Objective To evaluate the short-middle term clinical effects of the fixed platform stabilized prosthesis in the treatment of the elderly patients with rheumatoid arthritis(RA).Methods The clinical data of 53 cases elderly RA patients who were admitted to the People's Hospital of Liuzhou from January 2009 to January 2013 and were treated with fixed platform and stable prosthesis in 62 knees were retrospective analyzed.Results Fifty-three patients were followed up for 24.0-43.0 months with average (25 ± 2.1)months.At the last follow-up,the degree of knee motion was improved significantly compared with the preoperative((116.0±6.0) ° vs.(46.0±7.0)°),the difference was significant(t=35.323,P＜0.01).The HSS score was significantly improved compared with the preoperative ((85.3±7.6) points vs.(50.2±11.3)points),the difference was significant (t=4.002,P＜0.05).At the last follow-up,35 cases (66.0％) of excellent,11 cases (20.8％) of good,and 7 cases (13.2％) of normal.After the operation,all patients obtained obvious improvement in joint pain,swelling,dysfunction,deformity and so on.Conclusion The fixed platform stabilized prosthesis is simple,effective,and less postoperative complications,and it is a better choice for the elderly patients with high flexion activity.

OBJECTIVE To investigate the antimicrobial susceptibility of Streptococcus pneumoniae isolated in Yantai and their mechanisms of resistance to macrolides.METHODS Antimicrobial susceptibility of S.pneumoniae was determined by agar dilution method.Phenotypes of macrolide-resistant S.pneumoniae were determined using double disk test with erythromycin and clindamycin disks.ermB And mefE genes were amplified by PCR.RESULTS Among 42 strains of S.pneumoniae,65.0% were intermediate to and no strain was resistant to penicillin.The resistance rates to erythromycin and clindamycin were 93.0%,respectively.Of 41 erythromycin resistantstrains,93.0% were constitutive resistant.ermB Was detected in 40 strains and mefE in 1 strain,both ermB and mefE genes were found in 9 strains.CONCLUSIONS The resistance rate of S.pneumoniae to penicillin is high in Yantai area,the resistance rates to erythromycin and clindamycin are very high.Target modification by ermB methylase is the predominant mechanism in macrolide-resistant S.pneumoniae in Yantai.

Objective To study the variability of oxygen saturation in intestinal tissue of preterm infants during erythrocyte infusion .Method Preterm infants aged over 5 days, hospitalized in our NICU from March 2016 to August 2016 were selected by computer random number generator . Near-infrared spectroscopy was applied to monitor splanchnic tissue oxygen saturation ( SrSO2 ) and cerebral tissue oxygen saturation(CrSO2)during erythrocyte transfusion.The duration of transfusion was 4 hours.The mean value and range of SrSO2 and CrSO2 during transfusion were analyzed.To analysis the average and variable range of SrSO2 and CrSO2 and to illuminate the correlation with post-conceptional age. Result A total of 34 premature infants were collected.The average of SrSO2 was (0.56 ±0.06) and the average of CrSO2 was (0.62 ±0.02) throughout transfusion, There was a significantly greater change in SrSO2 than in CrSO2 during the transfusion period (0.35 ±0.14 vs.0.18 ±0.09) (P<0.05).The changing range of CrSO2 was smaller as the post-conceptional age increased , and was significant different statistically ( P=0.006). While there was little change in the range of SrSO 2 (P=0.191).Conclusion The of SrSO2 change was more significant than CrSO 2 in preterm infants during erythrocyte transfusion , which may cause ischemia-reperfusion injury to the intestinal tissue .It should be more cautious to avoid transfusion-related necrotizing enterocolitis.

Objective:To understand the epidemiological characteristics of an outbreak of Chikungunya fever (CHIK) in Ruili city at Sino-Myanmar border area in Yunnan province, China, 2019.Methods:The data of CHIK cases in Ruili city were collected. Serum samples were collected from acute phase of the patients for the detection of the viral nucleic acid with real-time reverse transcription PCR assay.Results:A total of 121 CHIK cases (laboratory-confirmed cases) were reported in Ruili city in 2019, in which 98 were indigenous cases (80.99%) including 2 pregnant women and 3 neonatal cases (twin boys and 1 girl) were observed with vertical mother-to-child transmission), and 23 were imported cases (19.01%) from Myanmar. CHIK mainly occurred in Urban area (Mengmao town) and port area (Jiegao development zone) of Ruili city. The epidemic of CHIK lasted from September to November. The epidemic peak was in October (74.38%). The majority of patients were aged from 20—59 years (77.69%), in addition to 3 cases of mother-to-child transmission, the youngest was 3 months and the oldest 72 year-old. The male to female ratio was 1∶1.28 (53∶68). Occupational distribution of CHIK cases was mainly for the commercial service personnel (33.06%), home workers and unemployed persons (21.49%) and retiree (11.57%).Conclusions:During the outbreak of CHIK in Ruili in 2019, both indigenous and imported cases were detected. The imported CHIK cases from Myanmar were the main sources for local transmission of CHIK in Ruili city. This is the first time that a local epidemic of CHIK has occurred in Yunnan Province. It is necessary to strengthen control of the cross-border spread of CHIK in this area.

Cervical spondylosis is due to degenerative cervical disc and its stimulation or oppression of the adjacent nerves, spinal cord, spinal artery and other tissue caused by clinical symptoms. The cervical spine is an anatomical structure with activity, while the pillow has a certain plastic fixation effect on the cervical spine anatomy. Therefore, the pillow not only plays a health role in the cervical spine, but also plays an important role in restoring the normal physiological curvature of the cervical spine. Based on this, a multi-functional cervical vertebra treatment pillow is designed, which not only has the functions of traction, maintaining different positions of the cervical spine, correcting the cervical curvature and equipment exercises, but also has the functions of voice broadcast and network data terminal.

In the research of artificial joint biomechanics, it is a common method in the world to evaluate the biomechanical properties of the implanted fixtures through experiments . The domestic research started late, and the corresponding testing methods were lacking. There is still no unified standard. In this paper, a complete hardware test system was designed and built around the existing mechanical testing machine, including:binocular vision catcher, torque bearing clamp, film pressure sensor and so on. The system can accurately measure the relative motion angle value, external torque value, and inter pressure value of each joint. It has some reference significance for the forming and standardization of the artificial joints' evaluation system.
Biomechanical Phenomena ; Joint Prosthesis ; Motion ; Pressure ; Torque

The syndrome/pattern of defensive qi deficiency is a common basic syndrome of traditional Chinese medicine in clinical practice. However,there is a lack of standardized and operable diagnostic specifications in practical applications. Based on the previous literature,this study proposed the idea of starting from the elements of the syndrome,qualitative diagnostic criteria for the syndrome/pattern of defensive qi deficiency oriented to the entire region of the disease were constructed based on the two dimensions of " deficient defensive qi failing to consolidate the exterior" and " qi deficiency" and constructing a set of quantitative evaluation criteria as the supporting content for the diagnostic items. The core members of the research group attempted to formulate the draft standard,then reached a consensus through the Delphi method expert questionnaire consultation and the Nominal group technique,and finally evaluated the reliability and validity of the standard through clinical verification to provide ideas for the standardization and normalization of research on syndromes.

In the research of artificial joint biomechanics, it is a common method in the world to evaluate the biomechanical properties of the implanted fixtures through experiments . The domestic research started late, and the corresponding testing software were lacking. There is still no special software. In this paper, an integrated software test system was designed and built based on the existing hardware system, including:hardware control, data collection, data save, data processing and display. It can directly show the 3D motion trajectory and the angle curve of joints. The system can accurately measure the relative motion angle value, external torque value, and inter pressure value of each joint. It has some reference significance for the development of the artificial joints' evaluation system.

Objective:To investigate the diagnostic accuracy of serological indicators and evaluate the diagnostic value of a new established combined serological model on identifying the minimal hepatic encephalopathy (MHE) in patients with compensated cirrhosis.Methods:This prospective multicenter study enrolled 263 compensated cirrhotic patients from 23 hospitals in 15 provinces, autonomous regions and municipalities of China between October 2021 and August 2022. Clinical data and laboratory test results were collected, and the model for end-stage liver disease (MELD) score was calculated. Ammonia level was corrected to the upper limit of normal (AMM-ULN) by the baseline blood ammonia measurements/upper limit of the normal reference value. MHE was diagnosed by combined abnormal number connection test-A and abnormal digit symbol test as suggested by Guidelines on the management of hepatic encephalopathy in cirrhosis. The patients were randomly divided (7∶3) into training set ( n=185) and validation set ( n=78) based on caret package of R language. Logistic regression was used to establish a combined model of MHE diagnosis. The diagnostic performance was evaluated by the area under the curve (AUC) of receiver operating characteristic curve, Hosmer-Lemeshow test and calibration curve. The internal verification was carried out by the Bootstrap method ( n=200). AUC comparisons were achieved using the Delong test. Results:In the training set, prevalence of MHE was 37.8% (70/185). There were statistically significant differences in AMM-ULN, albumin, platelet, alkaline phosphatase, international normalized ratio, MELD score and education between non-MHE group and MHE group (all P<0.05). Multivariate Logistic regression analysis showed that AMM-ULN [odds ratio ( OR)=1.78, 95% confidence interval ( CI) 1.05-3.14, P=0.038] and MELD score ( OR=1.11, 95% CI 1.04-1.20, P=0.002) were independent risk factors for MHE, and the AUC for predicting MHE were 0.663, 0.625, respectively. Compared with the use of blood AMM-ULN and MELD score alone, the AUC of the combined model of AMM-ULN, MELD score and education exhibited better predictive performance in determining the presence of MHE was 0.755, the specificity and sensitivity was 85.2% and 55.7%, respectively. Hosmer-Lemeshow test and calibration curve showed that the model had good calibration ( P=0.733). The AUC for internal validation of the combined model for diagnosing MHE was 0.752. In the validation set, the AUC of the combined model for diagnosing MHE was 0.794, and Hosmer-Lemeshow test showed good calibration ( P=0.841). Conclusion:Use of the combined model including AMM-ULN, MELD score and education could improve the predictive efficiency of MHE among patients with compensated cirrhosis.

Objective:To investigate the diagnostic value of independent and combined subtests of the psychometric hepatic encephalopathy score (PHES) in mild hepatic encephalopathy(MHE) of patients with liver cirrhosis, so as to optimize the PHES.Methods:This was a prospective, multicenter and real-world study which was sponsored by the National Clinical Research Center of Infectious Diseases and the Portal Hypertension Consortium. Twenty-six hospitals from 13 provinces, autonomous regions and municipalities countrywide participated in this study, induding Tianjin Third Central Hospital, the Fourth People′s Hospital of Qinghai Province, the Second Affiliated Hospital of Baotou Medical College, the Third People′s Hospital of Taiyuan, the Fifth Medical Center of PLA General Hospital and so on. From October 2021 to February 2022, outpatients and hospitalized patients with liver cirrhosis and no obvious hepatic encephalopathy were consecutively enrolled. All patients received 5 PHES subjects in the same order: number connection test(NCT)-A, NCT-B, digit symbol test(DST), line tracing test(LTT) and serial dotting test(SDT), and the scores were calculated. The total score of PHES <-4 was taken as the cut-off value for diagnosing MHE. Compare the differences in each subtest between MHE group and non-MHE group. Receiver operating characteristic curve(ROC) and area under the curve(AUC) was performed to assess the diagnostic value of independent and combined subtests in MHE. Mann-Whitney U test and DeLong test were used for statistical analysis. Results:A total of 581 patients with liver cirrhosis were enrolled, 457 were diagnosed as MHE, and the incidence of MHE was 78.7%. The results of NCT-A, NCT-B, SDT, LTT, DST of MHE group were 60.00 s(47.01 s, 88.00 s), 90.45 s(69.32 s, 125.35 s), 74.00 s(57.65 s, 96.60 s), 74.72(60.00, 98.61) and 27.00(20.00, 36.00), respectively. Compared those of non-MHE group(34.00 s(29.15 s, 44.48 s), 50.00 s(40.98 s, 60.77 s), 50.00 s(41.07 s, 63.03 s), 46.23(38.55, 59.42) and 42.00(34.00, 50.75)), the differences were statistically significant( Z=12.37, 12.98, 9.83, 11.56, 10.66; all P<0.001). The AUC(95% confidence interval(95% CI)) of subtests of PHES NCT-B, NCT-A, LTT, DST and SDT alone in MHE diagnosis were 0.880(0.849 to 0.910), 0.862(0.828 to 0.896), 0.838(0.799 to 0.877), 0.812(0.772 to 0.851) and 0.788(0.743 to 0.832), respectively. The combination of 2 PHES subtests significantly increased the diagnostic efficacy. Among them the diagnostic efficacy of the combination of NCT-B and LTT was the best, the AUC(95% CI) was 0.924(0.902 to 0.947), the specificity was 91.9% and the sensitivity was 79.2%, which was better than a single PHES subtest (NCT-A, NCT-B, SDT, LTT and DST) and the combination of NCT-A and DST(AUC was 0.879, 95% CI0.847 to 0.910) which was recommended by guidelines on the management of hepatic encephalopathy in cirrhosis, the differences were statistically significant ( Z=3.78, 3.83, 5.57, 5.51, 5.38, 2.93; all P<0.01). Furthermore, compared between the combination of NCT-B and LTT and the combination of 3 subests of PHES, only the diagnostic efficacy of combination of NCT-B, LTT and SDT (AUC was 0.936, 95% CI 0.916 to 0.956) was better than that of the combination of NCT-B and LTT, the difference was statistically significant( Z=2.32, P=0.020). Conclusion:Based on the diagnostic efficacy and clinical feasibility of PHES subtests and their combinations, the combination of NCT-B and LTT is recommended for the diagnosis of MHE.