OBJECTIVE: It provides reference for accurate and efficient supervision of medical artificial intelligence industry. METHODS: By summarizing the main responsibility dilemma of medical artificial intelligence diagnosis products, sorting out relevant researches at home and abroad, the primary responsibility system of medical artificial intelligence diagnosis products is constructed. RESULTS: A medical artificial intelligence diagnosis products primary responsibility system with the marketing authorization holder as the "first responsible person" is established, and three safeguard measures are proposed, namely, algorithm transparency and interpretability, classification supervision mode and social co-governance supervision mode. CONCLUSIONS The medical artificial intelligence diagnosis products primary responsibility system is helpful to implement the primary responsibility, to build "responsible and beneficial" artificial intelligence, and to realize "self-discipline", "good governance" and "in good order".
Artificial Intelligence ; China ; Humans

OBJECTIVE: To compare clinical efficacy of intramedullary nail fixation following two-step closed reduction or limited open reduction for femoral subtrochanteric fractures. METHODS: Forty six patients with femoral subtrochanteric fractures were analyzed retrospectively from January 2014 to April 2020. Twenty four patients which including 16 males and 8 females, aged from 34 to 91 years old with an average of (55.42±18.25) years old, were treated with two step closed reduction and intramedullary nail fixation on supine position. Twenty-two patients which including 15 males and 7 females, aged from 33 to 87 years old with an average of (56.31±14.77) years old, were performed limited open reductionand intramedullary nail fixation. Operation time, intraoperative blood loss, complications and fracture healing time were recorded and compared between two groups. Postoperative Harris hip score at 8 months was applied to evalaute joint function. RESULTS: All patients were successfully complete operation without incision infection. All patients were followed up from 8 to 36 months with an average of (18.2± 6.1) months. Introperation blood loss, operation time in closed reduction group were (157.92±51.07) ml, (82.08±13.43) min respectively, while in limited open reduction group were (230.91±87.88) ml, (92.73±12.79) min respectively; while there were statistical difference between two groups ( CONCLUSION Femoral subtrochanteric fractures could be effectively treated by both methods. Two-step closed reduction and intramedullary nail fixation may be more advantageous in less tissue damage, shorter operation time and less intraoperative bleeding.
Adult ; Aged ; Aged, 80 and over ; Bone Nails ; Female ; Femoral Fractures ; Fracture Fixation, Intramedullary ; Fracture Healing ; Hip Fractures/surgery* ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome

The aim of this study was to investigate the combined effects of bortezomib (Bor) and daunorubicin (DNR) or each drug alone on proliferation of human multiple myeloma cell line KM3. KM3 cells were cultured with different concentrations of Bor and DNR, Bor or DNR alone for different times. The cell proliferation was analyzed by MTT assay, and the concentration of 50% growth inhibition (IC(50)) was calculated. The results indicated that both of Bor and DNR inhibited KM3 cell proliferation in dose dependent manner. The IC(50) of both drugs were 0.27 micromol/L and 0.16 micromol/L respectively. The inhibiting rate of Bor plus DNR on KM3 cells was much higher than that of Bor (p < 0.05). It is concluded that the Bor has synergistic inhibitory effect with DNR on the growth of KM3 cell in vitro.
Boronic Acids ; pharmacology ; Bortezomib ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Daunorubicin ; pharmacology ; Drug Synergism ; Humans ; Inhibitory Concentration 50 ; Multiple Myeloma ; Pyrazines ; pharmacology

OBJECTIVE: To evaluate the methods and effects of arthroscopic operation in aged patients with meniscal injury. METHODS: From January 2014 to June 2018, 86 elderly patients with meniscal injury met the inclusion criteria, including 35 males and 51 females, aged 60 to 76 years old, with an average age of 63.7 years old, 32 patients with definite trauma and 54 without definite trauma. Arthroscopic partial meniscectomy was performed in 75 cases, partial meniscectomy and anterior angle repair in 2 cases, partial meniscectomy and body repair in 2 cases, and partial meniscectomy and repair in 7 cases of horizontal delamination rupture of posterior horn; 28 patients with mild joint degeneration went through drilling decompression of intercond-ylar fossa. Lysholm score and IKDC score were used to evaluate knee joint function and visual analogue scale(VAS) was used to evaluate pain. RESULTS: All patients were successfully operated under arthroscope. The follow-up period ranged from 6 to 36 months, with an average of 15 months. The Lysholm score of knee joint increased from preoperative 51.26±12.00 to final follow-up 81.20±4.89 points (=22.07, <0.001); IKDC scores increased from preoperative 48.05±10.68 to final follow-up 76.97±6.26(=23.04, <0.001); and the VAS decreased from preoperative 3.37±0.84 to final follow-up 0.57±0.62(=36.27, <0.001). Two patients with non-traumatic degenerative medial meniscus injury with medial osteoarthritis had no significant improvement after 1 year follow-up, so underwent total knee arthroplasty. CONCLUSIONS In elderly patients with knee meniscus injury, arthroscopic partial meniscectomy, or partial meniscectomy and repair can achieve satisfying clinical results. If the injuried joint is accompanied with mild degeneration, drilling hole decompression of intercondylar fossa should be performed at the same time.
Aged ; Arthroscopy ; Female ; Follow-Up Studies ; Humans ; Knee Injuries ; Male ; Menisci, Tibial ; Meniscus ; Middle Aged ; Tibial Meniscus Injuries ; Treatment Outcome

OBJECTIVE: To investigate the therapeutic effects of vacuum sealing drainage (VSD) combined with antibiotics in treating acute periprosthetic joint infection (PJI). METHODS: From March 2012 to December 2018, there were 11 patients with acute PJI underwent debridement, VSD, antibiotics and retention of implant, including 7 males and 4 females, with an average age of 72.5 years old (ranged, 58 to 88 years old). There were 8 hips and 3 knees. Three patients had sinus tract. RESULTS: There were 2 patients with negative culture result and 9 patients with positive culture result, including 5 cases of methicillin sensitive staphylococcus aureus, 2 cases of methicillin-resistant staphylococcus aureus (MRSA), 2 cases of staphylococcus epidermidis. The mean follow up duration was 28 months (ranged from 8 to 52 months). One case of infection around hip prosthesis failed to be debrided. The time of debridement and replacement of the calcar joint was 84 days. Debridement was successful in 10 cases. At the latest follow up, Harris score of patients with successful debridement of hip periprosthetic infection ranged from 74 to 93, with an average score of 84.1;Knee Society scores of patients with periprosthetic infection were 84, 84, 89. CONCLUSION For acute infection around the prosthesis within 1 month after knee replacement and 6 weeks after hip replacement, and for bleeding around the prosthesis with acute infection caused by anticoagulant drugs, satisfactory results can be obtained by debridement, VSD and sensitive antibiotics.
Aged ; Aged, 80 and over ; Anti-Bacterial Agents ; Arthroplasty, Replacement, Hip ; Debridement ; Drainage ; Female ; Hip Prosthesis ; Humans ; Male ; Methicillin-Resistant Staphylococcus aureus ; Middle Aged ; Negative-Pressure Wound Therapy ; Prosthesis-Related Infections ; Retrospective Studies ; Treatment Outcome

OBJECTIVE: To investigate the method and clinical effects of arthroscopic rotator cuff repair with footprint ending shift for massive rotator cuff tear. METHODS: From March 2015 to April 2019, 27 patients with massive rotator cuff tear underwent arthroscopic repair, including 12 males and 15 females, ranging in age from 37 to 74 years old, with an average age of (56.1±8.9) years. According to the tension of rotator cuff, 5 patients were treated with double row suture bridge technique, and 22 patients were treated with single row technique, among which 7 patients underwent partial rotator cuff repair. Before and after operation, University of California Los Angeles(UCLA) score, American Shoulder and Elbow Surgeons (ASES) score and visual analogue scale (VAS) were used to evaluate shoulder joint function. RESULTS: All the patients were followed up, and the duration ranged from 8 to 40 months, with an average of (18.0±5.9) months. The UCLA score increased from preoperative 8.67±0.78 to final follow-up 30.89±1.07( CONCLUSION Arthroscopic rotator cuff repair with footprint ending shift for massive rotator cuff tear has satisfactory results, and single-row can be chosen to completely or partial repair rotator cuff tear for most patients.
Adult ; Aged ; Arthroscopy ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Range of Motion, Articular ; Rotator Cuff/surgery* ; Rotator Cuff Injuries/surgery* ; Treatment Outcome

OBJECTIVE: To study the prognosis and complications of proximal femoral nail antirotation(PFNA) in the treatment of elderly intertrochanteric fracture. METHODS: From January 2016 to November 2019, 127 cases of femoral intertrochanteric fracture were treated with PFNA, including 51 males and 76 females. The average age was 81.39±8.16 (range from 60 to 98). According to Evans classification, the numbers of cases of typeⅠa, typeⅠb, typeⅠc, typeⅠd and typeⅡwere 10, 46, 48, 16 and 7, respectively. Based on the AO /OTA classification, there were 10 cases of type 31-A1.2, 84 of type 31- A1.3, 17 of type 31-A2.2, 9 of type 31-A2.3, and 7 of type 31-A3. Preoperative and the final follow up, function of hip joint of patients treatedwith the PFNA were evaluated by harris hip score, and the postoperative complications were observed. RESULTS: No incision infection occurred in all patients after PFNA. In this research, 4 cases failed in internal fixation, three of them underwent artificial femoral head replacement;5 cases died within one year after operation;2 cases had multiple embolizations of pulmonary artery branches, which recovered after anticoagulation treatment. There were 48 cases complicated with pneumonia, among which 9 cases had pulmonary inflammation before operation;27 cases with pleural effusion, 3 cases with acute heart failure, 3 cases with acute renal insufficiency, except one case died of pneumonia, pleural effusion, hypoproteinemia and respiratory failure during hospitalization, the other patients recovered after treatment. All 119 patients were followed up for 6 to 36 months, with an average of (17.01±6.03) months, Harris hip score increased from 8.96±5.40 preoperation to 83.57±8.92 at the final follow-up ( CONCLUSION PFNA is a recommended option for the treatment of senile patients with intertrochanteric fracture. However, there were a lot of complications when femoral intertrochanteric fractures happened in aged patients, especially prevention and treatment of pulmonary embolism, promptly corrected low hemoglobin and low albumin, and reduce complications.
Aged ; Aged, 80 and over ; Bone Nails ; Female ; Fracture Fixation, Intramedullary/adverse effects* ; Hip Fractures/surgery* ; Humans ; Male ; Retrospective Studies ; Treatment Outcome

Occupational exposure to diacetyl can lead to bronchiolitis obliterans. In this paper, two patients with severe obstructive ventilation disorder who were exposed to diacetyl at a fragrance and flavours factory were analyzed. The clinical manifestations were cough and shortness of breath. One of them showed Mosaic shadows and uneven perfusion in both lungs on CT, while the other was normal. Field investigation found that 4 of the 8 workers in the factory were found to have obstructive ventilation disorder, and 2 had small airway dysfunction. This paper summarizes the diagnostic process of patients in order to improve the understanding of airway dysfunction caused by occupational exposure to diacetyl and promote the development of relevant standards.
Humans ; Diacetyl/adverse effects* ; Occupational Diseases/diagnosis* ; Occupational Exposure/adverse effects* ; Lung ; Bronchiolitis Obliterans/diagnosis*

Objective: To introduce the surgical method of lateral dorsalis pedis chain-linked artery based flap for repairing foot, ankle, and posterior heel wounds, and to evaluate its clinical outcome. Methods: From June 2013 to February 2016, 11 cases with skin defects of foot, ankle, and posterior heel wounds were reviewed. The defects were repaired using the lateral dorsalis pedis chain-linked artery based flap.The wounds in 7 cases were repaired using the island flap based on the descending branch of the anterior lateral malleolar artery. The wounds in 3 cases were repaired using the island flap based on the lateral calcaneal branch of the posterior lateral malleolar artery. The reversed flap based on the forth metatarsal artery was used in one patient. The wound defects ranged from 1.5 cm×2.0 cm to 6.0 cm×13.0 cm.The area of the flap ranged from 2 cm×3 cm to 7 cm×15 cm were used to repair the wound.The donor site was skin grafted with split-thickness skin harvested from the abdomen. Results: Circulations of the all 11 cases were stable, with good wound healing after 2 weeks.10 patients had clinical follow-up. The patients were followed up from 2 months to 18 months, average of 8 months.All flap grafts survived with no bloated menifestion in pedical or "cat′s ear" deformity.Flaps were soft. Color was consistent with normal skin.Skin graft donor sites had no obvious scars.Patients were extremely satisfied with the result of repair. Conclusions The use of the lateral dorsalis pedis chain-linked artery based flap has many advantages, such as no sacrifice of the main vessels, extended coverage area and thin flap. It is a simple and effective method to repair wounds of the foot, ankle, and posterior heel.

OBJECTIVETo explore surgical method and clinical effects of descending branch of the anterior lateral malleolar artery based anterograde island flap for repairing foot and ankle wounds.

METHODSNine patients with skin defects of foot and ankle repaired by descending branch of the anterior lateral malleolar artery based anterograde island flap were studied from June 2015 to January 2017, including 6 males and 3 females aged from 32 to 63 years old. The wound were located on foot and ankle and associated with exposure of bone, tendon, blood vessels or nerves. The surface of wound located on foot in 6 patients, and 3 patients in ankle joint. The area of defect ranged from 1.5 cm×2.0 cm to 6.0 cm×13.0 cm, and the area of flap ranged from 2.0 cm×3.0 cm to 7.0 cm×15.0 cm. The donor site was skin grafted with split-thickness skin from abdomen. Appearance, texture, condition of donor site of island flaps after operation were observed, satisfied degree of clinical effects were evaluated by ZHANG Hao's evaluation, and AOFAS score were used to evaluate function.

RESULTSCirculations of flaps in 9 cases were stable without blockage, and healed well at 2 weeks after operation. All patients were followed up from 2 to 18 months with an average of(8.0±2.3) months. All flap were survived at stage I, pedicles looked smooth and tidy, no cat-ear formed, the texture of flap was soft with satisfied appearance, the color was near to surrounding skin. The surface of wound were tidy after skin graft of donor sites without scar hypertrophy. Nine patients got satisfied results according to ZHANG Hao's evaluation, and AOFAS score was excellent.

CONCLUSIONSDescending branch of the anterior lateral malleolar artery based anterograde island flap for repairing foot and ankle wounds, which has advantages of protect main vessel, thin flap, is a simple and effective method.