Objective To adopt the high-frequency ultrasound to conduct the diagnostic analysis for multiple factors of thyroid nodules and the case-control study to provide the reliable method for accurately diagnosing thyroid nodules.Methods The question-naire survey was performed on the residents in a region by using the overall random sampling method.The thyroid high-frequency ultrasound examination and the urine iodine value detection were conducted;the individuals with the positive thyroid nodules by high-frequency ultrasound and the individuals without thyroid nodules lesions were divided into the two groups according to the age,gender,occupation and urban-rural matching,400 cases in each group.The two groups were performed the case-control study;the study results were performed the single factor and multiple factors Logistic regression analysis.Results The combination of the single factor and multiple factors analysis showed that the protective factors were correlated with the patient annual income,the higher the income,the lower the probability suffering from thyroid nodules,the individuals with smoking history had the higher probability suffering from thyroid nodules,the detection and analysis showed that the urinary iodine value in the individuals with low prevalence rate of thyroid nodules was generally 100-190 μg/L (P <0.05).Conclusion Conducting the single factor and mul-tiple factors comparative analysis on the patients with thyroid nodules by the high-frequency ultrasound finds that the diet habit and the use amount of iodine have a certain correlation with the occurrence rate of thyroid nodules,the urinary iodine value affects the occurrence rate of thyroid nodules.The high-frequency ultrasound plays a role in the diagnosis of thyroid nodules and can be taken as the promotion application for the diagnosis of thyroid nodules in clinic.

Objective To study the clinical results of grafting of vascularized fibular and ilium to repair bone defects of limbs. Methods From January 1992 to January 2004, 49 cases of bone defects of limbs were treated with vascularized fibular grafting (33 cases) and vascularized iliac grafting (16 cases). Their limb functions were graded according to Ennekings system. The changes of the vascularized fibular and iliac grafts were evaluated radiographically according to the International Symposium on Limb Salvage. Results All the patients were followed up for 1 to 12 years. In the vascularized fibular group, the recovery rate for the operated limbs was 82.7%, the average healing time of the bone was 16.8 weeks and the healing rate of the bone was 87.9%. In the other group, the recovery rate of the operated limbs was 88%, the average healing time of the bone was 15.2 weeks and the healing rate of the bone was 93.8%. Conclusion The vascularized fibular graft can be adopted to repair long bone defects of lower limbs and distal radius, while the vascularized iliac graft can be adopted to repair the bone defects of upper limbs.

Objective To investigate the risk factors of premature atherosclerotic three-vessel coronary artery dis?ease (CHD), and the association between single nucleotide polymorphism (SNP) of CD36 rs3211956, rs7755 and premature CHD. Methods Patient with premature three-vessel coronary artery disease (n=102) which were confirmed by consecutive coronary angiogram (lesion group) and patients (n=72) without CHD (control group) were enrolled in the study. Conventional CHD risk factors were compared between the two groups as well as SNPs of CD36 rs3211956 and rs7755 to disclose inde?pendent risk factor for CHD, which were measured by mass spectrometry. Results Among the conventional CHD risk fac?tors, male, HBP, high LDL-C, low HDL-C were independent risk factors of premature CHD. The GT genotype proportion of rs3211956 was significantly lower (χ2=8.042,P=0.005) in the lesion group than that in control group while the TT genotype proportion is significantly higher in lesion group compared with that in control group (χ2=6.191,P=0.014). Patients with the TT genotype have higher score of BMI than patients with GG or GT genotype (P=0.037). The G allele proportion of rs7755 in the lesion group was significantly higher than control group (χ2=3.636, P=0.047). Patients of the GG genotype have higher scores of BMI but lower level of HDL-C than those with AA or AG genotype (P<0.001). Logistic regression analysis re?vealed that after excluding a number of confounding factors, GG and TT genotype of rs3211956 and GG and GA genotype of rs7755 were respectively one of the independent risk factors for premature CHD. Conclusion The SNPs of CD36 rs7755 and rs3211956 may be the independent risk factors of premature coronary heart disease and might affect the the onset of CHD by affectting BMI and HDL-C.

Objective To systematically review the efficacy and safety of solifenacin in the treatment of patients with bladder spasm after transurethral resection of prostate based on current evidence.Methods We searched Pubmed,EMbase,the Cochrane Library,CBM,CNKI,VIP and Wanfang Database from the establishment to October 2016 for the published literature on the treatment of patients with bladder spasm after transurethral resection of prostate with solifenacin.Two reviewers independently screened literature,extracted data and assessed the risk of bias of included studies.Then,meta-analysis was performed using RevMan 5.3 software.Results A total of 11 RCTs involving 621 patients were included.The results of meta-analysis showed that:compared with the no-solifenacin group(n=311),the numbers of bladder spasm episodes[MD=-1.38,95%CI(-1.97,-0.97)P<0.00001],duration of bladder spasm[MD=-0.26,95%CI(-0.41,-0.11),P=0.0008],the time of bladder perfusion clearance[MD=-0.59,95%CI(-0.88,-0.29),P<0.0001],indwelling catheter delivery[MD=-0.29,95%CI(-0.48,-0.11),P=0.09]in solifenacin group(n=310) reduced significantly,and there was no statistical difference in the incidence of overall adverse events between the two groups[RR=0.71,95%CI(0.17,2.98),P=0.64].Conclusion Current evidence indicates that solifenacin is more effective and safe in the treatment of patients with bladder spasm after transurethral resection of prostate.Due to the limited quantity and quality of the include studies,more high quality studies are needed to verify the above conclusion.

Objective To study the protein expression levels of matrix metalloproteinases (MMPs)and their inhibitors in bone tissues of rat femoral head and to explore the relationship between necrosis of femoral head and glucocorticoid.Methods Twenty healthy adult SD rats were randomly divided into glucocorticoid group and control group,with 10 rats in each.Glucocorticoid group was treated with intramuscular injection of hydrocortisone twice a week.The control group received normal saline of the same volume.Four weeks later,bone tissues of left femoral head were collected from each group of rats for HE determination of femoral head necrosis.The expressions of matrix metalloproteinase-1 (MMP-1 ), matrix metalloproteinase-2 (MMP-2 ), tissue inhibitor of matrix metalloproteinase-1 (TIMP-1 ),and tissue inhibitor of matrix metalloproteinase-2 (TIMP-2 )at mRNA and protein levels were detected by RT-PCR and Western blot techniques,respectively.Results The expressions of MMP-1 and MMP-2 at mRNA and protein levels were higher in glucocorticoid group than those in the control group. However,TIMP-1 and TIMP-2 gene and protein expression levels were lower in glucocorticoid group (all P<0.05). Conclusion The expressions of MMPs in bone tissues of rat femoral head in early necrosis were increased,but their inhibitors had decreased expressions. We can draw the conclusion that glucocorticoid-induced necrosis of femoral head may be related to its regulation of the expression levels of MMPs and their related inhibitors.

Background Lensectomy with anterior capsule preserving is still advisable under specific conditions during vitrectomy.Although lens epithelial cells were polished off during surgery,opacification in varying degrees could be observed.Understanding the composition of proliferative anterior capsule membrane is of an important clinical significance for the prevention and manegement.Objective This study was to investigate the management and pathology of the pupillary area membranous opacity underling preserved anterior capsule after lensectomy in diabetic eyes with silicone oil tamponade.Methods Twenty-three eyes of 21 patients with proliferative diabetic retinopathy (PDR) and cataract received vitrectomy combined with lensectomy preserved anterior capsule in China-Japan Friendship Hospital from January to December 2013,and the proliferative anterior capsular membrane specimens with the opacification grade C or D were obtained.The fibrotic membrane underlying anterior capsules were removed in order to make a clear optical area during the operation of silicone oil removal.The proliferative membrane at pupillary area was cut off by cutter probe for the eyes with the membrane attaching tightly or partial capsule laceration occurred.The available specimens were examined under the optical microscope and polarized microscope respectively after hemotoxylin and eosin staining,Van Gieson collagen staining,Masson collagen staining and Picrosirius staining.Results The proliferative fibrosis membranes were pilled to get a clear pupillary area in 15 eyes,with the successfully rate 65.2％ (15/23).In 14 eyes with degree C opacity,the proliferative fibrosis membranes were pilled in 9 eyes,with the successfully rate 64.3 ％ (9/14),and 5 eyes received anterior capsule cutthrough by cutter in pupillary area,with a diameter of 3-4 mm,and available specimens were obtained in 3 eyes.In 9 eyes with degree D opacity,the proliferative membranes were pilled in 6 eyes,with the successfully rate of 66.7％ (6/9),and 3 eyes underwent cut-through by cutter,and available specimens were obtained in 7 eyes.The best corrected visual acuity was obviously improved in 20 eyes and unchanged in 3 eyes after surgery.The histopathological examination showed fibroblasts,pigment particles and intracellular and extracellular vacuolus formation by hemotoxylin and eosin staining,fibril tissue with the pinke staining by Van Gieson,collage formation with green color by Masson staining in the specimens.Picrosirius staining plus polarization microscopy observation revealed that the collagen consisted of abundant type Ⅰ collagen with stronger reddish yellow color and small amount of type Ⅲ collagen with green color.Conclusions A combination of silicon oil removal with proliferative mambrane pelling is a available way to restore pupillary transparency in the eyes of PDR with cataract and silicone oil tamponade eyes.Proliferative residual lens epithelial cells,pigment epithelial cells and silicon oil granules are the main composition of opacity mambrane.The type Ⅰ collagen is dominant in proliferative collagen tissue.

Objective:To investigate the current situation of the fatalism of the disabled elderly in hospital, and to analyze the influencing factors, so as to provide a basis for the later development of targeted intervention programs.Methods:This was a cross-sectional survey study. From December 2 to 29, 2023, the convenience sampling method was used to investigate the disabled elderly hospitalized in 7 tertiary general hospitals in Sichuan Province by the general information questionnaire, the Activity of Daily Living scale and the Fatalism Scale. And its influencing factors were conducted by the multivariate linear regression.Results:A total of 280 questionnaires were distributed in this survey, and 269 questionnaires were effectively recovered, with an effective recovery rate of 96.07%(269/280). There were 136 males and 133 females, aged 60-69 years old with 61 cases, 70-79 years old with 103 cases, ≥80 years old with 105 cases. The score of the fatalism in hospitalized disabled elderly was (48.87 ± 10.02) points, of which the pre-determined dimension score was (18.73 ± 4.17) points, the luck dimension score was (12.75 ± 3.42) points, and the pessimistic dimension score was (17.39 ± 4.72) points. Multivariate linear regression showed that the frequency of visits to relatives and friends and the level of education were protective factors for the occurrence of fatalism (t=-3.02, -2.81, both P<0.05), and economic pressure was a risk factor for the occurrence of fatalism (t=4.35, P<0.01).Conclusions:The fatalistic view of the disabled elderly in the hospital is at a medium level.Medical staff can start from the influencing factors, formulate relevant intervention measures, and improve the level of the patient's fatalism.

Objective:To explore the current situation of stigma among disabled elderly inpatients and analyze its influencing factors, so as to provide reference for formulating targeted intervention measures.Methods:This study was a cross-sectional survey. In December 2023, convenience sampling was used to select 428 disabled elderly inpatients from 12 ClassⅢ Grade A hospitals in Sichuan Province as research subjects. General Information Questionnaire and Social Impact Scale (SIS) were used to conduct surveys on patients. Multiple linear regression analysis was used to explore the influencing factors of stigma among disabled elderly inpatients.Results:A total of 428 questionnaires were distributed, and 407 valid questionnaires were collected, with a valid response rate of 95.09% (407/428). SIS score of 407 disabled elderly inpatients was (56.55±8.38). Multiple linear regression analysis showed that the number of diseases, educational level, and self-rating economic pressure were the influencing factors of stigma among disabled elderly inpatients ( P<0.05) . Conclusions:The stigma among disabled elderly inpatients is at a moderate level. Medical and nursing staff should establish a comprehensive prevention and management mechanism based on influencing factors.

Independent component analysis (ICA) is a novel method developed in recent years for Blind Source Separation. In this paper, the phonocardiogram (PCG) was separated into three components by applying ICA. The basic principle of ICA was introduced in this paper. A fast and robust fixed-point algorithm for ICA was used to analyze PCG signals in this study. The experiments showed that ICA could separate the components of heart sounds from PCG signals successfully.
Algorithms ; Heart Sounds ; Humans ; Phonocardiography ; methods ; Principal Component Analysis ; Signal Processing, Computer-Assisted

Objective To investigate the effect of different lower extremity force lines after initial total knee arthroplasty(TKA)on the early clinical outcomes of patients with varus knee osteoarthritis(KOA).Methods Fifty-five patients(73 knees)with KOA who underwent TKA at the First Affiliated Hospital of Xinxiang Medical University from October 2018 to March 2022 were selected as research subjects.According to the postoperative hip-knee-ankle angle(HKA),the patients were divided into the valgus alignment group(HKA＜-3°,4 knees),neutral alignment group(-3°≤HKA ≤3°,32 knees),mild varus alignment group(3°＜HKA＜6°,30 knees),and severe varus alignment group(HKA ≥6°,7 knees).The mechanical lateral distal femoral angle(mLDFA),mechanical medial proximal tibial angle(mMPTA),range of motion(ROM)of knees,and joint line convergence angle(JLCA)of the four groups of patients were measured before and 1 week after surgery.The Hospital for Special Surgery Knee Scores(HSS),The Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)scores,and numeric rating scale(NRS)scores of the knee joints of patients in the four groups were also recorded preoperatively and 6 months postoperatively.Results The overall postoperative mLDFA,mMPTA,ROM and HSS scores were significantly greater than the preoperative values and the JLCA,WOMAC and NRS scores were significantly less than the preoperative values in 55 patients(73 knees)(P＜0.01).There was no statistically significant difference in the preoperative mLDFA,mMPTA,JLCA and ROM among the patients in the four groups(F=2.689,0.692,0.476,0.892;P＞0.05).Postoperative mLDFA,mMPTA,and ROM were significantly greater than preoperative values and JLCA was significantly less than preoperative value in patients in the neutral alignment,mild varus alignment,and severe varus groups(P＜0.05).Postoperative mMPTA and ROM were significantly greater than preoperative values and JLCA was significantly less than preoperative value in patients in the valgus group(P＜0.05);the difference was not statistically significant when compared with preoperative and postoperative mLDFA in patients in the valgus group(P＞0.05).There was no statistically significant difference in the postoperative JLCA and ROM among the four groups(F=1.164,1.045;P＞0.05).The difference in postoperative mLDFA and mMPTA was statistically significant among the four groups(F=21.068,4.551;P＜0.05);the mLDFA of patients in the neutral alignment,mild varus alignment,and severe varus alignment groups was significantly greater than that of the valgus alignment group,and patients in the mild varus alignment and severe varus alignment groups had greater mLDFA than those in the neutral alignment group,patients in the severe varus alignment group had greater mLDFA than those in the mild varus alignment group(P＜0.05);the mMPTA of patients in the neutral alignment,mild varus alignment,and severe varus alignment groups was less than that of patients in the valgus alignment group(P＜0.05);there was no statistically significant difference in the mMPTA among patients in the neutral alignment,mild varus alignment and severe varus alignment groups(P＞0.05).There was no statistically significant difference in the preoperative HSS,WOMAC and NRS scores among the four groups(F/x2=0.141,1.587,3.811;P＞0.05).Postoperative HSS scores were significantly higher and WOMAC and NRS scores were significantly lower than preoperative scores in all groups(P＜0.05).The difference between the postoperative HSS and WOMAC scores of patients in the four groups was statistically significant(F=6.216,7.632;P＜0.05).The postoperative HSS scores of patients in the neutral alignment group and the mild varus alignment group were significantly higher than those of the valgus alignment group and the severe varus alignment group(P＜0.05);the difference in the postoperative HSS scores of patients in the neutral alignment group compared with those of patients in the mild varus alignment group was not statistically significant(P＞0.05);and the difference in the postoperative HSS scores of patients in the valgus alignment group compared with those of patients in the severe varus alignment group was not statistically significant(P＞0.05).The postoperative WOMAC scores of patients in the valgus alignment,mild varus alignment and severe varus alignment groups were significantly higher than those in the neutral alignment group,and the postoperative WOMAC scores of patients in the valgus alignment and severe varus alignment groups were significantly higher than those of patients in the mild varus alignment group(P＜0.05);the difference in postoperative WOMAC scores of patients in the valgus alignment group compared with those in the severe varus alignment group was not statistically significant(P＞0.05).There was no statistically significant difference in the postoperative NRS scores among the four groups(P＞0.05).Conclusion The lower extremity force line in a neutral position after TKA has the best early clinical outcome for patients with preoperative varus KOA,and the lower extremity force line should be reconstructed to a neutral level during TKA.