Current status and distribution of hip fractures among older adults in China.

China is a middle-risk country for hip fracture at present, which differs from previous data that it was low-risk. By 2050, the total number of hip fractures in people older than 65 years is predicted to be 1.3 million. INTRODUCTION: To assess hip fracture incidence in China and examine the heterogeneity of hip fracture in seven geographical regions of China. METHODS: There were 238,230 hip fracture patients aged 65 years or older from 2013 to 2016 from a large national in-patients database (HQMS) involving 30.6 million hospitalizations. Taking into account the total national hospitalization rate per calendar year, we estimated the incidence of hip fracture per 100,000 residents older than 65 years in China overall and in seven geographical Chinese regions. RESULTS: The proportion of men and women older than 65 years with hip fractures was 1.00:1.95. Between 2013 and 2016, the number of hip fractures per 100,000 people age 65+ was 278. China has vast territories; the number of hip fractures per 100,000 people over 65 years old was 202 in Northeast China and 374 in Northwest China. Northwest has higher altitude, lower population density, is less developed with lower urbanization than Northeast China which is low altitude, and highly urbanized. CONCLUSIONS: China should no longer be regarded as a low-risk country for hip fracture. By 2050, the total number of hip fractures in people older than 65 years in China is predicted to be 1.3 million. Higher altitude areas had higher hip fracture rates than lower altitude, higher urbanized areas.

[Evaluation of the proximal femur geometry in patients with elderly osteoporotic hip fractures].

Objective: To investigate the relationship between the proximal femur geometry and elderly osteoporotic hip fractures. Methods: From May 2015 to December 2015, 137 patients with elderly osteoporotic hip fractures were involved.69 cases were in the fracture group and 68 cases were in the control group.CT scan were performed on all patients and the proximal femur geometry parameters were measured, including the neck width (NW), neck length (NL), neck shaft angle (NSA), femur head diameter (FHD), head height (HH) and Offset.Statistical analysis was performed between two groups. Results: The results of single factor analysis showed that age, sex, NL, FHD, NSA and Offset had significantly differences between two groups (P<0.05). The multiple Logistic regression analysis showed that age, sex, NL and NSA were independent risk factor for the hip fractures.The ROC curve analysis showed that area under curve (AUC) were 0.818, 0.818 and 0.725, respectively. Conclusions: The patients with older age, longer NL and larger NSA might be prone to hip fracture and it was an effective and feasible method to reconstruct and measure the CT data of the proximal femur with Mimics software.

[A correlation analysis of the ankle CT and ankle fracture classification].

OBJECTIVE: To summarize the CT features of ankle fracture and to analyze the relationship between the CT images and the most commonly used ankle fracture classification. METHODS: With 369 cases of adult ankle fractures analyzed retrospectively, the CT images 1 cm above the ankle joint and its characteristics, the Danis-Weber classification of ankle fracture were studied, and so was the relationship between CT images and the fracture classification. RESULTS: There were 8 forms of CT images. With a, b, and c referred to the fibular fracture, posterior malleolar fracture and interosseous tibiofibular ligament (IOL) rupture respectively. 369 CT imges had 40 cases of 0 degree injury (fibula, posterior malleolus, IOL all intact); 60 cases of Ia degree injury (fibular fracture, posterior malleolus and IOL intact), 3 cases of Ib degree injury (fibula intact, posterior malleolus fracture, IOL intact), 26 cases of Ic degree injury (fibula and posterior malleolus intact, IOL rupture); 163 cases of IIab degree injury (fibula and posterior malleolus fractures, IOL intact), 6 cases of IIac degree injury (fibular fracture, posterior malleolus intact, IOL rupture), 61 cases of IIbc degree injury (fibula intact, posterior malleollar fracture, IOL rupture); 10 cases of III degree injury (fibular fracture, posterior malleollar fracture and IOL rupture). According to the Danis-Weber classification, there were 18 cases of type A, 238 cases of type B, 94 cases of type C, and 19 cases without fibular fracture. The prevalence of IOL rupture were 0, 5.9%, and 88.3% in types A, B, and C respectively. There was a correlation between the CT image and Danis-Weber classification, the incidence of IOL rupture was changed with the severity of Danis-Weber classification, and the difference was statistically significant after the rank correlation test (Spearman R=0.781, P<0.001). IOL rupture not determined by the fracture classification was found with the CT images and the incidence was 5.9%. CONCLUSION: Cross-sectional CT images 1 cm above the ankle joint can clearly determine the IOL injury preoperatively with a good correlation with the Danis-Weber fracture classification, IOL rupture unrecognized with the fracture classification can also be noticed with the CT image.

[Epidemiological analysis of hospitalized patients with femoral neck fracture in a first-class hospital of Beijing].

OBJECTIVE: To analyze the clinical parameters of the patients with femoral neck fracture such as general condition, therapy method, hospitalized expense so as to provide more effective management plan for the clinical work. METHODS: The patients with femoral neck fracture above 50 years who received in-patient treatment from 2008 January to 2012 December were admitted into this study. We collected and analyzed the information, such as age, chronic medical disease, therapy method, hospitalized duration and expense and so on. RESULTS: There were 1 794 femoral neck fracture patients above 50 years (male/female=1/2.06) in our hospital in recent 5 years and the annual average rate of increase was 7.3%. The average age of the patients was (69.9±10.7) years and the annual average rate of increase was 0.6%. The chronic medical disease diagnosis ratio was 55.0%. The average waiting time for operation was (6.8±4.2) days and the average hospitalized duration was (12.9±4.9) days which showed downward trend in recent years. The most popular operations were cannulated screw internal fixation (41.8%) and artificial femoral head replacement (34.1%). In the study, 146 cases (7.9%) received nonsurgical treatment which showed downward trend. The average hospitalized expense was (35 075.7±11 343.2) yuan which showed no obvious change in recent years. The cost for the females was more than that for the males. The expense for hemiarthroplasty and total hip arthroplasty increased while that for cannulated screw internal fixation decreased gradually. CONCLUSION: The cannulated screw internal fixation and artificial femoral head replacement were the most important operations for the patients with femoral neck fracture. The number and the average age of the patients were on the rise while the expense showed no obvious change in recent years.

Recycling agriculture wastes of ramie stalk as bioadsorbents for Cd(2+) removal: a kinetic and thermodynamic study.

In this study, we exhibit the recycling of agriculture wastes of ramie stalk as bioadsorbents for Cd(2+) removal. Based on our experimental results, it is realized that Cd(2+) adsorption to ramie stalk is highly pH sensitive, indicating the adsorption is driven by surface complexation reaction. The high adsorption capacity of ramie stalk toward Cd(2+) (qm = 10.33 mg g(-1), 0.09 mol-Cd g(-1)), which corresponds to around 21.95% of active adsorption sites available of ramie stalk, is believed to be closely related to its high cellulose and lignin content. The inhomogeneous surface of ramie stalk due to the high cellulose and lignin content also accounts for the observation that the adsorption kinetic is described well by the pseudo second order kinetic model. Results from thermodynamic studies suggest that the adsorption process is endothermic and spontaneous. All these properties demonstrate the potential of ramie stalk as a low cost bioadsorbent for the application of heavy metal removal.

Phytophthora infestans isolates from Northern China show high virulence diversity but low genotypic diversity.

Phenotypic and genotypic characteristics of 48 Phytophthora infestans isolates, collected in five provinces in Northern China between 1997 and 2003, were determined and compared with reference isolates. Characterisation included mating type, virulence, mitochondrial DNA (mtDNA) haplotype and DNA fingerprinting patterns based on simple sequence repeats (SSR) and amplified fragment length polymorphisms (AFLP). All isolates had the A1 mating type, mtDNA haplotype IIa and an identical SSR genotype (designated as SG-01-01) that differed from SSR genotypes found in the reference isolates, including those representing the 'old' US-1 lineage that dominated the P. infestans population worldwide prior to 1980. In contrast, the virulence spectra were highly variable and virulence to all resistance genes present in the standard differential set (R1 to R11) was found. AFLP analysis revealed some diversity; eight different AFLP genotypes were found that could be grouped into two major clusters. This study shows that there is very little genotypic diversity in the P. infestans population in Northern China. The occurrence of many different races within this rather uniform population is discussed in the framework of recent insights into the molecular determinants of avirulence in potato-P. infestans'gene-for-gene' interactions.

Experimental imaging of the acoustic nonlinearity parameter B/A for biological tissues via a parametric array.

The acoustic nonlinearity parameter B/A is an important parameter in nonlinear acoustics and has been suggested to be a novel parameter for ultrasound tissue characterization. In this paper, the principle and experimental results for B/A imaging by using a parametric array are presented. As two primary waves with different frequencies are radiated simultaneously from a circular piston source, a secondary wave at the difference frequency is generated due to the nonlinear interaction of the two primary waves. The axial sound pressure amplitude curve for the generated difference frequency wave in the near field is measured and agrees well with the theoretical calculation. Unlike the second harmonic wave, the difference frequency component of the parametric array grows almost linearly with distance from the piston source and goes through fewer oscillations in the near field. It therefore provides a better source for acoustic nonlinearity parameter tomography. On the basis of the finite amplitude insert substitution method and the conventional CT technology, an experimental imaging system for acoustic nonlinearity parameter B/A via a parametric array is set up. B/A images for several biological specimens, including normal and pathological tissues, are obtained.

The experimental investigation of ultrasonic properties for a sonicated contrast agent and its application in biomedicine.

The ultrasonic properties of a promising ultrasound (US) contrast agent, named SDA (sonicated dextrose albumin) are reported in this paper. SDA is a suspension of stable microencapsulated gas bubbles with average diameter 2.0 microm prepared from sonicated dextrose albumin. The ultrasonic linear and nonlinear parameters, such as acoustic velocity, sound attenuation and acoustic nonlinearity parameter B/A of SDA, as a function of its bubble concentration from 1.0 x 10(7) to 2.05 x 10(8) microbubbles/mL in the frequency range of 2-6 MHz are measured in vitro. The sound attenuation coefficients over 2-6 MHz are linearly proportional to the bubble concentration and frequency. It is important to point out that the acoustic nonlinearity parameter B/A for SDA has a very large value that nonlinearly increases with the increase of bubble concentration.

Experimental investigation of the acoustic nonlinearity parameter tomography for excised pathological biological tissues.

The acoustic nonlinearity parameter B/A tomography is proposed as a novel imaging method in this paper. By using this method, the B/A tomography for various kinds of normal and pathological porcine tissues in vitro, including eight kinds of diseased livers, four kinds of diseased kidney and one kind of diseased spleen, are studied. Results indicate that all diseased tissues with changes in tissue composition and structural features exhibit higher grey-scale (higher B/A values) than corresponding normal tissues. In addition, the acoustic nonlinearity parameter is more sensitive to pathological states than acoustic linear parameters. To make a comparison with the acoustic nonlinearity parameter tomography, the acoustic linear parameter images, including two B-scan images for two kinds of diseased specimens, are also presented. Results of this paper show that the acoustic nonlinearity parameter tomography may be a novel method for tissue characterization in ultrasonic medical diagnosis.

Determination of the acoustic nonlinearity parameter in biological media using FAIS and ITD methods.

Two methods for determination of the acoustic nonlinearity parameter B/A in biological media are presented. One is the finite amplitude insert-substitution method (FAIS), considering the influence of both the sound attenuation of samples and the diffraction of the transducer on the experimental measurement. The other is the improved thermodynamic method (ITD), based on the measurement of phase shifts in the acoustic wave due to the change of ambient pressure. The nonlinearity parameter B/A has been measured for various biological solutions and soft tissues using these two methods. Some results of dependence of B/A values on the concentration and temperature are also presented here.