BACKGROUND:Lifespan of prosthetic joint was being influenced by periprosthetic infection after total hip arthroplasty. Combination of debridement,antibiotics,and implant retention with the replacement of assembled components represents a novel approach in the management of acute prosthetic joint infection after total hip arthroplasty.OBJECTIVE:To observe the efficacy of debridement,antibiotics,and implant retention combined with the replacement of assembled components in the treatment of acute prosthetic joint infection after total hip arthroplasty.METHODS:Twenty-two patients with acute prosthetic joint infection after initial total hip arthroplasty at the Department of Orthopedics,Huangshi Central Hospital,China,between July 2018 and February 2022 were enrolled. The infection time of all patients was less than 3 weeks after the initial arthroplasty. Intraoperative joint fluid extraction and bacterial culture of infected synovium proved to be acute stage infection. They were treated using debridement,antibiotics,and implant retention combined with the replacement of assembled components. Infections were assessed using leukocyte count,erythrocyte sedimentation rate,and C-reactive protein levels before,3 and 6 months after surgery. Improvements in hip joint function were evaluated using Harris hip score. Pain relief was assessed using visual analog scale score. Paired sample t-test was used to analyze the improvement of each index before and after operation.RESULTS AND CONCLUSION:(1) One patient died of non-periprosthesis infection and was subsequently lost to follow-up,which was excluded. The remaining 21 patients received clinical follow-up,and the follow-up time was more than 1 year,with a mean follow-up time of (19.52±3.88) months. Among them,20 patients were successfully treated with surgery and 1 patient failed,and the infection control rate was 95％. (2) The levels of leukocyte count,erythrocyte sedimentation rate,and C-reactive protein were lower in 3 and 6 months after surgery (P<0.05);Harris hip function scores were higher than those before surgery (P<0.05);pain visual analog scale scores were lower than those before surgery (P<0.05),and the differences were significant (P<0.05). (3) It is indicated that debridement,antibiotics,and implant retention combined with the replacement of assembled components after total hip arthroplasty in patients with acute prosthetic joint infection can effectively control prosthetic joint infection,improve hip function,and relieve hip pain caused by infection.

BACKGROUND:Lifespan of prosthetic joint was being influenced by periprosthetic infection after total hip arthroplasty. Combination of debridement,antibiotics,and implant retention with the replacement of assembled components represents a novel approach in the management of acute prosthetic joint infection after total hip arthroplasty.OBJECTIVE:To observe the efficacy of debridement,antibiotics,and implant retention combined with the replacement of assembled components in the treatment of acute prosthetic joint infection after total hip arthroplasty.METHODS:Twenty-two patients with acute prosthetic joint infection after initial total hip arthroplasty at the Department of Orthopedics,Huangshi Central Hospital,China,between July 2018 and February 2022 were enrolled. The infection time of all patients was less than 3 weeks after the initial arthroplasty. Intraoperative joint fluid extraction and bacterial culture of infected synovium proved to be acute stage infection. They were treated using debridement,antibiotics,and implant retention combined with the replacement of assembled components. Infections were assessed using leukocyte count,erythrocyte sedimentation rate,and C-reactive protein levels before,3 and 6 months after surgery. Improvements in hip joint function were evaluated using Harris hip score. Pain relief was assessed using visual analog scale score. Paired sample t-test was used to analyze the improvement of each index before and after operation.RESULTS AND CONCLUSION:(1) One patient died of non-periprosthesis infection and was subsequently lost to follow-up,which was excluded. The remaining 21 patients received clinical follow-up,and the follow-up time was more than 1 year,with a mean follow-up time of (19.52±3.88) months. Among them,20 patients were successfully treated with surgery and 1 patient failed,and the infection control rate was 95％. (2) The levels of leukocyte count,erythrocyte sedimentation rate,and C-reactive protein were lower in 3 and 6 months after surgery (P<0.05);Harris hip function scores were higher than those before surgery (P<0.05);pain visual analog scale scores were lower than those before surgery (P<0.05),and the differences were significant (P<0.05). (3) It is indicated that debridement,antibiotics,and implant retention combined with the replacement of assembled components after total hip arthroplasty in patients with acute prosthetic joint infection can effectively control prosthetic joint infection,improve hip function,and relieve hip pain caused by infection.

Specialty English of Medical Laboratory is a comprehensive and overlapping discipline and plays a major role in multiple medical courses, including Life Science, Clinical Medicine and Laboratory Medicine.However, its teaching practices are limited due to the extensive contents, scattered basic knowledge points, complexities of language learning processes and high demanding of sophisticated teaching skills.Since internet technology′s breakout and the web-based education expanding in the past decade, personalized flipped classroom has drawn considerable attention in the education field and became a hop-spot in teaching practice system.In the present study, the concepts of flipped classroom and basic characteristics of Specialty English of Medical Laboratory were elaborated, as well as the reconstructing teaching processes, exploring the concrete plan for teachers and students in undergraduate program.

Objective To study the clinical efficacy and safety of posterior laminoplasty combined with foraminotomy in the treatment of mixed cervical spondylosis.Methods A total of 70 patients with mixed type cervical spondylosis from January 2012 to January 2014 in our hospital were randomly divided into observation group and control group.Patients in observation group received posterior laminoplasty com-bined with foraminotomy,and patients in control group received anterior cervical discectomy and fusion surgery.The operation time,intraoper-ative blood lossing,postoperative JOA scores and NDI scores between two groups were compared.The cervical curvature and range of motion were measured by X-ray.Results There was no significant difference in postoperative JOA scores,cervical curvature and range of motion be-tween two groups(P >0.05).The operative time and intraoperative blood loss of observation group was less than those of control group,the difference was no significance.The NDI scores of carrying and drive in observation group were higher than those in control group,while the NDI scores of other items between two groups had no significant difference(P >0.05).The incidence of complications in observation group was 10.81% (4 /37),the control group was 24.42% (8 /33),the difference between two groups was statistically significant,(χ2 =3.428, P <0.05).Conclusion The posterior laminoplasty combined with foraminotomy have good clinical effect for mixed type cervical spondylosis with advantages of a shorter operation time,simple operation,less intraoperative bleeding,lower incidence of complications,which is a kind of safe and effective surgical method.

Objective To investigate the effects of simulated 7 500 high altitude on the changes of such related indicators as heart rate variability (HRV),heart rate (HR),respiratory rate,body surface temperatures (BST),arterial oxygen saturation (SaO2) and blood pressure (BP) of the aviators flying 3 different types of aircraft.Methods Forty-nine aviators were chosen as research subjects,and were divided into 3 groups in accordance with the different types of aircraft they flew.Changes in HRV and other vital signs were observed in the aviators flying 3 different types of aircraft.Results As compared with that before hypoxia exposure,HR and BST of the aviators flying different types of aircraft were significantly increased,3 minutes after exposure to hypoxia (P ＜ 0.01),while SaO2 was significantly decreased (all P ＜ 0.01),and respiratory frequency was also decreased (P ＞ 0.05).Before exposure,the values of low frequency (LF),high frequency (HF) and total power (TP) of the aviators flying bombers were all obviously higher than those after exposure (P ＜ 0.05).The LF value before hypoxia was significantly higher than that of the aviators flying transports (P ＜ 0.05).Both before and after hypoxia,body surface temperature of the aviators flying fighters [(32.05 ± 1.16) 、(32.69 ±0.87)℃] was all significantly higher than that of the aviators flying bombers [(30.45 ± 2.13)、(31.76 ± 1.05) ℃] (P ＜ 0.05).Following exposure to hypoxia,the maximum A and minimum mean HRB difference of the aviators flying fighters was significantly higher than that before hypoxia exposure (P ＜ 0.01).Following exposure to hypoxia,the maximum mean respiratory rate of the aviators flying fighters was obviously decreased (P ＜ 0.05),and the maximum and minimum mean respiratory rate difference of the aviators was significantly lower than that before hypoxia exposure (P ＜ 0.05).Conclusions Following hypoxia for 3 minutes at a simulated altitude of 7 500 meters,HR and BST of the aviators in the 3 groups were all increased,SaO2 and respiratory rate were decreased,but BP was not significantly increased.There were variable differences in vital signs and HRV for the aviators flying different types of aircraft.

Objective To investigate the effects of simulated 7 500 high altitude on the changes of such related indicators as heart rate variability (HRV),heart rate (HR),respiratory rate,body surface temperatures (BST),arterial oxygen saturation (SaO2) and blood pressure (BP) of the aviators flying 3 different types of aircraft.Methods Forty-nine aviators were chosen as research subjects,and were divided into 3 groups in accordance with the different types of aircraft they flew.Changes in HRV and other vital signs were observed in the aviators flying 3 different types of aircraft.Results As compared with that before hypoxia exposure,HR and BST of the aviators flying different types of aircraft were significantly increased,3 minutes after exposure to hypoxia (P ＜ 0.01),while SaO2 was significantly decreased (all P ＜ 0.01),and respiratory frequency was also decreased (P ＞ 0.05).Before exposure,the values of low frequency (LF),high frequency (HF) and total power (TP) of the aviators flying bombers were all obviously higher than those after exposure (P ＜ 0.05).The LF value before hypoxia was significantly higher than that of the aviators flying transports (P ＜ 0.05).Both before and after hypoxia,body surface temperature of the aviators flying fighters [(32.05 ± 1.16) 、(32.69 ±0.87)℃] was all significantly higher than that of the aviators flying bombers [(30.45 ± 2.13)、(31.76 ± 1.05) ℃] (P ＜ 0.05).Following exposure to hypoxia,the maximum A and minimum mean HRB difference of the aviators flying fighters was significantly higher than that before hypoxia exposure (P ＜ 0.01).Following exposure to hypoxia,the maximum mean respiratory rate of the aviators flying fighters was obviously decreased (P ＜ 0.05),and the maximum and minimum mean respiratory rate difference of the aviators was significantly lower than that before hypoxia exposure (P ＜ 0.05).Conclusions Following hypoxia for 3 minutes at a simulated altitude of 7 500 meters,HR and BST of the aviators in the 3 groups were all increased,SaO2 and respiratory rate were decreased,but BP was not significantly increased.There were variable differences in vital signs and HRV for the aviators flying different types of aircraft.

BACKGROUND:For vertebral compression fractures treated by bal oon vertebroplasty, there were stil controversies in biomechanical and clinical studies about adjacent vertebral fractures is the result of osteoporosis progress, or the result of vertebral intervention and strengthening by injecting bone cement. More accurate conclusions can be obtained through more in-depth research and long-term fol ow-up. OBJECTIVE:To evaluate the effect of bal oon vertebroplasty on biomechanical properties of vertebral body with compression fractures and unstrengthened adjacent vertebral body. METHODS:Total y 40 pig specimens with vertebral compression fractures were prepared and randomly divided into study and control groups. Specimens in the study group were subjected to bal oon vertebroplasty. Specimens in the control group only wrapped with normal saline gauze. The biomechanical properties (vertebral height, maximum load), stress, strain and displacement values of specimens under 500 N loading in these two groups were compared. The stress and strain values of unstrengthened adjacent vertebral body before and after the bal oon vertebroplasty in the study group were measured, and compared with the control group. RESULTS AND CONCLUSION:Compared with the original height, specimens in the study group can restore to its original height after bal oon vertebroplasty, the differences were not significant (P>0.05). The former, back, left and right vertebral height in the study group were significantly higher than those in the control group (P<0.01). After the bone cement augmentation, the stiffness of vertebral body in the study group was significantly lower than that in the control group, the maximum loading was significantly increased compared with that in the control group (P<0.05). Under a fixed loading of 500N, compared with the control group, the disc displacement value after the bal oon vertebroplasty was significantly reduced and the disc strain and stress values were significantly increased in the study group (P<0.05). There were no significant differences in the strain and stress values of the unstrengthened adjacent vertebral body before and after the bal oon vertebroplasty in the study group (P>0.05). There were no significant differences in the strain and stress values of the unstrengthened adjacent vertebral body after the bal oon vertebroplasty between study group and control group (P>0.05). These results suggest that vertebral maximum loading and stiffness recover wel after the treatment of bal oon vertebroplasty for vertebral compression fractures, which can achieve the effect of preventing vertebral fractures again. Meanwhile, bal oon vertebroplasty treatment can not alter the biomechanical properties of adjacent vertebrae, and it is difficult to influence and lead vertebral fractures again, with a better security.