1.The role of color doppler ultrasonography, thyroid function and auto antibody for the screening of Graves' disease in pregnancy
Meng XUE ; Qiuling SHI ; Kunneng TAN ; Yan WU ; Ren ZHOU
Chinese Journal of Internal Medicine 2016;55(6):470-473
Objective To determine whether color doppler ultrasonography (CDU),thyroid function or thyroid autoimmune antibodies could identify Graves' disease in pregnancy(GDP) in pregnant patients with newly diagnosed thyrotoxicosis.Methods It is an observational study.Sixty-eight pregnant patients with newly diagnosed thyrotoxicosis including gestational hyperthyroidism (GHT) subjects (GHT group,n =33) and GDP subjects (GDP group,n =35),and 62 age-and sex-matched healthy subjects (C1 group:pregnant,n =32,C2 group:non-pregnant,n =30) were recruited.Thyroid function,human chorionic gonadotropin(HCG),thyroid autoimmune antibodies were detected.Peak systolic velocity of the superior thyroid artery (STA-PSV) and diastole inner diameter(STA-D) of the superior thyroid artery were measured by CDU.A ROC curve was used to evaluate STA-PSV,STA-D,thyroid function and thyroid autoimmune antibodies for identification of GDP.Results The area under the ROC curve of STA-PSV,STA-D and thyroid stimulating hormone (TSH),free T4 (FT4) for GDP were 0.905,0.887,0.803 and 0.786,respectively.The optimal cut-off points of STA-PSV,STA-D,TSH and FT4 for GDP were 40 cm/s,2.0mm,0.03 mIU/L and 30 pmol/L with the sensitivity of 82.9%,72.1%,81.8%,76.2% and specificity of 81.8%,87.9%,75.2%,80.3%,respectively.Conclusions Detection of STA-PSV and STA-D by CDU,as well as thyroid function,is useful in screening GDP in pregnant patients with thyrotoxicosis.
2.Effects of Different Posterior Tibial Slopes in Unicompartmental Knee Arthroplasty on the Wear and Function of Prosthesis
Kunneng WU ; Gaiping ZHAO ; Dongqing LIU ; Shengqi HANG ; Peng LIANG ; Pengxiang LI ; Tong MA ; Yihui TU
Journal of Medical Biomechanics 2021;36(4):E618-E624
Objective To establish the three-dimensional (3D) finite element model of unicompartmental knee arthroplasty (UKA) with 3° and 7° posterior tibial slope at different knee flexion angles, and to study biomechanical properties and prosthetic wear of the knee joints with two types of posterior tibia slope and their effects on knee function. Methods Combining CT and MRI images of human knee joints with the 3rd-generation Oxford prosthesis, the finite element UKA model with 3° and 7° posterior tibia slope were established. The 1 kN load was applied to center point of the medial and lateral condyles of the femur to simulate the standing load of human body. The maximum stresses and distributions of the prosthesis and articular cartilage at different knee flexion angles were analyzed. ResultsThe maximum stress of the meniscus liner with 3° posterior tibia slope at 0°, 30°, 60°, 90°, 120° knee flexion angles increased by 28.06%, 68.99%, 19.45%, 21.06% and 53.38%, the distribution area was concentrated from the side of the meniscus liner to the central area, and the stress concentration was obvious at 120° knee flexion. The maximum stress of prosthesis with 3° posterior tibia slope was greater than that with 7 ° posterior tibia slope. The expansion of stress concentration area would cause wear and loosening of the prosthesis, contact stress and concentration area of the articular cartilage would subsequently increase with posterior tibia slope increasing, and stress concentration would be more obvious at high knee flexion angles. Conclusions Tibial prosthesis has the higher stress and greater wear under the condition of 3° posterior tibia slope than 7° posterior tibia slope. The research findings provide theoretical basis for the UKA design in clinic.