OBJECTIVESTo measure the linear polyethylene wear with use of a computer-assisted two-dimensional method, and to evaluate the relationship between wear and long-term clinic-radiological findings.

METHODSBetween December 1991 and December 1995, the senior author performed 40 primary total hip arthroplasties with use of H/G porous-coated acetabular component. Radiographs of 40 H/G cementless total hip arthroplasties were examined for osteolysis, radiolucent line, cup migration and so on. To measure the linear polyethylene wear, migration in the femoral head center relative to the cup shell center was calculated on digitized consecutive radiographs with special computer software program.

RESULTSThe minimum follow-up was 10 years. Total linear wear was 2-8 mm, the mean rate of linear polyethylene wear was (0.32+/-0.31) mm/year. Twelve acetabular components (30%) were revised at an average follow-up point of 12 years. Three types of polyethylene liner failure were identified: wear-through of the polyethylene liner with resultant metallosis (5 hips), excessive wear necessitating revision (5 hips), and polyethylene liner dissociation without gross evidence of wear (2 hips).

CONCLUSIONSHigh wear rates and femoral and acetabular osteolysis have been and still are the main problems in uncemented total hip replacement. There is clear relationship between wear and acetabular osteolysis or loosening of the prostheses. The poor long-term results with these uncemented total hip arthroplasties illustrate the necessity of regular radiographic evaluation in order to detect osteolysis and liner failure, which are both generally asymptomatic until catastrophic failure appears.

Adult ; Aged ; Arthroplasty, Replacement, Hip ; methods ; Follow-Up Studies ; Hip Prosthesis ; Humans ; Middle Aged ; Osteolysis ; etiology ; Polyethylene ; Postoperative Complications ; Prosthesis Failure ; Retrospective Studies

Objective To evaluate the change of treatment gap of epilepsy after intervention in rural areas of China.Method Six months after being stopped from the intervention project in 2004,using the same method as the first survey at the baseline,a door-to-door epidemiological survey was conducted again in 5 rural areas where the intervention measures had been carried out for about 3 years.Results Three hundred and twenty cases of epilepsy were diagnosed in the total sample population,yielding a prevalence rate of 0.62% and the prevalence of active epilepsy 0.44%.The prevalence and the active prevalence of epilepsy in the survey in 2000 were 0.70% and 0.46% respectively.Of the people with epilepsy,39.1% were treated regularly which increased about 14% than that in the baseline survey (24.8%).The treatment gap for active epilepsy was 49.8%,which decreased by 12.8% than that in the first survey (62.6%). Conclusion The treatment gap of epilepsy in the demonstration areas has decreased remarkably,proving that the intervention measures used in the study are effective and feasible in rural areas of China.

OBJECTIVETo explore the effects of large dose of Astragalus membranaceus (Astragalus) on the dentritic cell (DC) induction in vitro and augumentation by peripheral mononuclear cell (MNC) and on antigen presenting ability of DC in children with acute leukemia.

METHODSForty-four children with acute leukemia in complete remission stage were divided into two groups. Twenty patients in the Astragalus (90 g daily) group were treated with large dose of Astragalus (90 g daily) based on conventional chemotherapy for one month, while 24 patients in the control group received chemotherapy alone. MNC were extracted from peripheral blood by wall-sticking method and cultured with such cell factors as interleukin-4, gramulocyte macrophage colony stimulating factor, tumor necrosis factor-alpha for 7-8 days. Phenotype of DC was assayed by flow cytometry and antigen presenting ability of them was assayed by mixed lymphocyte reaction.

RESULTSThere was no morphological difference in MNC induced DC between the two groups. The average number of DC in Astragalus group and control group was 4.4 x 10(6) / 2.5 x 10(6) MNC and 2.6 x 10(6) / 2.5 x 10(6) MNC, respectively, showing significant difference (P < 0.001). DC in Astragalus group could stimulate the proliferation of allogeneic lymphocytes strongly, showing significant difference when compared with that in the control group (P < 0.001). Conclusion Large dose of Astragalus could increase the DC induction of MNC and enhance the antigen presenting ability of DC in acute leukemia patients.

Acute Disease ; Antigen-Presenting Cells ; cytology ; Astragalus membranaceus ; chemistry ; Cell Differentiation ; Cells, Cultured ; Child ; Child, Preschool ; Dendritic Cells ; drug effects ; immunology ; Dose-Response Relationship, Drug ; Drug Administration Schedule ; Drugs, Chinese Herbal ; pharmacology ; Female ; Humans ; Leukemia ; pathology ; Leukemia, Myeloid, Acute ; pathology ; Leukocytes, Mononuclear ; cytology ; Male ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; pathology ; Tumor Cells, Cultured

Objective To assess the characteristics of the dysfunction of semicircular canal in benign paroxysmal positional vertigo and the relationship with the ectopic otoconia.Methods There were 214 patients with benign paroxysmal positional vertigo( BPPV),including 107 cases of posterior semicircular canal canalithasis(PSC-Can) 80 cases of horizontal semicircular canal canalithasis( HSC-Can),27 cases of horizontal semicircular canal cupulolithiasis (HSC-Cup).One hundred and ninety (88.8％)patients were accompany with relevant diseases while 24 ( 11.2％ ) cases were not.They accepted low,middle and high frequency vestibular function tests,including caloric test ( CT),head shaking test (HST) and video head impulse test(vHIT) respectively.The parameters of the unilateral weakness(UW),head shaking nystagmus (HSN) and video head impulse test gain(vHIT-G) were observed.Patients classified into three groups (PSC-Can,HSC-Can,HSC-Cup) according to the involvement semicircular canal.The results of the three tests were analyzed with SPSS16.0 software.Results The positive cases of the three tests were vHIT:15 (7.0％),HST:52(24.3％ ),CT:152(71.0％ ),a statistically significant difference(P ＜ 0.05) was found between the three tests.When compared the Calorie Test,HST and vHIT between the BPPV patients with and without relevant diseases,there were no significant differences ( P ＞ 0.05 ).The variance without statistical significance(P ＞ 0.05) was showed between three tests' results in each groups,it was also showed that the variance between the three groups in each tests reached no statistical significance(P ＞0.05 ).The test of affected side UW between PSC-Can,HSC- Can and HSC-Cup showed the variance without statistical significance( F =0.970,P =0.383 ). Conclusions The lesion of semicircular canals has the same etiological factors with the utricle pathological change in benign paroxysmal positional vertigo,and the dysfunction mostly happens in low frequency range of semicircular canal frequency band. The ectopic otoconia is not the main etiological factors for that.HST and vHIT of middle and high frequency can not be ultimately used for the screening test evaluating due to the semicircular canal function in BPPV.

Purpose: This study aimed to identify prognostic factors for patients with distant lymph node-involved gastric cancer (GC) using a machine learning algorithm, a method that offers considerable advantages and new prospects for high-dimensional biomedical data exploration. Materials and Methods: This study employed 79 features of clinical pathology, laboratory tests, and therapeutic details from 289 GC patients whose distant lymphadenopathy was presented as the first episode of recurrence or metastasis. Outcomes were measured as anycause death events and survival months after distant lymph node metastasis. A prediction model was built based on possible outcome predictors using a random survival forest algorithm and confirmed by 5×5 nested cross-validation. The effects of single variables were interpreted using partial dependence plots. A contour plot was used to visually represent survival prediction based on 2 predictive features. Results: The median survival time of patients with GC with distant nodal metastasis was 9.2 months. The optimal model incorporated the prealbumin level and the prothrombin time (PT), and yielded a prediction error of 0.353. The inclusion of other variables resulted in poorer model performance. Patients with higher serum prealbumin levels or shorter PTs had a significantly better prognosis. The predicted one-year survival rate was stratified and illustrated as a contour plot based on the combined effect the prealbumin level and the PT. Conclusions Machine learning is useful for identifying the important determinants of cancer survival using high-dimensional datasets. The prealbumin level and the PT on distant lymph node metastasis are the 2 most crucial factors in predicting the subsequent survival time of advanced GC.Trial Registration: ChiCTR Identifier: ChiCTR1800019978

Purpose: While several prognostic models for the stratification of death risk have been developed for patients with advanced gastric cancer receiving first-line chemotherapy, they have seldom been tested in the Chinese population. This study investigated the performance of these models and identified the optimal tools for Chinese patients. Materials and Methods: Patients diagnosed with metastatic or recurrent gastric adenocarcinoma who received first-line chemotherapy were eligible for inclusion in the validation cohort. Their clinical data and survival outcomes were retrieved and documented. Time-dependent receiver operating characteristic (ROC) and calibration curves were used to evaluate the predictive ability of the models. Kaplan-Meier curves were plotted for patients in different risk groups divided by 7 published stratification tools. Log-rank tests with pairwise comparisons were used to compare survival differences. Results: The analysis included a total of 346 patients with metastatic or recurrent disease.The median overall survival time was 11.9 months. The patients were different into different risk groups according to the prognostic stratification models, which showed variability in distinguishing mortality risk in these patients. The model proposed by Kim et al. showed relative higher predicting abilities compared to the other models, with the highest χ 2 (25.8) value in log-rank tests across subgroups, and areas under the curve values at 6, 12, and 24 months of 0.65 (95% confidence interval [CI]: 0.59–0.72), 0.60 (0.54–0.65), and 0.63 (0.56–0.69), respectively. Conclusions Among existing prognostic tools, the models constructed by Kim et al., which incorporated performance status score, neutrophil-to-lymphocyte ratio, alkaline phosphatase, albumin, and tumor differentiation, were more effective in stratifying Chinese patients with gastric cancer receiving first-line chemotherapy.

OBJECTIVETo investigate the validity of transesophageal echo-Doppler technique for hemodynamic monitoring of patients with extensive burns during shock stage to provide guidance for fluid resuscitation.

METHODSMongrel dogs were inflicted with 50% TBSA full-thickness burns. Cardiac output (CO) were determined by Swan-Ganz catheter, and other hemodynamic indices by transesophageal echo-Doppler device, including aortic blood flow (ABF), stroke volume (SVa), left ventricle ejection time (LVET), peak velocity (PV), max acceleration (max ACC), total systemic vascular resistance (TSVR) were collected before and after burns. Hemodynamic indices of ten patients with extensive burns were collected by transesophageal echo-Doppler device with in 24 hours after the injury.

RESULTSBoth CO and ABF showed continuous decrease after burns, and there was positive correlation between them (r = 0.90, P < 0.01). The myocardiac contractibility (ACC, PV) and the preload of the left ventricle (LVET) were also decreased continuously after bums,but the postburn afterload (TSVR) were obviously increased. For the patients with conventional therapy, the hemodynamic state of low cardiac output and high peripheral resistance during early period was converted to high cardiac output and low peripheral resistance 24 hours after injury.

CONCLUSIONTransesophageal echo-Doppler technique is useful in monitoring hemodynamic in patients with extensive burn, and it is non-invasive, real-time, synchronized and rapid, and it can provide complete profile of hemodynamic data.

Animals ; Blood Flow Velocity ; Burns ; diagnostic imaging ; therapy ; Dogs ; Fluid Therapy ; Humans ; Male ; Ultrasonography, Doppler ; Vascular Resistance

OBJECTIVETo study the risk factors of infection of extended-spectrum beta-lactamases (ESBL)-producing strains and drug resistance of Enterobacteriaceae that infected burn patients.

METHODSA retrospective study was performed on clinical information of 92 patients with Enterobacteriaceae infection in our burn unit from January 2001 to December 2008. The distribution and drug resistance of Enterobacteriaceae, and the detection rate, drug resistance of ESBL-producing strains, and its risk factors of nosocomial infection were analyzed. Data were processed with Chi-square test.

RESULTSOne hundred and nine strains of Enterobacteriaceae were isolated, with 38 (34.9%) strains of Enterobacter cloacae, 25 (22.9%) strains of Escherichia coli, 22 (20.2%) strains of Klebsiella pneumoniae, 13 (11.9%) strains of Proteus mirabilis, and 11 (10.1%) other strains of Enterobacteriaceae. Enterobacteriaceae were moderately or highly resistant to antibiotics except imipenem, resistance rate of which was less than 8.0%. ESBL-producing strains accounted for 44.0% in Escherichia coli, and 77.3% in Klebsiella pneumoniae. Drug-resistance rate of ESBL-producing strains to antibiotics was obviously higher than that of non ESBL-producing strains. Length of hospital stay longer than 20 days, and use of the third-generation cephalosporin longer than 5 days, quinolone antibiotics longer than 7 days, and topical antibiotics longer than 5 days were the risk factors of nosocomial infection caused by ESBL-producing strains, comparing with non ESBL-producing strains, the difference was statistically significant (with chi2 value respectively 5.491, 4.441, 15.186, 4.938, P values all below 0.05).

CONCLUSIONSEnterobacteriaceae strains in burn unit of our hospital are highly drug resistant, with high lactamase-producing rates, calling for intense monitor to control the risk factors that predispose the infection of ESBL-producing strains in order to lower the infection rate.

Adolescent ; Adult ; Burn Units ; Child ; Drug Resistance, Bacterial ; Enterobacteriaceae ; drug effects ; Enterobacteriaceae Infections ; epidemiology ; microbiology ; Female ; Humans ; Male ; Microbial Sensitivity Tests ; Middle Aged ; Retrospective Studies ; Risk Factors ; Young Adult ; beta-Lactam Resistance

A highly sensitive, rapid and selective liquid chromatography-tandem mass spectrometry (LC-MS/MS) method for the quantitative determination of retinamido-ester in rat plasma was developed and validated. A simplified protein precipitation with acetonitrile was employed for the sample preparation. The separation was carried out on an Agilent TC C18 column (150 mm x 4.6 mm ID, 5 microm particle size) with the mobile phase consisted of methanol-water-formic acid (93: 7: 0.1). Simvastatin was used as internal standard. The detection was performed on a trap-quadrupole tandem mass spectrometer by selected reaction monitoring (SRM) scan mode via atmospheric pressure chemical ionization (APCI). The range of calibration curve was 0.05-50 ng x mL(-1) and the limit of quantification was 10 pg x mL(-1). The intra- and inter-day precision values were between 95.97% and 104.43%, and RSD was between 4.63% and 10.69%, respectively. This method was applied to determine the pharmacokinetic parameters. The main pharmacokinetic parameters of retinamido-ester after oral administration via gastric gavage of 2.5, 5, 10 mg x kg(-1) were as follows, T(1/2): (11.28 +/- 7.23), (8.90 +/- 3.82), (8.01 +/- 5.65) h; AUC(0-infinity): (103.41 +/- 61.46), (190.23 +/- 74.99), (421.66 +/- 229.20) ng x h x mL(-1); MRT: (6.31 +/- 0.75), (5.98 +/- 0.71), (6.18 +/- 0.97) h; CL/F: (30.10 +/- 13.67), (29.58 +/- 10.59), (31.18 +/- 17.51) L x h(-1) x kg(-1); Vd/F: (414.94 +/- 159.82), (356.16 +/- 139.85), (369.28 +/- 322.72) L x kg(-1), respectively.
Administration, Oral ; Animals ; Antineoplastic Agents ; administration & dosage ; blood ; pharmacokinetics ; Area Under Curve ; Chromatography, Liquid ; methods ; Rats ; Rats, Sprague-Dawley ; Tandem Mass Spectrometry ; methods ; Tretinoin ; administration & dosage ; analogs & derivatives ; blood ; pharmacokinetics

OBJECTIVETo compare screw's inserting angle through the 11th and 12th rib in treating L1 burst fracture, explore effects on inserting screw and postoperative angle.

METHODSFrom October 2007 to October 2010, 108 patients with L1 brust fracture treated through anterior approach were analyzed,including 68 males and 40 females, aged from 21 to 64 years (mean 38.22 years). All patients were divided into the 11th (A, 51 cases) and 12th (B, 57 cases) approach. The data of operation time,blood loss, duration of incision pain, JOA score, Oswestry score, VAS score, quality of life (SF-36), recovery of nervous function, coronal Cobb angle, included angle between screw and plate were observed.

RESULTSAll patients were followed up for 9 to 37 months, mean 23 months. The operation time, blood loss, duration of incision pain, in group A were lower than group B (P<0.05), JOA score, Oswestry score, VAS score, SF-36, recovery of nervous function had no significant differences (P>0.05). There were no differences in Cobb angle before operation, but had significance after operation (P=0.000). There were statistically significance between two group in angle between screw and plate (P=0.000, P=0.003).

CONCLUSIONThe 11th rib approach for the treatment of L1 burst fracture has less effects on screw, less trauma and less angle between screw and plate.

Adult ; Bone Screws ; Female ; Fracture Fixation, Internal ; adverse effects ; instrumentation ; Humans ; Male ; Middle Aged ; Postoperative Complications ; Recovery of Function ; Rib Fractures ; diagnostic imaging ; physiopathology ; surgery ; Ribs ; surgery ; Spinal Cord ; physiopathology ; Tomography, X-Ray Computed ; Young Adult