specimen collection.ResultsThe overall standardized rate of diabetes mellitus was 5.94％ ( crude prevalence 8.80％ ).It was increased by 96.67％ during past 8 years,as compared with the prevalence 3.02％ in 2002.The standardized rate of diabetes mellitus of the urban and rural area were 7.52％ and 5.19％ ( crude prevalence 11.33％ and 7.09％ ),respectively.The standardized rate of diabetes mellitus in the urban was higher than rural ( u =6.58,P＜0.05 ).The standardized rate of diabetes mellitus of the male and the female were 5.74％ and 6.15％ ( crude prevalence 8.36％ and 9.13％ ),respectively,without significant difference ( u =1.39,P＞0.05 ).The awareness rate of diabetes mellitus was 59.19％ ( 56.66％ in male and 61.23 ％ in female,x2 =3.26,P＞0.05 ).The awareness rate of the urban was higher than the rural (63.47％ vs 54.69％,x2=12.20,P＜0.01 ).ConclusionThe prevalence of diabetes mellitus showed a rapidly rising trend in Zhejiang province.The effective intervention should be taken at its early stage.
Résumé
Objective To observe the change of liver sinusoid in BALB/c mice infected with Schistosoma japonicum and explore its relationship between the degree of hepatic fibrosis and liver function. Methods A model was established in BALB/c mice infected with cercariae of Schistosoma japonicum. The liver specimens of mice were used for pathological examination with routine and picric acid-sirius red staining to know the degree of hepatic fibrosis by semi-quantity. The expressions of C-IV and vWF in liver sinusoid were assayed through the immuhistochemistry staining. The serum ALT and AST were detected by the automatic biochemistry analyzer, and the ultramicrostructure of the liver tissue was observed by a transmission electron microscope. Results The number and diameter of fenestrations in SEC reduced 4 weeks after the infection. The fenestrations were disappeared and the base membrane established 8 weeks after the infection. The expressions of C-IV and vWF in liver sinusoid and the degree of hepatic fibrosis increased with the time after infection. The levels of serum ALT and AST were not correlated with the infection time. Conclusions The phenotype alteration of the hepatic sinusoidal endothelium may be a vital issue triggering the liver fibrosis induced by Schistosoma japoncium.