Venous thromboembolism is a serious complication of the patients undergoing orthopaedic surgery.Effective diagno-sis and assessment are important methods to predict venous thromboembolismand decrease the incidence of venous thromboenbolism . This paper summaries the advantages and disadvantages of subjective and objective assessment tools to help doctors and nurses find the patients with high risk in the early stage,take individual prevention,and decrease the incidence of venous thromboembolism.

BACKGROUND:Compliance of mechanical device reduced in the prevention of deep venous thrombosis.
OBJECTIVE:To evaluate the compliance on mechanical prevention measures in the prevention of deep venous thrombosis, and to analyze the reason for compliance reduction.
METHODS:We searched Cochrane Library, PubMed, Embase, and Medline for articles on compliance of inpatients on mechanical device for prevention of deep vein thrombosis published from inception to December 2015. At the same time, the“snowbal”method was used to screen the references. After the literatures were screened, using the Newcastle Ottawa Scale tools and Agency for Healthcare Research and Quality standard, two researchers evaluated the quality of the literatures independently and strictly. Data were extracted if meet the discharge standard. The software of Meta-analyst Beta3.13 was used for heterogeneity analysis and publication bias test in the extracted data. According to the heterogeneity analysis results and literature types, a reasonable statistical analysis method was selected to col ate, summarize and discuss.
RESULTS AND CONCLUSION:Final y, 12 papers were included, 9 of which were cross-sectional studies, 2 cohort studies, and 1 case-control study. The odds ratio about compliance rate of inpatients with mechanical devices was 53.2%(95%CI:38.7-67.2). Subgroup analysis showed that the odds ratio about compliance rate of pneumatic compression devices was 54.9%(95%CI:34.9-73.4). The odds ratio about compliance rate on elastic stockings was 47.9%(95%CI:34.3-61.8). The detection of mechanical device of surgical patients showed that odds ratio about compliance rate was 66.8%(95%CI:47.4-81.7). Our results confirm that the compliance rate of the use of mechanical devices for the prevention of deep venous thrombosis in clinical inpatients requests to be improved. The reason for reduced compliance rate should be further investigated to improve the compliance rate.

Objective:To evaluate the changes of the left atrial systolic function in patients with acute myocardial infarction(AMI)using quantitative tissue velocity imaging(QTVI).Methods:The systolic velocities of the middle of left atrial lateral wall,anterior wall,inferior wall and atrial septum were measured with QTV1 in 45 patients with AMI.The left atrial volume and active atrial emptying fraction(AA-EF)were measured using single-plane Simpson method.Results:(1)Compared with the control group(30 normal subjects),the diameter and volume of the left atrium,as well as AA-EF,increased obviously in patients with AMI(P ＜ 0.01).(2)Compared with the control group,the systolic velocities of the middle of left atrial lateral wall,anterior wall,inferior wall and atrial septum,as well as the average value,increased significantly in patients with AMI (P ＜ 0.05 or P ＜ 0.01).In addition,the average value of left atrial systolic velocity was closely correlated with AA-EF(r=-0.906,tr=14.001,P ＜ 0.01).Conclusion:QTVI could be used to evaluate the left atrial systolic function accurately in patients with AMI.

OBJECTIVECombined the optical principle with automatic control technology and computer real-time image detection technology to develop a non-contact system for noninvasive esophageal varices pressure measurement.

METHODSThe system included the adjustable air pump, laser device, image collection and analysis program. The feasibility and accuracy of the system were verified by in vitro experiments.

RESULTSThe bionic vascular pressure measured by this system had good correlation and repeatability with the actual pressure.

CONCLUSIONSThis system is accurate, feasible and has good application prospects.

BACKGROUND:Tranexamic acid has been more and more used in reducing bleeding after joint replacement, but its usage method and dosage remain controversial, and become a hot focus in recent years. OBJECTIVE: To investigate the efficacy and safety of intravenous drip combined with intra-articular injection of tranexamic acid on postoperative hidden blood loss in patients who received primary total hip arthroplasty. METHODS:Clinical data of 65 patients undergoing primary total hip arthroplasty were randomized to the test group and the control group. The patients in the test group received 0.5 g tranexamic acid through intravenous drip when the surgery starts and 0.5 g tranexamic acid inside hip joint through a drainage tube after capsule closure, and retaining for 6 hours. The patients in the control group intravenously received the same volume of physiological saline, and 50 mL physiological saline through a drainage tube after suture, and retaining for 6 hours. We compared with intraoperative blood loss, postoperative dominant blood loss and hidden blood loss, pain score, blood transfusion rate, deep vein thrombosis and day of hospitalization in both groups. RESULTS AND CONCLUSION:Hemoglobin and hematocrit were higher in the test group than in the control group after replacement (P < 0.05). The volumes of dominant blood loss and hidden blood loss were lower in the test group than in the control group after replacement (P < 0.05). Blood transfusion rate and day of hospitalization were less in the test group than in the control group (P < 0.05). No significant difference in intraoperative blood loss, pain score and incidence of deep vein thrombosis was detectable between the two groups (P > 0.05). These results indicate that the intravenous drip combined intra-articular injection of tranexamic acid in patients receiving total hip arthroplasty could reduce the amounts of postoperative dominant and hidden blood loss and blood transfusion rate, and did not increase the incidence of deep vein thrombosis.

Objective To investigate the application of Critical Care Chest Ultrasonic Examination (CCUE)-plus (CCUE-plus) in the etiological diagnosis in patieuts with dyspnea and/or hemodynamic instability caused by abdominal abnormalities.Methods Patients who suffered from dyspnea and/or hemodynamic instability in the Department of Critical Care Medicine,Xiangya Hospital,Central South University from September 2013 to September 2016 were recruited in this study.A total of 255 consecutive patients completed CCUE within 2hrs of admission.If the diaphragm could not be seen in the routine phrenic points according to Bedside Lung Ultrasound Evaluation (BLUE) protocol,it would be found along midaxillary line and defined m-point.The 59 patients with altered diaphragmatic position (m-point was more than 2 cm higher than phrenic point) received sequential abdominal ultrasonography.The latter ultrasonographic findings were compared with CT results.Results There were 42 (71.19％) cases with positive findings of abdominal ultrasonography,including 18 cases of seroperitoneum,16 cases of intestinal obstruction and 8 cases combined.Compared with 56 patients who applied with CT exam,the abdominal ultrasonography revealed a sensitivity of 76.7％ and a specificity of 100.0％ to diagnose seroperitoneum (AUCRoc 0.917);whereas the sensitivity was 75.0％ and the specificity was 90.9％ (AUCRoc 0.778) to diagnose intestinal obstruction.Moreover,there were 44 (74.58％) patients with normal left ventricular systolic function;more than three quarters (46/59,77.97％) patients had pulmonary consolidation.Conclusion In patients with dyspnea and/or hemodynamic instability caused by abdominal abnormalities and altered diaphragmatic position in BLUE protocol,CCUE-plus protocol has a high positive predictive value of more than 90％ in abdominal abnormality.The findings of abdominal ultrasonography may change therapeutic target from cardio-pulmonary optimization to relief of intestinal obstruction or drainage of seroperitoneum.

Objective Combined the optical principle with automatic control technology and computer real-time image detection technology to develop a non-contact system for noninvasive esophageal varices pressure measurement.Methods The system included the adjustable air pump, laser device, image colection and analysis program. The feasibility and accuracy of the system were verifi ed by in vitro experiments.Results The bionic vascular pressure measured by this system had good correlation and repeatability with the actual pressure.Conclusions This system is accurate, feasible and has good application prospects.

Objective To compare predictive power for deep vein thrombosis among hip and knee joint replacement patients using Autar scale and Wells scale.Methods Convenience sampling method was used.Totally 331 patients from ten tertiary hospitals receiving hip and knee joint replacement were recruited.General information questionnaire,Autar scale and Wells scale were used to collect data.Telephone follow-up was performed at 2 weeks,1 month and 3 months after hospital discharge.The primary endpoint of follow-up was occurrence of DVT,and the secondary endpoint was no occurrence of DVT within 3 months after hospital discharge.Results The Cronbach's α coefficients of Autar scale ranged from 0.716 to 0.762 for scores 24h before operation,24h after operation and at the day of discharge,and those of Wells scale ranged from 0.580 to 0.603.The area under the ROC curve of Autar scale ranged from 0.726 to 0.798.The area under the ROC curve of Wells scale ranged from 0.568 to 0.628.Conclusion The predictive power of Autar scale was higher than that of Wells scale which enabled Autar scale to better predict deep vein thrombosis for patients receiving hip and knee joint replacement.

A cross-sectional study was conducted on 1 052 patients with coronary heart disease (CHD) who visited 10 community health service centers in Chaoyang and Haidian districts of Beijing from March 2019 to September 2019. Basic information, medical history, cardiovascular risk factors, β-blocker use, height, weight, blood pressure level and resting heart rate were collected by face-to-face interview;biochemical tests and on-site physical examination were performed;and the influencing factors of heart rate control were analyzed by logistic regression. There were 563 males (53.5%) and 489 females(46.5%),with a mean age of (66.7±9.5) years. The rate of β-blockers use was 43.6% (459/1 052). The average resting heart rate was (70±8)/min, and only 14.5% (153/ 1 052) patients had the heart rate under control. The resting heart rate control rate in patients with β-blockers use was 17.9% (82/459), higher than that of those without β-blockers use [12.0% (71/593), χ 2=7.23, P=0.007]. Moderate leisure activities were beneficial to the control of resting heart rate ( OR=2.14, 95% CI: 1.26-3.62). The study shows that β-blockers use and resting heart rate control in CHD patients in Beijing community health institutions were both at low levels, and the resting heart rate was not well controlled even in patients taking beta-blockers.

Objective To investigate the efficacy of CT-guided percutaneous microwave ablation for the treatment of primary hepatocellular carcinoma.Methods A total of 132 patients with primary hepatocellular carcinoma were divided into control group and study group(66 cases in each group)according to different treatment plans.The control group received transcatheter arterial chemoembolization(TACE)treatment,while the study group received TACE combined with percutaneous microwave ablation under CT guidance.The changes in serum tumor markers and liver function indicators were observed before and after treatment in the two groups,and the efficacy(short-and long-term)and safety of the two groups were compared.Results The levels of serum carcinoembryonic antigen(CEA),alpha-fetoprotein(AFP),carbohydrate antigen 125(CA125),and carbohydrate antigen 19-9(CA19-9)in both groups decreased significantly after treatment compared to those before treatment,and intergroup comparison showed that the levels of CEA,AFP,CA125,and CA1 9-9 in the study group were significantly lower those after treatment(P＜0.05).Compared with those before treatment,the levels of alanine transaminase(ALT)and aspartate transaminase(AST)were decreased,and the level of albumin(ALB)was increased of both groups after treatment.The intergroup comparison showed that the study groups ALT and AST levels were lower and ALB level was higher(P＜0.05).The total effective rate of the study group was clearly higher than that of the control group(75.76％vs 46.97％,P＜0.05).The 1-year survival rates of the two groups were similar(90.91％vs 81.82％,P＞0.05),however,the 2-year survival rate of the study group was clearly higher than that of the control group(84.85％vs 63.64％,P＜0.05).Conclusion CT-guided percutaneous microwave ablation for the adjuvant TACE treatment of primary hepatocellular carcinoma can effectively reduce tumor burden and lower tumor marker levels,its short-and long-term efficacy is significant,with a low incidence of adverse reactions and good safety.