Objective To investigate the effects of design parameters such as neck-shaft angle, femoral offset and anteversion angle of total hip arthroplasty ( THA) prosthesis on contact forces of the hip. Methods A musculoskeletal multi-body dynamic model of THA was established based on AnyBody software. The effects of single or multiple factors on hip contact force were studied when the neck-shaft angle, eccentricity and anteversion angle varied within ±10°, ±20 mm and ±10°, respectively. Results The maximum hip contact force increased by 26. 08% when femoral offset was reduced by 20 mm. The maximum hip contact force increased by 5. 99% when the neck-shaft angle increased by 10°. When the anteversion angle increased by 10°, the hip contact force decreased at 0% -24% of gait cycle, with the peak decreasing by 19. 16% . However, the hip contact force was significantly increased at 38% -70% of gait cycle, with the peak increasing by 67. 78% . Conclusions In extramedullary design of the femoral stem, based on reconstruction of the patient’s anatomical parameters, the offset of the femoral stem can be appropriately increased, and the neck-shaft angle and anteversion angle can bereduced to avoid increasing forces on the hip.

Objective:To determine whether there is a correlation between the cross-sectional area (CSA) and the parameters as measured on nerve conduction studies.Methods:Twenty-one patients with neuromuscular diseases in Beijing Tiantan Hospital from March 3, 2022 to May 4, 2023 underwent ultrasound measurement of the CSA of the median nerves and ulnar nerves at the wrist, elbow and the upper arm, followed by nerve conduction studies (NCS). A linear regression model was performed to compare NCS and CSA.Results:A total of 180 sets of motor nerve conduction velocity (MCV) and CSA at the different sites including 102 sets of median nerve and 78 sets of ulnar nerve, 220 sets of compound muscle action potential (CMAP) amplitude and CSA at the different sites including 104 sets of median nerve and 116 sets of ulnar nerve, 60 sets of sensory nerve conduction velocity (SCV) and CSA and sensory nerve action potential (SNAP) amplitude and CSA at the wrist including 32 sets of median nerve and 28 sets of ulnar nerve were recorded. The linear correlation between MCV and CSA was statistically significant both in median nerve ( r2=0.10,adjusted r2=0.09, P=0.001) and in ulnar nerve ( r2=0.18,adjusted r2=0.17, P<0.001).When CSA>10 mm 2, the linear correlation between CMAP amplitude and CSA was statistically significant both in median nerve ( r2=0.09,adjusted r2=0.08, P=0.024) and ulnar nerve ( r2=0.19,adjusted r2=0.17, P=0.004). The correlation between CMAP and CSA was not statistically significant when CSA≤10 mm 2. And the correlations between SCV and CSA and between SNAP and CSA were not statistically significant. Conclusions:CSA can better show the characteristics of changes in motor nerve conduction especially in motor conduction velocity. It is suggested that its application prospect in demyelinating peripheral neuropathy with motor nerve damage may be more extensive.

The geometric bone model of patients is an important basis for individualized biomechanical modeling and analysis, formulation of surgical planning, design of surgical guide plate, and customization of artificial joint. In this study, a rapid three-dimensional (3D) reconstruction method based on statistical shape model was proposed for femur. Combined with the patient plain X-ray film data, rapid 3D modeling of individualized patient femur geometry was realized. The average error of 3D reconstruction was 1.597-1.842 mm, and the root mean square error was 1.453-2.341 mm. The average errors of femoral head diameter, cervical shaft angle, offset distance and anteversion angle of the reconstructed model were 0.597 mm, 1.163°, 1.389 mm and 1.354°, respectively. Compared with traditional modeling methods, the new method could achieve rapid 3D reconstruction of femur more accurately in a shorter time. This paper provides a new technology for rapid 3D modeling of bone geometry, which is helpful to promote rapid biomechanical analysis for patients, and provides a new idea for the selection of orthopedic implants and the rapid research and development of customized implants.
Humans ; Imaging, Three-Dimensional/methods* ; Tomography, X-Ray Computed/methods* ; Femur/surgery* ; Femur Head ; Lower Extremity

Objective: To investigate the effect of tripartite motif containing 59(TRIM59) on the biological function of human colorectal cancer HCT116 cells and its possible mechanism. Methods: The recombinant TRIM59 interference plasmid(si-TRIM59) was constructed and transfected into colorectal cancer cell line HCT116 by liposome transfection. The transfection efficiency was verified by RT-qPCR and Western blot. The effects of TRIM59 gene silencing on the proliferation, colony-formation ability and cell cycle of colorectal cancer cells were detected by CCK-8 method, colony formation assays and flow cytometry respectively. Western blot was used to detect the expression level of CDK4 and cyclinD1. Results: The expression levels ofTRIM59mRNA and protein in colorectal cancer cells were significantly higher than those in normal colorectal mucosa cells(P<0. 05). After knockdown of TRIM59expression, the proliferation activity and colony forming ability of HCT116 cells were significantly inhibited(P<0. 05), and the cell cycle was arrested in G0/G1 phase. At the same time, the expression levels of CDK4and CyclinD1 significantly decreased(P<0. 05). Conclusion TRIM59was highly expressed in colorectal cancer cells. Down regulation ofTRIM59expression can inhibit the proliferation and clone formation of colorectal cancer cells, suggesting thatTRIM59may become a new target for gene therapy of colorectal cancer.

Objective? To compare the reliability and validity of Intensive Care Delirium Screening Checklist (ICDSC) and Neelon and Champagne Confusion Scale (NEECHAM) when evaluating non-mechanical ventilation patients in Neurosurgery Department. Methods? A total of 100 non-mechanical ventilation patients in the Neurosurgery Department of a ClassⅢ Grade A hospital in Shanxi Province from August to December 2018 were selected. The non-operative patients were assessed on the third day after admission, and the operative patients were assessed on the third day after operation. Qualified nurses assessed the patients at 00:00—1:00, 8:00—9:00 and 16:00—17:00 with ICDSC and NEECHAM. Psychiatrists assess the patients at 16:30—17:30 on the same day by Richmond Agitation and Sedation Scale (RASS) and Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV). Using the results of DSM-IV as the gold standard, the curve of ROC was drawn, and the sensitivity and specificity of the two scales were compared. Results? Area under ROC Curve (ROCAUC) of ICDSC was 0.891 (95%CI: 0.826-0.956,P＜0.01). The ROCAUC of NEECHAM was 0.987 (95% CI: 0.970-0.999, P＜ 0.01). When the optimal threshold of ICDSC was 4.25, the sensitivity and specificity were 87.8% and 76.2% respectively. When the optimal threshold of NEECHAM was 23.5, the sensitivity and specificity were 98.0% and 92.9% respectively. Conclusions? The misdiagnosis rate of NEECHAM is lower than ICDSC, and the diagnostic efficacy, authenticity, reliability and diagnostic value of NEECHAM are higher than ICDSC. NEECHAM is more suitable for nurses to evaluate delirium in neurosurgery patients without mechanical ventilation.

Objective To explore the value of cMRI and MRS in diagnosis and differential diagnosis of single brain metastases and localized high grade gliomas.Methods The cMRI (T1WI,T2WI and contrast-enhanced MRI)and MRS data of 23 cases with single brain metastases and in 28 cases with high grade gliomas confirmed by pathology were collected and analyzed retrospectively.Results cMRI:①There were no significant differences of T1WI,T2WI and constrast-enhanced MRI between single brain metastases and high-grade gliomas.②Enhanced images of single brain metastases and localized high-grade gliomas showed that there was a significant difference in the peritumoral edema area:the nodular or ring enhancement were found in single brain metastases,the outer outline of ring enhancement was smooth,and there was no enhancement at the peripheral edema area;Irregular patchy or ring enhancement were found in localized high-grade glioma tumor,both of the outer and inner edges of the ring enhancement rough,a little patchy enhancement at the peripheral edema area were found in 1 6 patients,and there was no enhancement of the edema area in the other 1 2 patients.MRS:①There were no significant differences of the tumor parenchyma in the peaks of NAA,Cr,Cho and central Lac between single brain metastases and localized high grade gliomas.②A significant difference of the peripheral edema area were observed between them.The peaks of NAA,Cr,Cho at the edema area in all single brain metastases patients were normal.But in all high-grade glioma patients,the NAA and Cr peaks were decreased,while the Cho peaks were increased.Conclusion The morphological manifestations of single brain metastases are similar to localized high grade gliomas.An obvious difference of cMRI and MRS lines exists in the peritumoral edema area between them,which could be used for differential diagnosis.

Patient transport is an important part of medical work, and maintaining the stability of vital signs of transport patients is an significant prerequisite for safe transportation. Appropriate oxygen therapy can effectively ensure the stability of vital signs and reduce the incidence of clinical complications in patients' transport. Excellent oxygen therapy device is an important guarantee to ensure adequate oxygen inhalation for transporting patients. There are a variety of devices for providing oxygen therapy in patients' transportation, and each has its advantages and disadvantages. This article aims to summarize the commonly used oxygen therapy devices in clinical transport of patients.

Objective To introduce the application of grafting mechanism on a classⅢ grade A hospital's nursing counterpart support to county-level hospitals in Shanxi Province, and to summarize its effects and existing problems, so as to promote nursing counterpart support work and provide reference for the increase of the efficiency of counterpart support. Methods From 2014 to 2016, grafting mechanism was carried out in 23 county-level hospitals nursing counterpart supported by a classⅢ grade A hospital of Shanxi Province through 4 segments: field investigation, content selection, cultural integration and guided implementation. The evaluation of various mechanisms before and after grafting and the nurse satisfaction, patient satisfaction, high quality nursing service, as well as key discipline construction were statistically analyzed in 23 count-level hospitals. Results 100% of the 23 county-level hospitals applied grafting mechanism. A total of 20 nursing mechanism were grafted, focusing on 7 personnel systems, 3 performance management systems and 10 nursing quality management systems. The evaluation level of various mechanisms was significantly improved in the county-level hospitals after mechanism grafting. Nurse satisfaction increased from (87.6±15.2) to (89.7±16.8);patient satisfaction increased from (92.3±17.5) to (94.1±18.1); and high quality nursing service score increased from (73.5±12.9) to (75.8±14.0), and the differences were statistically significant (t=5.725, 4.042, 6.493;P< 0.01). A total of 5 of the county-level hospitals were approved provincial key discipline construction projects. Conclusions The mechanism of grafting plays a significant role in nursing counterpart support activities. Its theories and practice are worth of promoting.

Objective:To measure the mesio-distal interradicular space of posterior teeth at different height by CBCT.Methods:60 subjects with skeletal Class Ⅰ,Ⅱ and Ⅲ patterns were included(n =20).From the distal of first premolar to the mesial of second molar,the mesiodistal width at the height of 2,4,6,8 and 10 mm from the alveolar crest were measured and analysed.Results:The interradicular distance was larger than 3 mm within 4-10 mm height in maxilla and in mandible.The maxillary mesiodistal width values measured between the first premolar and second premolar in skeletal Class Ⅰ and Class Ⅱ pattern was greater than that in Class Ⅲ(P ＜0.05) and there was no significant difference in other zones.In the mandible,the values of skeletal Class Ⅲ pattern were greater than those of skeletal Class Ⅰ and Class Ⅱ pattern(P ＜0.05).Conclusion:The suitable interradicular zone is within 4-8 mm to the alveolar crest between the second premolar and first molar for miniscrew implant placement in maxilla,and over 4 mm between the first molar and second molar in mandible.The difference of interradicular spaces in sagittal skeletal features is existed.

Objective To explore nursing requirement and its influencing factors for patients staying at home.Methods We utilized self-designed questionnaire to investigate general information and nursing requirement among 500 patients,who had different nursing care needs at home in Taiyuan city,and describe patients' need by constituent ratio,mean standard deviation and percentage.The patient's personal data used descriptive analysis,two sample t test,single factor variance analysis,while the influence factors of patient care needs at home applied multiple linear regression analysis.Results The total score nursing requirement of patient at home were (2.25 ± 1.63),and the requirement intensity in proper sequence as:health guidance (2.82 ± 1.34),psychological nursing (2.57 ± 1.68),primary nursing (2.39 ± 1.16),life care (.1.70 ± 1.31),specific nursing (1.65 ± 1.07).Multiple linear regression analysis showed that gender was the influence factors of primary nursing needs,the influencing factors of per capita income impacted the needs of health guidance,and age was the influencing factor of psychological nursing demand.Conclusions Home care is the development direction of future nursing,which should be guided by the requirement.We should base on multi-dimension to develop suitable home care according to national situation and meet the diversified demand.