Objective To evaluate the effectiveness of arthroscopically assisted percutaneous reduction and internal fixation with eannulated screws.Methods The fracture was reduced by closed manipulation or percutaneous leverage force by using the Kirschner wire.Then the patella was temporarily fixed by using a large size towel clamp or Kirschner wires.Under the guidance of knee arthroscopy,a micro-incision was made at the size of cannulated screw placement,the pilot holes were drilled at a proper depth,and the thread was configured.Two titanium screws were inserted parallelly.Results Following-up chekups for 4～24 months in 18 cases showed a satisfactory recovery of knee functions.According to the Bostman' standard,excellent effects were obtained in 16 cases and good effects in 2 cases.Conclusion Treatment of patellar fractures by percutaneous cannulated screw fixation under arrhroscope of- fered advantages of minimal invasion,accurate reduction,reliable fixation,and excellent recovery of joint functions.

Objective To study the precision of computer-aided preoperative templating for total hip arthroplasty. Methods Thirty patients (11 males, 19 females; age ranged from 42 to 85 years, mean 56 years) received unilateral total hip arthroplasty from March 2008 to December 2008. Preoperative tem-plating was done with LINK -Preop-PlanTM to compare the size of the planned hip joint with the size of the prosthesis, as well as the discrepancy of the limbs before and after operation. Results The predicted sizes of the prosthesis corresponded well with the actual ones. The cup size of the prosthesis completely matched the actual ones in 19 patients (63%), and the variation was within 1 size in 8 patients (27%) and ≥2 sizes in 3 patients (10%). The stem size of the prosthesis completely matched the actual ones in 19 patients (63%), and the variation was within 1 size in 9 patients (30%) and ≥2 sizes in 2 patients (7%). The variation of the cemented and cementless stem size of the prosthesis was within 1 size in 16 patients (89%) and 12 patients (100%), respectively, with no statistical difference (P > 0.05). The discrepancy of limb length was (9.0±8.5) mm preoperatively and (1.1±2.4) mm postoperatively. Conclusions Preoperative planning is of paramount significance in total hip arthroplasty. Computer-ai-ded preoperative templating can accurately anticipate the type of the prosthesis, which is helpful in correc-ting the discrepancy in leg length.

OBJECTIVETo introduce the application of bipolar radiofrequency energy in the treatment of elongated anterior cruciate ligament (ACL) reconstruction during arthroscopy.

METHODSFrom January 2002 to June 2003, 12 cases whose anterior cruciate ligament reconstruction were elongated accepted the therapy of bipolar radiofrequency energy during arthroscopy. The 12 patients included 11 men and 1 woman with an average age of 30 years ranging from 18 to 45 years old. The ACL grafts were composed of 5 patellar tendons and 7 semitendinosus tendons. The elongated reconstruction were treated by bipolar radiofrequency energy with an output of 284W. This was continued until the elongated reconstruction were tight. After the operation, the patients received unlimited orthosis and were conducted to do functional exercise of the knees. All the patients were followed up. The Lysholm-Tegner score and clinical examination of the knees were recorded and analyzed statistically with paired t text.

RESULTSThe elongated ACL reconstruction became shrinkage and tighten after treated by bipolar radiofrequency energy. The palpation by hook and Lachman test showed negative results. The follow-up time was 5-13 months, averaged 8 months. The postoperative mean Lysholm-Tegner score of the knee was 88.5, which was significantly higher than that of preoperative score of 45.5 (P < 0.01). All the patients had no postoperative complications.

CONCLUSIONBy application of bipolar radiofrequency energy, the elongated ACL reconstruction can be shrunk and tightened to make the knees stabilize. The shrinkage procedure is simple, convenient and effective.

Adolescent ; Adult ; Anterior Cruciate Ligament ; surgery ; Arthroscopy ; Catheter Ablation ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Orthopedic Procedures ; methods ; Postoperative Complications ; surgery ; Tendons ; transplantation ; Transplantation, Autologous

A simple, rapid and sensitive colorimetric reverse transcription loop-mediated isothermal amplification (RT-LAMP) method was established to detect norovirus genotype GII. The method employed a set of six specially designed primers that recognized eight distinct sequences of RNA-dependant RNA polymerase and capsid protein gene for amplification of nucleic acid under isothermal conditions at 65 degrees C for 60 minutes. The amplification process of RT-LAMP was monitored by the addition of HNB (Hydroxy naphthol blue) dye prior to amplification. A positive reaction was indicated by a color change from violet to sky blue and confirmed by agarose electrophoresis. The specificity of the RT-LAMP was validated by detecting several different diarrhea viruses including norovirus genotype GII. The sensitivity was determined by serial dilutions of RNA molecules from in vitro transcription of norovirus genotype GII in parallel with conventional RT-PCR detection. The assay was further evaluated with 93 clinical specimens of diarrhea patients. The results showed that the sensitivity of RT-LAMP was 1 000 copies/microL with a high specificity and the relative sensitivity was at the same level as that of conventional RT-PCR. Positive rate of RT-LAMP in analysis of clinical specimens was approximately the same as that of conventional RT-PCR as well. This colorimetric RT-LAMP assay was potential for rapid detection of norovirus genotype GII on spot due to the observation of visual result with high specificity and sensitivity, time-saving and cost benefit.
Caliciviridae Infections ; diagnosis ; virology ; Colorimetry ; methods ; Feces ; virology ; Genotype ; Humans ; Norovirus ; genetics ; isolation & purification ; Nucleic Acid Amplification Techniques ; methods

OBJECTIVETo evaluate the risk factors related to mortality in old patients with coronary heart disease after revascularization.

METHODSA total of 675 patients (498 males) with age >or= 70 years old who received revascularization during July 2003 to June 2004 and followed up > 30 days after discharge were included in this study. Clinical characteristics, death and major adverse cardiac and cerebral events (MACCE) during follow up were recorded.

RESULTSThe patients were followed up for a mean period of (754 +/- 355) days. 27 patients (4.0%) died and MACCE developed in 50 patients (7.4%) during follow up. Female and patients with anemia took a significantly higher risk of mortality (RR = 2.750, 95% CI 1.116 - 6.779, P = 0.028, RR = 0.385 95% CI 0.164 - 0.904, P = 0.028, respectively); Creatinine level is positively related to mortality rate. When comparing patients with Cr > 115 micromol/L and Cr > 177 micromol/L with patients with Cr < 115 micromol/L, the hazard rate was 2.963 and 10.785, respectively (95% CI 1.114 - 9.952, P = 0.035 and 95% CI 2.659 - 78.097, P = 0.000) after adjustment for other risk factors.

CONCLUSIONPreexisting anaemia (male Hb < 120 g/L, female Hb < 110 g/L), renal insufficiency (Cr > 115 micromol/L) and female gender were found to be independent risk factors for mortality in old patients with coronary heart disease post revascularization.

Aged ; Aged, 80 and over ; Coronary Disease ; mortality ; surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Myocardial Revascularization ; Postoperative Period ; Prognosis ; Regression Analysis ; Risk Factors ; Sex Factors ; Survival Analysis

Objective:To analyze the costs and effectiveness of five common screening modes and genetic screening for thalassemia in China in order to find the optimal way and provide evidence for the implementation of thalassemia prevention and control projects in Hunan Province.Methods:From June 2020 to April 2021, 12 971 couples from 14 cities and autonomous prefectures in Hunan Province were selected as the study population. The diagnosis of thalassemia was based on the results of genetic testing. Results of routine blood test and hemoglobin electrophoresis were collected and analyzed. The efficacy of five screening modes, at the cut-off value of <80 fl or 82 fl for the mean corpuscular volume (MCV), was analyzed by positive predictive value, negative predictive value, Jorden index and cost-effectiveness ratio. Sensitivity analysis was used to assess the feasibility of genetic screening at different costs after fixing the costs of routine blood and hemoglobin electrophoresis. The five thalassemia screening models are as follows: Mode 1: The woman had a blood routine test first. If the result was positive, the spouse required a blood routine test. If both results were positive, a thalassemia gene test should be offered to the couple. Mode 2: Both husband and wife were screened by blood routine and hemoglobin electrophoresis. If one or both of them were positive, both would be tested for thalassemia gene. Mode 3: The couple received blood routine tests initially. If either was positive, both should receive hemoglobin electrophoresis testing. If either was positive, both parties will conduct thalassemia gene testing. Mode 4: The woman was screened by blood routine and hemoglobin electrophoresis. If any one of them was positive, the woman would be tested for thalassemia gene. If the gene test result was positive, the spouse should receive thalassemia gene. Mode 5: Both spouses conducted a blood routine test. If either was positive, both would conduct hemoglobin electrophoresis test. If both were positive, both spouses should receive thalassemia gene testing. Gene testing mode: The woman would be tested for thalassemia, and her spouse would have thalassemia test too if her result was positive.Results:When using MCV<80 fl as the cut-off for diagnosing thalassemia, the Youden indices of the five prenatal screening modes in Hunan Province were 0.551, 0.639, 0.898, 0.555 and 0.356, while when using MCV<82 fl as the cut-off, the Youden indices were 0.549, 0.629, 0.851, 0.548 and 0.356. When the MCV cut-off value was <80 fl, the missed diagnosis rates of the five screening modes were 44.44%, 0.00, 0.00, 18.52% and 62.96%, and the cost-effectiveness ratios were 21 709, 250 939, 76 870, 138 463 and 92 860 yuan (RMB)/couple, respectively. When the price of genetic testing was lower than 55 yuan (RMB), the cost-effectiveness ratio of genetic screening was lower than that of Mode 3.Conclusions:MCV<80 fl can be considered as the positive criteria in blood routine screening for thalassemia in Hunan Province, and the cost-effectiveness ratio of Mode 3 (the couple received blood routine tests initially. If either was positive, both should receive hemoglobin electrophoresis testing. If either was positive, both parties will conduct thalassemia gene testing) is the best. Genetic screening has certain advantages with the decreasing price.

OBJECTIVE: To observe the effect of electroacupuncture (EA) on the rehabilitation of knee joint function after anterior cruciate ligament (ACL) reconstruction. METHODS: A total of 140 patients with ACL reconstruction were randomly divided into an observation group (58 cases recruited, 12 cases dropped out) and a control group (65 cases recruited, 5 cases dropped out). The patients in the control group were treated with routine rehabilitation treatment. The patients in the observation group, on the basis of the treatment in the control group, were treated with EA at Fengshi (GB 31), Futu (ST 32), Zusanli (ST 36), Shangjuxu (ST 37), Fenglong (ST 40), Xuanzhong (GB 39), Diji (SP 8) and Sanyinjiao (SP 6) on the affected side (2 Hz/100 Hz of dilatational wave, 2-5 mA). Each EA treatment lasted 20-30 min, twice a day for 7 days. The swelling degree (d), pain visual analogue scale (VAS), knee joint range of motion (ROM), scores of International Knee Documentation Committee (IKDC) subjective short form and scores of Lysholm were observed in the two groups 1 day, 1 month, 3 months, 6 months and 1 year after operation. RESULTS: One month and 3 months after operation, the swelling degree (d) and VAS scores in the observation group were lower than those in the control group (<0.05); 6 months and 1 year after operation, there was no significant difference between the two groups on the swelling degree (d) and VAS scores (>0.05). One month, 3 months, 6 months and 1 year after operation, the ROM of the knee joint in the observation group was higher than that in the control group (<0.05), the IKDC score and Lysholm score were higher than those in the control group (<0.05). Within one year, there were no relaxations, fractures and other related complications in the two groups. The pivot shift test, anterior drawer test and the Lachman test were all negative. CONCLUSION EA combined with routine rehabilitation training could obviously reduce the pain of knee joint, improve the swelling degree, increase the ROM of knee joint, promote the functional recovery in patients with ACL reconstruction, which are superior to rehabilitation training alone.

OBJECTIVE: This study was aimed at investigating the carrier rate of, and molecular variation in, α- and β-globin gene mutations in Hunan Province. METHODS: We recruited 25,946 individuals attending premarital screening from 42 districts and counties in all 14 cities of Hunan Province. Hematological screening was performed, and molecular parameters were assessed. RESULTS: The overall carrier rate of thalassemia was 7.1%, including 4.83% for α-thalassemia, 2.15% for β-thalassemia, and 0.12% for both α- and β-thalassemia. The highest carrier rate of thalassemia was in Yongzhou (14.57%). The most abundant genotype of α-thalassemia and β-thalassemia was -α ^3.7/αα (50.23%) and β ^IVS-II-654/β ^N (28.23%), respectively. Four α-globin mutations [CD108 (ACC>AAC), CAP +29 (G>C), Hb Agrinio and Hb Cervantes] and six β-globin mutations [CAP +8 (C>T), IVS-II-848 (C>T), -56 (G>C), beta nt-77 (G>C), codon 20/21 (-TGGA) and Hb Knossos] had not previously been identified in China. Furthermore, this study provides the first report of the carrier rates of abnormal hemoglobin variants and α-globin triplication in Hunan Province, which were 0.49% and 1.99%, respectively. CONCLUSION Our study demonstrates the high complexity and diversity of thalassemia gene mutations in the Hunan population. The results should facilitate genetic counselling and the prevention of severe thalassemia in this region.
Humans ; beta-Thalassemia/genetics* ; alpha-Thalassemia/genetics* ; Hemoglobinopathies/genetics* ; China/epidemiology* ; High-Throughput Nucleotide Sequencing