Objective To understand the distribution characteristics and stroke risk of hospitalized patients in single center atrial fibrillation in traditional Chinese medicine hospitals for guidance in prevention and treatment of atrial fibrillation.Methods A total of 667 clinical diagnosis and treatment data from Guangdong Provincial Hospital of Chinese Medicine,Hainan Hospital from October 2020 to September 2022 in the data filling platform of China Atrial Fibrillation Center through retrospective investigation was collected[including hospitalization information,diagnosis and treatment,demographic information symptoms,European Heart Rhythm Association(EHRA),health assessment].Descriptive epidemiological methods were employed to analyze the distribution characteristics of different populations,and a Logistic regression model was used with CHA2DS2-VASc score as the dependent variable to analyze the risk factors of stroke in men and women with non-valvular atrial fibrillation respectively.Results Among patients with atrial fibrillation,valvular atrial fibrillation accounted for 5.85%(39/667),while non-valvular atrial fibrillation accounted for 94.15%(628/667).Persistent atrial fibrillation was the main type at 65.52%(437/667),with a higher proportion of patients in males than that in females(1.22∶1).The average age of patients was 75.14±11.23 years,mainly aged 71-80 years and 81-90 years,accounting for 33.28%(222/667)and 28.78%(192/667)respectively.Clinical symptoms mainly include palpitations(51.27%)and chest discomfort(45.43%),79.01%(527/667)of patients had EHRA symptom rating below gradeⅡ,while 20.99%(140/667)had ratings above gradeⅢ.The highest incidence of comorbidities of atrial fibrillation was hypertension at 64.62%(431/667),followed by chronic heart failure at 36.43%(243/667).The proportion of high-risk stroke population in the CHA2DS2-VASc score was significantly higher than that of the medium to low-risk stroke population[89.17%(560/628)vs.10.83%(68/628)].In contrast,the proportion of people with low risk of bleeding in the HAS-BLED score was significantly higher than that of people with high risk of bleeding[69.27%(462/667)vs.30.73%(205/667)].A univariate analysis was conducted on 628 patients with non-valvular atrial fibrillation by gender.The results showed that among 279 female patients with CHA2DH2-VASc score≥3 as the dependent variable,univariate analysis showed that there were significant differences in age,hypertension,coronary heart disease,cardiomyopathy,chronic heart failure,cerebrovascular disease,and thyroid disease between the two groups(all P<0.05).A total of 349 male patients with CHA2DH2-VASc score≥2 as the dependent variable,statistically significant differences were showed in age,education level,EHRA and whether had hypertension,coronary heart disease,chronic heart failure,cerebrovascular disease,and thyroid disease(all P<0.05)by univariate analysis.Multivariate Logistic regression analysis showed that the high-risk factors for stroke were age,systolic blood pressure,thyroid disease and cerebrovascular disease in women[female>75 years old:odds ratio(OR)=42.270,95%confidence interval(95%CI)was 9.130-195.800;systolic blood pressure>160 mmHg(1 mmHg≈0.133 kPa):OR=3.530,95%CI was 1.420-8.760,and thyroid disease:OR=0.140,95%CI was 0.040-0.460,cerebrovascular disease:OR=9.400,95%CI was 2.130-41.440;all P<0.05].While age,education level,systolic blood pressure,chronic heart failure,cerebrovascular disease,and thyroid disease in men were high-risk factors(male>75 years old:OR=81.270,95%CI was 27.730-238.210;education level:OR=0.250,95%CI was 0.120-0.530;systolic blood pressure>160 mmHg:OR=14.110,95%CI was 7.250-27.460;patients with chronic heart failure:OR=23.780,95%CI was 7.850-71.970;thyroid disease:OR=0.240,95%CI was 0.110-0.540;patients with cerebrovascular disease:OR=0.580,95%CI was 0.360-0.940;all P<0.05).Conclusions The proportion of male hospitalized patients with atrial fibrillation at Guangdong Provincial Hospital of Chinese Medicine,Hainan Hospital is greater than that of females.The majority of these patients are elderly,with an average age higher than recently reported.They face a more prominent of stroke,especially those with high blood pressure,chronic heart failure,cerebrovascular disease,and thyroid disease.It is crucial to strengthen targeted prevention and treatment efforts in this population.

OBJECTIVE: To analyze the accuracy of prosthesis size selection in Naton robot-assisted medial unicondyle knee arthroplasty by comparing the actual prosthesis size used during operation and the preoperative planning. METHODS: The clinical data of 100 patients (110 knees) who underwent Naton robot-assisted medial unicondylar knee arthroplasty between June 2023 and July 2024 was retrospectively analyzed, including 47 knees on left side and 63 knees on right side. There were 37 males (40 knees) and 63 females (70 knees) with a mean age of 65.4 years (range, 59-71 years). Body mass index was 22.2-28.6 kg/m ² (mean, 25.4 kg/m ²). The disease duration ranged from 1 to 8 years (mean, 3.4 years). Preoperative planning was performed by Naton robotic surgical system based on lower limb CT data. The final prosthesis size after osteotomy was recorded and compared with the preoperative plan to analyse whether it was consistent with the preoperative plan, as well as the situation of knee flexion and extension gaps (<0.5 mm, >2.0 mm) corresponding to the different models of prostheses. RESULTS: During operation, 5 patients (5 knees) were treated with traditional UKA due to mechanical arm failure, software obstacles, significant bone amputation bias, or loose reference frame, and were excluded from the final analysis. The remaining 95 patients (105 knees) successfully received Naton robot-assisted surgery, and no related complications occurred. The prosthesis size was consistent with the preoperative plan in 101 knees (96.2%) on the femur side, 100 knees (95.2%) on the tibia side, and 97 knees (92.4%) on both femur and tibia sides. The prosthesis size was inconsistent in 3 cases (2.86%) on the femur side alone, 4 cases (3.81%) on the tibial side alone, and 1 case (0.95%) on both femur and tibial sides. Among the prostheses with different models, the flexion and extension gaps were less than 0.5 mm in 3 knees, the flexion gap was less than 0.5 mm and the extension gap was more than 2.0 mm in 3 knees, and the flexion gap was more than 2.0 mm and the extension gap was less than 0.5 mm in 2 knees. CONCLUSION The accuracy of prosthesis size selection for Naton robot-assisted medial unicondylar knee arthroplasty is relatively high.
Humans ; Arthroplasty, Replacement, Knee/instrumentation* ; Female ; Male ; Middle Aged ; Aged ; Knee Prosthesis ; Retrospective Studies ; Robotic Surgical Procedures/methods* ; Prosthesis Design ; Knee Joint/surgery* ; Osteoarthritis, Knee/surgery* ; Range of Motion, Articular

Objective To analyze the population distribution pattern of inpatients in the China Atrial Fibrillation Center of Hainan Traditional Chinese Medicine Hospital to guide clinical diagnosis and treatment.Methods Clinical diagnosis and treatment(including hospitalization information,diagnosis and treatment,symptoms,health assessment,physical examination,examination,testing,therapeutic drugs),European Heart Rhythm Association(EHRA)symptom score,CHA2DS2-VASc score for predicting stroke risk stratification in atrial fibrillation,HAS-BLED score for predicting bleeding risk in anticoagulated were collected from Hainan Traditional Chinese Medicine Hospital from October 2020 to September 2022 in the data filling platform of China Atrial Fibrillation Center through retrospective investigation.The normal reference values of various examination indicators set for analysis are heart rate 60-100 beats/min,QTc interval <480 ms for males and<470 ms for females,ejection fraction(EF)0.50-0.75 for B-ultrasound,left atrial anteroposterior diameter <35 mm,left ventricular end-diastolic diameter(LVEDD)<55 mm for males and <50 mm for females,no left atrial thrombosis,International normalized ratio(INR)0.85-1.20,brain natriuretic peptide(BNP)0-100 ng/L,N-terminal pro-brain natriuretic peptide(NT-proBNP)0-125 ng/L in cardiology,0-250 ng/L in non cardiology.Results Among 667 patients,there were 39 cases of valvular atrial fibrillation and 628 cases of non valvular atrial fibrillation.The completion rate of various diagnostic(physical examination/examination/testing)indicators was 19.94％-100.00％.Statistically significant differences were showed in every EHRA symptom score,HAS-BLED score,BMI,hypertension,heart rate,EF,left atrial diameter,LVEDD,left atrial thrombus,INR(Warfarin user),BNP,NT-proBNP and atrial fibrillation treatment methods(all P<0.01).No statistically significant difference was shown in CHA2DS2-VASc scores for each gender,QTc and NT-proBNP(all P>0.05).409 patients were treated with antiarrhythmic drugs,with a treatment rate of 61.32％.Statistically significant difference was showed in the proportion of medication use among different populations with heart rates of<60,60-100,and ≥100 beats/min,respectively[46.51％(20/43)vs.54.60％(196/359),72.83％(193/265),P<0.01],and the highest drug usage rate was β receptor blockers.Statistically significant difference was shown in the use rate of different antiarrhythmic drugs(P<0.01).There were 342 patients treated with anticoagulant therapy,with a treatment rate of 51.27％,the treatment rate of valvular atrial fibrillation was significantly higher than that of non-valvular atrial fibrillation[84.62％(33/39)vs.49.20％(309/628)],with a statistically significant difference(P<0.01).No statistically significant difference was shown in treatment rates between individuals with CHA2DS2-VASc scores of ≥2 for males and ≥3 for females of non-valvular atrial fibrillation,and between individuals with CHA2DS2-VASc scores of <2 for males and <3 for females,as well as between individuals with HAS-BLED scores of ≤2 and ≥3 for treatment rates(all P>0.05).Statistically significant differences were shown in the usage rates of different anticoagulants,antiplatelet aggregation drugs,blood lipid control(statins)drugs,and blood pressure control drugs(all P<0.01).The types of medication used for blood pressure control are angiotensin converting enzyme inhibitor(ACEI),angiotensin Ⅱ receptor blocker(ARB),calcium channel blocker(CCB),β receptor blockers and diuretics.The single drug composition ratio of the medication plan was the highest(39.75％),and the diuretics composition ratio of drug use was the highest(48.00％),with statistically significant differences(all P<0.01).Conclusions The operation of the Atrial Fibrillation Center of Hainan Traditional Chinese Medicine Hospital has covered all clinical diagnosis and treatment projects,and the treatment plan is consistent with the guidelines.At present,the control of blood pressure,BMI,and heart rate of hospitalized patients needs to be further strengthened,especially the proportion of high-risk people with stroke,and there is insufficient anticoagulation treatment.The training of the guidelines should be improved to promote standardized treatment.

Objective To investigate some improvements in the surgical techniques of adult-to-adult living donor liver transplantation( A-A LDLT) without the middle hepatic vein(MHV) for hepat-ic vein reconstruction. Methods The retrospective analysis was made on the clinical data of 11 recipi-ents who underwent the operation in A-A LDLT including the hepatic vein reconstructed in right liver lobe without MHV from June 2007 to January 2008. The key techniques included reconstructing out-flow of graft on shaping the tips of vena cava and right hepatic veins, cadaveric vein allografts stored in 4℃ UW solution within 7d being used for significant-sized hepatic vein reconstruction such as tributa-ries of the middle hepatic vein from V5, V8 and right inferior hepatic vein. Results 10 cases success-fully underwent reconstruction of outflow of graft on shaping the tips of vena cava and right hepatic veins and the outflow reconstruction ratio of V5, V8 and right inferior hepatic vein was 81. 8% (9/11), 7 one-vein reconstruction, 1 two-vein reconstruction and 1 three-vein reconstruction. 1 recipient died of renal failure and pulmonary infection 14 days after operation without venous outflow obstruc-tion. Doppler ultrasonography showed no thrombosis and the blood flowed smoothly in the right he-patic vein of other 8 recipients during the 9th to 15th mouth of follow-up. The cumulative patency rates of these 8 survivals for interposition vein grafts were 100% (11/11), 72. 7 %(8/11), 54. 5%(6/11) and 36. 5%(4/11) in 1, 3, 6 and 9 mouths, respectively. The regeneration of paramedian sectors was equivalent. Conclusion Shaping the tips of vena cava and right hepatic veins and using cadaveric vein allografts in adult-to-adult right lobe living donor liver transplantation for hepatic vein reconstruc-tion are both safe,simple and effective methods.This approach can be recommended.