Application of 3D printing guide plate in total hip arthroplasty for developmental dysplasia of the hip / 中国骨伤

OBJECTIVE@#To explore the value of 3D-printed navigation template using in total hip arthroplasty(THA)for developmental dysplasia of the hip (DDH).@*METHODS@#Twenty five patients with DDH underwent total hip arthroplasty from February 2016 to May 2018 were analyzed retrospectively, including 4 males and 21 females, aged from 40 to 75 years old. Among them, 5 cases were Crowe typeⅡ, 14 cases were Crowe type Ⅲ and 6 cases were Crowe type Ⅳ. Twelve cases of them underwent THA with the 3D printing navigation plate, another 13 cases underwent the same operation but without the aid of navigation templates. All patients were treated by the same operators. The operating time, intra- and post-operative hemorrhage and Harris Hip Score(HHS) at six months postoperativelywere compared, anteversion angle, abduction angle and the distance from rotation center to the ischial tuberosity connection between ipsilateral and contralateral sides were also compared.@*RESULTS@#All of the patients were followed up for 12 to 26 months. The operation time, intra- and post-operative hemorrhage and Harris score in the 3D printing group were better than those in the conventional hip replacement group(@*CONCLUSION@#The 3D-printed operation navigation template technique is an individualized, accurate and promisingtechnique for THA with DDH.

Identification of alkaloids and flavonoids in all parts of Fritillaria thunbergii using LC-LTQ-Orbitrap MSn / 中国中药杂志

Alkaloids and flavonoids in flowers, flower buds, stems, leaves, and bulbs of Fritillaria thunbergii were identified by LC-LTQ-Orbitrap MSn.Alkaloids were identified by ACQUITY UPLC BEH C₁₈（2.1 mm×50 mm, 1.7 μm ) chromatographic column with a mobile phase of 10 mmol•L⁻¹ ammonium formate-acetonitrile and gradient elution in positive MS scan mode.Meanwhile, flavonoids were analyzed by Agilent-Zorbax SB C₁₈ (4.6 mm×250 mm, 5 μm) chromatographic column with a mobile phase of 0.2% acetic acid-acetonitrile and gradient elution in negative MS scan mode.Combined with literature reports, chemical constituents were identified and determined by accurate molecular weights and fragment ion peaks in the ESI-MS/MS spectra based on high resolution mass spectrometer.In all parts of F.thunbergii, 37 alkaloids including 7 alkaloids (zhebeininoside, peimisine, peimine, peiminine, ebeiedinone/puqiedinone, ebeiedine/ puqiedine, peimisine-N-oxide) were simultaneously analyzed.Moreover, 16 flavonoids including quercetin, kaempferol and their glycosides were identified.The results indicated that the aerial parts had the similar alkaloids as the bulbs on the whole.Meanwhile, it had a series of flavonoids undetected in the bulbs.Our results provided the scientific basis for the development and utilization of aerial parts of F.thunbergii.

Spatio-temporal analysis of female breast cancer incidence in Shenzhen, 2007-2012 / 癌症

<p><b>INTRODUCTION</b>Breast cancer is a leading tumor with a high mortality in women. This study examined the spatio-temporal distribution of the incidence of female breast cancer in Shenzhen between 2007 and 2012.</p><p><b>METHODS</b>The data on breast cancer incidence were obtained from the Shenzhen Cancer Registry System. To describe the temporal trend, the average annual percentage change (AAPC) was analyzed using a joinpoint regression model. Spatial autocorrelation and a retrospective spatio-temporal scan approach were used to detect the spatio-temporal cluster distribution of breast cancer cases.</p><p><b>RESULTS</b>Breast cancer ranked first among different types of cancer in women in Shenzhen between 2007 and 2012 with a crude incidence of 20.0/100,000 population. The age-standardized rate according to the world standard population was 21.1/100,000 in 2012, with an AAPC of 11.3%. The spatial autocorrelation analysis showed a spatial correlation characterized by the presence of a hotspot in south-central Shenzhen, which included the eastern part of Luohu District (Donghu and Liantang Streets) and Yantian District (Shatoujiao, Haishan, and Yantian Streets). Five spatio-temporal cluster areas were detected between 2010 and 2012, one of which was a Class 1 cluster located in southwestern Shenzhen in 2010, which included Yuehai, Nantou, Shahe, Shekou, and Nanshan Streets in Nanshan District with an incidence of 54.1/100,000 and a relative risk of 2.41; the other four were Class 2 clusters located in Yantian, Luohu, Futian, and Longhua Districts with a relative risk ranging from 1.70 to 3.25.</p><p><b>CONCLUSIONS</b>This study revealed the spatio-temporal cluster pattern for the incidence of female breast cancer in Shenzhen, which will be useful for a better allocation of health resources in Shenzhen.</p>

Relationship of iron overload to bone mass density and bone turnover in postmenopausal women with fragility fractures of the hip / 中华外科杂志

<p><b>OBJECTIVE</b>To study relationships between serum ferritin and bone metabolism in patients with hip fragility fractures.</p><p><b>METHODS</b>This cross-sectional study included 76 postmenopausal women with hip fracture from Feburary 2011 to June 2012. The mean age of the women was (73 ± 10) years (range, 55-93 years) and the mean duration of menstruation was (22 ± 10)years (range, 5-50 years). Serum concentrations of ferritin, transferrin, alkaline phosphatase (ALP), amino-terminal extension peptide of type I collagen (P1NP), C-terminal telopeptides of type I collagen (β-CTX)and femoral and lumbar bone mineral density by dual-energy X-ray absorptiometry were measured. Bone metabolism was compared between normal and elevated ferritin groups with t-test, Pearson linear, partial correlation and multiple regression analysis examined associations between iron- and bone-related markers.</p><p><b>RESULTS</b>Serum ferritin concentration raised to (230 ± 146)µg/L, transferrin concentration reduced to (1.89 ± 0.33)g/L. P1NP concentration raised to (61 ± 32) ng/L when the concentration of serum ALP and β-CTX were in the normal range. T-scores for bone mineral density in the femoral neck (-2.0 ± 1.1) and lumbar (-2.1 ± 1.2) were below the normal ranges(-1.0-1.0). The subjects were divided into two groups according to serum ferritin concentration, normal group(serum ferritin concentration ≤ 150 µg/L, n = 25) and elevated group(serum ferritin concentration > 150 µg/L, n = 51). Patients of elevated group had lower bone mineral density in femoral neck and lumbar than normal group(t = 3.13,2.89, P < 0.01), and higher P1NP, β-CTX concentration (t = -2.38, -3.59, P < 0.05) . In partial correlation analysis adjusted for confounders, serum ferritin concentration was correlated negatively with bone mineral density in both femoral neck and lumbar (r = -0.335,-0.295, P < 0.05), and positively with P1NP and β-CTX (r = 0.467,0.414, P < 0.05), but not correlated with ALP (r = 0.188, P > 0.05). Transferrin concentration tended to be correlated positively with bone mineral density in both femoral neck and lumbar (r = 0.444, 0.262, P < 0.05) and negatively with ALP, P1NP and β-CTX(r = -0.326,-0.285,-0.278, P < 0.05).</p><p><b>CONCLUSIONS</b>Iron overload has a high prevalence in postmenopausal women with fragility fracture. Increased iron stores, which might lead to bone loss and lower bone mineral density by enhancing the activity of bone turnover, could be an independent factor to take effects on bone metabolism on postmenopausal women.</p>

Feasibility and safety of early removal of incisional dressings following thoracic surgery

To investigate the feasibility and safety of early dressing removal of clean wounds following thoracotomy. A total of 230 patients [127 males, mean age 55.6 +/- 16.7 years] were randomly divided into study and control groups. In the study group the cotton gauze dressing was removed 48 h after the surgery, whereas in the control group the dressing was kept on for 7-8 days until the removal of skin sutures. The infection and healing of the wounds were examined, and patients were followed up for 30 days. There was no statistically significant difference in age, sex, smoking rates, concurrent illnesses and operational characteristics between the study and control groups [p > 0.05]. The wound infection rate in the study and control groups was 6 [5.2%] and 7 patients [6.1%], respectively [p = 0.775]. Two patients [1.7%] from the study group and 1 [0.9%, p = 0.561] from the control group had partial wound approximation by day 7. Surrounding skin integrity was normal in 106 [92.2%] of the study group and 107 [93.0%] of the control group patients by postoperative day 7 [p = 0.801]. Removal of wound dressing 48 h after thoracic surgery was not associated with an increased risk of surgical site infection. Hence the early removal of wound dressing did not appear to have an adverse impact on wound healing

Effect of health education on control of diabetes mellitus and prevention of its complications / 中国实用护理杂志

Objective To discuss the active role of health education on control of diabetes mdlitus and prevention of its complications.Methods 96 cases of hospitalized patients with diabetes mellitus were randomly divided into the control group and the observation group with 48 patients in each group from June 2009 to June 2010.The control group received conventional diabetes treatment and distribution of health education brochures,based on this,the observation group was given health education,including cognitive,nutrition,behavioral intervention.The general prevention condition of diabetes and its complications as well as the education effect were compared before the education and six months after education.Results The fasting blood glucose,2-hour postprandial blood glucose,glycosylated hemoglobin,body mass index and incidence of complications were greatly improved in the observation group than those of the control group.Conclusions Strengthening health education can improve self-care ability of patients,effectively improve the overall control level of diabetes,reduce acute and chronic complications,disability,death rate.

Prevalence of diabetes in Shenzhen between 1997 and 2009 / 中华预防医学杂志

<p><b>OBJECTIVE</b>To analyze the trend of prevalence and major risk factors for diabetes between 1997 and 2009 in Shenzhen.</p><p><b>METHODS</b>A total sample of 7956 and 8487 residents aged from 20 to 69 years were selected using multi-stage cluster sampling from two cross-sectional chronic diseases survey in Shenzhen in 1997 and 2009 respectively. The variation of prevalence between different age groups (divided into a 5-year age group) were compared. The effect of risk factors was evaluated by population attributable risk percentage (PARP), and time trend of PARP for risk factors were analyzed.</p><p><b>RESULTS</b>Compared with that in 1997, the aged-adjusted prevalence of diabetes has increased from 3.85% (306/7956) to 5.21% (441/8487) in 2009 (χ(2) = 17.54, P < 0.001). The prevalence in age group 50 - 54, 60 - 64, and 65 - 69 years increased significantly from 7.88% (35/444), 8.55% (36/421) and 11.34 (33/291) to 12.09% (59/488), 14.63% (55/376) and 20.71% (70/338) respectively (χ(2) = 4.54, 7.25 and 10.01, P < 0.05). After controlling for age, the rates of abdominal obesity, family history of diabetes, dyslipidemia and hypertension increased from 21.56% (1715/7956), 4.39% (349/7956), 26.34% (2096/7956) and 11.53% (917/7956) to 31.88% (2706/8487), 12.84% (1090/8487), 41.38%(3512/8487) and 14.61% (1240/8487) respectively (χ(2) = 5.52, 14.83, 18.38 and 20.22, P < 0.01). For diabetes, the PARP of aging, dyslipidemia and abdominal obesity were 41.55%, 29.25% and 25.10% respectively.</p><p><b>CONCLUSION</b>The prevalence of diabetes in Shenzhen increases rapidly and more patients are found in younger age. The rise of diabetes was mainly attributed to aging and increasing exposures to risk factors.</p>

Clinical outcome of single-bundle versus anatomic double-bundle reconstruction of the anterior cruciate ligament: a meta-analysis / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate clinical outcome after anterior cruciate ligament (ACL) reconstruction with double-bundle or single-bundle by meta-analysis.</p><p><b>METHODS</b>Randomized controlled trials (RCTs) on differences of clinical outcomes of ACL reconstruction were retrieved in Ovid Medline, PubMed, Embase, Cochrane Library, CBM and VIP database. Relevant journals or conference proceedings were also searched manually. Then extracted the date of KT-1000 arthrometer, pivot-shift testing, Lysholm score and IKDC final score in these researches. RevMan 5.0.23 software was used for data analyses.</p><p><b>RESULTS</b>Eight prospective RCTs met the inclusion criteria. The combined results of meta-analysis indicated that there was statistical difference between two operative procedures on postoperative KT-1000 arthrometer side-to-side [WMD = -0.35, 95%CI (-0.61, -0.08), P = 0.01], Lysholm score [WMD = -1.91, 95%CI (-3.45, -0.37), P = 0.01]. But the difference of KT-1000 arthrometer side-to-side is demonstrated to be clinically insignificant. Others indicated that there was no statistical differences with respect to IKDC final score [OR = 1.80, 95%CI (0.98, 3.31), P = 0.06], having a normal or nearly normal pivot-shift testing [OR = 1.64, 95%CI (0.85, 3.16), P = 0.14].</p><p><b>CONCLUSIONS</b>Double-bundle reconstruction does not result in clinically significant advantage when compared with single-bundle. The results do not support the theory that double-bundle reconstruction controls knee rotation better.</p>

Mutation analysis in families with 21-hydroxylase deficiency / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To investigate the steroid 21-hydroxylase gene (CYP21) mutations in families with 21-hydroxylase deficiency (21-OHD).</p><p><b>METHODS</b>The CYP21 gene mutations were detected in four patients with 21-hydroxylase deficiency and their relatives. The genomic DNA of the patients was isolated from whole blood.Two pairs of primers were used to amplify the CYP21 gene. The amplified PCR products were purified by agarose gel and then directly sequenced.</p><p><b>RESULTS</b>Six kinds of mutations were found. In the first family, the patient was a compound heterozygote carrying four different mutations (cluster E6, Q318X, A391T, P459H) onCYP21 gene, three mutations (cluster E6, Q318X, A391T) were on her maternal allele, a novel mutation was found:P459H. It located at codon 459 in exon 10 and changing a proline (CCC) to a histidine (CAC), and A391T was a rare mutation. In the second family, two kinds of mutations were found:cluster E6 and R483W. R483W was also a rare mutation. In the third family, the sequencing of the CYP21 gene of two patients revealed a homozygous T to A transition in codon 172 leading to substitution of isoleucine by asparagine (I172N).</p><p><b>CONCLUSION</b>Six kinds of mutations were found in three families with 21-hydroxylase deficiency. Using DNA sequencing we have identified a novel mutation (P459H) and two rare mutations (A391T, R483W) of the CYP21 gene. Although microconversion events are the main cause of mutations in the CYP21 gene, random mutations can also be the cause of 21-hydroxylase deficiency.</p>

Study on the epidemiology and risk factors of renal calculi in special economic zone of Shenzhen city / 中华流行病学杂志

<p><b>OBJECTIVE</b>To study the epidemiological characters and risk factors of renal calculi in Shenzhen for future intervention.</p><p><b>METHODS</b>Risk factors of renal calculi were analyzed by factor analysis and linear structural relation model, followed by fitting and evaluating the model.</p><p><b>RESULTS</b>The prevalence rates of renal calculi were 8.00% and 5.12% in males and females. The results of LISEREL showed that the total effect of age and sex affecting the development of renal calculi was 0.4614, with directly effect 0.3600 and indirect 0.1014. The direct effects of blood uric acid, blood calcium and body mass index, blood cholesterol, blood sugar were 0.3400 and 0.3200 respectively. The indirect effect of education, exercise and dietary habit affected the development of renal calculi through index of biochemistry and obesity, were -0.0416 and 0.1882.</p><p><b>CONCLUSION</b>Sex, age, obesity and high blood cholesterol, high blood sugar, high blood uric acid, high blood calcium were the direct influencing factors to renal calculi. At the same time, education, exercise and dietary habit were also associated with the disease.</p>

Diagnostic Value of Computed Radiography on Neonatal Respiratory Distress Syndrome / 实用儿科临床杂志

Objective To improve the knowledge and diagnostic ability of imagiology on neonatal respiratory distress syndrome (NRDS) computed radiograph(CR).Methods The doubtful patients were done to photographs bedside using the high resolution imaging plate, 50 cases of newborn with NRDS were selected whose clinical diagnosed clearly and had been treated and had the complete CR image documents.The CR change and clinical characteristics were observed dynamically.Results Nine of 50 cases were combined with aspirated pneumonia,8 cases with infective pneumonia,3 cases with intra-alveolar hemorrage,and 2 cases with pneumothorax.Accoding to X-ray manifestations,all cases were divided into four stages:Ⅰ stage(n=5), Ⅱ stage(n=20),Ⅲ stage(n=22),Ⅳstage(n=3).Typical CR signs included:the pulmonary lucency decreasd,wide-ranging net and grain shadowes of high density, and in companing with a lot of air brunchus sing.Conclusions Computed radiography is the most important imaging method in diagnosis of NRDS bedside ,and shall be improved the ability of diagnosis and differential of NRDS combined with the clinic.