Objective The application of metal augments in the revision of total hip arthroplasty(THA)has achieved re-markable results in the treatment of bone defects.However,there are limited studies compared this effective method with the traditional treatment.The purpose of this article is to investigate the curative effect of both metal augmentation and impacted bone grafting in the revision of acetabular bone defect. Methods We retrospectively analyzed 20 patients(20 hips)with bone defects after THA in Au-thority of Nanjing General Hospital of Nanjing Military Region from August 2010 to February 2017.These 20 patients were allocated into 2 groups:impacted bone grafting group(n=11,filling acetabular bone defect with autogenous iliac bone and artificial bone)and metal aug-mentation group(n=9,filling acetabular bone defect with metal aug-ment).The duration of surgery,blood loss and the hospital for special surgery knee score(HSS)were compared between these two groups and the Harris score was applied to evaluate the hip function and full weight bearing. Results The surgery duration and blood loss of impacted bone grafting group were significantly increased when compared with the metal augmentation group(44.5±7.82 min vs 36.22±5.19 min and 431.82±57.76 mL vs 333.33±72.80 mL respec-tively).there were 3 cases showed mild bone resorption in the I regions in the impacted bone grafting group, while only one case showed mild bone resorption in the II region in the metal augmentation group.The HSS scores in the metal augmentation group were higher than those in the impacted bone grafting group at the time of postoperative 2 weeks(43.89±2.76 vs 40.82±4.42), 3 months (49.89±2.03 vs 45.27±3.90)and 6 months(53.44±2.46 vs 50.55±3.67), the differences were statistically significant(P<0.001). The Harris scores in the metal augmentation group were higher than those in the impacted bone grafting group(P<0.01).The metal augmentation group had a shorter time of getting out of bed compared with the impacted bone grafting group(P<0.01). Conclusion For those patients with upper acetabular bone defect,revision surgery using metal augments can save the operation time.Meanwhile, it is also superior to the impacted bone grafting in the early prosthesis stability and bone ingrowth,and thus enables to shorten the time on getting out of bed and promote functional.

BACKGROUNDData on the epidemiology of hypertension in Chinese non-dialysis chronic kidney disease (CKD) patients are limited. The aim of the present study was to investigate the prevalence, awareness, treatment, and control of hypertension in the non-dialysis CKD patients through a nationwide, multicenter study in China.

METHODSThe survey was performed in 61 tertiary hospitals in 31 provinces, municipalities, and autonomous regions in China (except Hong Kong, Macao, and Taiwan). Trained physicians collected demographic and clinical data and measured blood pressure (BP) using a standardized protocol. Hypertension was defined as systolic BP ≥ 140 mmHg and/or diastolic BP ≥ 90 mmHg, and/or use of antihypertensive medications. BP < 140/90 mmHg and < 130/80 mmHg were used as the 2 thresholds of hypertension control. In multivariate logistic regression with adjustment for sex and age, we analyzed the association between CKD stages and uncontrolled hypertension in non-dialysis CKD patients.

RESULTSThe analysis included 8927 non-dialysis CKD patients. The prevalence, awareness, and treatment of hypertension in non-dialysis CKD patients were 67.3%, 85.8%, and 81.0%, respectively. Of hypertensive CKD patients, 33.1% and 14.1% had controlled BP to < 140/90 mmHg and < 130/80 mmHg, respectively. With successive CKD stages, the prevalence of hypertension in non-dialysis CKD patients increased, but the control of hypertension decreased (P < 0.001). When the threshold of BP < 130/80 mmHg was considered, the risk of uncontrolled hypertension in CKD 2, 3a, 3b, 4, and 5 stages increased 1.3, 1.4, 1.4, 2.5, and 4.0 times compared with CKD 1 stage, respectively (P < 0.05). Using the threshold of < 140/90 mmHg, the risk of uncontrolled hypertension increased in advanced stages (P < 0.05).

CONCLUSIONSThe prevalence of hypertension Chinese non-dialysis CKD patients was high, and the hypertension control was suboptimal. With successive CKD stages, the risk of uncontrolled hypertension increased.

Adult ; Aged ; Awareness ; Female ; Humans ; Hypertension ; complications ; epidemiology ; therapy ; Male ; Middle Aged ; Prevalence ; Renal Insufficiency, Chronic ; complications

To scientifically evaluate the intervention effect of Chinese medicine preventive administration(combined use of Huo-xiang Zhengqi Oral Liquid and Jinhao Jiere Granules) on community population in the case of coronavirus disease 2019(COVID-19), a large cohort, prospective, randomized, and parallel-controlled clinical study was conducted. Total 22 065 subjects were included and randomly divided into 2 groups. The non-intervention group was given health guidance only, while the traditional Chinese medicine(TCM) intervention group was given two coordinated TCM in addition to health guidance. The medical instructions were as follows. Huoxiang Zhengqi Oral Liquid: oral before meals, 10 mL/time, 2 times/day, a course of 5 days. Jinhao Jiere Granules: dissolve in boiling water and take after meals, 8 g/time, 2 times/day, a course of 5 days, followed up for 14 days, respectively. The study found that with the intake of medication, the incidence rate of TCM intervention group was basically maintained at a low and continuous stable level(0.01%-0.02%), while the non-intervention group showed an overall trend of continuous growth(0.02%-0.18%) from 3 to 14 days. No suspected or confirmed COVID-19 case occurred in either group. There were 2 cases of colds in the TCM intervention group and 26 cases in the non-intervention group. The incidence of colds in the TCM intervention group was significantly lower(P<0.05) than that in the non-intervention group. In the population of 16-60 years old, the incidence rate of non-intervention and intervention groups were 0.01% and 0.25%, respectively. The difference of colds incidence between the two groups was statistically significant(P<0.05). In the population older than 60 years old, they were 0.04% and 0.21%, respectively. The incidence of colds in the non-intervention group was higher than that in the intervention group, but not reaching statistical difference. The protection rate of TCM for the whole population was 91.8%, especially for the population of age 16-60(95.0%). It was suggested that TCM intervention(combined use of Huoxiang Zhengqi Oral Liquid and Jinhao Jiere Granules) could effectively protect community residents against respiratory diseases, such as colds, which was worthy of promotion in the community. In addition, in terms of safety, the incidence of adverse events and adverse reactions in the TCM intervention group was relatively low, which was basically consistent with the drug instructions.
Adolescent ; Adult ; Betacoronavirus ; Coronavirus Infections ; drug therapy ; Drugs, Chinese Herbal ; Humans ; Medicine, Chinese Traditional ; Middle Aged ; Pandemics ; Pneumonia, Viral ; drug therapy ; Prospective Studies ; Young Adult