Objective To investigate the clinical effects of arthroscopic patelloplasty combined with lateral patellar retinaculum release and circumpatellar denervation for treatment of moderate and severe patellofemoral osteoarthritis.Methods A retrospective case-control study was done on 80 patients with moderate to severe patellofemoral osteoarthritis who were treated in our hospital between March 2013 and March 2015.According to treatment methods,the patients were divided into two groups:Group A including 40 cases (22 cases of Outerbridge grade Ⅲ degree and 18 cases of Outerbridge grade Ⅳ) undergone arthroscopic debridement,and Group B including 40 cases (22 cases of Outerbridge grade Ⅲ degree and 18 cases of Outerbridge grade Ⅳ) undergone arthroscopic patelloplasty combined with lateral patellar retinaculum release and circumpatellar denervation.The Kujula scores and Lysholm scores of the patellofemoral joint were compared between the two groups before and after operation.The lateral patellofemoral angle was measured according to patellar axial X-ray performed 3 months after operation to evaluate patellofemoral joint function.Results All patients were followed up for 13-36 months (average 19.8 months).The patellofemoral joint scores of the two groups was increased at different degrees after operation.In moderate patellofemoral osteoarthritis patients,at 3 months after operation and the last follow-up of Group B,Kujula scores [(85.1 ± 6.8)points,(86.8 ± 4.6)points] and Lysholm scores [(88.1 ± 1.8) points,(88.4 ± 2.3) points] were higher than that of Group A [(78.1 ± 5.7) points,(78.3±5.3)points,(82.4 ±2.9)points,and (82.5 ±2.5)points] (P＜0.05).In each group,the Kujula scores and Lysholm scores at 3 months after operation and the last follow-up were improved to be higher than preoperation (P ＜ 0.05),with insignificant statistical difference between the two groups (P ＞ 0.05).According to the Lysholm scores,the excellent rate after operation in Group B (86％) was higher than that of Group A (55％) (P ＜ 0.05).For patients with severe patellofemoral osteoarthritis,Kujula scores [(72.3 ± 5.3) points,(72.7 ± 3.6) points] and Lysholm scores [(75.1 ± 1.9) points,(75.3 ± 2.3) points] at 3 months postoperatively and at the last follow-up in Group B were higher than that of Group A [(70.8 ± 5.2) points,(71.1 ± 4.2) points,(73.4 ± 2.8) points,and (73.6 ± 2.5) points],but the difference was not statistically significant (P ＞ 0.05).Within each group,although the Kujula scores and Lysholm scores at 3 months postoperatively and at the last follow-up were improved compared with before operation,but the difference was not statistically significant (P ＞ 0.05).According to the Lysholm scores,although the excellent rate after operation of Group B (33％) was higher than that of Group A (28％),with insignificant statistical difference (P ＞ 0.05).No matter Outerbridge Ⅲ or Ⅳ patellofemoral osteoarthritis a patient was,the lateral patellofemoral angle of Group A after operation had no significant improvement (P ＞ 0.05),while Group B showed significant improvement after operation (P ＜0.01).Group B had better improvements than that of Group A (P ＜0.01).Conclusions Compared with simple arthroscopic debridement,patelloplasty combined with lateral patellar retinaculum release and circumpatellar denervation can better relieve the symptoms of moderate patellofemoral osteoarthritis and improve knee function.But for patients with severe patellofemoral osteoarthritis,this method is not effective.

Objective To investigate the difference between single lumen endotracheal intubation of thoracoscope and traditional double lumen endotracheal intubation of thoracoscope in process of thymectomy. Methods From January 2010 to June 2014, clinical data of 30 cases with thymectomy under single lumen endotracheal intubation of thoracoscope (group A) and 30 cases with thymectomy under traditional double lumen endotracheal intubation thora-coscope (group B) were analyzed. Results There were no death patients in both groups. Group A:endotracheal intu-bation time (2.67 ± 0.72) min, surgery time (48.37 ± 4.64) min, the bleeding (26.17 ± 9.62) ml; Group B:endotracheal intubation time (5.55 ± 0.71) min, surgery time (52.10 ± 5.68) min, the bleeding (33.00 ± 7.94) ml. Conclusion Compared with traditional double lumen endotracheal intubation under thoracoscope, the single lumen endotracheal intubation of thoracoscope showed that intubation time was significantly shorter, and reduced the oc-currence of postoperative complications, the operative field was exposed more completely, reduced operation time and blood loss.

Objective To explore the treatment characteristics and effect of hip fracture in aged patients. Methods A retrospective analysis was performed in 143 elderly patients with hip fracture, aged 75 years and over. 28 cases received non-surgery treatment and 115 cases received surgery treatment. Much of them had at least one chronic disease. The complications, preoperative preparation, operative indications, internal fixation devices, postoperative management, mortality rate and recovery rate were reviewed. Results The mortality rate of nonoperative management patients was 39.3% (11/28) in one year, and that of operative management patient was 8.7% (10/115). The recovery rate of nonoperative management patients was 28.5% (8/28) in one year, and that of operative management patients was 75.3% (79/115). Conclusions If full attention is paid to preoperative treatments, hip fracture of aged patients treated by operation is safe and effective.

AIM:To analyze the relationship between epicardial adipose tissue (EAT) thickness and plasma N-terminal pro-B-type natriuretic peptide ( NT-proBNP ) level in the patients with stable coronary artery disease . METHODS:The patients with chest pain ( n=115) admitted to our hospital underwent coronary artery computer tomo-graphy and further underwent coronary angiography for confirming whether they had coronary artery disease .EAT thickness was evaluated at the right ventricular free wall imaged by coronary artery computer tomography .Plasma NT-proBNP level was examined by an automatic biochemistry analyzer .RESULTS:Eighty-one patients were confirmed to have stable coro-nary artery disease and thirty-four patients were excluded to have coronary artery disease .Left ventricular ejection fraction of these patients of 2 groups were all normal.The natural logarithm of plasma NT-proBNP level [ln(NT-proBNP)] of the patients with stable coronary artery disease was significantly higher than that of the patients without coronary artery disease (P<0.05).EAT thickness of the patients with stable coronary artery disease was also higher than that of the patients with -out coronary artery disease(P<0.05).EAT thickness was related to ln(NT-proBNP) positively (P<0.05).After adjust-ment of related impact factors , EAT thickness was still related to ln (NT-proBNP) positively (P<0.05).Multiple-factor regression analysis showed that EAT thickness was the independent influence factor on LnNT -proBNP (P<0.05).CON-CLUSION:EAT thickness and plasma NT-proBNP level are both increased significantly and is related to each other in the patients with stable coronary artery disease .

Irreparable rotator cuff tear can result in pain and should disfunction, and the management of patient with it remains a challenge. A variety of treatment options have been proposed, such as debridement, tuberplasty, partial rotator cuff repair, patch augmented rotator cuff repair, tendon transfers, superior capsule reconstruction, suprascapular nerve ablation or kill, inpace and reverse shoulder arthroplasty. These procedures are still widely debated, The aim of this review is to summarise procedures and the results, the operative essence is to restore the stable rotation center of glenohumeral joint, the choice is dictated by our special need.

Objective: Evaluate GII.4 norovirus infection and blocking effects of serum antibodies against HBGAs binding to GII.4 norovirus of population in oyster culture area, provide references for screening of fully human monoclonal antibody. Methods: Using a random survey method to collect blood and saliva samples in oyster culture area, select serum samples from the inland region of Guangdong as control group. Identification of salivary HBGA receptor phenotype and detection of serum antibody levels between two areas by ELISA. A vitro neutralization model was to determine the efficiency of serum antibodies blocking GII.4 norovirus and HBGA receptors binding. Results: The age were (50.68 ± 15.17), (52.52 ± 15.90) and (51.37 ± 13.32) years old of 2015, 2016 in experimental group, and in control group, respectively. Males accounted for 5.9% (70/195), 36.6%(60/164), 40.8% (69/169) (χ²=0.93, P=0.334). The mean value of serum antibodies Absorbance value was 2.521±0.05 of 2015 and was 2.583±0.045 of 2016 in oyster culture area, the mean value was 2.249±0.05 in control group, there was a statistical difference among three group (F=13.28, P<0.001). The antibody prevalence in the three groups was 100%. BT50 geometric mean titer (GMT) of oyster culture area in 2015 was 423.1±40.11, culture group was 248.2±25.63, there was a statistical difference (t=3.73, P<0.001). Conclusion The population in oyster culture area does have more chance of exposure and infection GII.4 norovirus, Serum antibody of blocking ability in oyster culture areas is better than the general population in inland city. Suggesting that the population is more immunity resistant infected GII.4 norovirus.

Currently, the total ureteral avulsion are mainly secondary to ureteroscopy, and it is rarely caused by uterine evacuation clinically. This paper reported a case of total ureter avulsion after uterine evacuation, treating by ileal replacement for ureter under general anesthesia, and the surgical outcome was good. Uterine evacuation is a routine, less risky procedure, but it also can lead to serious complications such as total ureteral avulsion or bladder rupture. For potential high-risk patients with uterine evacuation, preventive measures such as accurate localization under B-ultrasound guidance or pre-operative ureteral stents indwelling are useful to avoid the occurrence of such serious complications. If total ureteral avulsion occurs, ileal replacement for ureter is a viable and effective treatment.

【Objective】 To objectively evaluate the quality control level of blood testing process in blood banks through quantitative monitoring and trend analysis, and to promote the homogenization level and standardized management of blood testing laboratories in blood banks. 【Methods】 A quality monitoring indicator system covering the whole process of blood collection and supply, including blood donation service, blood component preparation, blood testing, blood supply and quality control was established. The questionnaire Quality Monitoring Indicators for Blood Collection and Supply Process with clear definition of indicators and calculation formulas was distributed to 17 blood banks in Shandong province. Quality monitoring indicators of each blood bank from January to December 2022 were collected, and 31 indicators in terms of blood testing were analyzed using SPSS25.0 software. 【Results】 The proportion of unqualified serological tests in 17 blood bank laboratories was 55.84% for ALT, 13.63% for HBsAg, 5.08% for anti HCV, 5.62% for anti HIV, 18.18% for anti TP, and 1.65% for other factors (mainly sample quality). The detection unqualified rate and median were (1.23±0.57)% and 1.11%, respectively. The ALT unqualified rate and median were (0.74±0.53)% and 0.60%, respectively. The detection unqualified rate was positively correlated with ALT unqualified rate (r=0.974, P<0.05). The unqualified rate of HBsAg, anti HCV, anti HIV and anti TP was (0.15±0.09)%, (0.05±0.04)%, (0.06±0.03)% and (0.20±0.05)% respectively. The average unqualified rate, average hemolysis rate, average insufficient volume rate and the abnormal hematocrit rate of samples in 17 blood bank laboratories was 0.21‰, 0.08‰, 0.01‰ and 0.02‰ respectively. There were differences in the retest concordance rates of four HBsAg, anti HCV and anti HIV reagents, and three anti TP reagents among 17 blood bank laboratories (P<0.05). The usage rate of ELISA reagents was (114.56±3.30)%, the outage rate of ELISA was (10.23±7.05) ‰, and the out of range rate of ELISA was (0.90±1.17) ‰. There was no correlation between the out of range rate, outrage rate and usage rate (all P>0.05), while the outrage rate was positively correlated with the usage rate (r=0.592, P<0.05). A total of 443 HBV DNA positive samples were detected in all blood banks, with an unqualified rate of 3.78/10 000; 15 HCV RNA positive samples were detected, with an unqualified rate of 0.13/10 000; 5 HIV RNA positive samples were detected, with an unqualified rate of 0.04/10 000. The unqualified rate of NAT was (0.72±0.04)‰, the single NAT reaction rate [(0.39±0.02)‰] was positively correlated with the single HBV DNA reaction rate [ (0.36±0.02) ‰] (r=0.886, P<0.05). There was a difference in the discriminated reactive rate by individual NAT among three blood bank laboratories (C, F, H) (P<0.05). The median resolution rate of 17 blood station laboratories by minipool test was 36.36%, the median rate of invalid batch of NAT was 0.67%, and the median rate of invalid result of NAT was 0.07‰. The consistency rate of ELISA dual reagent detection results was (99.63±0.24)%, and the median length of equipment failure was 14 days. The error rate of blood type testing in blood collection department was 0.14‰. 【Conclusion】 The quality monitoring indicator system for blood testing process in Shandong can monitor potential risks before, during and after the experiment, and has good applicability, feasibility, and effectiveness, and can facilitate the continuous improvement of laboratory quality control level. The application of blood testing quality monitoring indicators will promote the homogenization and standardization of blood quality management in Shandong, and lay the foundation for future comprehensive evaluations of blood banks.

【Objective】 To establish an effective quality monitoring indicator system for blood quality control in blood banks, in order to analyze the quality control indicators for blood collection and supply, and evaluate blood quality control process, thus promoting continuous improvement and standardizing management of blood quality control in blood banks. 【Methods】 A quality monitoring indicator system covering the whole process of blood collection and supply, including blood donation services, component preparation, blood testing, blood supply and quality control was established. The Questionnaire of Quality Monitoring Indicators for Blood Collection and Supply Process was distributed to 17 blood banks in Shandong, which clarified the definition and calculation formula of indicators. The quality monitoring indicator data from January to December 2022 in each blood bank were collected, and 20 quality control indicators data were analyzed by SPSS25.0 software. 【Results】 The average pass rate of key equipment monitoring, environment monitoring, key material monitoring, and blood testing item monitoring of 17 blood banks were 99.47%, 99.51%, 99.95% and 98.99%, respectively. Significant difference was noticed in the pass rate of environment monitoring among blood banks of varied scales(P<0.05), and the Pearson correlation coefficient (r) between the total number of blood quality testing items and the total amount of blood component preparation was 0.645 (P<0.05). The average discarding rates of blood testing or non-blood testing were 1.14% and 3.36% respectively, showing significant difference among blood banks of varied scales (P<0.05). The average discarding rate of lipemic blood was 3.07%, which had a positive correlation with the discarding rate of non testing (r=0.981 3, P<0.05). There was a statistically significant difference in the discarding rate of lipemic blood between blood banks with lipemic blood control measures and those without (P<0.05). The average discarding rate of abnormal color, non-standard volume, blood bag damage, hemolysis, blood protein precipitation and blood clotting were 0.20%, 0.14%, 0.06%, 0.06%, 0.02% and 0.02% respectively, showing statistically significant differences among large, medium and small blood banks(P<0.05).The average discarding rates of expired blood, other factors, confidential unit exclusion and unqualified samples were 0.02%, 0.05%, 0.003% and 0.004%, respectively. The discarding rate of blood with air bubbles was 0.015%, while that of blood with foreign body and unqualified label were 0. 【Conclusion】 The quality control indicator system of blood banks in Shandong can monitor weak points in process management, with good applicability, feasibility, and effectiveness. It is conducive to evaluate different blood banks, continuously improve the quality control level of blood collection and supply, promote the homogenization and standardization of blood quality management, and lay the foundation for comprehensive evaluation of blood banks in Shandong.

【Objective】 To establish an effective quality indicator monitoring system, scientifically and objectively evaluate the quality management level of blood banks, and achieve continuous improvement of quality management in blood bank. 【Methods】 A quality monitoring indicator system that covers the whole process of blood collection and supply was established, the questionnaire of Quality Monitoring Indicators for Blood Collection and Supply Process with clear definition of indicators and calculation formulas was distributed to 17 blood banks in Shandong. Statistical analysis of 21 quality monitoring indicators in terms of blood donation service (10 indicators), blood component preparation (7 indicators ), and blood supply (4 indicators) from each blood bank from January to December 2022 were conducted using SPSS25.0 software The differences in quality monitoring indicators of blood banks of different scales were analyzed. 【Results】 The average values of quality monitoring indicators for blood donation service process of 17 blood banks were as follows: 44.66% (2 233/5 000) of regular donors proportion, 0.22% (11/50) of adverse reactions incidence, 0.46% (23/5 000) of non-standard whole blood collection rate, 0.052% (13/25 000) of missed HBsAg screening rate, 99.42% (4 971/5 000) of first, puncture successful rate, 86.49% (173/200) of double platelet collection rate, 66.50% (133/200) of 400 mL whole blood collection rate, 99.25% (397/400) of donor satisfaction rate, 82.68% (2 067/2 500) of use rate of whole blood collection bags with bypass system with sample tube, and 1 case of occupational exposure in blood collection.There was a strong positive correlation between the proportion of regular blood donors and the collection rate of 400 mL whole blood (P<0.05). The platelet collection rate, incidence of adverse reactions to blood donation, and non-standard whole blood collection rate in large blood banks were significantly lower than those in medium and small blood banks (P<0.05). The average quality monitoring indicators for blood component preparation process of 17 blood banks were as follows: the leakage rate of blood component preparation bags was 0.03% (3/10 000), the discarding rate of lipemic blood was 3.05% (61/2 000), the discarding rate of hemolysis blood was 0.13%(13/10 000). 0.06 case had labeling errors, 8 bags had blood catheter leaks, 2.76 bags had blood puncture/connection leaks, and 0.59 cases had non-conforming consumables. The discarding rate of hemolysis blood of large blood banks was significantly lower than that of medium and small blood banks (P<0.05), and the discarding rate of lipemic blood of large and medium blood banks was significantly lower than that of small blood banks (P<0.05). The average values of quality monitoring indicators for blood supply process of 17 blood banks were as follows: the discarding rate of expired blood was 0.023% (23/100 000), the leakage rate during storage and distribution was of 0.009%(9/100 000), the discarding rate of returned blood was 0.106% (53/50 000), the service satisfaction of hospitals was 99.16% (2 479/2 500). The leakage rate of blood components during storage and distribution was statistically different with that of blood component preparation bags between different blood banks (P<0.05). There were statistically significant differences in the proportion of regular blood donors, incidence of adverse reactions, non-standard whole blood collection rate, 400 mL whole blood collection rate, double platelet collection rate, the blood bag leakage rate during preparation process, the blood components leakage rate during storage and distribution as well as the discarding rate of lipemic blood, hemolysis blood, expired blood and returned blood among large, medium and small blood banks (all P<0.05). 【Conclusion】 The establishment of a quality monitoring indicator system for blood donation services, blood component preparation and blood supply processes in Shandong has good applicability, feasibility and effectiveness. It can objectively evaluate the quality management level, facilitate the continuous improvement of the quality management system, promote the homogenization of blood management in the province and lay the foundation for future comprehensive evaluation of blood banks.