Objective To explore early postoperative gait characteristics and clinical outcomes after total knee arthroplasty(TKA).Methods From February 2023 to July 2023,26 patients with unilateral knee osteoarthritis(KOA)were treated with TKA,including 4 males and 22 females,aged from 57 to 85 years old with an average of(67.58±6.49)years old;body mass in-dex(BMI)ranged from 18.83 to 38.28 kg·m-2 with an average of(26.43±4.15)kg·m-2;14 patients on the left side,12 pa-tients on the right side;according to Kellgren-Lawrence(K-L)classification,6 patients with grade Ⅲ and 20 patients with grade Ⅳ;the courses of disease ranged from 1 to 14 years with an average of(5.54±3.29)years.Images and videos of standing up and walking,walking side shot,squatting and supine kneeling were taken with smart phones before operation and 6 weeks after operation.The human posture estimation framework OpenPose were used to analyze stride frequency,step length,step length,step speed,active knee knee bending angle,stride length,double support phase time,as well as maximum hip flexion angle and maximum knee bending angle on squatting position.Western Ontario and McMaster Universities(WOMAC)arthritis index and Knee Society Score(KSS)were used to evaluate clinical efficacy of knee joint.Results All patients were followed up for 5 to 7 weeks with an average of(6.00±0.57)weeks.The total score of WOMAC decreased from(64.85±11.54)before op-eration to(45.81±7.91)at 6 weeks after operation(P＜0.001).The total KSS was increased from(101.19±9.58)before opera-tion to(125.50±10.32)at 6 weeks after operation(P＜0.001).The gait speed,stride frequency and stride length of the affected side before operation were(0.32±0.10)m·s-1,(96.35±24.18)steps·min-1,(0.72±0.14)m,respectively;and increased to(0.48±0.11)m·s 1,(104.20±22.53)steps·min-1,(0.79±0.10)m at 6 weeks after operation(P＜0.05).The lower limb support time and active knee bending angle decreased from(0.31±0.38)sand(125.21±11.64)° before operation to(0.11±0.04)s and(120.01±13.35)° at 6 weeks after operation(P＜0.05).Eleven patients could able to complete squat before operation,13 patients could able to complete at 6 weeks after operation,and 9 patients could able to complete both before operation and 6 weeks after operation.In 9 patients,the maximum bending angle of crouching position was increased from 76.29° to 124.11° before operation to 91.35° to 134.12° at 6 weeks after operation,and the maximum bending angle of hip was increased from 103.70° to 147.25° before operation to 118.61° to 149.48° at 6 weeks after operation.Conclusion Gait analysis technology based on artificial intelligence image recognition is a safe and effective method to quantitatively identify the changes of pa-tients'gait.Knee pain of KOA was relieved and the function was improved,the supporting ability of the affected limb was im-proved after TKA,and the patient's stride frequency,stride length and stride speed were improved,and the overall movement rhythm of both lower limbs are more coordinated.

Hip fracture in the elderly is characterized by high incidence, high disability rate, and high mortality and has been recognized as a public health issue threatening their health. Surgery is the preferred choice for the treatment of elderly patients with hip fracture. However, lower extremity deep venous thrombosis (DVT) has an extremely high incidence rate during the perioperative period, and may significantly increase the risk of patients′ death once it progresses to pulmonary embolism. In response to this issue, the clinical guidelines and expert consensuses all emphasize active application of comprehensive preventive measures, including basic prevention, physical prevention, and pharmacological prevention. In this prevention system, basic prevention is the basis of physical and pharmacological prevention. However,there is a lack of unified and definite recommendations for basic preventive measures in clinical practice. To this end, the Orthopedic Nursing Professional Committee of the Chinese Nursing Association and Nursing Department of the Orthopedic Branch of the China International Exchange and Promotive Association for Medical and Health Care organized relevant nursing experts to formulate Expert consensus on perioperative basic prevention for lower extremity deep venous thrombosis in elderly patients with hip fracture ( version 2024) . A total of 10 recommendations were proposed, aiming to standardize the basic preventive measures for lower extremity DVT in elderly patients with hip fractures during the perioperative period and promote their subsequent rehabilitation.

Pulmonary cryptococcosis(PC)is a fungal infection that can be easily misdiagnosed due to its non-specific clinical features and imaging findings.This article reviews the imaging findings of PC,their relationships with pathology and immune status,and differential diagnosis of PC with other disease,so as to improve the clinical management of PC.
Cryptococcosis ; Diagnosis, Differential ; Humans ; Lung Diseases, Fungal ; Tomography, X-Ray Computed

Dual-energy computed tomography,with fast image acquisition at two different X-ray energies,enables material-specific and spectral imaging,which offers objective and quantitative parameters for tumor detection,characterization,staging,and treatment monitoring without increasing radiation exposure.This article reviews the applications of dual-energy computed tomography technique and its applications in the evaluation of lung cancer and elucidates its future developments.
Humans ; Lung Neoplasms ; diagnostic imaging ; Radiation Dosage ; Radiography, Dual-Energy Scanned Projection ; Tomography, X-Ray Computed

Abstract：Objective To develop a colloidal gold immunochromatographic strip ⁃ based method for the rapid detection of Zika virus（ZIKV）NS1 antigen. Methods The gold nanoparticles modified with the anti⁃ZIKV NS1 monoclonal antibody as the detection probe were coated on the glass ⁃fiber pad. The anti ⁃ZIKV NS1 monoclonal antibody and the goat anti ⁃mouse polyclonal antibody were immobilized on a nitrocellulose membrane as the test line and the control line，respectively. In order to achieve critical results，the ratio of the optical density （OD）of the test line to that of the control line was compared. Serial diluted ZIKV NS1 standard antigen was applied to evaluate sensitivity of the immunoassay. The culture supernatant and serum samples for arboviruses（ZIKV，Dengue virus, Japanese encephalitis virus and Chikungunya virus） were utilized to demonstrate the specificity of the method. Results The detection result could read by naked eyes within 20 minutes. The visual cut ⁃off level for the test strip was achieved at 100 ng/mL of the Zika virus NS1 standard antigen. No cross⁃reactions with Dengue virus，Japanese encephalitis virus and Chikungunya virus were observed. The strip could remain good stability within 36 weeks whether stored in 4 ℃ or room temperature（22-25 ℃）. Conclusion Apart from stability， the method was convenient，rapid and specific for ZIKV NS1 antigen，which showed a promising potential in the point of care test and the screening test.

The study is aimed to effectively obtain the planting area of traditional Chinese medicine resources. The herbs used as the material for traditional Chinese medicine are mostly planted in natural environment suitable mountainous areas. The UAV low altitude remote sensing data were used as the samples and the GF-2 remote sensing images were applied for the data source to extract the planting area of Salvia miltiorrhiza and Artemisia argyi in Luoning county combined with field investigation. Remote sensing satellite data of standard processing obtain specific remote sensing data coverage. The UAV data were pre-processed to visually interpret the species and distribution of traditional Chinese medicine resources in the sample quadrat. Support vector machine( SVM) was used to classify and estimate the area of traditional Chinese medicine resources in Luoning county,confusion matrix was used to determine the accuracy of spatial distribution of traditional Chinese medicine resources. The result showed that the application of UAV of low altitude remote sensing technology and remote sensing image of satellite in the extraction of S. miltiorrhiza and other varieties planting area was feasible,it also provides a scientific reference for poverty alleviation policies of the traditional Chinese medicine Industry in local areas.Meanwhile,research on remote sensing classification of Chinese medicinal materials based on multi-source and multi-phase high-resolution remote sensing images is actively carried out to explore more effective methods for information extraction of Chinese medicinal materials.
Altitude ; Drugs, Chinese Herbal ; Medicine, Chinese Traditional ; Natural Resources ; Remote Sensing Technology ; Support Vector Machine

Objective To understand the status quo of health resource allocation of medical institutions in poverty-stricken areas, and to provide decision-making basis for rationalizing health and poverty alleviation policies and improving the overall service capacity of medical institutions in poverty-stricken areas. Me thods The overall institutions, bed capacity and staffs in medical institutions in 680 poor counties were analyzed. Re s ults The proportion of government health expenditure in 14 concentrated areas was lower than 15％. The largest number of health institutions was 349 in the Dabie Mountains and 70 in Tibet, and the number of beds was lower than the national average level of 5.11.The largest number of health technical staff for 1 000 people of the four provinces is 4.42 people, the smallest number is 2.72 in Wumeng mountain area;the registered nurses (number) for 1 000 people is up to 1.56 people in the Luo Xia mountain area, the lowest Tibet, only 0.39 people. Thousands of population practice (assistant) physician number of Tibetans is up to 2.98 people, the lowest is 1.07 for the Xinjiang Southern Xinjiang three states; health care than the lowest in Tibet 1:0.54. Conclus ion At present, China's centralized contiguous poverty-stricken areas of county-level medical institutions is extremely short of resources, and the health resource allocation is uneven.

Objective To investigate the evaluating the value of CT quantitative analysis and visual scores on pulmonary alveolar proteinosis (PAP). Methods Thirty one patients with PAP who underwent chest HRCT scans and pulmonary function tests(PFTs)between July 2014 and April 2016 in our hospital were collected and analyzed.HRCT mean lung density(MLD)was measured by syngo InSpace Lung Parenchyma Analysis.Using CT visual scores(HRCT score and RE score),two radiologists with three-years experience at least evaluated pulmonary lesions retrospectively. SPSS 21.0 statistical software was used to analyze the data. Spearman correlation analysis was used to evaluate the correlation between MLD, HRCT score and RE score.The correlation between MLD, HRCT score, RE score, the parameters of PFTs, and blood gas parameters were also analyzed by Spearman correlation analysis. Results There were correlations between MLD,HRCT score and RE score.The correlation coefficient among MLD,HRCT score and RE score were r=0.835 vs r=0.768 vs r=0.838 in baseline. The correlation coefficient among MLD, HRCT score and RE score were r=0.827 vs r=0.780 vs r=0.896 in follow-up. And there were also strong correlation between ΔMLD, ΔHRCTscore and ΔREscore. The correlation coefficient among ΔMLD, ΔHRCTscore and ΔREscore were r=0.599 vs r=0.651 vs r=0.867. There were significantly (P＜0.05) negative correlations among MLD, HRCT score, RE score and VA, DLCO in baseline and follow-up retrospectively. There were significantly (P≤0.001) negative correlations among the ΔMLD, ΔHRCTscore, ΔREscore and ΔVA, ΔDLCO.The correlation among MLD, HRCT score, RE score and DLCO was more significant than that of VA. The correlation among ΔMLD, ΔHRCTscore,ΔREscore and ΔDLCO was more significant than that of ΔVA.There were markedly(P＜0.05) negative correlations between MLD and PO2,and the correlation coefficient were r=-0.738 in baseline vs r=- 0.810 in follow-up. Conclusion The HRCT quantitative analysis and HRCT visual scores are feasible to evaluate PAP.

Objective To investigate the clinical usefulness of quantitative dual-source dual-energy CT (DECT) iodine enhancement metrics combined with morphological CT features in distinguishing different lung cancer subtypes. Methods One hundred and sixty-two consecutive patients suspected with lung cancer were prospectively enrolled and underwent DECT in arterial phase prior to biopsy or surgery.Tumor histological subtypes were determined in 110 patients. Two radiologists interpreted CT morphologic features of 110 lesions in a consensual manner. In addition, two radiologists independently contoured lesions and placed regions of interest in descending aorta or subclavian artery on the same section for normalization , from which automated computer measurements were generated:iodine density and iodine ratio (the ratio of iodine density of lesion to that of artery on the same section). DECT metrics and morphological CT features were compared among different lung cancer subtypes. Chi-square was used to compare qualitative parameters. One way ANOVA was used to compare quantitative parameters satisfying normal distribution, while those parameters not satisfying normal distribution or ranked data were compared by Kruskal-Wallis rank sum test. Multinomial logistic regression models were used to differentiate the histological subtypes of lung cancer: adenocarcinoma, squamous cell carcinoma (SCC), small cell lung cancer (SCLC). Results There were 48 cases of adenocarcinomas, 36 cases of SCC and 26 cases of SCLC. In analysis of CT features, tumor diameter, distribution, spiculation, pleural retraction, vascular involvement, confluent mediastinal lymphadenopathy, encasement of mediastinal structures and enhancement heterogeneity showed statistical difference (all P<0.05). The diameter of SCC[(5.73 ± 3.67)cm] and SCLC [(6.08 ± 4.39)cm] were larger than adenocarcinoma [(3.75 ± 2.80 cm)] (H=13.806,P<0.05). Adenocarcinomas were mostly located in the periphery (31 cases), while SCC (26 cases) and SCLC (21 cases) were mainly centrally located. Spiculation was mostly found in adenocarcinoma (44 cases) rather than SCLC (13 cases). Pleural retraction was mostly observed in adenocarcinoma (36 cases) rather than SCC (10 cases) and SCLC (5 cases). Vascular involvement was mostly found in SCLC (19 cases) rather than adenocarcinoma (15 cases). Confluent mediastinal lymphadenopathy was more frequently found in SCLC (15 cases) compared with adenocarcinoma (3 cases) and SCC (4 cases). Encasement of mediastinal structures was mostly found in SCLC (13 cases) rather than adenocarcinoma (7 cases). Homogeneous enhancement was more frequently found in SCLC (10 cases) than SCC (6 cases). No significant differences were observed in other CT features between any other two groups. Iodine density and iodine ratio were statistically different among these three subtypes lung cancer (H=16.817,20.338,P<0.001). Iodine density of adenocarcinoma and SCC was (1.50±0.80) and (1.40± 0.40) mg/ml, respectively, higher than the (1.20±0.40) mg/ml for SCLC (P<0.01). Iodine ratio of adenocarcinoma and SCC was (16.10 ± 7.02)％and (15.05 ± 4.62)％, respectively, higher than the (11.55 ± 3.15)％ for SCLC (P<0.01). No significant difference was observed between adenocarcinoma and SCC. Accuracy of the model based on CT features was 69.1％, accuracy of the model based on CT features combined with DECT parameters was 80.9％. Conclusions Quantitative DECT metrics are different among adenocarcinoma, SCC and SCLC, when combined with morphological CT features, higher diagnostic accuracy can be achieved.

Objective To investigate the compliance of follow-up and the associated factors of diabetic retinopathy screening among diabetes patients in Muping District,Yantai City.Methods 438 diabetes patients who received free diabetic retinopathy (DR) screening in Traditional Chinese Medicine Hospital of Muping District of Yantai City from April 2012 to June 2013 were enrolled in the cross-sectional study.The re-examination rate at five years later,as well as the possible associated factors,including age,gender,height,weight,education level,occupation,past medical history,smoking and drinking habits,diabetes process,diabetes medication history,severity of DR,glycosylated hemoglobin (HbA1 c),renal functionand blood lipid were analyzed and evaluated.Results Among 438 patients,159 returned for check up five years later,with a follow-up rate of 36.3％.Further analysis revealed that follow-up rate was related to occupation types (P =0.003) and HbAlc level (P =0.006).Other factors did not show statistical significance (P ＞ 0.05).Conclusions The compliance of DR screening visits is related to occupational type and blood glucose control.It is suggested that in the screening of DR in China,we should pay attention to the propaganda and education of diabetic patients to control blood glucose,and focus on some occupational diabetes people,such as housework workers and farmers.