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Objective:To investigate the intervention effects of fracture liaison service (FLS)-based intervention in elderly patients with meniscus injury, to provide reference for clinical rehabilitation.Methods:A total of 86 elderly patients with meniscus injury from February 2018 to October 2019 in the Second Affiliated Hospital of Xi ′an Jiaotong University were divided into experimental group and control group according to random number table method. There were 43 cases in each group.The control group was given routine nursing, and the experimental group implemented FLS-based nursing intervention on the basis of the control group. The clinical effects were compared between the two groups by using knee function, knee joint mobility and degree of frailty. Results:Finally, 38 cases were included in the experimental group and 41 cases in the control group. There was no significant difference in knee function, knee joint mobility and degree of frailty between the two groups at discharge ( P>0.05). At 1, 3 months after discharge, the knee scores and knee joint mobility were (75.37 ± 4.68) points, (90.34 ± 3.02) points and (96.68 ± 8.11)°, (119.11 ± 7.92)° in the experimental group, higher than those in the control group (73.17 ± 3.92) points, (87.76 ± 2.93) points and (91.76 ± 7.75)°, (108.61 ± 7.72)°, the differences were statistically significant ( t values were 2.26-5.96, all P<0.05). The knee function scores and knee joint mobility of the two groups changed with time ( F=264.33, 279.54, both P<0.05). There were interaction effects between groups and time in the knee joint mobility of the two groups ( F=6.12, P<0.05). At 1, 3, 6 months after discharge, the physiological dimension scores and frailty total scores were 5.08 ± 1.34, 4.74 ± 1.10, 4.13 ± 0.88 and 8.32 ± 1.50, 7.82 ± 1.31, 6.82 ± 0.95 in the experimental group, lower than those in the control group 5.68 ± 1.15, 5.22 ± 0.85, 5.02 ± 0.76, 9.05 ± 1.28, 8.40 ± 0.89, 8.18 ± 0.90, the differences were statistically significant ( t values were 2.15-6.57, all P<0.05). At 6 months after discharge, the psychological and cognitive dimension scores were 0.98 ± 0.30 and 0.45 ± 0.24 in the experimental group, lower than those in the control group 1.32 ± 0.37 and 0.59 ± 0.22, the differences were statistically significant ( t=4.49, 2.82, both P<0.05). The physiological and cognitive dimension scores and total scores of the two groups changed with time ( F=30.61, 31.72, 38.50, all P<0.05). There were interaction effects between groups and time in the physiological demension scores and the frailty total scores of the two groups ( F=2.86, 4.03, both P<0.05). Conclusions:FLS-based intervention can promote the rehabilitation of knee joint function and alleviate the degree of frailty of elderly patients with meniscus injury.
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Objective:To explore the diagnostic performance of ultrasound attenuation imaging (ATI) in grading the degree of hepatic steatosis in metabolic dysfunction-associated fatty liver disease (MAFLD).Methods:The liver gray-scale ultrasound and ATI examinations were performed on 212 subjects who were treated in Zhongshan Hospital Affiliated to Fudan University from August 2020 to March 2021. The attenuation coefficient(AC) values among different degrees of hepatic steatosis were analyzed and the diagnostic performance of ATI was evaluated. Relationships between AC values and clinical characteristics were assessed by Pearson′s correlation analysis.Results:The AC values for normal liver, mild, moderate and severe fatty liver were (0.56±0.05)dB·cm -1·MHz -1, (0.68±0.09)dB·cm -1·MHz -1, (0.82±0.09)dB·cm -1·MHz -1, (0.94±0.09)dB·cm -1·MHz -1, respectively. There were significant differences in AC values among different hepatic steatosis divisions( P<0.008). There was highly significant correlation between AC values and the degree of hepatic steatosis( r=0.860, P<0.01), moderate correlation between AC values and BMI( r=0.425, P<0.01), weak correlation between AC values and HDL-C( r=-0.237, P=0.029), no correlations between AC values and age, TC, TG, LDL-C ( r=0.083, 0.055, 0.133, -0.039, all P>0.05) .The areas under the receiver operating characteristics curve of ATI for mild fatty liver and above, moderate fatty liver and above, severe fatty liver and above were 0.958, 0.962, 0.918; the sensitivity were 90.1%, 95.8%, 94.9%, the specificity were 96.1%, 87.1%, 73.9%, and the cut-off values were 0.666 dB·cm -1·MHz -1, 0.719 dB·cm -1·MHz -1, 0.803 dB·cm -1·MHz -1, respectively. Conclusions:ATI is a reliable and convenient method for evaluating the degree of hepatic steatosis in MAFLD.
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Objective To evaluate the value of contrast-enhanced ultrasound (CEUS) in preoperative classification for hilar cholangiocarcinoma. Methods Forty-six patients with 46 hilar cholangiocarcinoma were diagnosed by surgical pathology in Zhongshan Hospital of Fudan University from January 2007 to April 2013. The echogenicity difference on conventinal ultrasound and CEUS were compared with chi-square test. The accuracy of conventinal ultrasound and CEUS for evaluating invaded bile duct, detective rates for portal vein invasion and displaying rate of metastatic hilar lymph nodes were compared with chi-square test or Fisher’s Exact test according to the golden standard of operative exploration. Results On CEUS, 82.6%(38/46) and 91.3%(42/46) hilar cholangiocarcinoma were hypoechoic in portal vein phase and delayed phase respectively, while 63.0%(29/46) hilar cholangiocarcinoma were isoechoic on conventinal ultrasound with vague margin. The clearly displaying rates were 37.0%(17/46), 84.8%(39/46) and 91.3%(42/46) in conventinal ultrasound, portal vein and delayed phase of CEUS and the echogenicity was signiifcantly different. The evaluation accuracy of hilar cholangiocarcinoma invading bile duct was improved from 80.4%(37/46, conventinal ultrasound) to 100%(46/46, CEUS) significantly (χ2=7.882,P=0.005). Portal vein invasion were found in 9 cases during operative exploration and the detective rates on conventinal ultrasound and CEUS were 78%(7/9) and 89%(8/9) without signiifcant difference (P=1.000). Metastatic hilar lymph nodes were found in 8 cases and the displaying rates on conventinal ultrasound and CEUS were the same (75%, 6/8) without signiifcant difference (P=1.000). Conclusions CEUS could signiifcantly improve the clearly displaying rate of hilar cholangiocarcinoma and improve the evaluation accuracy for invaded bile duct comparing with conventinal ultrasound.
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Objective To evaluate contrast-enhanced ultrasound imaging of carotid atherosclerosis with different stenostic degree as a clinical tool to study intraplaque neovascularization.Methods Fifty-eight patients suspected of carotid stenosis with 73 plaques were studied by standard and contrast-enhanced ultrasound.Plaque echogenicity at standard ultrasound were evaluated.Contrast enhancement within the plaques was categorized as 0 - 4 degree and compared to the stenosis degree and the plaque echogenicity.The degree of stenosis was determined by intravenous digital subtraction angiography.Results In the group with stenosis less than 90% ,stenosis degree was not associated with the grade of contrast enhancement (P =0.358),while the grade of enhancement was significantly higher in the group with sever stenosis(＞90%).The grades of enhancement were significantly different between plaques with different echogenicity (P =0.000).Conclusions Contrast-enhanced real-time ultrasound imaging can demonstrate the enhancement of carotid plaques non-invasively,which is helpful for assessing intraplaque neovascularization and provide valuable information for plaque risk stratification