Improved surgical exposure and early clinical outcomes using a femoral-release-first technique in direct anterior approach during total hip arthroplasty.

BACKGROUND: Total hip arthroplasty (THA) performed using the direct anterior approach (DAA) has demonstrated favourable early-, mid-, and long-term outcomes. However, the traditional femoral release technique remains technically demanding and is associated with challenges and a heightened risk of complications. This study aimed to compare the clinical outcomes of patients who underwent THA with DAA performed using either the femoral-release-first (FRF) or the traditional approach (TA) strategy. METHODS: A retrospective analysis of demographics, clinical and radiological outcomes, and occurrence of complications was performed using data from 106 patients between 2018 and 2019. The patients were categorised into two groups: FRF (44 hips) and TA (69 hips). RESULTS: The FRF group showed a reduced operative time, haemoglobin (Hb) drop, postoperative hospital stay, and more optimal acetabular cup anteversion angles. Furthermore, during the first 2 months postoperatively, the FRF group demonstrated superior visual analogue scale, Harris Hip, and Oxford Hip scores. In the TA group, two hips experienced greater trochanter fractures, and one experienced delayed incision healing. CONCLUSIONS: Compared with the TA, employing the FRF strategy during THA with DAA resulted in improved outcomes within the first 2 months postoperatively and comparable functional recovery beyond this period. The FRF method exhibited advantages such as favourable acetabular exposure and alignment and a reduced risk of complications. Therefore, the FRF strategy may be a favourable option.

Lipoprotein A, combined with alanine aminotransferase and aspartate aminotransferase, contributes to predicting the occurrence of NASH: a cross-sectional study.

BACKGROUND: Nonalcoholic steatohepatitis (NASH) progresses from simple nonalcoholic fatty liver (NAFL) and has a poor prognosis. Abnormal lipid metabolism is closely related to the occurrence and development of nonalcoholic fatty liver disease (NAFLD). This study aimed to study the relationships between serum lipid metabolites and NASH, and to improve the early diagnosis of NASH. METHODS: This study included 86 NAFLD patients (23 NASH and 63 NAFL), and 81 unaffected individuals as controls from West China Hospital between October 2018 and May 2019. With lipid metabolites as the focus of the study, the differences in lipid metabolites were compared between the control group, NAFL patients, and NASH patients. Logistic regression analysis was used to examine the risk factors of NASH. Finally, receiver operating characteristic curve (ROC curve) was used to analyze the efficacy of the metabolites in NASH prediction. RESULTS: The levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), and lipoprotein A (LPA) increased with the severity of NAFLD. In NAFLD patients, LPA (OR:1.61; 95%CI: 1.03-2.52) was a potential risk factor for NASH, and ROC analysis showed that the combination of LPA, ALT, and AST had a greater predictive efficiency for NASH. CONCLUSIONS: Abnormal apolipoprotein/lipoprotein is closely related to lipid metabolism disorder in patients with NAFLD. In NAFL, the combination of LPA, ALT, and AST contributes to predicting the occurrence of NASH. LPA may be a potential biomarker and therapeutic target for diagnosing and treating NASH.

[Interference of Exogenous Insulin on Insulin Detection Test by Electrochemiluminescence Immunoassay].

OBJECTIVE: To explore the interference of exogenous insulin therapy on insulin detection test by electrochemical luminescence immunoassay (ECLIA). METHODS: Insulin level was determined by ECLIA. According to the requirements of EP7-A2 of American Society for Clinical Laboratory Standards Institute Standards, paired difference experiment was conducted to evaluate the interference of 8 kinds of exogenous insulin on insulin detection, dose effect experiment was conducted to determine the relationship between exogenous insulin concentration and interference degree. RESULTS: When the interfering substance concentrations were ≤250 µU/mL, Gansulin NⓇ, Gansulin RⓇ, Humulin RⓇ,Novolin RⓇ and LantusⓇ all showed linear positive interference, while LevemirⓇ showed a linear negative interference in high concentrations insulin and non-interfering in low concentrations insulin, HumalogⓇ and Novo RapidⓇ showed non-interference in insulin detection. CONCLUSIONS: The use of different exogenous insulin may have different interference on insulin measurement, which need laboratorians and physicians notice to avoid misdiagnosis.

[Bushen Jiedu Recipe Protected Radiation Induced Hematopoietic Injury].

Objective To observe the protective effects of Bushen Jiedu Recipe (BJR) on radia- tion induced hematopoietic injury. Methods C57BL/10J mice TLR4 gene (TLR4 +/+) and knockout mice (TLR4 -/-) were randomly divided into 3 groups, the blank control group, the radiation model group, the BJR group. Sampling was respectively performed at day 1 , 14, and 30 after radiation. The general condi- tion of mice was observed. White blood cell (WBC) , red blood cell ( RBC) , and platelet ( PLT) were counted in each group. Thigh bone of mice was collected for bone marrow specimen. Bone marrow slice was prepared. Pathomorphological changes were observed under electron microscope. Results Com- pared with the blank control group, WBC, RBC, and PLT all decreased or showed a decreasing tendency after one day radiation. RBC and PLT significantly decreased after 14 days of radiation (P <0. 01 , P < 0. 05). Counts of WBC and RBC were higher in the TLR4 +/+ BJR group than in the rest 2 groups (P < 0. 01 , P <0. 05). No statistical difference in RBC or PLT between mice after 30 days of radiation and mice in the blank control group (P >0. 05). PLT count in the TLR4 +/+ BJR group was most approximate to the normal value. WBC count obviously increased, but still with statistical difference as compared with the blank control group (P <0.01). WBC count recovered most rapidly in the TLR4 +/+ BJR group. Results under light microscope showed the structure of bone marrow was injured to different degrees in all mice except those in the TLR4 +/+ BJR group. Conclusion BJR could attenuate radiation induced hematopoi- etic injury possibly through TLR4 signal pathway, thus playing significant radioprotective roles.