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Objectives@#Bipolar hemiarthroplasty is commonly performed to treat displaced femoral neck fractures in osteo porotic patients. This study aimed to assess the occurrence and outcomes of unplanned return visits to the emergency department (ED) within 90 days following bipolar hemiarthroplasty for displaced femoral neck fractures. @*Methods@#The clinical data of 1322 consecutive patients who underwent bipolar hemiarthroplasty for osteoporotic femoral neck fractures at a tertiary medical center were analyzed. Data from the patients’ electronic medical records, including demographic information, comorbidities, and operative details, were collected. The risk factors and mortality rates were analyzed. @*Results@#Within 90 days after surgery, 19.9% of patients returned to the ED. Surgery-related reasons accounted for 20.2% of the patient’s returns. Older age, a high Charlson comorbidity index score, chronic kidney disease, and a history of cancer were identified as significant risk factors for unplanned ED visits. Patients with uncemented implants had a significantly greater risk of returning to the ED due to periprosthetic fractures than did those with cemented implants (P = 0.04). Patients who returned to the ED within 90 days had an almost fivefold greater 1-year mortality rate (15.2% vs 3.1%, P < 0.001) and a greater overall mortality rate (26.2% vs 10.5%, P < 0.001). @*Conclusions@#This study highlights the importance of identifying risk factors for unplanned ED visits after bipolar hemiarthroplasty, which may contribute to a better prognosis. Consideration should be given to the use of cemented implants for hemiarthroplasty, as uncemented implants are associated with a greater risk of peri prosthetic fractures.
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Objective To establish a method for the determination of 10 organophosphorus flame retardants in drinking water by on-line solid phase extraction coupled with high performance liquid chromatography-tandem mass spectrometry (On-line SPE-UPLC-MS/MS). Methods After adding the internal standard, the water sample was filtered by Millipore filtration, and then concentrated and detected by Online SPE-UPLC-MS/MS. Samples were concentrated by C8 SPE column and separated by C18 column with acetonitrile-water-formic acid as the mobile phases gradient elution,and were detected by multiple reaction monitoring (MRM) acquisition under anion mode. Results The 10 organophosphorus flame retardants all displayed good linear relationships within a certain range of concentrations, with the correlation coefficients being more than 0.990. The method detection limits were 0.60-5.50 ng/L, and the spiked recoveries of low, medium and high concentrations were 64%-106% , 83%-104% and 85%-99%, respectively. Conclusion The method is simple, sensitive, rapid, accurate and reliable, so it is applicable for the determination of 10 organophosphorus flame retardants in drinking water.
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Objective To explore the spatial epidemiological characteristics of mortality and probability of premature death caused by chronic obstructive pulmonary disease (COPD) among residents in Pudong New Area of Shanghai from 2010 to 2020, and to provide reference for the formulation of chronic obstructive pulmonary disease prevention and control strategies according to local conditions. Methods The death data of chronic obstructive pulmonary disease were obtained from the local death surveillance system of Pudong New Area. Crude mortality, age-standardized mortality, and probability of premature death caused by COPD in each subdistricts and towns of Pudong New Area were calculated. The geographical information system (GIS) was used to plot the spatial distribution maps of chronic obstructive pulmonary disease death. The trend surface analysis and the spatial autocorrelation analysis were performed to analyze the spatial distribution of chronic obstructive pulmonary disease death. Results The crude mortality, age-standardized mortality and probability of premature death caused by COPD among residents in Pudong New Area between 2010 and 2020 were 58.40/100,000, 22.35/100,000, and 0.26%, respectively. The results of trend surface analysis showed that the crude mortality, age-standardized mortality and probability of premature death caused by COPD gradually increased from north to south. In the east-west direction, the crude mortality, age-standardized mortality, and probability of premature death showed an upward trend from west to east. The global autocorrelation analysis suggested that there existed a positive spatial autocorrelation for the crude mortality, age-standardized mortality, and probability of premature death. The local spatial autocorrelation analysis showed that the high-high clustering areas of COPD crude mortality, standardized mortality and premature mortality were all located in the rural areas of the southeast of Pudong New Area. Conclusion There are urban and rural differences in the mortality of chronic obstructive pulmonary disease among residents in Pudong New Area from 2010 to 2020. The residents living in rural southeast coast of Pudong New Area are more seriously affected by chronic obstructive pulmonary disease and should be paid more attention.
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Immunoglobulin G4-related diseases(IgG4-RD)are chronic, systemic diseases that have received much attention in recent years. IgG4-RD can affect almost all tissues of the body, mainly manifested by swelling and space-occupying changes in the involved sites. It is called IgG4-related ophthalmic disease(IgG4-ROD)when the lesions invade the ocular area. The disease mainly invades the lacrimal glands, orbital fat, infraorbital nerve, extraocular muscles, and eyelids. At present, the main treatment modalities for IgG4-ROD include medication, surgery, and radiation therapy, etc. With the enhanced understanding of the disease and the increasing cure rate in recent years, this article reviews the latest progress in the epidemiological characteristics, clinical manifestations, imaging features, diagnosis and treatment of IgG4-ROD.
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Botulinum toxin-A ( botulinum toxin-A, BTX-A) is a double chain polypeptide structure formed by 100 kDa heavy chain and 50 kDa light chain through disulfide bond. The light chain is a kind of protease, which can combine with the fusion protein at the neuromuscular junction to prevent synaptic vesicles from anchoring on cell membrane and release acetylcholine, thus interfering with the transmission of nerve impulses. In recent years, the discussion on the clinical application of BTX-A has been a hot spot. Studies have shown that Botulinum toxin A (BTX-A) can effectively treat pain, exerting the characteristics of sustainable effect without addiction, but the mechanism of action of BTX-A is still controversial. This article reviews the mechanism of BTX-A in peripheral and central nervous system.
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Objective To compare the response measures and outcomes of SARS-CoV(2003), H1N1 influenza(2009), H7N9 influenza(2013)and COVID-19(2020)in Shanghai and provide scientific evidence for the emergency response of public health emergencies. Methods We compared the response measures and outcomes of the four epidemics in Shanghai in the aspects of government response, prevention and control system, scientific and technological support, social mobilization and prevention effects, using critical incident analysis based on the time axis of the epidemics from literature review. Results In response to the four epidemics of infectious diseases occurred in 2003-2020, Shanghai has generally made some significant effort and flexible measures in the first month of the epidemics, including"closure of live poultry markets"and"three closed-loops and four 100% coverage"and other specific prevention and control measures, which have enhanced the prevention and control system. However, we identified that the construction of prevention and control system for public health emergencies remained inefficient, compared to rapid economic development. The majority of the construction measures were principally post-epidemic. In addition, there were many challenges, such as passive response, temporary response teams and measures, and difficulties in the flexible bottom-up response for residents, families and industries without standard operating procedure and guidelines. Conclusion It may be an effective measure for the prevention and control of infectious diseases to build joint prevention and control measures with mass participation and regular drills, in the perspectives of strategic, tactical and operational levels of epidemic prevention and control.
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Objective To evaluate the interactive effects of fine particulate matter and temperature on non-accidental mortality of residents in Pudong, Shanghai. Methods Daily mortality, air pollutants and meteorological data from Jan 1st.2016 to Dec 31st.2017 were collected.Generalized additive Poisson regression models was used to estimate the effects of PM2.5 pollution on daily mortality, bivariate response surface models and temperature stratified models were applied to examine the interaction of temperature with PM2.5 on mortality. Results A total of 43 345 non-accidental deaths were included, daily mean PM2.5 concentration was 39.1 μg/m3, daily mean temperature was 17.7 ℃.A 10 μg/m3 increase in the daily PM2.5 at lag 1 day was associated with a 0.56%(95%CI:0.11%-1.01%), 0.49%(95%CI:-0.19%-1.18%) and 0.22%(95%CI:-1.14%-1.60%) increase in non-accidental, cardiovascular and respiratory mortality, respectively.Higher risks were identified for males and the older (≥65 years).The effect estimates per 10 μg/m3 increase in PM2.5 in medium temperature level were 0.59%(95%CI:0.04%-1.14%)for non-accidental, 0.51%(95%CI:-0.32%-1.35%)for cardiovascular and 0.51%(95%CI:-0.32%-1.35%) for respiratory mortalities.The PM2.5 effects were approximately 2-4 times higher in higher temperature level for non-accidental and cardiovascular mortalities compared with other temperature levels; for respiratory mortality, the PM2.5 effects was approximately 2-fold higher in lower temperature levels than the medium, although the interactions between temperature and PM2.5 were statistically insignificant. Conclusions Temperature may modify the effects of PM2.5 on mortality in Pudong, Shanghai and the interactive pattern may be different across disease-specific mortalities.
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<p><b>OBJECTIVE</b>To explore the analgesic effect of Zhixin Formula (ZF) and its effects on spinal glial fibrillary acidic protein (glial fibillary acidic protein, GFAP, a marker of astrocyte) , CD11b (a maker of microglia), Toll like receptors (TLR2 and TLR4) and nuclear factor κB (NF-κB) in bone cancer pain model rats.</p><p><b>METHODS</b>Totally 20 male SD rats were randomly divided into the blank control group and the bone cancer pain group, 10 in each group. The bone cancer pain model was induced by injecting ascites tumor fluid containing 3 x 10(3) Walker256 cell line from the left tibia. Ethological tests, X-ray test, and HE staining were performed to confirm a successful modeling. After model was successfully established, 70 male SD rats were randomly divided into seven groups, 10 in each group: the blank control group, the bone cancer pain group (as the model group), the Western medicine (WM) group (Tramadol Hydrochloride), the high dose ZF group, the middle dose ZF group, the low dose ZF group, and the Chinese medicine (CM) group (Wulin Zhitong Capsule). Fourteen days after modeling, rats in the high, middle, and low dose ZF groups were administrated by gastrogavage with 9, 4.5, and 2.25 g/kg ZF water condensed preparation respectively, once a day for seven consecutive days. On day 21 MS typical protein expressions including GFAP, CD11b, TLR (2,4) and NF-κB from cornu dorsal medullae spindis L4-L5 were detected by immunohistochemistry, reverse transcription-polymerase chain reaction (RT-PCR) and Western blot.</p><p><b>RESULTS</b>Compare with the blank control group, increased weight in the model group was slow and showed a decreasing trend (P < 0.01), spontaneous ambulatory pain score (SAPS) obviously increased (P < 0.01), paw withdrawal threshold (PWT) obviously decreased in the model group (P < 0.05, P < 0.01). Results of lateral tibial X-ray and HE staining showed obvious changes and damage occurred in bone structures of rats in the model group. Immunohistochemistry showed that GFAP expression significantly increased in the model group (P < 0.05). Protein levels of NF-κB also significantly increased in the model group (P < 0.05). Compared with the model group, CD11b expressions obviously decreased in the middle and high dose ZF groups (P < 0.01). Meanwhile, protein expressions of TLR2 and TLR4, as well as NF-κB also obviously decreased (P < 0.05).</p><p><b>CONCLUSION</b>ZF had analgesic effect, which might be probably related to inhibiting proliferation and activation of gliocytes, as well as activation of TLRs and NF-κB.</p>