Kashin-Beck disease (KBD), a common joint disorder that can lead to joint deformities and restricted mobility, significantly affects patients' quality of life. Traditional conservative treatments have shown limited efficacy. With advancements in total ankle replacement prosthesis and the successive updates of mobile and fixed -bearing in ankle prosthesis, more and more clinical trial results indicate that ankle prosthesis replacement is expected to become a new approach for treating KBD. This article reviews the progress in ankle prosthesis and studies their clinical application potential in KBD management.

Kashin-Beck disease (KBD), a common joint disorder that can lead to joint deformities and restricted mobility, significantly affects patients' quality of life. Traditional conservative treatments have shown limited efficacy. With advancements in total ankle replacement prosthesis and the successive updates of mobile and fixed -bearing in ankle prosthesis, more and more clinical trial results indicate that ankle prosthesis replacement is expected to become a new approach for treating KBD. This article reviews the progress in ankle prosthesis and studies their clinical application potential in KBD management.

Objective:To explore the surveillance and management method of adverse events of medical consumables based on the capability target hierarchical model,and to analyze its monitoring and management effect.Methods:A four-level medical consumables adverse events monitoring and managing target was set up for each department monitoring level,monitoring expert level,multi department comprehensive office level and monitoring leadership level of the hospital.The monitoring layer of each department collected and summarized the information on medical consumables adverse events,and the monitoring expert layer analyzed the cause and effect of medical consumables adverse events based on the collected information.The support vector machine(SVM)in the machine learning model was used to determine the type of adverse event,and the adverse events of medical consumables were reported through the multi-department comprehensive office layer,and the reported problems were analyzed in detail through the fishbone diagram,and the final management decision was made at the monitoring leadership level.Statistics were conducted on the adverse event data of the top 10 medical consumables in Shanxi Provincial People's Hospital from 2021 to 2022.The changes in data,severity of hazard,distribution of causes and reporting qualification of medical consumables adverse events before and after the application of the medical consumables adverse event monitoring and management method based on the capability target hierarchical model were compared.Results:From 2021 to 2022,a total of 442 adverse events occurred in the top 10 medical consumables of medical consumables,of which 346 occurred in 2021 before the application of the medical consumables adverse event monitoring and management method based on the capability target hierarchical model,and 96 occurred in 2022 after the application.Compared with before the application,the proportion of different medical consumables(0～25%),the proportion of hazard severity(0～79%)and the different causes of adverse events(3-23%)in the top 10 medical consumables adverse events after the application of capability target hierarchical model,the difference was statistically significant(x2=7.92,7.83,7.52,P<0.05);the qualified rate of adverse event reports of medical consumables increased from 60.70%(210/346)before application to 83.30%(80/96),the difference was statistically significant(x2=17.071,P<0.001).Conclusion:The medical consumables adverse event monitoring and management method based on the capability target hierarchical model can ensure that adverse events of medical consumables are monitored and reported in a timely and accurate manner,promptly discover and resolve existing problems,reduce the risks of medical consumables use,and ensure medical quality.

Objective To investigate the recognition of nurses and patients on chosing daily caregivers and analyze the influencing factors. Method Totally 1,119 nurses and 1,134 patients from five first-class and two second-class hospitals in Zhuhai participated in the survey using self-designed questionnaires from April to June in 2014. Results There were significant differences between nurses and patients in all life nursing projects (P<0.001) except making beds for patients. The top three factors influencing the nurses′recognition were shortage of nursing staff and time, less presence of professional values and feeling no respects. The top three factors influencing the patients′recognition included tending to be nursed by family members, worries about medical expenses, and nurses′being too busy on treatment. Conclusion The different recognitions of nurses and patients on daily caregivers are influenced by multiple factors. Therefore , nursing managers should take some effective strategies to change the concepts of nurses and patients so as to improve quality of nursing service.

Objective To evaluate the levels of serum TAM and Cyfra21-1 in diagnosis and chemotherapeutic efficacy assess-ment of patients with esophageal cancer.Methods The serum TAM and Cyfra21-1 levels were measured in 92 patients with initially diagnosed esophageal cancer or postoperative recurrence of esophageal cancer from September 2012 to September 2013 and 50 cases of healthy people in the same periods as control.The sensitivity and specificity of TAM and Cyfra21-1 were analyzed.Moreover,60 patients with high TAM and Cyfra21-1 levels before chemotherapy from September 2012 to A-pril 2014 were detected TAM and Cyfra21-1 levels after two cycles of chemotherapy.Relation between changes of TAM or Cyfra21-1 and chemotherapeutic efficacy were investigated.Results The diagnostic sensitivity of TAM for esophageal canc-er was 71.7%,which was higher than that of Cyfra21-1 (51.1%,P = 0.004).The diagnostic specificity of TAM and Cy-fra21-1 for esophageal cancer was 94.0% and 92.0% respectively.There were no significantly different between TAM and Cyfra21-1 (P =0.695).Of patients undergoing chemotherapy,the overall response was 25 cases,progress was 11 cases. There was no statistically significant difference in the coincidence rate of TAM and Cyfra21-1 (77.8% vs 75.0%,P =0.781).Conclusion Detection of serum TAM and CYFRA21-1 was valuable in the diagnosis and assessment of the thera-peutic efficacy of chemotherapy in patients with esophageal carcinoma.TAM was better than Cyfra21-1 in the diagnosis of e-sophageal carcinoma.

Objective To investigate the effect of genistein on the expression of Bax and Bcl-2 protein in PC12 cells transfected with mutant APP695 Type.Methods PC12 cells were transfected with pIRES2-EGFP plasmid or pIRES2-EGFP/APP695MT expression plasmid,and then divided into normal control group,Unladen group,APP695 transfected group,GST treatment group(5 μmol/L,15 μmol/L).The Bax and Bcl-2 protein expression in PC12 cells was measured by Immunocytochemistry SABC and Western-blot.Results Immunocyto-chemistry SABC showed that:compared with the normal control group,the expression of bax protein in APP695 transfected group was strongly increased((78.02 ± 1.26) ％,P＜0.01)) and the expression of bcl-2 protein was very weak oppositely ((15.40 ± 0.72) ％,P＜0.01)).Compared with APP695 transfected group,the expression of bax protein in cells of 15umol/L GST treatment group was significantly decreased((22.35 ± 0.49) ％,P＜0.01))and the expression of bcl-2 protein in these cells was strongly increased ((68.11 ± 0.24) ％,P ＜0.01)).Western-Blot showed that:compared with the normal control group,the expression of bax protein in APP695 transfected group was markedly increased and the expression of Bcl-2 protein was significantly decreased.Compared with the APP695 transfected group,the expression of Bax protein was markedly decreased and the expression of Bcl-2 protein was significantly increased in the cells of the GST treatment groups.Conclusion GST can reduce the expression of bax protein and the increased expression of Bcl-2 protein has protective effect on PC12 cells transfected with APP696MT.

Objective To study the clinical values and relativity of serum levels of NSE and ProGRP (P31-98) in patients with small-cell lung cancer. Methods Serum levels of NSE and ProGRP (31-98) was measured by ELISA in 159 patients with small cell lung cancer(SCLC), 99 patients with benign lung diseases, and 100 healthy subjects, 141 SCLC patients before and after treatment were also measured. Results The medians of NSE and ProGRP (31-98) was 21.33 μg/L and 323.70 pg/ml in patients with SCLC, 4.24 μg/L and 11.94 pg/ml in patients with benign lung diseases, 5.82 μg/L and 8.54 pg/ml in healthy subjects respectively,significantly increased in patients with SCLC as compared to that of the other two groups (P ＜0.01).Given the cut-off levels of 10.35 pg/L for NSE and 47.98 pg/ml for ProGRP(31-98), the sensitivity of diagnosis in SCLC was 71.1% and 88.7 %, respectively.The combination sensitivity and specificity of NSE and ProGRP(31-98)was 95.6 % and 96.8 %. The medians of NSE in SCLC patients with extensive and limited disease was 14.75 μg/L and 34.10 μg/L, the sensitivity was 51.14 % and 93.44 %, respectively; ProGRP (31-98) in the two groups was 143.14 pg/ml and 1061.14 pg/ml, 80.61% and 98.61%, respectively.In SCLC patients with remission after treatment the levels of NSE and ProGRP31-98 was significantly lower than that before treatment, but the levels without remission had no significantly change. There was significant relationship between NSE and ProGRP(31-98) in serum levels of patients with SCLC (r =0.379, P ＜0.01).Conclusion The serum levels of NSE and ProGRP (31-98) in patients are both increased, there are a significant relationship.But ProGRP(31-98) is a more specific and sensitive marker than NSE for the diagnosis of SCLC.The combination of the two markers can improve positive rate and validity.