Objective:To investigates the clinical efficacy of the trabecular metal acetabular revision system (TMARS) in one-stage reconstruction of acetabular deficiencies associated with periprosthetic joint infection (PJI).Methods:This is a retrospective case series study,including the data of 59 patients with PJI underwent acetabular defect reconstruction by TMARS during one-stage revisions in the Department of Orthopaedics, the First Affiliated Hospital of Xinjiang Medical University from January 2013 to December 2021. There were 32 males and 27 females, aged (59.5±14.6) years (range: 26 to 84 years). Among them, 29 cases used tantalum cups, 13 cases used tantalum cups and tantalum reinforcing blocks, 9 cases used cup-cage, and 8 cases used multi-cup reconstruction techniques. The surgery procedure, Harris Hip score (HHS), recovery of the hip rotation center, implant survival rate, postoperative reinfection rate, and complications were recorded. Data were compared using the Wilcoxon rank-sum test.Results:All of the 59 patients underwent the operations successfully. Operation time was (188.9±48.4) minutes (range: 110 to 340 minutes), and intraoperative bleeding volume was ( M(IQR)) 1 000(400)ml (range: 600 to 1 800 ml). After a postoperative follow-up of 5.1 (2.6) years (range: 2.0 to 10.5 years), the prosthesis survival rate was 94.9% (56/59). Recurrence of infection occurred in 3 cases (5.1%), aseptic loosening in 1case(1.7%), and hip dislocation in 4 cases (6.8%). At the last follow-up, HHS improved significantly(84 (12) vs. 44 (9), Z=-6.671, P<0.01), and the center of rotation of the hips were recovered in all cases. Conclusions:In one-stage revision surgeries aimed at reconstructing acetabular defects, utilizing the TMARS can provide stable initial fixation, restore a more natural center of rotation, significantly enhance early postoperative hip joint function, and reduce the likelihood of infection recurrence. This approach stands as a reliable choice for addressing acetabular defects during revision surgeries for infected hip joints.

Objective:To investigates the clinical efficacy of the trabecular metal acetabular revision system (TMARS) in one-stage reconstruction of acetabular deficiencies associated with periprosthetic joint infection (PJI).Methods:This is a retrospective case series study,including the data of 59 patients with PJI underwent acetabular defect reconstruction by TMARS during one-stage revisions in the Department of Orthopaedics, the First Affiliated Hospital of Xinjiang Medical University from January 2013 to December 2021. There were 32 males and 27 females, aged (59.5±14.6) years (range: 26 to 84 years). Among them, 29 cases used tantalum cups, 13 cases used tantalum cups and tantalum reinforcing blocks, 9 cases used cup-cage, and 8 cases used multi-cup reconstruction techniques. The surgery procedure, Harris Hip score (HHS), recovery of the hip rotation center, implant survival rate, postoperative reinfection rate, and complications were recorded. Data were compared using the Wilcoxon rank-sum test.Results:All of the 59 patients underwent the operations successfully. Operation time was (188.9±48.4) minutes (range: 110 to 340 minutes), and intraoperative bleeding volume was ( M(IQR)) 1 000(400)ml (range: 600 to 1 800 ml). After a postoperative follow-up of 5.1 (2.6) years (range: 2.0 to 10.5 years), the prosthesis survival rate was 94.9% (56/59). Recurrence of infection occurred in 3 cases (5.1%), aseptic loosening in 1case(1.7%), and hip dislocation in 4 cases (6.8%). At the last follow-up, HHS improved significantly(84 (12) vs. 44 (9), Z=-6.671, P<0.01), and the center of rotation of the hips were recovered in all cases. Conclusions:In one-stage revision surgeries aimed at reconstructing acetabular defects, utilizing the TMARS can provide stable initial fixation, restore a more natural center of rotation, significantly enhance early postoperative hip joint function, and reduce the likelihood of infection recurrence. This approach stands as a reliable choice for addressing acetabular defects during revision surgeries for infected hip joints.

Purpose To explore the application value of artificial intelligence(AI)assistant diagnosis system based on Chinese thyroid imaging reporting and data system(C-TIRADS)in the diagnosis of suspected thyroid nodules.Materials and Methods A total of 441 patients(445 nodules)with suspected thyroid nodules examined in Huadong Sanatorium from January 2018 to December 2021 were retrospectively analyzed.The low seniority group,the senior seniority group and the AI group were composed of the junior doctors,the senior doctors and the AI assistant diagnosis system,respectively.The suspicious thyroid nodules were classified according to the C-TIRADS guideline,and then the suspicious thyroid nodules were classified again by the low seniority group and the senior group combined with the AI assistant diagnosis system.Taking the pathological results as the gold standard,the diagnostic efficacy of each group was compared,and the sensitivity,specificity,accuracy,positive predictive value,negative predictive value,Jordan index and area under the curve(AUC)were further compared.Results Of the 445 thyroid nodules,there were 277 malignant nodules and 168 benign nodules.The AUCs of thyroid nodules in low seniority group,high seniority group and AI group were 0.760,0.858 and 0.849,respectively.The AUCs in high seniority group and AI group were significantly higher than that in low seniority group(both P<0.001),and the AUC in high seniority group was similar to that in AI group(P>0.05).The AUCs of thyroid nodules in low seniority group and high seniority group combined with AI assistant diagnosis system was higher than those in low seniority group and high seniority group,especially in low seniority group(0.830 vs.0.760,P<0.001).The accuracy,Jordan index and AUC were the highest when TR4C was used as the cut-off point of suspected thyroid nodules.Conclusion The AI assistant diagnosis system based on C-TIRADS has high value in the differential diagnosis of thyroid suspicious nodules,and the combined model can improve the diagnostic efficiency of different seniority doctors.The best cut-off point of different seniority doctors and combined model of AI assistant diagnosis system for differential diagnosis of thyroid suspicious nodules may be TR4C.

Objective:To compare the dose and image quality of selected photon shield (SPS) technique, organ-based tube current modulation (OBTCM) technique and the combination of these two techniques for reducing the organ dose in head CT examination for infants.Methods:Two anthropomorphic head phantoms (CIRS 1-yr-old and 5-yr-old) were scanned by using Reference mode, Reference + OBTCM mode, SPS mode and SPS + OBTCM mode, respectively. Radiation doses to the lens of the eye, the anterior of the brain, the posterior of the brain, noise level and CNR of orbit and brain in different phantoms were measured and compared by using different scanning modes.Results:Compared with Reference mode, the doses to the lens of the eye in 1-yr-old and 5-yr-old phantom decreased by (21.89 ± 0.01)% and (28.33 ± 0.34)%, respectively. In SPS mode, the reduction in doses to the lens of the eye in 1-yr-old and 5-yr-old phantom were (71.38 ± 1.30)% and (53.72 ± 2.42)%, respectively. In SPS + OBTCM mode, the reduction was (71.12 ± 2.54)% and (55.73 ± 1.90)%, respectively. There was significant difference in the noise level of orbit and brain in different phantoms under various scanning modes ( F=5.67-85.47, P< 0.05). The noise level in OBTCM mode compared with reference mode increased slightly (<1.45 HU) in various phantoms. SPS and SPS + OBTCM mode resulted in a small noise increase (<2.58 HU). There was no significant difference in CNR of different phantoms under various scanning modes ( P>0.05). Conclusions:SPS and SPS + OBTCM mode can significantly reduce the radiation dose of lens and the whole image plane in the head CT scan for infants, with maintaining the image quality.

Objective:To explore the effects of continuous nursing based on timing theory on quality of life, self-care ability and caring ability of family caregivers of male patients with first-episode depression.Methods:From March 2018 to March 2020, the convenient sampling was used to select 100 male patients with depression and 100 caregivers who were hospitalized in the First Department of Mood Disorders in the Second Affiliated Hospital of Xinxiang Medical University as the research objects. The patients and their caregivers were divided into the experimental group and the control group by the random number table method, with 50 patients and 50 caregivers in each group. The control group received routine nursing and follow-up, while the experimental group received continuous nursing intervention based on timing theory for 6 months on this basis. Hamilton Depression Scale (HAMD) , Hamilton Anxiety Scale (HAMA) , World Health Organization on Quality of Life Brief Scale (WHOQOL-BREF) , Exercise of Self-Care Agency Scale (ESCA) and Family Caregiver Task Inventory (FCTI) scale were used in the control group and the experimental group. The patients and their families were evaluated at 72 h after admission, at discharge, 3 months after discharge and 6 months after discharge.Results:After the intervention, the scores of HAMA and HAMD in the experimental group were lower than those in the control group, and the scores of each dimension of WHOQOL-BREF were higher than those in the control group, and the differences between the two groups were statistically significant ( P<0.01) . At the time of discharge, 3 months and 6 months after discharge, the total score of the FCTI scale of the caregivers in the experimental group was lower than that of the control group, and the ESCA total score of the patients was higher than that of the control group, and the differences between the two groups were statistically significant ( P<0.01) . Conclusions:Continuous nursing based on timing theory can effectively relieve anxiety and depression of male patients with first-episode depression, improve quality of life and self-care ability of patients and improve the care level of family caregivers.

Objective: To investigate the diagnostic value of whole liver CT perfusion imaging in the quantitative evaluation of hemodynamic changes before and after transcatheter arterial chemoembolization (TACE). Methods: Twenty-six patients with hepatocellular carcinoma underwent TACE therapies were recruited. Whole -liver computed tomographic perfusion imaging (CTPI) was performed 2~3 days before TACE and 1 month after TACE. We measured the following perfusion parameters: hepatic arterial perfusion (HAP), portal venous perfusion (PVP), total liver perfusion (TLP), hepatic arterial perfusion index (HAPI), and time-to-peak (TTP).The F-test, t-test and Rank sum test were used for statistical analysis. Results: A total of 34 HCC lesions were detected. According to the deposition of lipiodol after TACE, they were divided into a lipiodol dense group (21) and a lipiodol light group (13). The length of hepatocellular carcinoma lesions after TACE showed a decreasing trend compared with preoperative TACE. The lesions in the lipiodol dense group had smaller lesions than those in the lipiodol light group. The preoperative and postoperative longitudinal diameters were (3.12 ± 0.58) cm vs. (1.93 ± 0.79) cm, (2.98 ± 2.01) cm vs. (2.58 ± 2.00) cm, the differences were statistically significant (t = 15.1, 8.65, P < 0.05). The preoperative HAP and HPI of the lipiodol dense group were the highest, and the peritumoral within 1cm was higher than that of the surrounding liver parenchyma. The PVP, TLP, and TTP were highest in the surrounding of liver parenchyma, and 1 cm higher than the tumor area in the background. The corresponding perfusion parameters were statistically significant (P < 0.05); HAP and HPI were 1 cm higher than the surrounding liver parenchyma. After the operation, PVP, TLP and TTP were lower than the background liver parenchyma, the difference was statistically significant (P < 0.05); HAP and HPI decreased by 1 cm after the operation, and the PVP, TLP, and TTP increased. There was no significant difference after operation in the blood perfusion of background liver parenchyma (P ˃ 0.05). The HAP and HPI decreased, and the PVP and TTP increased in the lipiodol light group after operation (P < 0.05). There was no significant difference between the other two regions (P ˃ 0.05). Conclusion There was no blood perfusion in the lipiodol deposition area after TACE. The perfusion volume of hepatic artery in the peritumoral 1 cm and lipiodol light group decreased and the portal venous perfusion increased. CTPI can quantitatively evaluate blood perfusion state, which is of great significance for the determination of treatment plans before TACE treatment to assume the postoperative therapeutic effect in liver cancer.

Objective To evaluate the value of MRS in quantitative assessment of degeneration of lumbar discs.Methods Totally 82 patients with lumbago underwent lumbar MR scanning.All the discs were classified with Pfirrmann grades in the sequences of sagittal T2WI.The area under N-acetyl peak,under water peak and the ratio of N-acetyl/Water were measured by MRS.Correlation between MRS values and Pfirrmann grade,age were analyzed.Results In 82 patients,204 lumbar discs were measured by MRS.There were 89,73,39,3 discs in Pfirrmann Ⅱ,Ⅲ,Ⅳ,V respectively.The areas of N-acetyl,water peak and N-acetyl/Water ratio of nucleus region were positively correlated with Pfirrmann grading,respectively (rs =-0.460,-0.204,-0.526,all P＜0.05).There were 62,25,37,51,29 discs in patients aged ＜30,30-39,40-49,50-59,＞59 years respectively.The ares of N-acetyl peak,N-acetyl/Water ratio of nucleus region was negatively correlated with the age (rs=-0.247,-0.385,both P＜0.05).Conclusion MRS can be used for quantitative assessment of lumbar discs degeneration.

BACKGROUND:Total knee replacement is the main treatment for the end of the knee joint disease. How to choose prosthesis replacement according to the different situations of the patient is one of the focuses in the field of joint surgery.
OBJECTIVE: To evaluate middle or short term effects of rotating high-flexion prosthesis for the middle-aged patients with osteoarthritis of knee in total knee replacement.
METHODS: We retrospectively analyzed 48 osteoarthritis patients (55 knees) undergoing total knee replacement with rotating high-flexion prosthesis in the Liuzhou People’s Hospital from January 2009 to January 2013.
RESULTS AND CONCLUSION:(1) Forty-eight patients were folowed up for 23-42 months, mean (24±2.7) months. (2) Knee range of motion and Hospital for Special Surgery knee score were significantly increased after implantation. The excelent and good rate of Hospital for Special Surgery knee score was 85.4%. (3) No infection, loosening or dislocation occurred in al patients. (4) These findings suggest that curative effect of rotating high-flexion prosthesis is definite. After implantation, the range of motion was high, which was accorded with movement pattern of the human body. Prosthesis has a long life, and its repair rate is low. It is an ideal method for the middle-aged patients who want to perform high-flexion activities.

BACKGROUND:Disc functional magnetic resonance imaging studies are mostly carried out under lying and a non-load state, and do not reflect the changes in morphology and function of the upright human body under disc load conditions. Therefore, we need to study characteristics of disc functional magnetic resonance imaging in the upright state. OBJECTIVE: To analyze the effect of axial load on apparent diffusion coefficient and T2 of intervertebral discs. METHODS:The study consisted of 17 patients with low back pain aged 34-65 years. Before and after axial load, T2 weighted MR imaging, T1 weighted MR imaging, diffusion tensor imaging, and T2-mapping imaging of the lumbar spine were performed. Load quality was 40%-50% body weight. At 10 minutes after axial load, another diffusion tensor imaging was performed. After 15-minute load, another T2-mapping sequence was scanned. Diffusion tensor imaging scan parameters: single echo-planar imaging, repetition time 2 500 ms, echo time 89 ms, six diffusion directions, b value of 400 s/mm2, sweep time 4:10 minutes. Raw data of diffusion tensor imaging were used to construct apparent diffusion coefficient map and b0 map. Apparent diffusion coefficient value of intervertebral discs was calculated before and after loading. T2 map was automaticaly constructed using T2-mapping sequence to measure apparent diffusion coefficient and T2 values in the whole intervertebral disc of nucleus pulposus, and the changes of them were analyzed under short-time axial load. RESULTS AND CONCLUSION:Pfirrmann grading results in 17 patients with 85 discs were obtained as folows: 0 in Grade I, 26 in Grade II, 19 in Grade III, 30 in Grade IV, and 10 in Grade V. Al 85 disc T2 relaxation time mapping and 84 disc apparent diffusion coefficient mapping were accepted. Under short-time axial load in 84 discs, apparent diffusion coefficient reduced in the whole disc (reduced 38×10-3 mm2/s,Z=2.567,P < 0.05) and nucleus pulposus (reduced 62×10-3mm2/s,Z=3.461,P < 0.05). Apparent diffusion coefficient changes mainly affected Grade Pfirrmann III discs (reduced 55×10-3mm2/s,Z=2.556,P < 0.05). T2 changes mainly affected normal intervertebral discs (Pfirrmann grade II). Under the load, T2 value of intervertebral discs diminished (reduced 3.17 ms,Z=2.967,P < 0.05). No significant difference in apparent diffusion coefficient and T2 value was detected under the load in other grades of the intervertebral discs (P > 0.05). These results suggest that changes in apparent diffusion coefficient and T2 values were different due to different Pfirrmann grades under short-time axial load. To evaluate magnetic resonance imaging function of intervertebral discs, we should choose different evaluation method according to different degeneration degrees.

OBJECTIVEThe objective of this paper is to investigate the pharmacokinetics of Chlorogenic acid (CA)and CA-Baicalin compound after intravenous injection (iv) in rabbits.

METHODTen rabbits were randomly divided into two groups. One group were administered CA (6 mg x kg(-1)) by iv, while the other were treated with CA (6 mg x kg(-1))-baicalin (90 mg x kg(-1)) compound by iv. administration. The concentration of CA in plasma was determined by HPLC. The key parameters of pharmacokinetics were calculated and analyzed by kinetic software.

RESULTBoth Concentration-time courses of CA alone and CA-Baicalin compound were consistent with a two-compartment model after administration. The key pharmacokinetic parameters of CA alone were significantly different from that of CA-Baicalin compound (P < 0.05). Compared with the group treated with CA alone, the group treated with CA-Baicalin compound had dramatic increased in AUC(0-infinity), MRT and T1/2alpha.

CONCLUSIONThere are significant difference between the pharmacokinetics of CA and CA-Baicalin compound in rabbits. Baicalin has impact on the pharmacokinetics of CA in rabbits.

Animals ; Calibration ; Chlorogenic Acid ; administration & dosage ; pharmacokinetics ; Flavonoids ; pharmacology ; Injections, Intravenous ; Linear Models ; Male ; Rabbits ; Tissue Distribution ; drug effects