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BACKGROUND:Thromboelastography plays an important role in identifying the hypercoagulable state of blood and thrombosis in humans.Recent studies have shown a correlation between an increase in mean platelet volume and thrombosis.We can therefore ask whether the combined diagnosis of thromboelastography and mean platelet volume is a more accurate predictor of thrombosis. OBJECTIVE:To predict the status of blood and the occurrence of thrombosis after total knee arthroplasty by means of mean platelet volume combined with thromboelastography. METHODS:One hundred and twenty patients who underwent unilateral total knee arthroplasty between May 2015 and March 2022 were collected.Patients were divided into 60 patients in the thrombosis group and 60 patients in the control group based on ultrasound findings on postoperative day 7.Whole blood cell and thromboelastography were performed 1 day before,1 and 7 days after surgery,respectively.Multifactorial analysis was used to investigate independent predictors of thrombosis after total knee arthroplasty.The receiver operating characteristic curve and area under the curve were measured in the subjects. RESULTS AND CONCLUSION:Mean platelet volume correlated most strongly with maximum amplitude,followed by coagulation angle.Mean platelet volume and coagulation angle on postoperative day 1 were independent predictors of thrombosis.Mean platelet volume tended to rise and then fall in patients with thrombosis.The best critical value for mean platelet volume to predict thrombosis was 10.73 fL.The area under the receiver operating characteristic curve of subjects was 0.665(95%CI:0.568-0.762,P<0.05];whereas the area under the receiver operating characteristic curve for subjects using mean platelet volume combined with coagulation angle was 0.815(95%CI:0.750-0.879,P<0.05).In addition,the maximum amplitude,coagulation angle,coagulation index and mean platelet volume were significantly higher in the thrombosis group than in the control group postoperatively(P<0.05).The results suggest that the mean platelet volume can reflect the hypercoagulable state of blood after surgery,and the combination of mean platelet volume and coagulation angle on day 1 after total knee arthroplasty can improve the prediction of thrombosis.
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BACKGROUND:Previous studies on the effects of valgus and varus angles of tibial component on short-term postoperative outcomes after mobile bearing unicompartmental knee arthroplasty have been reported in and outside China.However,there are few reports on the effect of the valgus and varus angles of tibial component on short-term postoperative outcomes after fixed bearing unicompartmental knee arthroplasty. OBJECTIVE:To investigate the effect of valgus and varus angles of tibial component on short-term clinical outcomes in patients with medial knee osteoarthritis undergoing fixed bearing unicompartmental knee arthroplasty. METHODS:120 patients(122 knees)who underwent fixed bearing unicompartmental knee arthroplasty for medial knee osteoarthritis in Department of Orthopedic Surgery,Affiliated Hospital of Xuzhou Medical University from August 2020 to January 2023 were selected as the study subjects.Two physicians measured the varus angle of femoral prosthesis,valgus and varus angles of tibial prosthesis,flexion and extension angles of femoral prosthesis,and posterior inclination angle of tibial prosthesis after unicompartmental knee arthroplasty based on postoperative X-ray.After excluding the influence of the other three angles,the measurement results of the tibial component varus angle were divided into three groups:<-2°,-2° to 2°,>2°,which were denoted as groups 1,2,and 3,respectively.The range of knee motion,the hospital for special surgery knee score,the American knee society score,and forgotten joint score were recorded and compared before and after the operation. RESULTS AND CONCLUSION:(1)A total of 120 patients(122 knees)were enrolled in this study.They were divided into three groups according to the size of the valgus and varus angles of the tibial prosthesis after operation:37 patients in the first group,60 patients in the second group,and 23 patients in the third group.There was no significant difference between the three groups in terms of baseline information such as age,gender,and side of surgery(P>0.05).(2)Patients were followed up for 3-30 months after arthroplasty.(3)The hospital for special surgery knee score of the second group was higher than that of the first group(P=0.015)and the third group(P=0.012).The American knee society score of the second group was significantly higher than that of the first group(P=0.014)and the third group(P<0.001).The forgotten joint score of the second group was higher than that of the first group(P=0.033)and the third group(P=0.016).(4)After fixed bearing unicompartmental knee arthroplasty,when the valgus angle of tibial prosthesis was-2° to 2°,which can achieve better short-term clinical results,the degree of prosthesis self-realization is higher.
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Objective@#To analyze the spatio-temporal distribution characteristics of new HIV/AIDS cases at ages of 50 years and older in Wenzhou City from 2006 to 2020, so as to provide insights into precise control of AIDS. @*Methods @#The data of new HIV/AIDS cases aged 50 years and older in Wenzhou City from 2006 to 2020 were collected from the China Information System for Disease Control and Prevention. The temporal and spatial distribution characteristics of new HIV/AIDS cases at ages of 50 years and older were identified using global and local spatial autocorrelation analyses and spatial-temporal scan analysis.@*Results@#Totally 1 917 new HIV/AIDS cases aged 50 years and older were detected in Wenzhou City from 2006 to 2020, and there were 179 new HIV/AIDS cases in 58 townships ( streets ) from 2006 to 2010, 643 cases in 113 townships ( streets ) from 2011 to 2015 and 1 095 cases in 147 townships ( streets ) from 2016 to 2020, respectively. The distribution of new HIV/AIDS cases appeared positive spatial autocorrelations from 2006 to 2010 ( Moran's I value=0.05, Z=1.976, P=0.046 ), from 2011 to 2015 ( Moran's I value=0.08, Z=2.314, P=0.028) and from 2016 to 2020 (Moran's I value=0.18, Z=3.956, P=0.003 ). Spatial-temporal scan analysis identified two clusters. The primary cluster mainly covered 70 towns ( streets ) in Lucheng Distrct, Ouhai District, Longwan District, Economic and Technical Development Region, Rui' an City and Pingyang County of Wenzhou City from January 1, 2014 to December 31, 2020, with a cluster radius of 34.30 km [log likelihood ratio ( LLR )=192.84, RR=2.60, P<0.001], and the secondary cluster was located in Hongqiao Township of Yueqing City from January 1, 2009 to December 31, 2015, with a cluster radius of 0 ( LLR=90.60, RR=7.27, P<0.001 ).@*Conclusions@#The number of new HIV/AIDS cases aged 50 years and older appeared a tendency towards a rise in Wenzhou City from 2006 to 2020, with spatial clusters that were predominantly identified in urban areas, Rui' an City and Pingyang County of Wenzhou City.
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BACKGROUND: With the rapid development of surgical techniques, unicompartmental knee arthroplasty has become an issue of concern in the treatment of osteoarthritis, which has achieved significant progress inreducing trauma and rapid rehabilitation.OBJECTIVE: To summarize the development history, curative effect of unicompartmental knee arthroplasty, and the research progress of lateral unicompartmental knee arthroplasty aided with computer navigation or robot system, thus providing reference for further study on unicompartmental knee arthroplasty.METHODS: Web of Science, and PubMed databases were searched for the literatures published from January 1955 to April 2017 with the keywords of unicompartmental knee arthroplasty, osteoarthritis, unilateral compartment, lateral knee arthroplasty.RESULTS AND CONCLUSION: A total of 562 articles were retrieved, and finally 75 English literatures were enrolled according to the inclusion and exclusion criteria. With the continuous improvement of unicompartmental knee arthroplasty, it can retain the cruciate ligament and more bone mass. Notably, strict indications and reasonable postoperative functional exercise are essential for obtaining optimal effectiveness. At the same time, the development of computer navigation and robot-assisted technology has opened up a new horizon for the treatment of osteoarthritis,which makes the operation more accurate and minimally invasive. But the application still needs to be studied in depth.
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Objective To assess the mid-or long-term clinical outcomes of the structural bone graft of superolateral acetabulum in total hip arthroplasty (THA) for developmental dysplasia of the hip (DDH).Methods Thirty-three patients with DDH (33 hips) were treated by THA with the structural bone graft of superolateral acetabulum technique between April 2002 and December 2011.There were 28 females and 5 males with the mean age at surgery 54.0±14.5 years (21-76 years).The degree of dislocation was graded preoperatively as Crowe Ⅱ in 12 patients,Crowe Ⅲ in 8 patients,and Crowe Ⅳ in 13 patients.The following outcomes were assessed,Harris hip score (HHS),the leg-length discrepancy,the height and horizontal distance of center of hip rotation,rate of cup coverage,the coverage ratio of bone graft,periprosthetic osteolysis,bone ingrowth,and cup loosening.Results The average follow-up was 9.3±3.3 years (5-15 years).The HHS improved from 40.9±13.7 preoperatively to 93.6±7.8 at the final follow-up (t=21.483,P=0.000).The leg-length discrepancy decreased from 24.2± 17.1 mm pre-operatively to 3.7±3.5 mm at postoperative 3 months (t=6.747,P=0.000).The height and horizontal distance of center of hip rotation decreased from preoperative 45.9±16.0 mm and 42.9±8.7 mm to postoperative 23.8±5.8 mm and 23.6±2.9 mm (t=7.460,P=0.000;t=12.090,P=0.000) at postoperative 3 days,respectively.The cup coverage and coverage ratio of bone graft was 100％ and 27.1％±6.9％,respectively.All grafts appeared to be incorporated without evidence of resorption and collapse.The mean time of incorporation was 7.6 ± 2.8 months.The coverage ratio of bone graft ＞25％ have a significantly long time of incorporation than that ＜25％ (9.4±2.3 months versus 6.3±2.4 months,t=5.357,P=0.000).At the final follow-up,all hips showed bone ingrowth fixation of the acetabular cup and stem.Five hips showed osteolysis,two hips in acetabular zone Ⅱ,three hips in femur zone Ⅰ and five hips in femur zone Ⅶ.The main complications were intraoperative femoral fractures (61％) without neurological damage,nonunion and dislocation.Conclusion The structural bone graft of superolateral acetabulum in THA for DDH can achieve satisfactory mid-or long-term outcomes.The superolateral acetabular deficiency can be reconstructed by bone graft.The bone graft coverage less than 25％ is conducive to fusion of bone graft and acetabular bone.However,intraoperative femoral fracture is common complication.
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Objective To analyze the epidemiology,mechanisms of injury,type of fracture,clinical and radiological feature of acetabular fractures in patients aged 60 years and older.Methods Retrospectively analyzed the clinical data of patients with acetabular fractures between Janurary 1990 and December 2013 in Orthopaedic Department of the First Affiliated Hospital of Soochow University.According to certain inclusion and exclusion criteria,a total of 637 patients (637 hips) with acetabular fractures were included in the study.The patients were divided into 2 group acetabular fractures in elderly (≥60 years) and acetabular fractures in younger patients (＜ 60 years).Analysis of mechanism of injury,fracture pattern,the annual incidence of fracture,radiological features,associated injuries.Results 133 patients were ≥60 years and the remaining 504 were ＜ 60 years.We identified a significant increase in the incidence of elderly with acetabular fractures between 1990 and 2013 (6.7％ in 1990 vs.40.0％ in 2013).The incidence of associated injuries were significant lower in the elderly than younger (27.1％ vs.48.8％).The most common mechanism of injury in the elderly was a fall (36.1％),but this accounted for only 0.2％ of the younger with fractures.The incidence of anterior wall,anterior column,anterior and posterior hemitransverse were significant higher in the elderly than younger.The incidence of radiological features were significant higher in the elderly than younger,including quadrilateral plate fracture,Gull sign,anterior dislocation of hip,femoral head injury,comminuted posterior wall fracture and posterior wall marginal impaction,except posterior dislocation of hip which was significant lower in the elderly than younger.Conclusion There was an increasing trend of the proportion of elderly in acetabular fractures and the mean age of patients with fractures during the period of study.The older had a different incidence of associated injuries,mechanism of injury,fracture pattern,and radiological features compared with the younger.
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Objective To extract high quality genomic DNA of Cordia dicholoma seeds by using different methods;To provide references for researches on genomic DNA of Cordia dicholoma seeds. Methods Genomic DNA of Cordia dicholoma seeds was extracted through improved CTAB method and improved SDS method. Purity and concentration of obtained DNA were detected by spectrophotometry and agarose gel electrophoresis. Results The results of spectrophotometry showed that the purity of genomic DNA obtained through improved CTAB method was better than improved SDS method. Genomic DNA extracted through improved CTAB method was without protein and RNA pollution. The results of agarose gel electrophoresis showed that electrophoresis of genomic DNA obtained through the two methods both had the main belt. However, genomic DNA extracted through improved SDS method degraded more than improved CTAB method. Conclusion Improved CTAB method can obtain relatively high quality genomic DNA of Cordia dicholoma seeds.
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Objective To investigate the current status of critical thinking ability and commu-nication ability of nursing students, therefore providing reference for teaching reform. Methods The Critical Thinking Scale translated and revised by Pro. Peng MeiZi of Hong Kong Polytechnic University, and Supportive Communication Scale (SCS) edited by Whetten and his colleague were used to investi-gate nursing students' levels of critical thinking and communication ability among 176 selected nursing students in our college, with method of Random Cluster Sampling. Descriptive analysis, single sample t-test, and two independent sample t-test were applied to the collected data with SPSS l7.0. Results①The average score of critical thinking for the investigated college nursing students was (264.54± 29.94). 72.73% of them got 210~280 points, in which three items: cognitive maturity (t=4.695, P=0.000), open mind (t=4.016, P=0.000), and intellectual curiosity (t=2.973, P=0.003) were greater than 40 points. And the differences were statistically significant; compared to different individual character-istics, being a student cadre (t=3.494, P=0.001) or not is of statistical significance. ②The total average score of communication ability (t=3.219, P=0.002) for college nursing students,as well as the score of providing effective negative feedback (t=6.790, P=0.000) and supportive communication (t=4.267, P=0.000) were significantly higher than median 3.00. And the differences were statistically significant. Conclusion In order to improve the critical thinking ability and interpersonal communication ability of nursing students, and educate the nursing students to adapt to society and complicated clinical nursing environment, it is necessary to reform the curriculum setting, curriculum design and teaching method.
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Objective To explore the effect of diphosphonate on expression of matrix metalloproteinase-9(MMP-9) and cathepsin K(CK) in subchondral bone of unstable rabbit knee joints.Methods Fifty male New Zealand white rabbits were divided randomly into three groups according to random digits table:the control group (n=10),the model group (n=20).the diphosphonate group (n=20).Hulth model of unstable rabbit knee joint was achieved in the right knee joint.Ten rabbits from the diphosphonate group and 5 rabbits from the control group were sacrificed by aeroembolism at the second and tenth week postoperatively,respectively.Then the medial femoral condyles of the right knee were harvested.Specimens were processed for immunohistochemical analysis of MMP-9 and CK.Results Cells with expression of MMP-9 and CK could be found in the three groups at the second and tenth week after operation.Compared with the control group,there was a significant increase in the number of cells with expression of MMP-9 and CK in model group at the second and tenth week after operation.Diphosphonate could inhibit expression of MMP-9 and CK in cells.Compared with the model group,the number of cells with expression of MMP-9 and CK in diphosphonate group was fewer; there was a statistical significance between them.Conclusion Diphosphonate can inhibit the expression of MMP-9 and CK in subchondral bone of unstable rabbit knee joints,which can resist the bone resorption and protect articular cartilage.
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Objective To investigate the method of disinfection and sterilization of ventilator tubes and accessories in order to increase the sterilization quality of them. Methods 120 ventilator tubes and accessories from ICU and emergency department were randomly dividied into the control group,and the study group. Bacteriologic tests were conducted in the two groups. Results There was significat differ-ence in bacteriologic tests between the two groups. Conclusions It is necessary to research into steriliza-tion method of ventilator tubes and accessories.
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Objective To provide experimental basis for the weapon design by means of observing the injury by super high velocity fragments. Methods Nine male Huanan dogs were wounded by super high velocity aluminium bullet shot from an explosive gun with the energy of 15 360,12 643 and 8 144 J respectively, the degree of injury of local tissues and the pathological changes of main organs were observed. Results The injury degree of local tissue wounded by the super high velocity fragment of 15 360 J was similar to that of 8 144 J, and was more severe than that of wound by 12 643 J. Conclusion The injury degree is closely related to the mass and the momentum of the super high velocity fragment, the more the momentum is,the greater the execution is. No significant relationship exist between the injury degree and the energy.
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Objective To explore the characteristics of the changes of several metabolic and biochemical indices in dogs with both hindlimbs injured by kinetic weapon. Methods 12 animals were divided into 4 groups (Group Ⅰ, injured by regular weapon; Group Ⅱ,Ⅲ,Ⅳ injured by imitative kinetic weapons with different energy respectively). Levels of plasma Na+,Ca2+,K+ glucose, AMY, LDH, CK and serum T3,insulin,TSH were determined before and after injured. Results ①Local wounding conditions and distant organs' injuries in group Ⅱ,Ⅲ, and Ⅳ were more serious than those in group Ⅰ. ②Levels of plasma glucose in group Ⅱ,Ⅲ and Ⅳ were inereased significantly after injury than before(P<0.05), but not in group Ⅰ. Levels of Na+,Ca2+,K+,AMY,LDH in 4 groups had similar changes after injury while levels of CK in group Ⅱ,Ⅲ and Ⅳ were inereased significantly than that in group Ⅰ (P<0.05). ③After injury, levels of T3 in serum of all animals showed a decreased tendency and that of insulin decreased more significantly (P<0.05). There was no difference between every two groups. Levels of TSH in group Ⅱ,Ⅲ and Ⅳ were increased significantly after injured than before (P<0.05), but not in group Ⅰ. Conclusion Not only local severe injury but also more serious injury in distant organs and more obvious changes of metabolic and biochemical indices can be induced by kinetic weapons than regular weapons.
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Objective:To detect the changes of tumor necrosis factor-α(TNF-α) in nasopharyngeal secretion of patients with nasopharyngeal carcinoma(NPC).Method: The content of TNF-α in nasopharyngeal secretion was determined by radioimmunoassay (RIA) in 20 controls,52 patients with NPC.Result:The average concentrations of TNF-α were (12.95±4.62)pmol/L in control group,(33.68±15.13) pmol/L in NPC group and (64.00±11.57)pmol/L in NPC with necrosis group. The content of TNF-α in nasopharyngeal secretion in control group was lower significantly than that of patients with NPC (P<0.01).Conclusion:The level of TNF-α in nasopharyngeal secretion of NPC patients was higher than that of normal subjects. To detect the content of TNF-α in nasopharyngeal secretion is a useful test for the study and diagnosis of NPC.