A novel technology is proposed for non-contact and real-time detection of atrial fibrillation using millimeter-wave radar.A 60 GHz PCR millimeter wave radar is used to continuously detect the chest echo signal of the subject.After signal acquisition,I-Q signal is generated through I-Q demodulation,and the signal phase information is extracted using effective points phase trend evaluation for obtaining the signals from oscillations in the chest wall,from which the respiratory signals and cardiac signals are extracted through digital filtering for the analysis of cardiac movement.Whether the atrial fibrillation occurs or not is determined by the characteristics of atrial fibrillation wave in the time domain.The effective points phase trend evaluation for extracting more accurate signal phase information and the time-domain method for real-time atrial fibrillation detection are the innovations of the study.The experimental results show that the proposed method achieves a detection accuracy of 99.2%in clinic.

Objective:To explore the clinical predictive effect of the preoperative ratio of C reactive protein to albumin (CAR) on perioperative delirium (POD) in geriatric patients with femoral intertrochanteric fracture.Methods:The clinical data were analyzed retrospectively of the 398 patients who had undergone surgery for femoral intertrochanteric fractures at Department of Orthopedics, Xuanwu Hospital from January 2013 to March 2016. According to the presence or absence of POD, all the patients were divided into 2 groups: a delirium group and a normal group. The 2 groups were compared in terms of general clinical data like gender, age, body mass index, blood routine, CAR, biochemical indicators, blood coagulation indicators and concomitant internal diseases. After a single factor logistic regression analysis of the general clinical data of the patients, factors with P<0.10 were introduced into the multivariate logistic binary regression model to screen out the risk factors for POD in geriatric patients with femoral intertrochanteric fracture. The receiver operating characteristic (ROC) curve was drawn to analyze the predictive value and optimal cut-off point of CAR for POD in geriatric patients with femoral intertrochanteric fracture. Results:The incidence of POD in this cohort was 14.32%(57/398). The age, C-reactive protein, CAR, platelet and probability of pulmonary infection in the delirium group were significantly higher than those in the normal group, but the hemoglobin, albumin and prealbumin in the former were significantly lower than those in the latter ( P< 0.05). The multivariate logistic binary regression analysis showed that hemoglobin ( OR=0.975, 95% CI: 0.957 to 0.993, P=0.006) and CAR( OR=53.713, 95% CI: 17.713 to 162.876, P<0.001) were risk factors for POD in geriatric patients with femoral intertrochanteric fracture. The area under ROC of CAR in predicting POD in geriatric patients with femoral intertrochanteric fracture was 0.906 (95% CI: 0.873 to 0.933, P<0.001), and the cut-off point was 2.06. When CAR>2.06, its predicted incidence of POD was 50.50%, with a sensitivity of 89.47% and a specificity of 85.34%. Conclusion:As CAR is a risk factor for POD in geriatric patients with femoral intertrochanteric fracture, it can be used as an effective indicator to predict POD.

Objective:To explore the influence of lateral patellofemoral joint degeneration on the treatment of anteromedial osteoarthritis of knee joint by Oxford medial unicompartmental knee arthroplasty.Methods:The clinical data of 73 patients (73 knees) with knee osteoarthritis underwent unicompartmental knee arthroplasty at Department of Orthopaedic Surgery, Xuanwu Hospital, Capital Medical University from March 2016 to December 2017 were analysed respectively.There were 18 males and 55 females, aged (68.6±7.5) years(range: 53 to 89 years).The lateral patellofemoral joints of patients were evaluated by Ahlback grading system. Patients with Ahlback 0 andⅠ were in the non degenerative group (37 cases), and those with Ahlback Ⅱ and above were in the degenerative group (36 cases). Hospital for special surgery knee score(HSS) and the Western Ontario and McMaster Universities(WOMAC) osteoarthritis index, as well as the condition of kneeling, sit to stand movement, up stair and down stair were recorded. The data before and after operation were compared by paired sample t test, and the data between groups were compared by independent sample t test. χ 2 test was used for counting data. Pearson correlation analysis was used to compare the correlation between ahlback score, HSS and WOMAC osteoarthritis index. Results:The follow-up time was (35.1±6.6) months (range: 25 to 47 months).The knee function of the patients improved significantly after operation.The HSS score increased from 57.7±11.8 preoperative to 81.8±7.8 postoperative ( t=16.64, P=0.00) and WOMAC osteoarthritis index decreased from 48.9±13.4 preoperative to 15.6±8.8 postoperative ( t=20.48, P=0.00). There was no statistical difference in the change of HSS between the degenerative group and the non-degenerative group before and after surgery(27.5±12.2 vs. 22.5±12.3, t=-1.65, P=0.10) as well as the change of WOMAC osteoarthritis index(31.8±14.0 vs. 36.4±13.7, t=-1.35, P=0.18), but the lateral patellofemoral joint degeneration was related to inability to complete squats (χ 2=5.17, P=0.04) and sitting up (χ 2=7.22, P=0.01). Conclusion:The degeneration of lateral patellofemoral joint has no effect on the early functional recovery of patients with anteromedial knee osteoarthritis after Oxford medial unicompartmental knee arthroplasty.

Objective:To explore the influence of lateral patellofemoral joint degeneration on the treatment of anteromedial osteoarthritis of knee joint by Oxford medial unicompartmental knee arthroplasty.Methods:The clinical data of 73 patients (73 knees) with knee osteoarthritis underwent unicompartmental knee arthroplasty at Department of Orthopaedic Surgery, Xuanwu Hospital, Capital Medical University from March 2016 to December 2017 were analysed respectively.There were 18 males and 55 females, aged (68.6±7.5) years(range: 53 to 89 years).The lateral patellofemoral joints of patients were evaluated by Ahlback grading system. Patients with Ahlback 0 andⅠ were in the non degenerative group (37 cases), and those with Ahlback Ⅱ and above were in the degenerative group (36 cases). Hospital for special surgery knee score(HSS) and the Western Ontario and McMaster Universities(WOMAC) osteoarthritis index, as well as the condition of kneeling, sit to stand movement, up stair and down stair were recorded. The data before and after operation were compared by paired sample t test, and the data between groups were compared by independent sample t test. χ 2 test was used for counting data. Pearson correlation analysis was used to compare the correlation between ahlback score, HSS and WOMAC osteoarthritis index. Results:The follow-up time was (35.1±6.6) months (range: 25 to 47 months).The knee function of the patients improved significantly after operation.The HSS score increased from 57.7±11.8 preoperative to 81.8±7.8 postoperative ( t=16.64, P=0.00) and WOMAC osteoarthritis index decreased from 48.9±13.4 preoperative to 15.6±8.8 postoperative ( t=20.48, P=0.00). There was no statistical difference in the change of HSS between the degenerative group and the non-degenerative group before and after surgery(27.5±12.2 vs. 22.5±12.3, t=-1.65, P=0.10) as well as the change of WOMAC osteoarthritis index(31.8±14.0 vs. 36.4±13.7, t=-1.35, P=0.18), but the lateral patellofemoral joint degeneration was related to inability to complete squats (χ 2=5.17, P=0.04) and sitting up (χ 2=7.22, P=0.01). Conclusion:The degeneration of lateral patellofemoral joint has no effect on the early functional recovery of patients with anteromedial knee osteoarthritis after Oxford medial unicompartmental knee arthroplasty.

Total hip arthroplasty is currently an important surgical method for the treatment of hip diseases. The modular design of the head and neck taper facilitates the adjustment of limb length and femoral offset during surgery, however, complications such as wear, corrosion and looseness of the modular interface are also inevitable old problems. In recent years, with the changes in the design of prostheses, the trend that patients becomes younger and active, and the development of minimally invasive surgery, taper corrosion has again become a problem that needs to be solved and cannot be ignored, which is causing the attention of joint surgeons. There have been many studies on the complications associated with metal-on-metal prosthesis modular interfaces, such as increased metal ion level, taper corrosion and adverse local tissue reactions, while there are few studies on the complications of metal-on-polyethylene total hip arthroplasty, and metal-on-polyethylene prosthesis has similar problems such as increased local metal ion level and adverse tissue reactions caused by taper corrosion, which may also lead to complications such as prosthesis loosening, dislocation and fracture. Currently there are few reports about head and neck taper corrosion of metal-on-polyethylene prosthesis in China and there are still controversies about its manifestation and mechanism. In this paper, we summarized the above problems through literature reviewto expound the concept, research history, assessment methods, and incidence of metal-on-polyethylene prosthesistaper corrosion and the effect of material composition, diameter of the metal head, neck length, femoral offset, geometry of the taper, surgical factors, in vivo time, and patient factors on taper corrosion are analyzed. In summary, there are still many problems in the researches about the specific forming mechanism that have not been solved, thus it is very important for the prevention of taper corrosion: choosing the same material or ceramic material, avoiding overlarge diameter of the femoral head and femoral offset, avoiding too small taper degree, paying attention to the strength of tapping and cleaning of the taper are the current viable options.

Homoharringtonine (HHT), a plant alkaloid from Cephalotaxus harringtonia, exhibits a unique anticancer mechanism and has been widely used in China to treat patients with acute myeloid leukemia (AML) since the 1970s. Trial SCMC-AML-2009 presented herein was a randomized clinical study designed based on our previous findings that pediatric AML patients younger than two years old may benefit from HHT-containing chemotherapy regimens. Patients randomized to arm A were treated with a standard chemotherapy regimen comprising mainly of anthracyclines and cytarabine (Ara-C), whereas patients in arm B were treated with HHT-containing regimens in which anthracyclines in all but the initial induction therapy were replaced by HHT. From February 2009 to November 2015, 59 patients less than 2 years old with de novo AML (other than acute promyelocytic leukemia) were recruited. A total of 42 patients achieved a morphologic complete remission (CR) after the first course, with similar rates in both arms (70.6% vs.72.0%). At the end of the follow-up period, 40 patients remained in CR and 5 patients underwent hematopoietic stem cell transplantation in CR, which could not be considered as events but censors. The 5-year event-free survival (EFS) was 60.2%±9.6% for arm A and 88.0%±6.5% for arm B (P= 0.024). Patients in arm B experienced shorter durations of leukopenia, neutropenia, and thrombocytopenia and had a lower risk of infection during consolidation chemotherapy with high-dosage Ara-C. Consequently, the homoharringtonine-based regimen achieved excellent EFS and alleviated hematologic toxicity for children aged younger than 2 years with de novo AML compared with the anthracycline-based regimen.

Objective: To evaluate the long-term efficacy and prognostic factors of childhood acute lymphoblastic leukemia (ALL) enrolled in Shanghai Children's Medical Center-Acute Lymphoblastic Leukemia-2005(SCMC-ALL-2005) multicenter study. Methods: Between May 2005 and December 2014, 1 497 newly diagnosed ALL patients were enrolled and treated in 5 hospitals of SCMC-ALL-2005 study group, using risk-stratified SCMC-ALL-2005 protocol. Risk group classification and treatment intensity were based on clinical features, genetic abnormalities, early response to treatment and levels of minimal residual disease (MRD). Kaplan-Meier method was used to generate overall survival (OS) and event-free survival(EFS) curves. Cox proportional hazards models were used for multivariate analyses. Results: The patients were followed up to December 31, 2016, the median follow-up time was 69 months (24-141 months). The 5-year and 10-year OS rates were (80.0±1.0)% and (76.0±2.0)%. The 5-year and 10-year EFS rates were (69.0±1.0)% and (66.0±2.0)%. The 5-year and 10-year relapse rates were (23.0±1.0)% and (25.0±2.0)%. The 5-year OS and EFS for low risk (LR), intermediate risk (IR) and high risk (HR) were (91.1±1.4)% and (83.3±1.8)%, (79.2±1.5)% and (68.9±1.7)%, (52.9±4.4)% and (30.0±3.8)%, respectively. MRD negative status (<0.01%) on day 55 was seen in 792 patients (82.8%) and positive MRD on day 55 was associated with poor prognosis (OR=1.9, 95%CI: 1.3-2.7, P=0.001). Twenty-four HR patients received allogeneic hematopoietic stem cell transplantation and 17(70.8%) of them were alive and in remission. A total of 164 severe adverse events occurred, 46 of them died, treatment-related mortality was 3.1%. Conclusions In this large sample research, the overall outcome for multi-center SCMC-ALL-2005 study was favorable. This helps to promote the standardized treatment of childhood ALL to the whole country. MRD results on day 55 of induction therapy have important prognostic and therapeutic implications.

Objective:To analyze the reasons of early failure of the PHILOS in proximal humerus frac-tures.Methods:From Nov.2010 to Nov.2014,there were 117 patients with humerus fractures treated with PHILOS locking plate in Department of Orthopaedics,Xuanwu Hospital.All of the patients were treated with the plate by open reduction internal fixation,and we analyzed these cases retrospectively. After the operation,we removed the drainage tube within 48 h,and the patients were allowed to do the passive motion 3 days after the surgery if the X-Ray showed the plate and screws were reliable.Eight ca-ses failed within 4 weeks after the operation.We analyzed the reasons of the failure.Results:The rate of the failed cases was 6.83%(8 /117).The average age was 72.4(66 -82)years.In the 8 failed cases, 3 were on the right side,and the other 5 on the left side.As for the reason of the fractures,2 cases were because of car accidents,and the other 6 because of daily life injury.According to the Neer classifica-tion,3 cases were 2-part fractures,and the other 5 3-part fractures.Three cases were total failure,and the other 5 partial failure.All the 8 failed cases failed within 4 weeks after the operation,of which 1 was on the sixth day after surgery,the other 7 2 to 4 weeks after the surgery.The 3 totally failed cases were treated by removing the screws and plates,the other 5 by conservative methods.All of the cases were malunion at the end.Conclusion:The early failure of the PHILOS locking plate in proximal humerus fractures is related to the bad reduction during the operation,the loss of medial cortex support,the limi-tation of screw length,the osteoporosis and the improper rehabilitation after operation.It is very important to do good preoperative plan for a surgeon.During the operation,we should try our best in the fracture reduction,use the appropriate plate and screws,and then pay attention to the rehabilitation after the operation.After all of this,the rate of failure may be decreased.

BACKGROUNDA practical problem impeding clinical translation is the limited bone formation seen in artificial bone grafts. Low-pressure/vacuum seeding and dynamic culturing in bioreactors have led to a greater penetration into the scaffolds, enhanced production of bone marrow cells, and improved tissue-engineered bone formation. The goal of this study was to promote more extensive bone formation in the composites of porous ceramics and bone marrow stromal cells (BMSCs).

METHODSBMSCs/β-tricalcium phosphate (β-TCP) composites were subcultured for 2 weeks and then subcutaneously implanted into syngeneic rats that were split into a low-intensity pulsed ultrasound (LIPUS) treatment group and a control group. These implants were harvested at 5, 10, 25, and 50 days after implantation. The samples were then biomechanically tested and analyzed for alkaline phosphate (ALP) activity and osteocalcin (OCN) content and were also observed by light microscopy.

RESULTSThe levels of ALP activity and OCN content in the composites were significantly higher in the LIPUS group than in the control group. Histomorphometric analysis revealed a greater degree of soft tissue repair, increased blood flow, better angiogenesis, and more extensive bone formation in the LIPUS groups than in the controls. No significant difference in the compressive strength was found between the two groups.

CONCLUSIONLIPUS treatment appears to enhance bone formation and angiogenesis in the BMSCs/β-TCP composites.

Animals ; Bone Marrow Cells ; physiology ; Bone Transplantation ; Calcium Phosphates ; pharmacology ; Male ; Osteogenesis ; physiology ; Rats ; Stromal Cells ; Tissue Engineering ; methods ; Transplantation, Isogeneic ; Ultrasonics ; methods

Objectives To evaluate the long-term outcomes of childhood low-or intermediate-risk neuroblastoma (NB) and their relevant prognostic factors. Methods A total of 70 new cases of low-or intermediate-risk NB diagnosed and treated by NB-99 protocol between 1999 and 2008 were analyzed retrospectively. Results Of these 70 NB patients, fourteen patients were in low-risk group and 56 were in intermediate-risk group. Sixty-seven patients reached complete remission (CR) or very good partial remission and 3 (5%) achieved partial remission. Ten patients relapsed. One patient occured second malignant neo-plasm. No patients died of chemotherapy-related adverse events or infections. The 5 year overall survival rate was 85.9%, event-free survival rate was 81.0%. Bone marrow infiltration, age at diagnosis, stage, lactate dehydrogenase level had a significant effect on prognosis. Conclusion Develop cytogenetic and molecular biology tests and pretreatment risk stratification are im-portant for further improvement of treatment protocol.