OBJECTIVE: To investigate the short-to-medium-term clinical efficacy of total hip arthroplasty(THA) with Pinnacle ES constrained liner in the treatment of femoral neck fractures(FNF) associated with lower limb neuromuscular disorders. METHODS: A retrospective analysis was conducted on 16 patients who underwent primary THA using Pinnacle ES constrained liner for FNF with lower limb neuromuscular disorders and had complete follow-up data, treated between January 2020 and January 2023. There were 7 males and 9 females, with a mean age of (68.42±3.58) years old ranging from 61 to 75 years old. Among them, 10 cases had left-sided fractures and 6 had right-sided fractures;based on the Garden classification, 11 cases were type Ⅲ and 5 cases were type Ⅳ. The affected limbs were complicated with sequelae of poliomyelitis (2 cases), Parkinson's disease (2 cases), and sequelae of cerebral infarction (12 cases). All operations were performed via a posterolateral approach. Prosthesis position was evaluated using imaging data. Hip function was assessed by the Harris hip score(HHS) and Merle D'Aubigne hip score. During the follow-up period, the occurrence of complications such as prosthetic dislocation, loosening, and infection was recorded. RESULTS: One patient died of advanced tumor 2 years after surgery, and the remaining 15 patients were followed up for 24 to 64 months with a mean of (34.8±5.5) months. The operation time ranged from 50 to 90 minutes with a mean of (75.56±8.15) minutes, and the blood loss ranged from 150 to 200 ml with a mean of (170.32±12.56) ml. All patients achieved primary wound healing after surgery. Intraoperatively, femoral calcar splitting occurred in 2 cases, which were treated with titanium cable binding;no neurovascular injuries were observed in any case. The mean HHS increased from (18.95±2.25) preoperatively to (88.02±2.42) at the last follow-up, and the mean Merle D'Aubigne Score increased from (3.05±0.06) preoperatively to (16.65±0.93) at the last follow-up. Postoperative follow-up X-rays showed good prosthetic position, and no complications such as dislocation, prosthetic loosening, periprosthetic fracture, or deep infection occurred during the follow-up period. CONCLUSION Total hip arthroplasty with Pinnacle ES constrained liner is effective in the treatment of femoral neck fractures associated with lower limb neuromuscular disorders. It can significantly improve hip function, reduce the postoperative prosthetic dislocation rate, provide good initial stability, and achieve satisfactory short-to-medium-term clinical efficacy.
Humans ; Male ; Female ; Middle Aged ; Aged ; Arthroplasty, Replacement, Hip/methods* ; Femoral Neck Fractures/complications* ; Retrospective Studies ; Neuromuscular Diseases/surgery* ; Lower Extremity ; Treatment Outcome

AIM:To investigate the risk factors af-fecting serum digoxin concentration and the rela-tionship between the level of the concentration and adverse reactions(ADR),and to provide a basis for the safe and rational use of digoxin.METHODS:The serum digoxin concentration(SDC)was moni-tored by enzyme amplification immunoassay tech-nology.The basic data,laboratory indicators,con-comitant medication and adverse reactions of pa-tients were collected through the medical record system.RESULTS:Among the 55 patients,12.73％,76.36％and 10.91％of the patients were treated with＜0.125 mg/d,0.125 mg/d and 0.25 mg/d di-goxin,respectively.And the serum digoxin concen-tration increased in a dose dependent manner.Eleven patients(20％)developed ADR,the most common of which were arrhythmias.The SDC of patients with ADR was(2.55±1.59)ng/mL,which was significantly higher than that of the non-ADR group(0.93±0.63 ng/mL)(P＜0.000 1).The SDC in the patients with increased serum creatinine was higher than that in the normal creatinine group,and patients with severe renal impairment demon-strated significantly higher concentration of digoxin than that in patients with normal renal function(P＜0.05).The effect of concomitant administration of other drugs on the SDCof digoxin was not ob-served.CONCLUSION:The SDC varies greatly among individuals,and is associated with dosage and renal function.The higher the concentration of digoxin in serum,the higher the incidence of ADR.Therefore,monitoring the SDC of digoxin should be strengthened,so as to improve the level of individ-ual treatment.

Objective To investigate the effect of varying ureteral wall thickness(UWT)at the site of ureteral stones on the clinical efficacy of ureteroscopic lithotripsy(URL).Methods The clinical data of 164 patients with ureteral stones in our hospital were retrospectively analyzed.According to different UWT,the patients were divided into the mild thickening group(84 cases,UWT<3.16 mm),the moderate thickening group(31 cases,UWT 3.16 to 3.49 mm),and the severe thickening group(49 cases,UWT>3.49 mm),and the differences of clinical related indicators among the three groups were compared.Results The incidence of postoperative renal colic and leukocyte disorder in the mild thickening group and the moderate thickening group were lower than those in the severe thickening group,and the differences were statistically significant(P<0.05).The postoperative catheterization time in the mild thickening group and the moderate thickening group were shorter than that in the severe thickening group,and the incidences of secondary lithotripsy,residual stones and stone return to kidney in the mild thickening group and the moderate thickening group were lower than those in the severe thickening group,with statistically significant differences(P<0.05).The length of hospital stay and hospitalization cost in the mild thickening group and the moderate thickening group were shorter/less than those in the severe thickening group,with statistically significant differences(P<0.05).Conclusion With the increase of UWT(especially when UWT>3.49 mm),the incidence of postoperative complications and hospitalization cost of URL increase to varying degrees,and the surgical efficacy decreases.In clinical work,UWT measurement holds potential value in predicting the surgical efficacy and complications of URL.

AIM:To investigate the risk factors af-fecting serum digoxin concentration and the rela-tionship between the level of the concentration and adverse reactions(ADR),and to provide a basis for the safe and rational use of digoxin.METHODS:The serum digoxin concentration(SDC)was moni-tored by enzyme amplification immunoassay tech-nology.The basic data,laboratory indicators,con-comitant medication and adverse reactions of pa-tients were collected through the medical record system.RESULTS:Among the 55 patients,12.73％,76.36％and 10.91％of the patients were treated with＜0.125 mg/d,0.125 mg/d and 0.25 mg/d di-goxin,respectively.And the serum digoxin concen-tration increased in a dose dependent manner.Eleven patients(20％)developed ADR,the most common of which were arrhythmias.The SDC of patients with ADR was(2.55±1.59)ng/mL,which was significantly higher than that of the non-ADR group(0.93±0.63 ng/mL)(P＜0.000 1).The SDC in the patients with increased serum creatinine was higher than that in the normal creatinine group,and patients with severe renal impairment demon-strated significantly higher concentration of digoxin than that in patients with normal renal function(P＜0.05).The effect of concomitant administration of other drugs on the SDCof digoxin was not ob-served.CONCLUSION:The SDC varies greatly among individuals,and is associated with dosage and renal function.The higher the concentration of digoxin in serum,the higher the incidence of ADR.Therefore,monitoring the SDC of digoxin should be strengthened,so as to improve the level of individ-ual treatment.

OBJECTIVE: To analyze the characteristics, prognosis and risk factors of bloodstream infection in patients with hematological malignancies in the tropics, so as to provide evidence for the prevention and treatment of bloodstream infection. METHODS: The clinical features, blood culture results and prognosis of patients with bloodstream infection in patients with hematological malignancies admitted to Hainan Hospital of PLA General Hospital were retrospectively studied. RESULTS: The most common primary infection site of the 81 patients with hematological malignancies was lung (46.91%), followed by PICC (11.11%). The detection rate of Gram-positive bacteria and Gram-negative bacteria in the blood culture was 60.98% and 30.02%, respectively. Coagulase-negative staphylococci was the most common Gram-positive bacteria resulting in bloodstream infection in our study. Of the Gram-negatives, Klebsiella pneumoniae (34.38%) was predominant, followed by Escherichia coli (18.75%) and Pseudomonas aeruginosa (18.75%). Gram-positive bacteria was highly sensitive (100%) to vancomycin, linezolid and tigecycline. Study showed that Gram-negative bacteria had low sensitive to quinolones, in particular, the resistance rate of Escherichia coli to quinolones was as high as 83.33%. In terms of overall survival (OS), the 30-days OS of patients with Gram-negative and Gram-positive septicemia was 77.42% and 92.00%, respectively. There was no statistically significant difference between the two groups. Multivariate analysis revealed that septic shock (P=0.001, RR=269.27) was an independent risk factor for 30-day mortality, and remission status (P=0.027, RR=0.114) was an independent predictor of a favourable outcome of bloodstream infection in patients with hematological malignancies. CONCLUSION Gram-positive bacteria are the main pathogens causing bloodstream infections in patients with hematological malignancies in the tropics. Improving the care of PICC is an important measure to reduce the incidence of bloodstream infection in patients with hematological malignancies in the tropics. A correct treatment relieving disease and effective prevention and treatment of septic shock can reduce mortality of patients with bloodstream infection in patients with hematological malignancies in the tropics.
Anti-Bacterial Agents/therapeutic use* ; Bacteremia/drug therapy* ; Drug Resistance, Bacterial ; Gram-Negative Bacteria ; Hematologic Neoplasms/drug therapy* ; Humans ; Microbial Sensitivity Tests ; Prognosis ; Retrospective Studies ; Sepsis

The chromosomal aneuploidy in oocytes is one of main causes of abortion and neonatal birth defects.It is mainly due to the premature separation of sister chromatid caused by the loss of Cohesin protein complex and the non-disjunction sister chromatids caused by abnormal microtubule dynamics aneuploidy.As a pathway of protein post-translational modification,SUMO modification(or SUMOylation)involves many physiological regulation processes including cell proliferation,differentiation,apoptosis,and cycle regulation.In the oocytes,SUMOylation can regulate the localization of Cohesin protein complex on the chromosome to affect the chromosomal aneuploidy in oocytes caused by premature separation of sister chromatid.On the other hand,SUMOylation can regulate the microtubule dynamics to affect the chromosomal aneuploidy in oocytes caused by non-disjunction sister chromatids.Therefore,SUMOylation plays an important role in regulating the chromosomal aneuploidy of oocytes;the exact mechanisms via which the SUMOylated substrates affect aneuploidy in oocytes remain unclear.This articles reviews the roles of SUMOylation in premature separation and non-isolated chromatid aneuploidy in oocyte from the effects of SUMOylationon Cohesin protein complex and microtubule dynamics.
Aneuploidy ; Cell Cycle Proteins ; Chromatids ; Chromosomal Proteins, Non-Histone ; Chromosome Segregation ; Humans ; Microtubules ; Oocytes ; cytology ; Sumoylation

The growth and development of follicles are regulated by genes,hormones and growth factors autocrined and paracrined from granulosa cells,theca cells,and oocytes.Products of glycolysis from granulosa cells such as pyruvate and lactate are one of the main energy sources,which play an important role during folliculogenesis and follicle maturity.Studies on the changes of the products and rate-limiting enzymes during granulosa cells' glycolysis help to clarify the molecular mechanism of energy demand in folliculogenesis and guide the clinical treatment of infertility due to abnormal follicular development.This article reviews recent research advances in the energy demand and regulatory mechanism in different states of folliculogenesis.
Energy Metabolism ; Female ; Glycolysis ; Granulosa Cells ; Humans ; Intercellular Signaling Peptides and Proteins ; Oocytes ; Ovarian Follicle ; growth & development ; Theca Cells

Objective:To explore the protection of hyperbaric oxygen (HBO) preconditioning on blood-brain barrier of plateau hypoxia in Rats.Methods:SD rats were randomly divided into three groups including normal control group (group A),high altitude hypoxia group (group B) and HBO preconditioning treatment of high altitude hypoxia group (group C),by tail vein injection of 2％ Evans blue (EB),and by fluorescence microscopy to observe brain EB spot,we evaluated the changes of BBB permeability by detecting the contents of EB and water in brain tissue through UV spectrophotometer and dry wet weight method,respectively.Results:The number of red spots,EB content and brain water content of brain tissues in group A were significantly lower than those in group B and group C (P＜0.001).The number of red spots,EB content and brain water content in group B were significantly higher than those in group C (P＜0.001).Conclusions:HBO pretreatment can significantly reduce the increase of BBB permeability caused by high altitude hypoxia,and has obvious protective effect on the damage of BBB caused by high altitude hypoxia.

OBJECTIVETo establish the Chinese Pediatric Evaluation of Disability Inventory (PEDI) norms in Chongqing, China.

METHODSPEDI (English version) was translated into Chinese and proof read by back-translation. A total of 1 140 children stratified by age were randomly selected from Chongqing and evaluated by the Chinese version of the PEDI. The obtained data were statistically analyzed.

RESULTSOf 1 140 questionnaires, 1 075 (94.3%) were valid. The data showed that the raw and scale scores of PEDI increased with age, but the standard scores did not increase with age. The raw, scale, and standard scores on self-care and social function scales were significantly lower than American PEDI norms in some age periods (P<0.05), but the raw, scale, and standard scores on mobility scale were not significantly different from American norms (P>0.05).

CONCLUSIONSThe PEDI norms in Chongqing have been successfully established, and can be used to assess the daily function in children, judge the degree of daily function impairment, evaluate the effect of rehabilitation training, and make the rehabilitation plan for disabled children.

Adolescent ; Adult ; China ; epidemiology ; ethnology ; Female ; HIV Infections ; epidemiology ; ethnology ; transmission ; Humans ; Male ; Middle Aged ; Models, Theoretical ; Sexual Partners ; Social Networking ; Unsafe Sex ; ethnology ; Young Adult