Can Platelets/Mean Platelet Volume Accurately Diagnose Periprosthetic Joint Infection? Revealing Their Actual Diagnostic Efficacy.

Background: Currently, there is no single test indicator for diagnosing periprosthetic joint infection (PJI) with an acceptable level of sensitivity. Therefore, ratio indicators have been introduced to improve the accuracy of diagnostic algorithms. Platelet count /mean platelet volume (PMR) is reported to be a potential PJI diagnostic biomarker, but its clinical value for diagnosing PJI is still uncertain. This study aims to provide additional evidence to support the effectiveness of PMR in accurately diagnosing PJI. Methods: This study recruited 116 patients with PJI and 137 patients with aseptic loosening, divided them into PJI group and AL group. Collect subjects' preoperative laboratory indicators such as ESR, CRP, PLT, MPV, etc. The area under the curve (AUC) was calculated by plotting the receiver operating characteristic (ROC) curve to determine the diagnostic efficacy of PMR. Results: ESR, CRP, PLT, and PLT/MPV were significantly increased in the PJI group, while MPV levels were decreased (both P< 0.001). The AUC of the PMR was 0.752, and the optimal cut-off value for diagnosing chronic PJI was determined to be 27.8 based on the Youden index. The sensitivity and specificity for diagnosing PJI were 79.3% and 47.9%, respectively, with a positive predictive value of 68.27%, a negative predictive value of 69.80%, and a diagnostic odds ratio of 4.97. The AUC (0.752) of the ratio biomarker was lower than that of ESR (0.825) and CRP (0.900). After predictive model calculation, the combination of PMR, CRP, and ESR had an AUC value of 0.910, with a sensitivity of 84.5% and a specificity of 84.7%, showing good discriminative ability. Conclusion: Compared with traditional biomarkers ESR and CRP, the value of the PMR for diagnosing PJI is not significant, but it can be used as an auxiliary indicator for PJI diagnosis in combination with other indicators (P<0.001).

Grain Growth upon Annealing and Its Influence on Biodegradation Rate for Pure Iron.

Biodegradable pure iron has gained significant interest as a biomedical material. For biodegradable implant applications, the biodegradation behavior of pure iron is important. In this work, the influence of ferrite grain size on the biodegradation rate for pure iron was studied by means of heat treatment that was annealed below the austenized temperature using as-forged pure iron. Grains were coarsened and a spectrum of ferrite grain sizes was gained by changing the annealed temperature. Biodegradation behavior was studied through weight loss tests, electrochemical measurements and microscopic analyses. Hardness (HV) and biodegradation rate (Pi or Pw) were linearly ferrite grain size-dependent: HV=58.9+383.2d-12, and Pi=-0.023+0.425d-12 or Pw=0.056+0.631d-12. The mechanism by which the role of grain size on biodegradation rate was attributed to the ferrite grain boundary traits.

Arthroscopically assisted reduction and internal fixation of a femoral anterior cruciate ligament osteochondral avulsion fracture in an 11-year-old girl: A case report.

RATIONALE: The anterior cruciate ligament (ACL) is relatively rarely injured in children and adolescents, accounting for just 0.5% of all ACL rips that occur. Avulsion fractures are more common in youngsters because their ligamentous structures are known to be stronger than their physical insertion sites. Tibial eminences have been reported to be the sites of most ACL avulsions, and both cartilaginous and osteochondral avulsion fractures have been observed, whereas the latter occurs more commonly. On the other hand, femoral osteochondral avulsion fractures of the ACL in children are uncommon, as only a few studies describe their occurrence in immature patients. PATIENT CONCERNS: In this case report, we present an 11-year-old girl who suffered an ACL femoral attachment avulsion fracture after pivoting her knee during riding. A comprehensive formal evaluation of the knee was impractical due to the persistence of pain and tight haemarthrosis. DIAGNOSES: Femoral anterior cruciate ligament osteochondral avulsion fracture. INTERVENTIONS: We used Two No.2Ethibond sutures to pick up the osteochondral fragment and passed across the lateral femoral condyle to come out laterally and fixed with a tie proximally, and we recommended the patient perform reasonable functional exercises postoperatively. OUTCOMES: The patient had no pain, instability, or activity limitations after 24 months of surgery. Physical examination of the patient revealed full and symmetric ROM, and normal Lachman and pivot shift test performance. LESSONS: ACL avulsion fractures can be accurately treated with arthroscopic reduction and sutures via an inside-out technique, which can reduce the risk of persistent ligamentous laxity and reduce open surgery-related morbidity.

Discoid medial meniscus of both knees: A case report.

BACKGROUND: Discoid meniscus is a congenital anomaly that typically affects the lateral meniscus. The appearance of the discoid medial meniscus in both knees is extremely rare, with an incidence of only 0.012%. CASE SUMMARY: Our patient was a 30-year-old female. Under no obvious predisposing causes, she began to experience pain in both knees, which worsened while walking and squatting. The pain was aggravated after exercise, and joint flexion and extension activities were accompanied by knee snapping. Apley's test was positive on physical examination, and there was a pressing pain in the medial articular space. Plain radiographs of both knees revealed no obvious abnormalities in the bilateral knee joint space. Partial meniscectomy as well as menisci reformation were performed on both knees under arthroscopy. Under the guidance of rehabilitation, the patient's range of motion in both knees returned to normal without pain and knee snapping. CONCLUSION: This study showed that the clinical manifestations of the discoid medial meniscus injury are identical to those of the conventional medial meniscus injury, and arthroscopic surgery is effective.

Psychological distress and its influencing factors among psychiatric nurses in China: A cross-sectional study.

Background: Psychiatric nurses often face abuse, attacks, escape, suicides, and other situations related to the care of patients with mental disorders, which are more likely to induce psychological distress. Aims: This study aimed to examine the relationship between coping styles and psychological distress among Chinese psychiatric nurses in Shandong and the significance of sleep quality as a mediating factor. Methods: A total of 812 psychiatric nurses in Shandong, China, were investigated using the Psychological Distress Scale (K10), Simplified Coping Style Questionnaire (SCSQ), Pittsburgh Sleep Quality Index (PSQI) and self-compiled general information questionnaire. Results: Psychological distress was detected in 571 psychiatric nurses (70.3%). The psychological distress of psychiatric nurses was significantly different with respect to professional title (χ2 = 10.627, P < 0.05) and shift work (χ2 = 9.120, P < 0.01). Psychological distress positively correlated with negative coping style (r = 0.266, P < 0.01) and sleep quality (PSQIT) (r = 0.532, P < 0.01). A significant positive correlation was found between psychological distress and all dimensions of sleep quality (r = 0.158-0.456, P < 0.05). Professional title, positive coping style, negative coping style, sleep quality (PSQIT), subjective sleep quality, sleep disorder and daytime dysfunction predicted psychological distress in psychiatric nurses (R 2 = 0.363, F = 65.343, P < 0.01). The relationship between negative coping style and psychological distress was partially mediated by sleep quality, with the mediating effect accounting for 37.97% of the total effect. Conclusions: Psychiatric nurses have a high rate of psychological distress, which is closely related to coping styles, and sleep quality has a certain regulatory effect.

Relationship between Biodegradation Rate and Grain Size Itself Excluding Other Structural Factors Caused by Alloying Additions and Deformation Processing for Pure Mg.

This work studied the relationship between biodegradation rate and grain size itself, excluding other structural factors such as segregations, impure inclusions, second phase particles, sub-structures, internal stresses and textures caused by alloying additions and deformation processing for pure Mg. A spectrum of grain size was obtained by annealing through changing the annealing temperature. Grain boundary influenced the hardness and the biodegradation behavior. The hardness was grain size-dependent, following a typical Hall-Petch relation: HV=18.45+92.31d-12. The biodegradation rate decreased with decreasing grain size, following a similar Hall-Petch relation: Pi=0.17-0.68d-12 or Pw=1.34-6.17d-12. This work should be helpful for better controlling biodegradation performance of biodegradable Mg alloys through varying their grain size.

Comparison of corneal thickness of young people with middle and high myopia between Shantou and Zhengzhou.

PURPOSE: To compare the corneal thickness of young subjects (aged 13 to 30 years) with moderate and high myopia living in Shantou and Zhengzhou. METHODS: One hundred and forty myopic subjects from Shantou (Guangdong, southern China) and 101 from Zhengzhou (Henan, central China) were selected and divided into 2 groups (moderate-myopic group and high-myopic group). The participants were sex-and age-matched. The central corneal thickness (CCT) and thinnest corneal thickness (TCT) were measured by Orbscan and compared between the two groups. RESULTS: In the high-myopic group, CCT (515.47±40.39 µm) and TCT (510.22±40.95 µm) of the Shantou subjects (mean spherical equivalent [SE] -7.56±1.35), were thinner than those of their Zhengzhou counterparts (mean SE -7.47±0.88). In the moderate-myopic group (Shantou mean SE -4.52±0.83; Zhengzhou -4.67± 0.77), CCT and TCT did not differ between the two cities. CONCLUSION: The corneal thickness of high-myopic eyes may differ between Shantou and Zhengzhou.

Distribution and visual impact of postoperative refractive error after cataract surgery in rural China: study of cataract outcomes and up-take of services report 4.

PURPOSE: To model the possible impact of using average-power intraocular lenses (IOLs) and evaluate the postoperative refractive error in patients having cataract surgery in rural China. SETTING: Rural Guangdong, China. METHODS: Patients having cataract surgery by local surgeons were examined and visual function was assessed 10 to 14 months after surgery. Subjective refraction at near and distance was performed bilaterally by an ophthalmologist. Patients had a target refraction of -0.50 diopter (D) based on ocular biometry. RESULTS: Of the 313 eligible patients, 242 (77%) could be contacted and 176 (74% of contacted patients, 56% overall) were examined. Examined patients had a mean age of 69.4 +/- 10.5 years. Of the 211 operated eyes, 73.2% were within +/-1.0 D of the target refraction after surgery. The best presenting distance vision was in patients within +/-1.0 D of plano and the best presenting near vision, in those with mild myopia (<-1.0 D to > or =2.0 D) (P= .005). However, patients with hyperopia (>+1.0 D) reported significantly better adjusted visual function than those with emmetropia or myopia (<-1.0 D). When the predicted use of an average-power IOL (median +21.5 D) was modeled, predicted visual acuity was significantly reduced (P= .001); however, predicted visual function was not significantly altered (P>.3). CONCLUSIONS: Accurate selection of postoperative refractive error was achieved by local surgeons in this rural area. Based on visual function results, aiming for mild postoperative myopia may not be suitable in this setting. Implanting average-power IOLs significantly reduced postoperative presenting vision, but not visual function.

Visual outcomes and astigmatism after sutureless, manual cataract extraction in rural China: study of cataract outcomes and up-take of services (SCOUTS) in the caring is hip project, report 1.

OBJECTIVE: To study the visual acuity and astigmatism of persons undergoing cataract extraction by local surgeons in rural China. METHODS: Visual acuity, keratometry, and refraction were measured 10 to 14 months postoperatively for all cataract cases during 4 months in Sanrao, China. RESULTS: Among 313 eligible subjects, 242 (77%) could be contacted, of whom 176 (73%) were examined. Of those who were examined, mean +/- SD age was 69.3 +/- 10.5 years, 66.5% were female, 35 had been operated on bilaterally at Sanrao, and 85.2% had a preoperative presenting visual acuity of 6/60 or worse. Presenting and best-corrected postoperative acuity in the eye that was operated on were 6/18 or better in 83.4% and 95.7%, respectively. Among 27 fellow eyes operated on elsewhere, 40.7% had a presenting acuity of 6/18 or better and 40.7% were blind (P < .001). Mean +/- SD postoperative astigmatism did not differ between 211 eyes that were operated on (-1.13 +/- 0.84 diopters) and 109 eyes that were not (-1.13 +/- 1.17 diopters; P = .27). Presence of operative complications (8.5%) and older age were associated with worse vision; bilateral surgery was associated with better vision. CONCLUSIONS: These results confirm the effectiveness of skill transfer in this setting, with superior outcomes to most studies in rural Asia and to eyes in this cohort operated on at other facilities.