ObjectiveTo investigate the safety and early clinical efficiency of dynamic cervical implant (DCI) internal fixation to treat cervical disc herniation.Methods From September 2009 to December 2010,31 patients with herniation of cervical disc underwent DCI implantation.The operation time and blood loss were recorded and analyzed.Neck disability index (NDI),Japanese Orthopaedic Association (JOA) score,and visual analogue scale(VAS) score were used to evaluate neurofunctional recovery pre- and post-operation.Routinely,the patients accepted X-ray examination preoperatively and postoperatively.We used White's measurement to measure the range of motion(ROM) and height ratio of implant segment and the superior vertebra pre- and post-operation.ResultsThe average operation time and amount of bleeding were 45 (30-60) min and (100±30) ml respectively.The average postoperative follow-up was 14 months (range,6-20).The average NDI (50.5±16.2 vs.19.6±4.3,P＜0.05),JOA score (12.3±1.6 vs.13.9±1.8,P＜0.05) and VAS score (6.3±2.6 vs.3.1±2.2,P＜0.05) changed significantly at the last follow-up compared with those pre-operation.There were no significant differences in the average ROM of implant segment (9.6°±4.2° vs.6.9°±5.3°,P＞0.05),the height ratio of implant segment and the superior vertebra(2.6±0.1 vs.2.5±0.1,P＞0.05) and the angle of functional spine unit(2.6°±5.2° vs.1.7°±2.9°,P＞0.05) at last follow-up compared with those preoperation.ConclusionUsing DCI to treat cervical disc herniation had shorter operation time and less bleeding advantages,and the early clinical effect was satisfactory.It may retain the cervical biomechanical movement in some degree,maintain the cervical stability.

Objective? To?explore?the?resuscitation?effect?of?active?abdominal?compression-decompression?cardiopulmonary?resuscitation?(AACD-CPR)?on?patients?with?cardiac?arrest.? Methods? The?patients?with?cardiac?arrest?admitted?to?emergency?medical?center?of?Hainan?General?Hospital?from?June?2014?to?January?2016?were?enrolled,?who?were?satisfied?with?the?indication?of?AACD-CPR?and?had?no?contraindication?for?AACD-CPR,?and?with?40-150?kg?weight?and?over?16?years?old.?All?of?enrolled?patients?were?given?mechanical?ventilation?and?conventional?drug?rescue.?At?the?same?time,?AACD-CPR?was?performed?with?the?active?abdominal?compression-decompression?device,?the?rhythm?of?abdominal?compression-decompression?was?100?bmp?and?the?ratio?of?compression?time?to?lift?time?was?1∶1,?the?pressure?intensity?was?approximately?50?kg?and?the?lifting?intensity?was?approximately?30?kg.?Heart?rate?(HR),?mean?arterial?pressure?(MAP),?pulse?oxygen?saturation?(SpO2)?and?blood?lactic?acid?(Lac)?were?recorded?before?and?after?CPR,?and?restoration?of?spontaneous?circulation?(ROSC)?were?calculated.? Results? Forty-one?patients?with?cardiac?arrest?were?enrolled,?with?22?males?and?19?females,?and?the?age?between?15?years?old?and?89?years?old,?with?an?average?(66.5±?18.8)?years?old.?The?etiologies?of?cardiac?arrest?were?followed:?cardiogenic?for?10?cases,?non-cardiogenic?for?18?cases,?and?unknown?causes?for?13?cases.?The?rate?of?ROSC?in?patients?with?AACD-CPR?was?19.5%?(8/41).?During?the?resuscitation,?the?HR,?MAP?and?SpO2?of?those?patients?were?significantly?improved?compared?with?those?index?suffering?the?cardiac?arrest?[HR?(bmp):?67.0?(48.0,?105.0)?vs.?0.0?(0.0,?11.5),?MAP?(mmHg,?1?mmHg?=?0.133?kPa):?23.0?(16.0,?37.0)?vs.??0.0?(0.0,?0.0),?SpO2:?0.79?(0.45,?0.90)?vs.?0.00?(0.00,?0.32),?all?P??0.05).?Besides,?the?ROSC?rate?of?patients?who?suffered?cardiac?arrest?before?pre-hospital?care?or?in?emergency?ward?[11.1%?(2/18)]?were?lower?than?those?the?patients? who?suffered?cardiac?arrest?in?emergency?intensive?care?unit??[EICU,?26.1%?(6/23)];?while?the?cardiac?arrest?patients?who?didn't?experienced?AACD-CPR?until?they?got?complications?such?as?thoracic?rib?fracture?after?standard?cardiopulmonary?resuscitation?(STD-CPR),?the?ROSC?rate?of?those?patients?in?pre-hospital?care?or?in?emergency?ward?[10.0%?(1/10)]?were?lower?than?the?ROSC?rate?of?the?patients?who?suffered?cardiac?arrest?in?EICU?[20.0%?(4/20)],?but?there?was?no?significant?difference?between?the?two?groups?(both?P?>?0.05).? Conclusion? AACD-CPR?is?effective?in?the?treatment?of?sudden?cardiac?arrest?patients?with?contraindication?of?chest?compression,?and?makes?up?for?the?deficiency?of?STD-CPR.

Objective:To evaluate the application of a 3D printed positioner for hip rotation center in total hip arthroplasty.Methods:From August 2015 to December 2017, 14 patients were treated by unilateral total hip arthroplasty at Department Ⅰ of Joint Surgery, Orthopaedics Hospital of Zhengzhou for avascular necrosis of femoral head or femoral neck fracture. They were 8 males and 6 females with an average age of 51.8 years (from 37 to 65 years). All their surgeries were assisted by a 3D printed positioner for hip rotation center. Postoperatively, the abduction and anteversion of acetabular cup and the hip rotation center were measured, the agreement between the hip rotation center of the affected side (O2) and the anatomical rotation center of the healthy side (O1) was assessed, and the function of the affected hip and complications were recorded at the last follow-up.Results:The 14 patients were followed up for an average of 18 months (from 6 to 24 months). The postoperative ordinates of O2 and O1 were respectively 19.36 mm±3.61 mm and 18.33 mm±3.41 mm while their abscissas 39.93 mm±2.97 mm and 39.99 mm±3.16 mm, indicating agreement between O2 and O1 ( P>0.05). The postoperative abduction and anteversion of the cup were within a normal range (39.3°±3.2°and 14.6°±1.2°, respectively). The last follow-up showed that their preoperative Harris hip scores (42.3±3.2) were significantly improved (94.3±4.7) ( t=2.873, P=0.002) and that 13 cases were rated as excellent and one as good. X-ray follow-up showed good position of their acetabular prostheses, no loosening of the cups or femoral prostheses, and no heterotopic ossification. Conclusion:A 3D printed positioner for hip rotation center can effectively assist reconstruction of the hip rotation center and accurate implantation of acetabular prosthesis in total hip arthroplasty.

Background: Cardiopulmonary resuscitation (CPR) strategies in COVID-19 patients differ from those in patients suffering from cardiogenic cardiac arrest. During CPR, both healthcare and non-healthcare workers who provide resuscitation are at risk of infection. The Working Group for Expert Consensus on Prevention and Cardiopulmonary Resuscitation for Cardiac Arrest in COVID-19 has developed this Chinese Expert Consensus to guide clinical practice of CPR in COVID-19 patients. Main recommendations: 1) A medical team should be assigned to evaluate severe and critical COVID-19 for early monitoring of cardiac-arrest warning signs. 2) Psychological counseling and treatment are highly recommended, since sympathetic and vagal abnormalities induced by psychological stress from the COVID-19 pandemic can induce cardiac arrest. 3) Healthcare workers should wear personal protective equipment (PPE). 4) Mouth-to-mouth ventilation should be avoided on patients suspected of having or diagnosed with COVID-19. 5) Hands-only chest compression and mechanical chest compression are recommended. 6) Tracheal-intubation procedures should be optimized and tracheal-intubation strategies should be implemented early. 7) CPR should be provided for 20-30 min. 8) Various factors should be taken into consideration such as the interests of patients and family members, ethics, transmission risks, and laws and regulations governing infectious disease control. Changes in management: The following changes or modifications to CPR strategy in COVID-19 patients are proposed: 1) Healthcare workers should wear PPE. 2) Hands-only chest compression and mechanical chest compression can be implemented to reduce or avoid the spread of viruses by aerosols. 3) Both the benefits to patients and the risk of infection should be considered. 4) Hhealthcare workers should be fully aware of and trained in CPR strategies and procedures specifically for patients with COVID-19.