[Clinical study of constructing nomogram model based on multi-dimensional clinical indicators to predict prognosis of knee osteoarthritis].

OBJECTIVE: To analyze the factors affecting the prognosis of patients with knee osteoarthritis, and to construct a nomogram prediction model in conjunction with multi-dimensional clinical indicators. METHODS: The clinical data of 234 patients with knee osteoarthritis who were treated in our hospital from January 2015 to June 2021 were retrospectively analyzed, including 126 males and 108 females；age more than 60 years old for 135 cases, age less than 60 years old for 99 cases. Lysholm knee function score was used to evaluate the prognosis of the patients, and the patients were divided into good prognosis group for 155 patients and poor prognosis group for 79 patients according to the prognosis. The clinical data of the subjects in the experimental cohort were analyzed by single factor and multiple factors. The patients were divided into experimental cohort and verification cohort, the results of the multiple factor analysis were visualized to obtain a nomogram prediction model, the receiver operating characteristic curve（ROC）, calibration curve and decision curve were used to evaluate the model's discrimination, accuracy and clinical benefit rate. RESULTS: The results of multivariate analysis showed that smoking, pre-treatment K-L grades of Ⅲ to Ⅳ, and high levels of interleukin 6 （IL-6） and matrix metallo proteinase-3 （MMP-3） were risk factors for the prognosis of patients with knee osteoarthritis. ROC test results showed that the area under the curve of the nomogram model in the experimental cohort and validation cohort was 0.806[95%CI（0.742, 0.866）] and 0.786[（95%CI（0.678, 0.893）], respectively. The results of the calibration curve showed that the Brier values of the experimental cohort and verification cohort were 0.151 points and 0.134 points, respectively. When the threshold probability value in the decision curve was set to 31%, the clinical benefit rates of the experimental cohort and validation cohort were 51% and 56%, respectively. CONCLUSION: The prognostic model of patients with knee osteoarthritis constructed based on multi-dimensional clinical data has both theoretical and practical significance, and can provide a reference for taking targeted measures to improve the prognosis of patients.

Time to Occurrence of Phlebitis After Continuous Infusion of Total Nutrient Admixture Through Peripheral Veins: An Experimental Animal Study.

OBJECTIVE: To study the limit time of phlebitis caused by continuous infusion of KabivenTM Pl and TNA (KabivenTM Pl+ alanyl glutamine + potassium aspartate) through a peripheral vein, and to provide a reference for clinical formulation of preventive measures for phlebitis. METHODS: White rabbits (n = 72) were randomly divided into three groups: group A (Normal saline), group B (Kabiven™ Pl), and group C (TNA). Blood was collected from the ear margin vein before administration and after three hours, four hours, five hours, and six hours of administration. CRP and TNF-ɑ were measured by enzyme-linked immunosorbent assay. Hematoxylin and eosin staining and immunohistochemical staining were performed on tissue samples taken from the insertion point of the indwelling needle, the tip of the indwelling needle, and 1 cm from the tip of the indwelling needle, closer to the heart, to analyze early pathological changes in blood vessels. RESULTS: (1) There were no visible inflammatory symptoms in groups A, B, or C within 6 hours. (2) Four hours after starting intravenous administration, the levels of inflammatory markers in groups B and C were higher than in group A, and (3) the degree of inflammatory cell infiltration in groups B and C was more severe than in group A. (4) In all groups, the inflammatory reaction at the tip of the indwelling needle was more severe than at the other two sites. CONCLUSION: When the emulsions TNA and Kabiven™ Pl are infused through a peripheral vein, (1) four hours may be considered as the maximum time for continuous intravenous infusion in the same vein before inflammatory changes become evident, and (2) systematic assessment of the tip of the indwelling needle should be considered for inclusion in the nursing plan for phlebitis monitorings.