Objective To screen and verify hub genes TPM1 and CALD1 that can affect the diagnosis and prognosis of bladder cancer (BLCA). Methods We obtained gene chip expression data of 414 and 188 cases of bladder cancer from TCGA and GEO, respectively. By constructing a weighted gene co-expression network analysis (WGCNA) and identifying differentially-expressed genes between tumor tissues and normal tissues, the pivotal genes that were highly associated with bladder cancer were obtained, and the STRING database was used to construct a protein interaction network to screen out prognostic-related pivotal genes. We took 29 cases of bladder cancer samples from People's Hospital of Zhengzhou as external verification results. Results A total of 915 and 464 differentially-expressed genes were screened from the TCGA database and GSE13507, respectively. Two modules with the strongest correlation were obtained through WGCNA: the blue module (Pearson cor=0.60, P=1E-44) and the cyan module (Pearson cor=0.52, P=7E-19), and 156 intersection genes were obtained. Through protein interaction network analysis, 10 pivotal genes were screened out. TPM1 and CALD1 genes had the greatest correlation with the survival of bladder cancer patients, which was verified by external experimental verification group. Conclusion TPM1 and CALD1 are closely related to the prognosis of bladder cancer patients. They are also pivotal genes to promote tumor progression.

OBJECTIVE: To compile the Chinese Musculoskeletal Questionnaire(CMQ) and test its reliability and validity. METHODS: The initial CMQ was formed through studying literatures, interviewing professional workers who have work-related musculoskeletal disorders(WMSDs) and investigation with occupational health and ergonomics experts. Then, 436 and 443 manufacturing workers were selected as prediction and verification samples respectively by convensence sampling method. The reliability and validity of the CMQ were tested by item analysis, exploratory factor analysis and confirmatory factor analysis. RESULTS: i) The CMQ composed of 48 items with item analysis. ii) Nine common factors of CMQ were extracted using exploratory factor analysis, which explained 70.721% of WMSDs variance. iii) The results of confirmatory factor analysis showed that the ratio of chi-square to degree of freedom was 3.380, the comparative fit index was 0.781, the Tucker-Lewis index was 0.764, the root mean square error of approximation was 0.073, and the standardized root mean square residual was 0.068. iv) The results showed that the item reliabilities of the 9 common factors of CMQ such as upper and lower limbs posture load, neck posture load, back posture load, job demand, social support, job control, job environment, job system and job facilities were 0.205-0.841, the composite reliabilities were 0.545-0.894, and the convergence efficiencies were 0.377-0.834. The correlation coefficients between the common factors were less than its square root of the convergence validities. CONCLUSION: The CMQ has good reliability and validity, and is a reliable and effective tool for evaluating WMSDs.

OBJECTIVE: To investigate the prevalence of lower extremity work-related musculoskeletal disorders(WMSDs) among manufacturing workers, and to explore the association of lower extremity WMSDs and different types of working. METHODS: A total of 7 908 workers were selected as study subjects from four manufacturing factories in China using the cluster sampling method. The Musculoskeletal Disorders Investigating Questionnaire was adopted to investigate the prevalence of lower extremity WMSDs and the distribution of types of working. The prevalence ratio(PR) of WMSDs, calculated by log-binomial model, was used to estimate the correlation of WMSDs in different parts of lower extremity. The multi-factor logistic regression was used to analyze the association of lower extremity WMSDs and different types of working. RESULTS: The total annual prevalence of lower extremity WMSDs was 41.0%(3 241/7 908) among manufacturing workers. The annual prevalence of WMSDs of different parts in lower extremity from high to low were knee(29.5%), ankle/foot(23.9%) and hip/thigh(16.7%). The correlation of WMSDs of the three parts in lower extremity was close, and the range of PR values was 2.21-3.88. The result of logistic regression analysis showed that the workers who frequently sat for long periods had higher risk of lower extremity WMSDs than those who never/rarely sat for long periods(odds ratio=1.39, P<0.01). The higher the frequency of standing, kneeling/squatting for long periods, carrying heavy loads ≥5 kg and driving, the higher the risk of lower extremity WMSDs(the odds ratios were 1.33, 1.41, 1.16 and 1.12, respectively, P<0.01). CONCLUSION: The prevalence of lower extremity WMSDs was relatively high among manufacturing workers. There is a dose-effect relationship between the types of working and lower extremity WMSDs.

OBJECTIVE: To analyze the prevalence and influencing factors of multisite work-related musculoskeletal disorders(WMSDs) of workers in a railway vehicle manufacturing enterprise. METHODS: A total of 366 male workers in the assembly and riveting workshop of a railway vehicle manufacturing enterprise were selected as the research subjects using the cluster sampling method. The Chinese Musculoskeletal Questionnaire was used to investigate the prevalence of multiple sites of WMSDs. Multiple logistic regression analysis was used to analyze the influencing factors. RESULTS: The total prevalence of WMSDs was 56.3%(206/366). The prevalence of WMSDs in all parts from high to low was as follows: lower back(35.5%), hand and wrist(27.6%), neck(23.2%), shoulder(21.0%), knee(19.9%), upper back(18.6%), hip and leg(18.0%), ankle/foot(15.8%) and elbow(12.3%)(P<0.01). The total prevalence of multisite WMSDs was 38.0%(139/366). The prevalence of WMSDs in different numbers of parts from high to low was as follows: 6 or more parts(12.0%), 2 parts(10.7%), 3 parts(6.6%), 5 parts(5.5%) and 4 parts(3.3%)(P<0.01). Multiple logistic regression analysis results showed that the overweight and obese workers had higher risk of multi site WMSDs than those with normal body mass index(P<0.05).Those with long-term low heads, frequent bending, long bending of the elbows, and higher frequency of work requirements, and less frequently communicated with the leader had higher risk of multi site WMSDs(P<0.05). CONCLUSION: The prevalence of multisite WMSDs in railway vehicle manufacturing enterprise is relatively high. The influencing factors include individual factors, adverse ergonomic factors and psychosocial factors.

OBJECTIVE: To explore the occurrence pattern of work-related musculoskeletal disorders( WMSDs) in electronic parts processing workers. METHODS: A total of 498 workers from an electronic parts processing factory were selected as study subjects by judgement sampling method. The prevalence of WMSDs in the past 1 year was investigated by using the China Musculoskeletal Questionnaire. The potential category model was used to classify the categories of WMSDs. RESULTS: The incidence of WMSDs in the past 1 year was 46. 8%( 233/498). Among them,the incidence of WMSDs involving only one site was 13. 1%( 65/498),and those involving at least 2 sites were 33. 7%( 168/498). The multi-site WMSDs were about 6-58 times of the single-site WMSDs. According to potential category analysis,the occurrence patterns of WMSDs were divided into three categories: i) cervical and shoulder occurrence group( 135 persons,27. 1%); ii) all parts group( 31 persons,6. 2%); iii) few or no site group( 332 persons,66. 7%). CONCLUSION: The occurrence of multi-site WMSDs in electronic parts processing workers were more common than the single-site. Analysis of potential category can be used to explore the occurrence pattern of WMSDs.

Objective To evaluate the efficacy and safety of intra?articular injections of tranexamic acid (TXA) on perioperative blood loss and transfusion in primary unilateral total knee arthroplasty (TKA). Methods Primary TKA was per?formed on a total of 380 patients (380 knees) affected to various degrees by knee osteoarthritis. All the patients are divided into three groups according to different joint injection for 5 min at the end of surgery in which:120 patients received 1.5 g TXA injec?tion,136 patients received 0.5 g TXA injection, 124 patients no pharmacological intervention (control group). Blood loss, hidden blood loss, blood transfusion, drainage volume and limb circumference change after TKA were assessed. Results All the surger?ies were well performed. No complication including infection, necrosis, and fat liquefaction has been observed. The results indicat?ed no significant difference with pairwise comparisons in intra?operative time, intra?operative blood loss, hospitalization time, anes?thesia, and drainage volume and limb circumference change. The mean postoperative hidden blood loss (1.5 g TXA group 693.29± 377.91 ml, 0.5 g TXA group 835.41±481.97 ml, the control group 1 032.75±322.19 ml) and transfusion (1.5 g TXA group 7.5%, 0.5 g TXA group 13.2%, the control group 20.2%) requests were significantly different with pairwise comparisons among the three groups. Compared with the control group, both 1.5 g TXA group and 0.5 g TXA group showed better effects (P<0.05). Compared with the 0.5 g TXA group, 1.5 g TXA group showed better effects (P<0.05). Conclusion It can be concluded that intra?articular injection of TXA in patients undergoing unilateral TKA could significantly reduce postoperative hidden blood loss and blood trans?fusion, and did not increase the risk of phlebothrombosis. This efficacy demonstrated a concentration dependent effect. Compared with 0.5 g TXA, 1.5 g TXA performed a better efficacy.

Objective To investigate the effect of thrombelastography ( TEG ) monitoring on anticoagulation therapy in deep vein thrombosis ( DVT ) in the perioperative period of arthroplasty replacement through dynamic detecting of TEG.Methods 60 patients under went total knee arthroplasty ( TKA) were selected as the patient group from 2011 to 2013, Including 22 men and, 38 women, aging from 50 to 74 years old.These patients were divided into low molecular weight heparin ( LMWH ) group and rivaroxaban group according to random number table.Each group had 30 cases.Patients in both were all given routine dose anticoagulant drugs to prevent DVT.Other treatment were the same as conventional therapy for both group patients.Meannhile, 42 health examination participants were selected as the control group, 24 men and 18 women, aging from 45 to 75 years old.The parameters of TEG were measured by TEG@5000 thromboelastograph hemostasis system ( American Haemoscope Corporation).DVT was diagnosed by LOGIQ 7 color Doppler ultrasonic diagnostic apparatus of American GE Corporation. Data were analyzed by SPSS17.0.The predictive value of TEG on DVT was evaluated by receiver operating characteristic cure (ROC),sensitivity,specificity,positive predictive value (PPV) and negative predictive value (NPV). Results Abnormal detection rates of Angle,MA,CI in rivaroxaban group(36.7%,46.7%,36.7%) were higher than LMWH group ( 10.0%, 20.0%, 13.3%) , and the differences between both groups all had statistical significance between both group(χ2 =5.963,P=0.015;χ2 =4.800,P=0.028;χ2 =4.356,P=0.037).CI , MA and Angle had better clinical diagnostic value on DVT.Their sensitivity was 75.0%, 75.0% and 62.5%, specificity respectively was 80.8%, 76.9%and 78.8%respectively.MA=68.35 mm
could be the best clinical diagnosis of critical point on DVT at anticoagulation treatment endpoint.Conclusion TEG can monitor coagulation state of TKA patients, TEG′R can evaluate the safety and effectiveness of anticoagulation therapy on DVT.(Chin J Lab Med, 2015, 38:333-336)

Objective To investigate the predictive value and clinical significance of dynamic monitoring of thromboelas?tography (TEG) and D?dimer on anticoagulation therapy concurrenting DVT in the perioperative period of arthroplasty replace?ment. Methods All of 60 patients of total knee arthroplasty (TKA) were selected as patient group from 2011 to 2013. They were divided into low molecular weight heparin (LMWH) group and rivaroxaban group according to random number table. LM?WH group was given LMWH (xi fu quan) 4250 IUAXa 12 h after knee replacement, im, qd for 7 days, then rivaroxaban 10 mg, qd for 7 days. Rivaroxaban group was given rivaroxaban 10 mg 6 h after knee replacement, qd for 14 days. Meanwhile, 42 health examination participants were selected as control group. The parameters of TEG were detected by TEG 5000 thrombo?elastograph hemostasis system (American Haemoscope Corporation). Results D?dimer levels of postoperative before anticoagu?lation therapy were highest and there was statistical difference, while other parameters had no statistical difference. Intra?group comparison:the levels of R, K, Alpha, CI of TEG and D?D in LMWH group and the levels of Alpha, MA, CI of TEG and D?D in ri?varoxaban group had statistical difference, while other parameters' levels showed no statistical difference. At anticoagulation treat?ment endpoint, DVT occurred in 8 cases with an incidence of 13.3%(8/60). 7 cases were intramuscular vein thrombosis, and 1 case was popliteal vein thrombosis. The levels of Alpha, MA, CI of TEG and D?D in DVT group were higher than no DVT group, and there was statistical difference. TEG's CI, MA, Alpha and D?dimer had better clinical diagnostic value on DVT, whose area un?der receiver operating characteristic cure (ROC) respectively was 0.746, 0.733, 0.707 and 0.644, with sensitivity of 75%, 75%, 62.5%and 62.5%, specificity of 80.8%, 76.9%, 78.8%and 71.1%, positive predictive value of 37.5%, 33.3%, 31.3%and 25.0%, and negative predictive value of 95.4%, 95.2%, 93.2%and 93.1%. MA=68.35 mm was the best clinical diagnosis of critical point on DVT at anticoagulation treatment endpoint. Conclusion CI, MA, Alpha of TEG are better than D?dimer in predicting the inci?dence of DVT in the perioperative period of orthopaedics major operation. If these indexes are detected, the diagnosis value ’s ac?curacy of DVT will be improved.

Aged ; Arthroplasty, Replacement, Knee ; methods ; Female ; Humans ; Knee Joint ; abnormalities ; surgery ; Male ; Middle Aged

Objective To analyze the evolution of acetabular morphology changes of different Crowe types among adults with developmental dysplasia of the hip through standard hip 3D CT reconstruction.Methods From June 2010 to January 2013,there were 62 patients with 68 hips (8 hips of 6 male cases,56 female cases of 60 hips) diagnosed as acetabular dysplasia in our hospital,with an average age of 53.7±5.8 years old (range,47-59 years).According to Crowe classification,there were 14 cases (17 hips) of Crowe type Ⅰ,17 cases (17 hips) of Crowe type Ⅱ,15 cases (17 hips) of Crowe type Ⅲ,and 16 cases (17 hips) of Crowe type Ⅳ.Through standard hip 3D CT reconstruction,Harris nest in the pelvic side 3D image was marked,and the coronal and horizontal position of acetabular rotation center was determined by using the cross axis; secondly,in the anteroposterior 3D image (by gray level adjustment to the shape of X ray perspective effect) through Ranwant triangulation,sagittal position of the center of rotation of the hip joint was determined; finally,the acetabular rotation center in the acetabular horizontal reconstruction plane.The bone stock of anterior and posterior columns of acetabular was observed and acetabular anteversion,front cover angle,rear cover angle and medial wall thickness were measured.Results 1) With Crowe type increased,acetabular anteversion angle gradually increased as well,and there was a positive correlation between them with statistically significant (P＜0.05) except in Crowe Ⅰ and Ⅱ group.2) With Crowe type increased,anterior acetabular coverage angle was significantly decreased; the mean anterior acetabular coverage angle of Crowe Ⅲ and Ⅳ groups was less than 50°.3) With Crowe type increased,posterior acetabular coverage angle was decreased significantly as well the mean posterior acetabular coverage angle of Crowe Ⅲ and Ⅳ groups was less than 90°.4) With Crowe type increased,acetabular medial wall thickness was increased significantly.Conclusion Adult acetabular morphology changes between different Crowe types in patients with developmental dysplasia of the hip.For acetabular reconstruction of Crowe Ⅰ and Ⅱ,we could make full use of the acetabular bone stock of anterior and posterior column; for acetabular reconstruction of Crowe Ⅲ and Ⅳ,we could moderately shift the acetabular center superiorly and (or) medially.