BACKGROUND:Drainage has been applied as a routine to hip and knee replacement surgery. However, as a potential channel, drainage could become a portal for bacteria and other pathogens to invade the joint cavity. OBJECTIVE:To evaluate the clinical significance and safety of drainage in total knee arthroplasty.
METHODS:The 80 patients were prospectively randomized into two groups:Group 1 included 38 patients with wound drainage;Group 2 included 42 patients without any drainage. According to a formula calculation, blood loss, the number of subjects requiring blood transfusion, volume of blood transfusion, complications and the recovery of function after total knee arthroplasty were statistical y analyzed.
RESULTS AND CONCLUSION:The subjects were fol owed up for 2 years after discharge. Two patients lost to fol ow up in the non-drainage group. 78 patients were involved in the result analysis. The total blood loss, the number of subjects requiring blood transfusion and volume of blood transfusion were more in the drainage group than those in the non-drainage group after surgery. At 3 days after arthroplasty, active range of motion was larger in the drainage group than that in the non-drainage group. No significant differences in hemoglobin levels and Keen Society Score scores were detected after arthroplasty between the two groups. Results suggested that draining wil increase the blood loss and blood transfusion, but it may contribute to the early recovery of knee function. No significant differences in long-period Keen Society Score scores and postoperative complications were detectable between the two groups.

Objective To investigate whether sex,age-of-onset,education and asymmetry affect non-motor symptoms (NMS)in Parkinson disease,and to analyze the relationship between motor symptoms and NMS in Parkinson's disease.Methods The detailed clinical information of 157 patients with idiopathic Parkinson's disease(PD)was recorded and followed up.The data was calculated with SPSS statistic software.Sex had an impact on sleeping disorder (P＜ 0.05).Sleep disorder in female was more prominent.Cognitive disorder was affected by age-of-onset and education duration.The pain and sensory disorder were affected by age-of-onset (P ＜ 0.05).Differences in the effects of asymmetry on NMS were not statistically significant (P＞ 0.05).The higher the scores of postural instability and gait difficulty (PIGD)were,the lower the Mini-Mental State Examination (MMSE)score was(β=-1.837,P =0.004).The higher the tremor score was,the higher the Hamilton Depression Scale(HAMD) score was(β=3.460,P =0.001).The higher the rigidity akinesia score was,the higher the autonomic dysfunction score was(β=0.104,P=0.006).Conclusions The non-motor symptoms of Parkinson's disease are affected by the age,sex and cultural level.Symmetryor-not does not affect Parkinson's disease.Non-motor symptoms and motor symptoms are closely linked.The encountered posture and gait abnormalities of patients should trigger physician alerts to focus on patients' cognitive function.The encountered tremor of patients should trigger physician alerts to focus on their emotional changes.Facing to the patient with rigidity and less moving,physician should alert to the occurrence of autonomic symptoms.

Objective To investigate the influence of continuous veno-venous hemofiltration (CVVH) on cardiac output (CO) value and parameters of hemodynamics monitored by transpulmonary thermodilution technique in critical patients. Methods A prospective cohort study was conduced. Sixty-two critical patients admitted to intensive care unit (ICU) of Zunyi Medical College Affiliated Hospital from January 2011 to October 2015 were enrolled. All of the patients received CVVH through femoral vein puncture catheter. The CO value was monitored before CVVH operation, immediately after CVVH operation (8 ℃ normal saline was injected immediately after the output of blood from the arterial end), 5 minutes after operation, the time at the sudden interruption (press pause key after 10 minutes of operation) and resumed immediately, 15 minutes and 30 minutes after operation by pulse-indicated continuous cardiac output (PiCCO) with transpulmonary thermodilution method. The changes in heart rate (HR), mean arterial pressure (MAP), central venous pressure (CVP), and blood temperature were observed at all time points. Results From CVVH before start to 5 minutes thereafter, CO values were not significantly changed in patients, fluctuating in 6.96 (7.33, 8.67)-6.98 (6.43, 7.45) L/min. When CVVH was suddenly interrupted, CO value was immediately increased to the peak 8.04 (7.36, 8.77) L/min, which showed statistically significant difference as compared with other time points (all P < 0.01). Immediately after the CVVH recovery from interruption, the CO value dropped to 4.71 (4.14, 7.26) L/min, and it was significantly lower than those at other time points (all P < 0.01). With the CVVH recovery, the patients' CO value was gradually restored to the stable operation ahead of interruption [4.71 (4.14, 7.26)-6.85 (6.08, 7.26) L/min]. During CO monitoring, HR, MAP, CVP and blood temperature of the patients were at the same level, and no significant changes were founded. Conclusions CVVH interruption of immediate PiCCO monitoring CO value were significantly increased, immediately after the CVVH recovery the CO value were significantly reduced, and the normal operation of CVVH did not affect the CO value monitoring. Hemodynamics and blood temperature of all patients were stable during CVVH.

BACKGROUND:Studies have shown that human cartilage glycoprotein-39 has a certain relationship to articular cartilage degeneration and repair, but the mechanism of action is not very clear. OBJECTIVE:To investigate the effect of human cartilage glycoprotein-39 on chondrogenesis of precartilaginous stem cels. METHODS: Precartilaginous stem cels were isolated from the adult articular cartilage. Cels which could express CD105 and CD166 were detected using flow cytometry folowed by isolation and purification. Isolated precartilaginous stem cels werecultured using monolayer method, and then, passage 2 cels were cultured in the medium containing human cartilage glycoprotein-39 and normal chondrogenic medium for 14 days, respectively. Immunohistochemical staining was used to observe expression of type II colagen and gross observation was done for evaluation of cartilage formation. RESULTS AND CONCLUSION:The precartilaginous stem cels isolated from the adult articular cartilage could express CD105 and CD166. After induction, differentiated precartilaginous stem cels gradualy gathered and formed nudes. The induced cels were positive for type II colagen; after induction by human cartilage glycoprotein-39, the nodules became larger and the expression of type II colagen was increased. These findings indicate that precartilaginous stem cels with chondrogenic ability can be isolated from the adult articular cartilage, and can be induced to differentiate into chondrocytes, in which human cartilage glycoprotein-39 plays an important role.

Objective To study the effect of self-efficacy on learning effect of medical students.Methods Self-efficacy scores of the questionnaire to clinical medical students who practice in our hospital from September 2012 to April 2013 were measured.Students with score lower than the average were recruited into group A,and the others were recruited into group B.Then the scores of both-group students in the process of clinical practice,the theoretical knowledge,and triguaiacyl tests were gotten for statistical analysis.Results Group B (88.02 ± 3.902; 89.02 ± 3.902; 89.94 ± 3.794) were significantly better than group A (67.07 ± 5.131,66.02± 5.866,65.23 ±6.741) in the scores of the theory of knowledge,operation skills and triguaiacyl test.The correlation analysis showed that self-efficacy was positively related to these three aspects (P=0.032,0.024,0.001).Conclusion Clinical teachers should consciously improve students' self-efficacy in the process of their clinical practice,in order to improve the learning effect of the clinical medical students preferably.

BACKGROUND: With the increasing number of patients undergoing knee arthroplasty in China, the complications caused by the mismatch of prosthesis with anatomical parameters arouse extensive attentions.OBJECTIVE: To measure the anatomical parameters of the knee joints in healthy Zhuang ethnic group from Guangxi Zhuang Autonomous Region, China, using three-dimensional (3D) reconstruction technology, thus providing reference for the design and placement of the hip prosthesis.METHODS: Sixty-eight individuals, including 30 females and 38 males, were selected from 217 healthy people undergoing CT examination. All data were imported into Mimics 15.0 software used for 3D reconstruction, and then the knee parameters were then measured and analyzed.RESULTS AND CONCLUSION: There was no significant difference in the parameters of the bilateral femur and tibia (P > 0.05). The femoral parameters had significant differences between genders (P < 0.05). The width of tibial platform, sagittal length of lateral tibial platform, distance between medial tibial plateau and fibular head, and posterior slope of tibial plateau showed no significant differences between genders (P > 0.05), while there were significant differences in the width of medial/lateral tibial platform, and sagittal length of medial tibial platform between genders (P < 0.05). The sagittal length of medial femoral condyle was negatively correlated with age, and all femoral parameters were positively correlated with height; while only the width of medial and lateral tibial platform were positively correlated with height. To conclude, 3D reconstruction technology is available for research on the morphology of the knee joint in the Zhuang ethnic group from Guangxi Zhuang Autonomous Region, which provides references for prosthesis design and research appropriate for the Zhuang ethnic group.

OBJECTIVE:To systematically review the pregnancy safety of selective 5-serotonin reuptake inhibitor (SSRI) for depression in women underwent in vitro fertilization (IVF) combined with embryo transfer,and to provide evidence-based refer-ence. METHODS:Retrieved from PubMed,EMBase,Cochrane Library,Medline,CBM,CJFD,VIP and Wanfang database,tri-als about SSRI (trial group) vs. no medicine or placebo alone (control group) for depression in women underwent IVF combined embryo transfer were collected. Meta-analysis was performed by using Rev Man 5.3 statistical software after data extraction and quality evaluation. RESULTS:A total of 4 studies were included,involving 2122 patients. Results of Meta-analysis showed there was no statistical significance in miscarriage rate [RR=0.90,95%CI(0.61,1.35),P=0.62],pregnancy rate [RR=1.03,95%CI (0.73,1.45),P=0.87] or live birth rate [RR=1.03,95%CI(0.65,1.63),P=0.91] between 2 groups. CONCLUSIONS:For depres-sion in women underwent IVF combined with embryo transfer,SSRI do not increase miscarriage rate,decrease pregnancy rate and live birth rate and have no significant effect on the results of IVF combined with embryo transfer.

Objective To explore the subjective sleep quality and mental resilience in colorectal cancer patients during the treatment period. Methods A total of 72 colorectal cancer patients undergoing chemotherapy from May to September 2016 in First Affiliated Hospital of Xi'an Jiaotong University were selected by convenience sampling method. Pittsburgh sleep quality index (PSQI) and Conner-Davidson Resilience Scale (CD-RISC) were applied to investigate patients' sleep quality and mental resilience before discharge, and at the 1st month, 3rd month and 6th month of the chemotherapy. Single factor repeated measurement analysis of variance was applied to compare the difference between sleep quality score and mental resilience score, and Pearson correlation coefficient was used to analyze the correlation between them. Results The PSQI scores at the 4 follow-up time points were (9.43±4.26), (9.02±3.68), (7.58±4.01) and (6.16±3.22), and the difference was statistically significant (F=9.861,P<0.05). The CD-RISC scores at the 4 follow-up time points were (60.13±15.80), (66.56±16.17), (69.82±17.46) and (73.03±17.85), and the difference was statistically significant (F=7.681,P<0.05). The difference of PSQI scores of patients in different age groups was statistically significant (F=2.792,P< 0.05), and the differences of CD-RISC in patients with different education degree and in different cancer stages were statistically significant (F=3.321,3.534;P<0.05). There were a negative correlations between sleep quality and mental resilience at the each time point (r=-0.32--0.53;P<0.05). The CD-RISC score of the patients with early stage sleep disturbances was lower than that of non-sleep disturbances patients at each time point (P< 0.05). Conclusions Health professionals should pay close attention to the sleep status of colorectal cancer patients at the early stage of treatment, and take appropriate interventions to improve the quality of life and resilience development.

OBJECTIVE: To explore the clinical characteristics, genetic basis and clinical treatment of seven neonates with congenital nephrogenic diabetes insipidus (NDI). METHODS: Clinical data of the patients were collected. High-throughput sequencing was carried out to detect potential variants. Sanger sequencing was used to verify the results. RESULTS: The patients were all males, with the age of onset being 10 to 21 days. All patients were admitted to the hospital for intermittent fever as the first symptom during the neonatal period. Additional symptoms had included polydipsia and polyuria. After the treatment, 5 patients had recovered, the remainders still had NDI symptoms and developmental retardation. Five children were found to harbor pathogenic variants of the AVPR2/AQP2 gene, which included one in-frame mutation of c.645_646insGCACCTACCCTGGGTATCGCC, two missense mutations of c.541C>T and c.419C>A, and two hemizygous deletions of the AVPR2/AQP2 gene. Among these, two were unreported previously. Cases 6 and 7 were a pair of twins. Both had carried homozygous missense variants of c.538G>A of the AVPR2/AQP2 gene, which was known to be pathogenic. CONCLUSION AVPR2/AQP2 is the main pathogenic gene for congenital NDI, for which two novel pathogenic variants have been discovered in this study. Above results have provided a basis for clinical diagnosis and genetic counseling for the affected pedigrees.
Aquaporin 2/genetics* ; Child ; Diabetes Insipidus, Nephrogenic/genetics* ; Diabetes Mellitus ; Humans ; Infant, Newborn ; Male ; Molecular Biology ; Mutation ; Pedigree ; Receptors, Vasopressin/genetics*

Objective:To develop the Peristome Skin Injury Risk Assessment Scale and to verify its reliability, validity and predictive performance in patients with colorectal cancer stoma.Methods:The initial assessment scale was developed through literature review and Delphi expert consultation. From February 2020 to April 2021, convenient sampling was used to select 290 cases of colorectal cancer stoma patients who were reexamined in the Oncology Surgery of the First Affiliated Hospital of Xi'an Jiaotong University as the research object. Item analysis, validity analysis, reliability analysis, receiver operating characteristic curve (ROC) were used to test the reliability, validity and predictive performance of the scale.Results:Exploratory factor analysis extracted a total of 4 common factors, namely general condition, stoma condition, postoperative condition, education and self-care condition, a total of 17 items, and the cumulative variance contribution rate was 85.144%. The scale-level content validity index was 0.941, and the item-level content validity index was 0.857 to 1.000. The Cronbach's α coefficient of the total scale was 0.824, the split-half reliability coefficient was 0.837, and the test-retest reliability coefficient was 0.819. There was a statistically significant difference in the scores of the Peristome Skin Injury Risk Assessment Scale in patients with colorectal cancer stoma between the injury group and the non-injury group ( P<0.05) . The area under the ROC curve was 0.838 (95% confidence interval: 0.785-0.891) . When the cut-off score was 39.5, the sensitivity of the scale was 0.849, the specificity was 0.759, the Youden index was 0.608, and the predictive performance was the best. Conclusions:The Peristome Skin Injury Risk Assessment Scale has good reliability and validity, and has high predictive performance, which is suitable for the assessment of the risk of peristome skin injury in patients with colorectal cancer in China.