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Wang W, Jiang T, Zhang J, Liu J, Chan LC, Lin M, Li J, Ding C, Chiu KY, Fu H, Chan PK, Wen C. Subchondral bone expansion in advanced knee osteoarthritis: Relation with radiographic severity and role in surgical decision-making. Osteoarthr Cartil Open 2024; 6:100461. [PMID: 38558888 PMCID: PMC10979271 DOI: 10.1016/j.ocarto.2024.100461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 02/28/2024] [Accepted: 03/11/2024] [Indexed: 04/04/2024] Open
Abstract
Background Joint space width (JSW) is a traditional imaging marker for knee osteoarthritis (OA) severity, but it lacks sensitivity in advanced cases. We propose tibial subchondral bone area (TSBA), a new CT imaging marker to explore its relationship with OA radiographic severity, and to test its performance for classifying surgical decisions between unicompartmental knee arthroplasty (UKA) and total knee arthroplasty (TKA) compared to JSW. Methods We collected clinical, radiograph, and CT data from 182 patients who underwent primary knee arthroplasty (73 UKA, 109 TKA). The radiographic severity was scored using Kellgren-Lawrence (KL) grading system. TSBA and JSW were extracted from 3D CT-reconstruction model. We used independent t-test to investigate the relationship between TSBA and KL grade, and binary logistic regression to identify factors associated with TKA risk. The accuracy of TSBA, JSW and established classification model in differentiating between UKA and TKA was assessed using AUC. Results All parameters exhibited inter- and intra-class coefficients greater than 0.966. Patients with KL grade 4 had significantly larger TSBA than those with KL grade 3. TSBA (0.708 of AUC) was superior to minimal/average JSW (0.547/0.554 of AUC) associated with the risk of receiving TKA. Medial TSBA, together with gender and Knee Society Knee Score, emerged as independent classification factors in multivariate analysis. The overall AUC of composite model for surgical decision-making was 0.822. Conclusion Tibial subchondral bone area is an independent imaging marker for radiographic severity, and is superior to JSW for surgical decision-making between UKA and TKA in advanced OA patients.
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Affiliation(s)
- Wei Wang
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Tianshu Jiang
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Jiang Zhang
- Department of Health Technology and Informatics, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Jun Liu
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Lok Chun Chan
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong SAR, China
- Research Institute of Smart Ageing, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Mengqi Lin
- Department of Software Engineering, Faculty of Electrical and Computer Engineering, Jilin Jianzhu University, Changchun, China
| | - Jia Li
- Department of Orthopedics, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Changhai Ding
- Clinical Research Center, Zhujiang Hospital, Southern Medical University, Guangzhou, China
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Kwong Yuen Chiu
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong SAR, China
| | - Henry Fu
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong SAR, China
| | - Ping Keung Chan
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong SAR, China
| | - Chunyi Wen
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong SAR, China
- Research Institute of Smart Ageing, The Hong Kong Polytechnic University, Hong Kong SAR, China
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Xu D, Zhang AL, Zheng JS, Ye MW, Li F, Qian GC, Shi HB, Jin XH, Huang LP, Mei JG, Mei GH, Xu Z, Fu H, Lin JJ, Ye HZ, Zheng Y, Hua LL, Yang M, Tong JM, Chen LL, Zhang YY, Yang DH, Zhou YL, Li HW, Lan YL, Xu YL, Feng JY, Chen X, Gong M, Chen ZM, Wang YS. [A multicenter prospective study on early identification of refractory Mycoplasma pneumoniae pneumonia in children]. Zhonghua Er Ke Za Zhi 2024; 62:317-322. [PMID: 38527501 DOI: 10.3760/cma.j.cn112140-20231121-00383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 03/27/2024]
Abstract
Objective: To explore potential predictors of refractory Mycoplasma pneumoniae pneumonia (RMPP) in early stage. Methods: The prospective multicenter study was conducted in Zhejiang, China from May 1st, 2019 to January 31st, 2020. A total of 1 428 patients with fever >48 hours to <120 hours were studied. Their clinical data and oral pharyngeal swab samples were collected; Mycoplasma pneumoniae DNA in pharyngeal swab specimens was detected. Patients with positive Mycoplasma pneumoniae DNA results underwent a series of tests, including chest X-ray, complete blood count, C-reactive protein, lactate dehydrogenase (LDH), and procalcitonin. According to the occurrence of RMPP, the patients were divided into two groups, RMPP group and general Mycoplasma pneumoniae pneumonia (GMPP) group. Measurement data between the 2 groups were compared using Mann-Whitney U test. Logistic regression analyses were used to examine the associations between clinical data and RMPP. Receiver operating characteristic (ROC) curves were used to analyse the power of the markers for predicting RMPP. Results: A total of 1 428 patients finished the study, with 801 boys and 627 girls, aged 4.3 (2.7, 6.3) years. Mycoplasma pneumoniae DNA was positive in 534 cases (37.4%), of whom 446 cases (83.5%) were diagnosed with Mycoplasma pneumoniae pneumonia, including 251 boys and 195 girls, aged 5.2 (3.3, 6.9) years. Macrolides-resistant variation was positive in 410 cases (91.9%). Fifty-five cases were with RMPP, 391 cases with GMPP. The peak body temperature before the first visit and LDH levels in RMPP patients were higher than that in GMPP patients (39.6 (39.1, 40.0) vs. 39.2 (38.9, 39.7) ℃, 333 (279, 392) vs. 311 (259, 359) U/L, both P<0.05). Logistic regression showed the prediction probability π=exp (-29.7+0.667×Peak body temperature (℃)+0.004×LDH (U/L))/(1+exp (-29.7+0.667×Peak body temperature (℃)+0.004 × LDH (U/L))), the cut-off value to predict RMPP was 0.12, with a consensus of probability forecast of 0.89, sensitivity of 0.89, and specificity of 0.67; and the area under ROC curve was 0.682 (95%CI 0.593-0.771, P<0.01). Conclusion: In MPP patients with fever over 48 to <120 hours, a prediction probability π of RMPP can be calculated based on the peak body temperature and LDH level before the first visit, which can facilitate early identification of RMPP.
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Affiliation(s)
- D Xu
- Department of Pulmonology, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310052, China
| | - A L Zhang
- Department of Pediatrics, the Second Hospital of Jiaxing, Jiaxing 314001, China
| | - J S Zheng
- Department of Pediatrics, Ningbo Women and Children's Hospital, Ningbo 315012, China
| | - M W Ye
- Department of Pediatrics, Sanmen People's Hospital, Taizhou 317199, China
| | - F Li
- Department of Pediatrics, Shaoxing Second Hospital, Shaoxing 312099, China
| | - G C Qian
- Department of Pediatrics, Changxing Maternal and Child Health Care Hospital, Huzhou 313199, China
| | - H B Shi
- Department of Pediatrics, Ningbo Medical Center Lihuili Hospital, Ningbo 315048, China
| | - X H Jin
- Department of Pediatrics, Taizhou Hospital of Zhejiang Province, Taizhou 317099, China
| | - L P Huang
- Department of Pediatrics, Zhoushan Women and Children's Hospital, Zhoushan 316004, China
| | - J G Mei
- Department of Pediatrics, Cixi Maternal and Child Health Care Hospital, Ningbo 315331, China
| | - G H Mei
- Department of Pediatrics, Quzhou Maternal and Child Health Care Hospital, Quzhou 324003, China
| | - Z Xu
- Department of Pediatrics, Huzhou Central Hospital, Huzhou 313099, China
| | - H Fu
- Department of Pediatrics, Shengsi People's Hospital, Zhoushan 202450, China
| | - J J Lin
- Department of Pediatrics, Lishui City People's Hospital, Lishui 323050, China
| | - H Z Ye
- Department of Pediatrics, the First People's Hospital of Huzhou, Huzhou 313099, China
| | - Y Zheng
- Department of Pediatrics, People's Hospital of Quzhou, Quzhou 324002, China
| | - L L Hua
- Department of Pediatrics, Ningbo Women and Children's Hospital, Ningbo 315012, China
| | - M Yang
- Department of Pediatrics, Sanmen People's Hospital, Taizhou 317199, China
| | - J M Tong
- Department of Pediatrics, Changxing Maternal and Child Health Care Hospital, Huzhou 313199, China
| | - L L Chen
- Department of Pediatrics, Taizhou Hospital of Zhejiang Province, Taizhou 317099, China
| | - Y Y Zhang
- Department of Pulmonology, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310052, China
| | - D H Yang
- Department of Pulmonology, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310052, China
| | - Y L Zhou
- Department of Pulmonology, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310052, China
| | - H W Li
- Department of Pulmonology, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310052, China
| | - Y L Lan
- Department of Pulmonology, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310052, China
| | - Y L Xu
- Department of Pediatrics, Zhoushan Women and Children's Hospital, Zhoushan 316004, China
| | - J Y Feng
- Department of Pediatrics, Cixi Maternal and Child Health Care Hospital, Ningbo 315331, China
| | - X Chen
- Department of Pediatrics, Huzhou Central Hospital, Huzhou 313099, China
| | - M Gong
- Department of Pediatrics, People's Hospital of Quzhou, Quzhou 324002, China
| | - Z M Chen
- Department of Pulmonology, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310052, China
| | - Y S Wang
- Department of Pulmonology, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310052, China
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Hu M, Xu T, Xu K, Guo YK, Yu L, Xu HY, Cai XT, Fu H. [Characteristics and changes of cardiac injury with age in children of Duchenne muscular dystrophy: a prospective cohort study]. Zhonghua Er Ke Za Zhi 2024; 62:223-230. [PMID: 38378283 DOI: 10.3760/cma.j.cn112140-20230905-00158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 02/22/2024]
Abstract
Objective: To explore the characteristics and changes of cardiac injury with age in Duchenne muscular dystrophy (DMD) and its clinical significance. Methods: A prospective cohort study was conducted. The 215 patients diagnosed with DMD in West China Second Hospital from January 2019 to November 2022 and aged from 6 to 18 years were enrolled. Their clinical data, myocardial injury markers, routine electrocardiogram, cardiac magnetic resonance (CMR) and echocardiography were collected. The patients were divided into five age groups: 6-<8, 8-<10, 10-<12, 12-<14 and 14-18 years of age, and matched with healthy boys respectively. Independent sample t test or Mann-Whitney U test was used to compare the clinical data and CMR indexes between DMD patients and controls in all age subgroups, and to compare the value of left ventricular ejection fraction (LVEF) measured by echocardiography and CMR in each subgroup of DMD patitents. Pearson correlation analysis or Spearman correlation analysis was used to explore the relation between the CMR indexes and age in DMD patients. Results: A total of 215 patients with DMD (all male) and 122 healthy boys were included in the study. There were 75 DMD patients and 23 controls in 6-<8 years of age group, 77 DMD and 28 controls in 8-<10 years of age group, 39 DMD and 23 controls in 10-<12 years of age group, 10 DMD and 31 controls in the 12-<14 years of age group, and 14 DMD and 17 controls in 14-18 years of age group. In the DMD patients, the older the age, the lower the levels of creatine kinase (CK) and creatine kinase isoenzyme (CK-MB). In the 6-<8 years of age group, the CK level was 10 760 (7 800, 15 757) U/L, while in the group of 14-18 years of age, it was 2 369 (1 480, 6 944) U/L. As for CK-MB, it was (189±17) μg/L in the 6-<8 years of age group and (62±16) μg/L in the 14-18 years of age group. Cardiac troponin I remained unchanged in <12 years of age groups, but significantly increased in 12-<14 years of age group, reaching the highest value of 0.112 (0.006, 0.085) μg/L. In the DMD patients, the older the age, the higher the proportion of abnormal electrocardiogram (ECG). In the 6-<8 years of age group, the proportion is 29.3% (22/75), while in the 14-18 years of age group, it was 10/14. Correlation analysis showed that the left ventricular end-diastolic volume index was positively related with age (r=0.18, P=0.015), and the left ventricular stroke volume index and cardiac output index were negatively related with age (r=-0.34 and -0.31, respectively, both P<0.001). In the DMD patients, the older the age, the lower LVEF, with the LVEF decreasing to (49.3±3.1)% in the 14-18 years of age group. The LVEF of DMD cases was significantly lower than that of controls in the age subgroups of 8-<10, 10-<12, 12-<14 and 14-18 years of age groups ((57.9±5.2) % vs. (63.6±0.8)%, 60.7% (55.9%, 61.9%) vs. 63.7% (60.2%, 66.0%), 57.1% (51.8%, 63.4%) vs. 62.1 % (59.5%, 64.5)%, (49.3±3.1) % vs. (61.6±1.3)%, respectively; all P<0.01). In the DMD patients, the older the age, the higher the proportion of positive late gadolinium enhancement (LGE). In the 6-<8 years of age group, it was 22% (11/51), in the 12-<14 years of age group, it was 13/14, and in the 14-18 years of age group, all DMD showed positive LGE. The value of LVEF of DMD cases measured by echocardiography was significantly higher than that measured by CMR in 6-<8 years of age group and 8-<10 years of age group (63.2% (60.1%, 66.4%) vs. 59.1 % (55.4%, 62.9%), and (62.8±5.2) % vs. (57.9±5.2)%, all P<0.001). Conclusion: DMD patients develop cardiac injury in the early stage of the disease, and the incidence of cardiac damage gradually increases with both age and the progression of disease.
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Affiliation(s)
- M Hu
- Department of Radiology, West China Second Hospital, Sichuan University, Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth Defect of Ministry of Education, Chengdu 610041, China
| | - T Xu
- Department of Radiology, West China Second Hospital, Sichuan University, Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth Defect of Ministry of Education, Chengdu 610041, China
| | - K Xu
- Department of Radiology, West China Second Hospital, Sichuan University, Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth Defect of Ministry of Education, Chengdu 610041, China
| | - Y K Guo
- Department of Radiology, West China Second Hospital, Sichuan University, Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth Defect of Ministry of Education, Chengdu 610041, China
| | - L Yu
- Department of Medical Record Management, West China Second Hospital, Sichuan University, Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth Defect of Ministry of Education, Chengdu 610041, China
| | - H Y Xu
- Department of Radiology, West China Second Hospital, Sichuan University, Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth Defect of Ministry of Education, Chengdu 610041, China
| | - X T Cai
- Department of Rehabilitation, West China Second Hospital, Sichuan University, Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth Defect of Ministry of Education, Chengdu 610041, China
| | - H Fu
- Department of Radiology, West China Second Hospital, Sichuan University, Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth Defect of Ministry of Education, Chengdu 610041, China
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Yee AHF, Chan VWK, Fu H, Chan PK, Chiu KY. Long-term follow-up of an uncemented proximally hydroxyapatite-coated femoral stem in total hip arthroplasty. Bone Joint J 2024; 106-B:110-114. [PMID: 38423107 DOI: 10.1302/0301-620x.106b3.bjj-2023-0844.r1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
Aims The aim of this study was to evaluate the survival of a collarless, straight, hydroxyapatite-coated femoral stem in total hip arthroplasty (THA) at a minimum follow-up of 20 years. Methods We reviewed the results of 165 THAs using the Omnifit HA system in 138 patients, performed between August 1993 and December 1999. The mean age of the patients at the time of surgery was 46 years (20 to 77). Avascular necrosis was the most common indication for THA, followed by ankylosing spondylitis and primary osteoarthritis. The mean follow-up was 22 years (20 to 31). At 20 and 25 years, 113 THAs in 91 patients and 63 THAs in 55 patients were available for review, respectively, while others died or were lost to follow-up. Kaplan-Meier analysis was performed to evaluate the survival of the stem. Radiographs were reviewed regularly, and the stability of the stem was evaluated using the Engh classification. Results A total of seven stems (4.2%) were revised during the study period: one for aseptic loosening, three for periprosthetic fracture, two for infection, and one for recurrent dislocation. At 20 years, survival with revision of the stem for any indication and for aseptic loosening as the endpoint was 96.0% (95% confidence interval (CI) 92.6 to 99.5) and 98.4% (95% CI 96.2 to 100), respectively. At 25 years, the corresponding rates of survival were 94.5% (95% CI 89.9 to 99.3) and 98.1% (95% CI 95.7 to 99.6), respectively. There was radiological evidence of stable bony fixation in 86 stems (76.1%) and evidence of loosening in four (3.5%) at 20 years. All patients with radiological evidence of loosening were asymptomatic. Conclusion The Omnifit HA femoral stem offered promising long-term survival into the third decade.
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Affiliation(s)
- Andy H F Yee
- Department of Orthopaedics and Traumatology, Queen Mary Hospital, Hong Kong, Hong Kong
- Department of Orthopaedics and Traumatology, School of Clinical Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong, Hong Kong
| | - Vincent W K Chan
- Department of Orthopaedics and Traumatology, Queen Mary Hospital, Hong Kong, Hong Kong
- Department of Orthopaedics and Traumatology, School of Clinical Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong, Hong Kong
| | - Henry Fu
- Department of Orthopaedics and Traumatology, Queen Mary Hospital, Hong Kong, Hong Kong
- Department of Orthopaedics and Traumatology, School of Clinical Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong, Hong Kong
| | - Ping-Keung Chan
- Department of Orthopaedics and Traumatology, Queen Mary Hospital, Hong Kong, Hong Kong
- Department of Orthopaedics and Traumatology, School of Clinical Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong, Hong Kong
| | - Kwong Y Chiu
- Department of Orthopaedics and Traumatology, Queen Mary Hospital, Hong Kong, Hong Kong
- Department of Orthopaedics and Traumatology, School of Clinical Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong, Hong Kong
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Ye HP, Fu H, Shao J, Shan XY, Zhang L, Zhang L. [The method of determination for 2, 3-Butanedione in the air of workplace by high performance liquid chromatography with derivatization]. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi 2024; 42:129-132. [PMID: 38403422 DOI: 10.3760/cma.j.cn121094-20221201-00574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/27/2024]
Abstract
Objective: To establish a method for the determination of 2, 3-Butanedione (BUT) in the air of workplace, which including the process of collection by absorption in phosphoric acid aqueous solution and the process of analysis and detection by high performance liquid chromatography with derivatization. Methods: In October 2022, a porous glass plate absorption tube containing 10 ml of 0.01% phosphoric acid solution was used to collect BUT in the air of the workplace at a flow rate of 0.2 L/min. The absorption solution was derived by 2, 4-dinitrophenylhydrazine for 75 min and separated on a SB-C18 column (250 mm×4.6 mm, 5 μm) . At the column temperature of 30 ℃, the mixture of acetonitrile-water (V∶V, 1∶1) was eluted at the flow rate of 1.0 ml/min. It was detected by UV detector (λ=365 nm) , qualitatived by retention time and quantitatived by external standard. Results: It showed that BUT in phosphoric acid aqueous solution could be stored for at least 7 d at 4 ℃. There was a linear relationship within the determination range of 0.05-6.00 μg/ml, the linear regression equation was y=89.610x+0.133, r=0.9999. The sampling absorption efficiencies were 98.33%-100.00%, the detection limit of the method was 0.005 μg/ml, the minimum detection concentration was 0.016 mg/m(3) (based on V(0)=3.0 L) . The recovery rates were 95.96%-102.44%, the intra batch precision were 4.36%-7.78%, and the inter batch precision were 4.96%-6.06%. Conclusion: The method has the advantages of simple operation, high sensitivity and good accuracy. It can prevent the loss and degradation of BUT. It can be used for the determination of BUT in the air of workplace.
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Affiliation(s)
- H P Ye
- Health Testing Department, Hangzhou Occupational Disease Prevention and Control Hospital, Hangzhou 310014, China
| | - H Fu
- Health Testing Department, Hangzhou Occupational Disease Prevention and Control Hospital, Hangzhou 310014, China
| | - J Shao
- Health Testing Department, Hangzhou Occupational Disease Prevention and Control Hospital, Hangzhou 310014, China
| | - X Y Shan
- Health Testing Department, Hangzhou Occupational Disease Prevention and Control Hospital, Hangzhou 310014, China
| | - L Zhang
- Health Testing Department, Hangzhou Occupational Disease Prevention and Control Hospital, Hangzhou 310014, China
| | - L Zhang
- Health Testing Department, Hangzhou Occupational Disease Prevention and Control Hospital, Hangzhou 310014, China
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Zhu AA, Cao CJ, Zhang L, Li JT, Fu H, Zhu KQB. [Application of Delphi method and analytic hierarchy process to construct the evaluation index system of healthy enterprises]. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi 2024; 42:112-117. [PMID: 38403419 DOI: 10.3760/cma.j.cn121094-20221201-00571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 02/27/2024]
Abstract
Objective: Explore the application of Delphi method and analytic hierarchy process to explore the construction of scientific, objective and comprehensive evaluation index system for healthy enterprise construction and promote the construction of healthy enterprises. Methods: In October 2022, through Delphi expert consultation and analytic hierarchy process, the indexes were screened and the weights of the indexes were determined, and the evaluation index system of healthy enterprises was established. Results: The positive coefficients of experts in the two rounds were all 100.00%, the authority coefficient of experts was 0.82, the coefficients of variation of the indexes in the two rounds were all less than 0.30. The coordination coefficients of experts in the first and second rounds were 0.64 and 0.77, respectively (P<0.001) . After two rounds of Delphi method expert consultation, a healthy enterprise evaluation index system including 4 first-level indexes, 14 second-level indexes, and 63 third-level indexes was constructed. Conclusion: The constructed health enterprise evaluation index system is highly scientific and reliable, covering the main factors of healthy enterprise construction, and providing a reliable and quantifiable basis and self-assessment basis for the establishment of healthy enterprises.
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Affiliation(s)
- A A Zhu
- Medical Science and Education Department of Hangzhou Hospital for the Prevention and Treatment of Occupational Diseases, Hangzhou 310014, China
| | - C J Cao
- Dean's Office of Hangzhou Hospital for the Prevention and Treatment of Occupational Diseases, Hangzhou 310014, China
| | - L Zhang
- Dean's Office of Hangzhou Hospital for the Prevention and Treatment of Occupational Diseases, Hangzhou 310014, China
| | - J T Li
- Health City Evaluation Department of Hangzhou Municipal Health City Guidance Center, Hangzhou 310000, China
| | - H Fu
- Occupational Health Department of Hangzhou Hospital for the Prevention and Treatment of Occupational Diseases, Hangzhou 310014, China
| | - K Q B Zhu
- School of Pubilic Health of Hangzhou Normal University, Hangzhou 310000, China
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Khoo JR, Chan PK, Wen C, Lau LCM, Leung TKC, Luk MH, Chan VWK, Cheung A, Cheung MH, Fu H, Chiu KY. Feasible non-surgical options for management of knee osteoarthritis during the COVID-19 pandemic and beyond. Hong Kong Med J 2024; 30:56-61. [PMID: 38369959 DOI: 10.12809/hkmj2210209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2024] Open
Affiliation(s)
- J R Khoo
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong SAR, China
| | - P K Chan
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong SAR, China
| | - C Wen
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - L C M Lau
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong SAR, China
| | - T K C Leung
- Department of Orthopaedics and Traumatology, Queen Mary Hospital, Hong Kong SAR, China
| | - M H Luk
- Department of Orthopaedics and Traumatology, Queen Mary Hospital, Hong Kong SAR, China
| | - V W K Chan
- Department of Orthopaedics and Traumatology, Queen Mary Hospital, Hong Kong SAR, China
| | - A Cheung
- Department of Orthopaedics and Traumatology, Queen Mary Hospital, Hong Kong SAR, China
| | - M H Cheung
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong SAR, China
| | - H Fu
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong SAR, China
| | - K Y Chiu
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong SAR, China
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Chan HMH, Fu H, Chiu KY. Tuberculosis of the knee as a great mimicker of inflammatory arthritis: a case report. Hong Kong Med J 2023; 29:548-550. [PMID: 37914670 DOI: 10.12809/hkmj2210277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2023] Open
Affiliation(s)
- H M H Chan
- Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - H Fu
- Department of Orthopaedics and Traumatology, School of Clinical Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - K Y Chiu
- Department of Orthopaedics and Traumatology, School of Clinical Medicine, The University of Hong Kong, Hong Kong SAR, China
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Chan VWK, Chan PK, Fu H, Cheung MH, Cheung A, Tang TCM, Chiu KY. Prediction of Total Knee Arthroplasty Sizes with Demographics, including Hand and Foot Sizes. J Knee Surg 2023. [PMID: 37879355 DOI: 10.1055/a-2198-7983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2023]
Abstract
Anticipating implant sizes before total knee arthroplasty (TKA) allows the surgical team to streamline operations and prepare for potential difficulties. This study aims to determine the correlation and derive a regression model for predicting TKA sizes using patient-specific demographics without using radiographs. We reviewed the demographics, including hand and foot sizes, of 1,339 primary TKAs. To allow for comparison across different TKA designs, we converted the femur and tibia sizes into their anteroposterior (AP) and mediolateral (ML) dimensions. Stepwise multivariate regressions were performed to analyze the data. Regarding the femur component, the patient's foot, gender, height, hand circumference, body mass index, and age was the significant demographic factors in the regression analysis (R-square 0.541, p < 0.05). For the tibia component, the significant factors in the regression analysis were the patient's foot size, gender, height, hand circumference, and age (R-square 0.608, p < 0.05). The patient's foot size had the highest correlation coefficient for both femur (0.670) and tibia (0.697) implant sizes (p < 0.05). We accurately predicted the femur component size exactly, within one and two sizes in 49.5, 94.2, and 99.9% of cases, respectively. Regarding the tibia, the prediction was exact, within one and two sizes in 53.0, 96.0, and 100% of cases, respectively. The regression model, utilizing patient-specific characteristics, such as foot size and hand circumference, accurately predicted TKA femur and tibia sizes within one component size. This provides a more efficient alternative for preoperative planning.
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Affiliation(s)
- Vincent W K Chan
- Department of Orthopaedics and Traumatology, Division of Joint Replacement Surgery, The University of Hong Kong, Queen Mary Hospital, Hong Kong SAR, China
| | - Ping Keung Chan
- Department of Orthopaedics and Traumatology, Division of Joint Replacement Surgery, The University of Hong Kong, Queen Mary Hospital, Hong Kong SAR, China
| | - Henry Fu
- Department of Orthopaedics and Traumatology, Division of Joint Replacement Surgery, The University of Hong Kong, Queen Mary Hospital, Hong Kong SAR, China
| | - Man Hong Cheung
- Department of Orthopaedics and Traumatology, Division of Joint Replacement Surgery, The University of Hong Kong, Queen Mary Hospital, Hong Kong SAR, China
| | - Amy Cheung
- Department of Orthopaedics and Traumatology, Division of Joint Replacement Surgery, The University of Hong Kong, Queen Mary Hospital, Hong Kong SAR, China
| | - Thomas C M Tang
- Department of Orthopaedics and Traumatology, Division of Joint Replacement Surgery, The University of Hong Kong, Queen Mary Hospital, Hong Kong SAR, China
| | - Kwong Yuen Chiu
- Department of Orthopaedics and Traumatology, Division of Joint Replacement Surgery, The University of Hong Kong, Queen Mary Hospital, Hong Kong SAR, China
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Chen H, Chan VWK, Yan CH, Fu H, Chan PK, Chiu K. The effect of the surgical helmet system on intraoperative contamination in arthroplasty surgery. Bone Jt Open 2023; 4:859-864. [PMID: 37952558 PMCID: PMC10640923 DOI: 10.1302/2633-1462.411.bjo-2023-0078.r1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2023] Open
Abstract
Aims The surgical helmet system (SHS) was developed to reduce the risk of periprosthetic joint infection (PJI), but the evidence is contradictory, with some studies suggesting an increased risk of PJI due to potential leakage through the glove-gown interface (GGI) caused by its positive pressure. We assumed that SHS and glove exchange had an impact on the leakage via GGI. Methods There were 404 arthroplasty simulations with fluorescent gel, in which SHS was used (H+) or not (H-), and GGI was sealed (S+) or not (S-), divided into four groups: H+S+, H+S-, H-S+, and H-S-, varying by exposure duration (15 to 60 minutes) and frequency of glove exchanges (0 to 6 times). The intensity of fluorescent leakage through GGI was quantified automatically with an image analysis software. The effect of the above factors on fluorescent leakage via GGI were compared and analyzed. Results The leakage intensity increased with exposure duration and frequency of glove exchanges in all groups. When SHS was used and GGI was not sealed (H+S-), the leakage intensity via GGI had the fastest increase, consistently higher than other groups (H+S+, H-S+ and H-S-) after 30 minutes (p < 0.05) and when there were more than four instances of glove exchange (p < 0.05). Additionally, the leakage was strongly correlated with the duration of exposure (rs = 0.8379; p < 0.050) and the frequency of glove exchange (rs = 0.8198; p < 0.050) in H+S-. The correlations with duration and frequency turned weak when SHS was not used (H-) or GGI was sealed off (S+). Conclusion Due to personal protection, SHS is recommended in arthroplasties. Meanwhile, it is strongly recommended to seal the GGI of the inner gloves and exchange the outer gloves hourly to reduce the risk of contamination from SHS.
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Affiliation(s)
- Hongtai Chen
- Division of Joint Replacement Surgery, Department of Orthopaedics and Traumatology, The University of Hong Kong, Queen Mary Hospital, Hong Kong, China
| | - Vincent W. K. Chan
- Division of Joint Replacement Surgery, Department of Orthopaedics and Traumatology, The University of Hong Kong, Queen Mary Hospital, Hong Kong, China
| | - Chun H. Yan
- Division of Joint Replacement Surgery, Department of Orthopaedics and Traumatology, The University of Hong Kong, Queen Mary Hospital, Hong Kong, China
| | - Henry Fu
- Division of Joint Replacement Surgery, Department of Orthopaedics and Traumatology, The University of Hong Kong, Queen Mary Hospital, Hong Kong, China
| | - Ping-Keung Chan
- Division of Joint Replacement Surgery, Department of Orthopaedics and Traumatology, The University of Hong Kong, Queen Mary Hospital, Hong Kong, China
| | - KwongYuen Chiu
- Division of Joint Replacement Surgery, Department of Orthopaedics and Traumatology, The University of Hong Kong, Queen Mary Hospital, Hong Kong, China
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Yeung MHY, Fu H, Cheung A, Kwan VCW, Cheung MH, Chan PK, Chiu KY, Yan CH. Robotic arm-assisted unicondylar knee arthroplasty resulted in superior radiological accuracy: a propensity score-matched analysis. Arthroplasty 2023; 5:55. [PMID: 37915082 PMCID: PMC10621242 DOI: 10.1186/s42836-023-00210-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 09/01/2023] [Indexed: 11/03/2023] Open
Abstract
INTRODUCTION Unicompartmental knee arthroplasty (UKA) is an effective surgical treatment for medial compartment arthritis of the knee, yet surgical outcomes are directly related to surgical execution. Robotic arm-assisted surgery aims to address these difficulties by allowing for detailed preoperative planning, real-time intraoperative assessment and haptic-controlled bone removal. This study aimed to compare the clinical and radiological outcomes between conventional manual mobile bearing and robot arm-assisted fixed bearing medial UKA in our local population. MATERIALS AND METHODS This is a retrospective case-control study of 148 UKAs performed at an academic institution with a minimum of 1-year follow-up. 74 robotic arm-assisted UKAs were matched to 74 conventional UKAs via propensity score matching. Radiological outcomes included postoperative mechanical axis and individual component alignment. Clinical parameters included a range of motion, Knee Society knee score and functional assessment taken before, 6 and 12 months after the operation. RESULTS Robot arm-assisted UKA produced a more neutral component coronal alignment in both femoral component (robotic -0.2 ± 2.8, manual 2.6 ± 2.3; P = 0.043) and tibial component (robotic -0.3 ± 4.0, manual 1.7 ± 5.3; P < 0.001). While the postoperative mechanical axis was comparable, robot arm-assisted UKA demonstrated a smaller posterior tibial slope (robotic 5.7 ± 2.7, manual 8.2 ± 3.3; P = 0.02). Clinical outcomes did not show any statistically significant differences. CONCLUSION Compared with conventional UKA, robotic arm-assisted UKA demonstrated improved component alignment and comparable clinical outcomes. Improved radiological accuracy with robotic-arm assistance demonstrated promising early results.
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Affiliation(s)
- Matthew H Y Yeung
- Li Ka Shing Faculty of Medicine, School of Clinical Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Henry Fu
- Department of Orthopaedics and Traumatology, School of Clinical Medicine, The University of Hong Kong, Hong Kong SAR, China.
| | - Amy Cheung
- Department of Orthopaedics and Traumatology, Queen Mary Hospital, Hong Kong SAR, China
| | - Vincent Chan Wai Kwan
- Department of Orthopaedics and Traumatology, Queen Mary Hospital, Hong Kong SAR, China
| | - Man Hong Cheung
- Department of Orthopaedics and Traumatology, School of Clinical Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Ping Keung Chan
- Department of Orthopaedics and Traumatology, School of Clinical Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Kwong Yuen Chiu
- Department of Orthopaedics and Traumatology, School of Clinical Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Chun Hoi Yan
- Department of Orthopaedics and Traumatology, Gleneagles Hospital Hong Kong, Hong Kong SAR, China
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Cheung A, Chan PK, Fu H, Cheung MH, Chan VWK, Luk MH, Chiu KY. Metal-on-crosslinked polyethylene in total hip arthroplasty - an excellent combination at fifteen to twenty years of follow-up. Int Orthop 2023; 47:2547-2552. [PMID: 37247019 DOI: 10.1007/s00264-023-05844-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 05/15/2023] [Indexed: 05/30/2023]
Abstract
PURPOSE Cross-linked polyethylene (PE) has been used with great clinical success in total hip arthroplasty (THA) since its debut in the late 1990's. However, reports regarding this bearing couple near the end of its second decade of service are still scant. The aim of this study was to first determine the long term clinical and radiological results and second Investigate what factors affect wear rates using a metal-on-crosslinked PE bearing articulation. METHODS 55 THAs using a single brand of cross-linked liner, cementless cup and 28 mm hip ball were performed in 44 patients. Age, sex, Charlson Comorbidity Index (CCI) and need for revision surgery were recorded. Linear and volumetric wear was determined using the Martell method. RESULTS Mean age at operation was 51.2 (29-73 ± 12.1) years. Mean duration of follow-up was 16.9 years (range 15.0-20.1 ± 1.1 years). Osteolysis was not present in the latest follow-up radiographs. Median linear and volumetric wear rate was 0.038 mm/year (95% CI 0.032-0.047) and 7.115mm3/year (95% CI 6.92-17.25) respectively. Acetabular component position was not found to be related to both linear and volumetric wear. No significant difference was found in the linear and volumetric wear rates of thinner and thicker liners (8 mm or below and > 8 mm) (p = 0.849 and p = 0.64 respectively). CONCLUSION Metal-on-crosslinked PE is associated with low linear and volumetric wear rates which has virtually obviated osteolysis and has translated to excellent survivorship even at long term follow up. In-vivo oxidation does not appear to be of clinical concern at this point.
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Affiliation(s)
- Amy Cheung
- Department of Orthopaedics and Traumatology, Queen Mary Hospital, 102 Pok Fu Lam Road, Pok Fu Lam, Hong Kong SAR, China.
| | - Ping Keung Chan
- Department of Orthopaedics and Traumatology, Queen Mary Hospital, 102 Pok Fu Lam Road, Pok Fu Lam, Hong Kong SAR, China
| | - Henry Fu
- Department of Orthopaedics and Traumatology, Queen Mary Hospital, 102 Pok Fu Lam Road, Pok Fu Lam, Hong Kong SAR, China
| | - Man Hong Cheung
- Department of Orthopaedics and Traumatology, Queen Mary Hospital, 102 Pok Fu Lam Road, Pok Fu Lam, Hong Kong SAR, China
| | - Vincent Wai Kwan Chan
- Department of Orthopaedics and Traumatology, Queen Mary Hospital, 102 Pok Fu Lam Road, Pok Fu Lam, Hong Kong SAR, China
| | - Michelle Hilda Luk
- Department of Orthopaedics and Traumatology, Queen Mary Hospital, 102 Pok Fu Lam Road, Pok Fu Lam, Hong Kong SAR, China
| | - Kwong-Yuen Chiu
- Department of Orthopaedics and Traumatology, Queen Mary Hospital, 102 Pok Fu Lam Road, Pok Fu Lam, Hong Kong SAR, China
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13
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Luk MH, Fu H, Chan PK, Ng FY, Chiu KY. Two-stage Partial Component Retention and Interim Cemented Liner for Infected Total Hip Arthroplasty: A Case Report. J Orthop Case Rep 2023; 13:6-10. [PMID: 37885636 PMCID: PMC10599389 DOI: 10.13107/jocr.2023.v13.i10.3914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 08/23/2023] [Indexed: 10/28/2023] Open
Abstract
Introduction There is interest in partial exchange for infected total hip arthroplasty, as an alternative to complete removal of components in a traditional two-stage revision. Partial exchange avoids the difficulty of removing a well-fixed component and its associated bone loss. Case Report We report a case of a 61-year-old male patient with an infected total hip arthroplasty, who underwent a two-stage partial exchange, with retention of the well-fixed femoral stem, and an interim cemented liner. He had excellent function and no infection recurrence at 4 years of follow-up. Conclusion Two-stage partial exchange with interim cemented liner could be an effective option for infected total hip arthroplasty.
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Affiliation(s)
- Michelle Hilda Luk
- Department of Orthopaedics and Traumatology, Queen Mary Hospital, Hong Kong, London, United Kingdom
| | - Henry Fu
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong, London, United Kingdom
| | - Ping Keung Chan
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong, London, United Kingdom
| | - Fu Yuen Ng
- Specialist in Orthopaedics and Traumatology, Private Practice
| | - Kwong Yuen Chiu
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong, London, United Kingdom
- Department of Orthopaedic Surgery, Hong Kong Sanatorium and Hospital, Hong Kong, London, United Kingdom
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14
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Zhao R, Shao H, Shi G, Qiu Y, Tang T, Lin Y, Chen S, Huang C, Liao S, Chen J, Fu H, Liu J, Shen J, Liu T, Xu B, Zhang Y, Yang Y. The Role of Radiotherapy in Patients with Refractory Hodgkin Lymphoma after Brentuximab Vedotin and -/or Immune Checkpoint Inhibitors. Int J Radiat Oncol Biol Phys 2023; 117:e499. [PMID: 37785568 DOI: 10.1016/j.ijrobp.2023.06.1741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Brentuximab vedotin (BV) and immune checkpoint inhibitors (ICIs) had important roles in the treatment of relapse or refractory (R/R) Hodgkin lymphoma (HL). Treatment of refractory disease after BV and -/or ICIs remains a challenge. This study was conducted to evaluate the efficacy and safety of radiotherapy for R/R HL after failure to BV or ICIs. MATERIALS/METHODS We retrospectively analyzed patients in two institutions with R/R HL who had failed after first-line therapy, and were refractory to BV or ICIs, and received radiotherapy (RT) thereafter. The overall response rate (ORR), duration of response (DOR), progression-free survival (PFS) and overall survival (OS) were analyzed. RESULTS A total of 19 patients were enrolled. First-line systemic therapy consisted of ABVD (84.2%), AVD + ICIs (10.5%) and BEACOPP (5.3%), respectively. After first-line therapy, 15 patients (78.9%) were refractory, and 4 patients (21.1%) relapsed. After diagnosis of R/R HL, 8 patients (42.1%) received BV, and 17 patients (89.5%) received ICIs. RT was delivered in all 19 patients who failed after BV or ICIs. In 16 efficacy-evaluable patients, the ORR and CR rate were 100% and 100%. The median DOR was 17.2 months (range, 7.9 to 46.7 months). 3 patients progressed at outside of the radiation field. The in-field-response rate was 100%. The 12-month PFS and OS were 84.4% and 100%, respectively. No patients were reported with sever adverse events. CONCLUSION This study concluded that radiotherapy was effective and safe for refractory HL after BV or ICIs. Further prospective studies were warranted.
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Affiliation(s)
- R Zhao
- Department of Radiation Oncology, Fujian Medical University Union Hospital, Fujian Key Laboratory of Intelligent Imaging and Precision Radiotherapy for Tumors (Fujian Medical University), Fuzhou, China
| | - H Shao
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Guang Zhou, China
| | - G Shi
- Department of Radiation Oncology, Fujian Medical University Union Hospital, Fujian Key Laboratory of Intelligent Imaging and Precision Radiotherapy for Tumors (Fujian Medical University), Fuzhou, China
| | - Y Qiu
- Department of Hematology, Fujian Medical University Union Hospital, Fujian Institute of Hematology, Fujian Provincial Key Laboratory on Hematology, Fuzhou, China
| | - T Tang
- Department of Radiation Oncology, Affiliated Union Hospital of Fujian Medical University, Fuzhou, China
| | - Y Lin
- Department of Radiation Oncology, Fujian Medical University Union Hospital, Fuzhou, China
| | - S Chen
- Department of Radiation Oncology, Fujian Medical University Union Hospital, Fujian Key Laboratory of Intelligent Imaging and Precision Radiotherapy for Tumors (Fujian Medical University), Fuzhou, China
| | - C Huang
- Department of Radiation Oncology, Fujian Medical University Union Hospital, Fujian Key Laboratory of Intelligent Imaging and Precision Radiotherapy for Tumors (Fujian Medical University), Fuzhou, China
| | - S Liao
- Department of PET/CT Center, Fujian Medical University Union Hospital, Fuzhou, China
| | - J Chen
- Follow-Up Center, Fujian Medical University Union Hospital, Fuzhou, China
| | - H Fu
- Department of Hematology, The Third Affiliated People's Hospital of Fujian University of Traditional Chinese Medicine, The Third People's Hospital of Fujian Province, Fuzhou, China
| | - J Liu
- Department of Otorhinolaryngology, Fujian Medical University Union Hospital, Fuzhou, China
| | - J Shen
- Department of Hematology, Fujian Medical University Union Hospital, Fujian Institute of Hematology, Fujian Provincial Key Laboratory on Hematology, Fuzhou, China
| | - T Liu
- Department of Hematology, Fujian Medical University Union Hospital, Fujian Institute of Hematology, Fujian Provincial Key Laboratory on Hematology, Fuzhou, China
| | - B Xu
- Fujian Key Laboratory of Intelligent Imaging and Precision Radiotherapy for Tumors (Fujian Medical University), Fuzhou, China
| | - Y Zhang
- Sun Yat Sen University Cancer Hospital, Guandzhou, Guangdong, China
| | - Y Yang
- Fujian Key Laboratory of Intelligent Imaging and Precision Radiotherapy for Tumors (Fujian Medical University), Fuzhou, China
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Li KY, Chan PK, Yeung SS, Cheung A, Chan WKV, Luk MH, Cheung MH, Fu H, Chiu KY. The role of telemedicine in joint replacement surgery? An updated review. Arthroplasty 2023; 5:39. [PMID: 37537634 PMCID: PMC10401824 DOI: 10.1186/s42836-023-00196-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 05/22/2023] [Indexed: 08/05/2023] Open
Abstract
The usage of telemedicine and telehealth services has grown tremendously and has become increasingly relevant and essential. Technological advancements in current telehealth services have supported its use as a viable alternative tool to conduct visits for consultations, follow-up, and rehabilitation in total joint arthroplasty. Such technology has been widely implemented, particularly during the coronavirus 2019 (COVID-19) pandemic, to deliver postoperative rehabilitation among patients receiving total joint arthroplasty (TJA), further demonstrating its feasibility with a lower cost yet comparable clinical outcomes when compared with traditional care. There remains ample potential to utilize telemedicine for prehabilitation to optimize the preoperative status and postoperative outcomes of patients with osteoarthritis. In this review, various implementations of telemedicine within total joint arthroplasty and future application of telemedicine to deliver tele-prehabilitation in TJA are discussed.
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Affiliation(s)
- Ka Yau Li
- Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Ping Keung Chan
- Department of Orthopaedics and Traumatology, School of Clinical Medicine, The University of Hong Kong, Hong Kong SAR, China.
| | - Shun Shing Yeung
- Physiotherapy Department, MacLehose Medical Rehabilitation Centre, Hong Kong SAR, China
| | - Amy Cheung
- Department of Orthopaedics and Traumatology, Division of Joint Replacement Surgery, Queen Mary Hospital, Hong Kong SAR, China
| | - Wai Kwan Vincent Chan
- Department of Orthopaedics and Traumatology, Division of Joint Replacement Surgery, Queen Mary Hospital, Hong Kong SAR, China
| | - Michelle Hilda Luk
- Department of Orthopaedics and Traumatology, Division of Joint Replacement Surgery, Queen Mary Hospital, Hong Kong SAR, China
| | - Man Hong Cheung
- Department of Orthopaedics and Traumatology, School of Clinical Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Henry Fu
- Department of Orthopaedics and Traumatology, School of Clinical Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Kwong Yuen Chiu
- Department of Orthopaedics and Traumatology, School of Clinical Medicine, The University of Hong Kong, Hong Kong SAR, China
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16
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Duan ZM, Shen ZY, Hu Y, Wang KF, Fu H, Wang CL, Xie LX, Xie F. [The application value of metagenomic next-generation sequencing technology in diagnosis and treatment of pulmonary infection in immunocompromised patients]. Zhonghua Yi Xue Za Zhi 2023; 103:1885-1891. [PMID: 37402668 DOI: 10.3760/cma.j.cn112137-20221226-02703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 07/06/2023]
Abstract
Objective: To evaluate the application value of metagenomic next-generation sequencing (mNGS) in the diagnosis and treatment of pulmonary infection in immunocompromised patients. Methods: A total of 78 patients with immunocompromised pulmonary infection [55 males and 23 females, aged (50.3±16.9) years] and 61 patients with non-immunocompromised pulmonary infection [42 males and 19 females, aged (63.6±15.9) years] in the Intensive Care Unit of the First Medical Center of College of the Pulmonary & Critical Care Medicine, Chinese PLA General Hospital from November 2018 to May 2022 were retrospectively selected. Patients in both groups received bronchoalveolar lavage fluid (BALF) mNGS and conventional microbiological tests (CMTs) while clinically diagnosed with pulmonary infection. The diagnostic positive rate, pathogen detection rate and clinical coincidence rate of the two methods were compared. At the same time, the difference of adjustment rate of anti-infective treatment strategy based on the results of mNGS detection was compared between the two groups. Results: The positive rates of mNGS in patients with pulmonary infection were 94.9% (74/78) and 82.0% (50/61) in the immunocompromised group and the non-immunocompromised group, respectively. The positive rates of CMTs in patients with pulmonary infection were 64.1% (50/78) and 75.4% (46/61) in the immunocompromised group and the non-immunocompromised group, respectively. The positive rates of mNGS and CMTs in patients with pulmonary infection in immunocompromised group showed a statistically significant difference (P<0.001). The detection rates of mNGS in the immunocompromised group for pneumocystis jirovecii and cytomegalovirus were 41.0% (32/78) and 37.2% (29/78), respectively, and the detection rates of Klebsiella pneumoniae, chlamydia psittaci and Legionella pneumophila were 16.4% (10/61), 9.8% (6/61) and 8.2% (5/61) in the non-immunocompromised patients, respectively, which were higher than those of CMTs [1.3% (1/78), 7.7% (6/78), 4.9% (3/61), 0 and 0] (all P<0.05). In the immunocompromised group, the clinical coincidence rates of mNGS and CMTs and were 89.7% (70/78) and 43.6% (34/78), respectively, with a statistically significant difference (P<0.001). In the non-immunocompromised group, the clinical coincidence rates of mNGS and CMTs were 83.6% (51/61) and 62.3% (38/61), with a statistically significant difference (P=0.008). In the immunocompromised group, according to the results of the etiology of mNGS, the adjustment rate of anti-infection treatment strategy was 87.2% (68/78), while in the non-immunocompromised group, the adjustment rate of anti-infective treatment strategy was 60.7% (37/61), with a statistically significant difference (P<0.001). Conclusion: In patients with immunocompromised pulmonary infection, mNGS has more advantages than CMTs in diagnostic positive rate, diagnosis rate of mixed infection, pathogen detection rate and guidance of anti-infection treatment strategy adjustment, which is worthy of clinical promotion and application.
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Affiliation(s)
- Z M Duan
- College of the Pulmonary & Critical Care Medicine, Chinese PLA General Hospital, Beijing 100853, China
| | - Z Y Shen
- epartment of Respiratory and Critical Care Medicine, Jinjiang Municipal Hospital of Fujian Province, Jinjiang 362200, China
| | - Y Hu
- College of the Pulmonary & Critical Care Medicine, Chinese PLA General Hospital, Beijing 100853, China
| | - K F Wang
- College of the Pulmonary & Critical Care Medicine, Chinese PLA General Hospital, Beijing 100853, China
| | - H Fu
- College of the Pulmonary & Critical Care Medicine, Chinese PLA General Hospital, Beijing 100853, China
| | - C L Wang
- Department of Respiratory and Critical Care Medicine, Cangzhou Central Hospital of Hebei Province, Cangzhou 061001, China
| | - L X Xie
- College of the Pulmonary & Critical Care Medicine, Chinese PLA General Hospital, Beijing 100853, China
| | - F Xie
- College of the Pulmonary & Critical Care Medicine, Chinese PLA General Hospital, Beijing 100853, China
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17
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Zhao QW, Chen SH, Li XM, Gao JL, Fu H, Dai JM. [The mediating effect of resilience on anxiety and subjective well-being in occupational population]. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi 2023; 41:434-438. [PMID: 37400404 DOI: 10.3760/cma.j.cn121094-20211206-00603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 07/05/2023]
Abstract
Objective: To explore the current situation of anxiety, subjective well-being in occupational population and the mediating effect of resilience. Methods: From March 24th to 26th, 2020, a cross-sectional survey was conducted among occupational population aged ≥18 years old using online questionnaires. A total of 2134 valid questionnaires were obtained, with respondents from 30 provinces, autonomous regions, and municipalities directly under the Central Government. Their general demographic data, subjective well-being, anxiety, and resilience were collected. Pearson χ(2) test and Spearson correlation analysis were used for data analysis, and structural equation model was used to explore the mediating effect of resilience on anxiety and subjective well-being. Results: The age of the respondents ranged from 18 to 60 years old, with an average age of (31.19±7.09) years old, including 1075 (50.4%) women and 1059 (49.6%) men. The positive rates of low subjective well-being and anxiety were 46.5% (992/2134) and 28.4% (607/2134), respectively. Anxiety scores were significantly negatively correlated with subjective well-being scores and resilience scores (r(s)=-0.52, -0.41, P<0.05), while resilience was significantly positively correlated with subjective well-being (r(s)=0.32, P<0.05). Structural equation models showed that anxiety had a negative predictive effect on subjective well-being, while resilience not only had a positive predictive effect on subjective well-being, but also played a mediating role between anxiety and subjective well-being, with a mediating effect of 9.9%. Conclusion: The situation of anxiety and well-being in the occupational population is still not optimistic, and resilience has a mediating effect between anxiety and subjective well-being.
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Affiliation(s)
- Q W Zhao
- Department of Preventive Medicine and Health Education, School of Public Health, Fudan University, Shanghai 200032, China
| | - S H Chen
- Department of Preventive Medicine and Health Education, School of Public Health, Fudan University, Shanghai 200032, China
| | - X M Li
- Department of Preventive Medicine and Health Education, School of Public Health, Fudan University, Shanghai 200032, China
| | - J L Gao
- Department of Preventive Medicine and Health Education, School of Public Health, Fudan University, Shanghai 200032, China
| | - H Fu
- Department of Preventive Medicine and Health Education, School of Public Health, Fudan University, Shanghai 200032, China
| | - J M Dai
- Department of Preventive Medicine and Health Education, School of Public Health, Fudan University, Shanghai 200032, China
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Chong YY, Chan PK, Chan VWK, Cheung A, Luk MH, Cheung MH, Fu H, Chiu KY. Application of machine learning in the prevention of periprosthetic joint infection following total knee arthroplasty: a systematic review. Arthroplasty 2023; 5:38. [PMID: 37316877 DOI: 10.1186/s42836-023-00195-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 05/11/2023] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND Machine learning is a promising and powerful technology with increasing use in orthopedics. Periprosthetic joint infection following total knee arthroplasty results in increased morbidity and mortality. This systematic review investigated the use of machine learning in preventing periprosthetic joint infection. METHODS A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed was searched in November 2022. All studies that investigated the clinical applications of machine learning in the prevention of periprosthetic joint infection following total knee arthroplasty were included. Non-English studies, studies with no full text available, studies focusing on non-clinical applications of machine learning, reviews and meta-analyses were excluded. For each included study, its characteristics, machine learning applications, algorithms, statistical performances, strengths and limitations were summarized. Limitations of the current machine learning applications and the studies, including their 'black box' nature, overfitting, the requirement of a large dataset, the lack of external validation, and their retrospective nature were identified. RESULTS Eleven studies were included in the final analysis. Machine learning applications in the prevention of periprosthetic joint infection were divided into four categories: prediction, diagnosis, antibiotic application and prognosis. CONCLUSION Machine learning may be a favorable alternative to manual methods in the prevention of periprosthetic joint infection following total knee arthroplasty. It aids in preoperative health optimization, preoperative surgical planning, the early diagnosis of infection, the early application of suitable antibiotics, and the prediction of clinical outcomes. Future research is warranted to resolve the current limitations and bring machine learning into clinical settings.
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Affiliation(s)
- Yuk Yee Chong
- Department of Orthopaedics and Traumatology, School of Clinical Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Ping Keung Chan
- Department of Orthopaedics and Traumatology, School of Clinical Medicine, The University of Hong Kong, Hong Kong SAR, China.
| | - Vincent Wai Kwan Chan
- Department of Orthopaedics and Traumatology, Queen Mary Hospital, Hong Kong SAR, China
| | - Amy Cheung
- Department of Orthopaedics and Traumatology, Queen Mary Hospital, Hong Kong SAR, China
| | - Michelle Hilda Luk
- Department of Orthopaedics and Traumatology, Queen Mary Hospital, Hong Kong SAR, China
| | - Man Hong Cheung
- Department of Orthopaedics and Traumatology, School of Clinical Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Henry Fu
- Department of Orthopaedics and Traumatology, School of Clinical Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Kwong Yuen Chiu
- Department of Orthopaedics and Traumatology, School of Clinical Medicine, The University of Hong Kong, Hong Kong SAR, China
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Abbas A, Muhammad SA, Ashar A, Mehfooz SA, Rauf A, Bakhsh M, Nadeem T, Fu H. Comparison of the effect of zinc oxide nanoparticles and extract of Acorus calamus applied topically on surgical wounds inflicted on the skin of rabbits. Pol J Vet Sci 2023; 26:285-293. [PMID: 37389426 DOI: 10.24425/pjvs.2023.145035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/01/2023]
Abstract
Antibiotics are used for postsurgical wound healing purposes but unfortunately, resistance against them demands some alternatives for quick recovery. Sepsis of wounds is a challenge for medical as well as veterinary professionals. Nanoparticles have significant advantages in wound treatment and drug resistance reversal. This study was conducted to appreciate emerging alternates of antibiotics like zinc oxide nanoparticles and plant extracts in topical application. Zinc oxide is considered a good wound healer and its nanoparticles are easy to access. So, the efficacies of zinc oxide nanoparticles and sweet flag plant extract ointments were tested to compare modern and traditional therapeutics as sweet flag is considered a pure medicinal plant. Rabbits were selected for this study due to the healing properties of their skin. Wounds were inflicted on the thoracolumbar region and treated for 29 days post-surgically daily with normal saline and the ointment of zinc oxide nanoparticles and sweet flag extract ointment, prepared in a hydrophilic solvent. Wound shrinkage was observed daily and histopathological analysis was made and results were compared. Zinc oxide nanoparticles ointment showed the most satisfactory results for every parameter included in the study. No side effects of its topical application were observed. Healing was normal without any complications. The preparations of zinc oxide nanoparticles may help in the era of antibiotic resistance as topical drugs in the future.
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Affiliation(s)
- A Abbas
- Department of Pharmacy, College of Veterinary Medicine, Sichuan Agricultural University, Chengdu, Sichuan, China
- Department of Clinical Medicine and Surgery, University of Agriculture, Faisalabad 38000, Pakistan
| | - S A Muhammad
- University of Veterinary and Animal Sciences, Lahore, CVAS Jhang 35200, Pakistan
| | - A Ashar
- Wilson College of Textiles, North Carolina State University, North Carolina, USA
| | - S A Mehfooz
- Department of Clinical Medicine and Surgery, University of Agriculture, Faisalabad 38000, Pakistan
| | - A Rauf
- University of Veterinary and Animal Sciences, Lahore, CVAS Jhang 35200, Pakistan
| | - M Bakhsh
- University of Veterinary and Animal Sciences, Lahore, CVAS Jhang 35200, Pakistan
| | - T Nadeem
- University of Veterinary and Animal Sciences, Lahore, Para Veterinary Institute (PVI), Karor 31100, Layyah, Pakistan
| | - H Fu
- Department of Pharmacy, College of Veterinary Medicine, Sichuan Agricultural University, Chengdu, Sichuan, China
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20
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Zhai GY, Sun TN, Li X, Ye M, Wang CG, Zu XL, Yang D, Fu H, Qi SY, Zhou YJ, Gao H. [A prospective study on the safety and efficacy of excimer laser coronary angioplasty for the treatment of degenerated great saphenous vein graft]. Zhonghua Xin Xue Guan Bing Za Zhi 2023; 51:490-496. [PMID: 37198120 DOI: 10.3760/cma.j.cn112148-20220815-00631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
Objective: To explore the safety and efficacy of excimer laser coronary angioplasty (ELCA) for the treatment of degenerated great saphenous vein graft (SVG). Methods: This is a single-center, prospective, single-arm study. Patients, who were admitted to the Geriatric Cardiovascular Center of Beijing Anzhen Hospital from January 2022 to June 2022, were consecutively enrolled. Inclusion criteria were recurrent chest pain after coronary artery bypass surgery (CABG), and coronary angiography confirmed that the SVG stenosis was more than 70% but not completely occluded, and interventional treatment for SVG lesions was planned. Before balloon dilation and stent placement, ELCA was used to pretreat the lesions. Optical coherence tomography (OCT) examination was performed and postoperative index of microcirculation resistance (IMR) were assessed after stent implantation. The technique success rate and operation success rate were calculated. The technique success was defined as the successful passage of the ELCA system through the lesion. Operation success was defined as the successful placement of a stent at the lesion. The primary evaluation index of the study was IMR immediately after PCI. Secondary evaluation indexes included thrombolysis in myocardial infarction (TIMI) flow grade, corrected TIMI frame count (cTFC), minimal stent area and stent expansion measured by OCT after PCI, and procedural complications (Ⅳa myocardial infarction, no reflow, perforation). Results: A total of 19 patients aged (66.0±5.6) years were enrolled, including 18 males (94.7%). The age of SVG was 8 (6, 11) years. The length of the lesions was greater than 20 mm, and they were all SVG body lesions. The median stenosis degree was 95% (80%, 99%), and the length of the implanted stent was (41.7±16.3)mm. The operation time was 119 (101, 166) minutes, and the cumulative dose was 2 089 (1 378, 3 011)mGy. The diameter of the laser catheter was 1.4 mm, the maximum energy was 60 mJ, and the maximum frequency was 40 Hz. The technique success and the operation success rate were both 100% (19/19). The IMR after stent implantation was 29.22±5.95. The TIMI flow grade of patients after ELCA and stent implantation was significantly improved (all P>0.05), and the TIMI flow grade of all patients after stent implantation was Grade Ⅲ. The cTFC decreased significantly after ELCA (33.2±7.8) and after stent placement (22.8±7.1) than preoperative level (49.7±13.0) (both P<0.001). The minimum stent area was (5.53±1.36)mm2, and the stent expansion rate was (90.0±4.3)%. Perforation, no reflow, type Ⅳa myocardial infarction and other complications were not observed. However, postoperative high-sensitivity troponin level was significantly increased ((67.937±33.839)ng/L vs. (5.316±3.105)ng/L, P<0.001). Conclusion: ELCA is safe and effective in the treatment of SVG lesions and could improve microcirculation and ensure full expansion of stent.
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Affiliation(s)
- G Y Zhai
- Center for Coronary Artery Disease, Division of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - T N Sun
- Center for Coronary Artery Disease, Division of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - X Li
- Center for Coronary Artery Disease, Division of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - M Ye
- Center for Coronary Artery Disease, Division of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - C G Wang
- Center for Coronary Artery Disease, Division of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - X L Zu
- Center for Coronary Artery Disease, Division of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - D Yang
- Center for Coronary Artery Disease, Division of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - H Fu
- Center for Coronary Artery Disease, Division of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - S Y Qi
- Center for Coronary Artery Disease, Division of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - Y J Zhou
- Center for Coronary Artery Disease, Division of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - H Gao
- Center for Coronary Artery Disease, Division of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
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Chan PK, Chan TCW, Mak CYH, Chan THM, Chan SHW, Wong SSC, Fu H, Cheung A, Chan VWK, Cheung MH, Cheung CW, Chiu KY. Pain Relief After Total Knee Arthroplasty with Intravenous and Periarticular Corticosteroid: A Randomized Controlled Trial. J Bone Joint Surg Am 2023; Publish Ahead of Print:00004623-990000000-00809. [PMID: 37220180 DOI: 10.2106/jbjs.22.01218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
BACKGROUND Total knee arthroplasty (TKA) is a cost-effective procedure, but it is also associated with substantial postoperative pain. The present study aimed to compare pain relief and functional recovery after TKA among groups that received intravenous corticosteroids, periarticular corticosteroids, or a combination of both. METHODS This randomized, double-blinded clinical trial in a local institution in Hong Kong recruited 178 patients who underwent primary unilateral TKA. Six of these patients were excluded because of changes in surgical technique; 4, because of their hepatitis B status; 2, because of a history of peptic ulcer; and 2, because they declined to participate in the study. Patients were randomized 1:1:1:1 to receive placebo (P), intravenous corticosteroids (IVS), periarticular corticosteroids (PAS), or a combination of intravenous and periarticular corticosteroids (IVSPAS). RESULTS The pain scores at rest were significantly lower in the IVSPAS group than in the P group over the first 48 hours (p = 0.034) and 72 hours (p = 0.043) postoperatively. The pain scores during movement were also significantly lower in the IVS and IVSPAS groups than in the P group over the first 24, 48, and 72 hours (p ≤ 0.023 for all). The flexion range of the operatively treated knee was significantly better in the IVSPAS group than in the P group on postoperative day 3 (p = 0.027). Quadriceps power was also greater in the IVSPAS group than in the P group on postoperative days 2 (p = 0.005) and 3 (p = 0.007). Patients in the IVSPAS group were able to walk significantly further than patients in the P group in the first 3 postoperative days (p ≤ 0.003). Patients in the IVSPAS group also had a higher score on the Elderly Mobility Scale than those in the P group (p = 0.036). CONCLUSIONS IVS and IVSPAS yielded similar pain relief, but IVSPAS yielded a larger number of rehabilitation parameters that were significantly better than those in the P group. This study provides new insights into pain management and postoperative rehabilitation following TKA. LEVEL OF EVIDENCE Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
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Affiliation(s)
- P K Chan
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong SAR
| | - T C W Chan
- Department of Anaesthesia, Pain and Perioperative Medicine, Queen Mary Hospital, Hong Kong SAR
| | - C Y H Mak
- Department of Anaesthesia, Pain and Perioperative Medicine, Queen Mary Hospital, Hong Kong SAR
| | - T H M Chan
- Department of Anaesthesia, Pain and Perioperative Medicine, Queen Mary Hospital, Hong Kong SAR
| | - S H W Chan
- Department of Anaesthesia, Pain and Perioperative Medicine, Queen Mary Hospital, Hong Kong SAR
| | - S S C Wong
- Department of Anaesthesiology, The University of Hong Kong, Hong Kong SAR
| | - H Fu
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong SAR
| | - A Cheung
- Department of Orthopaedics and Traumatology, Queen Mary Hospital, Hong Kong SAR
| | - V W K Chan
- Department of Orthopaedics and Traumatology, Queen Mary Hospital, Hong Kong SAR
| | - M H Cheung
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong SAR
| | - C W Cheung
- Department of Anaesthesiology, The University of Hong Kong, Hong Kong SAR
| | - K Y Chiu
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong SAR
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Li YW, Li Z, Song HC, Ding L, Ji SS, Zhang M, Qu YL, Sun Q, Zhu YD, Fu H, Cai JY, Li CF, Han YY, Zhang WL, Zhao F, Lyu YB, Shi XM. [Association between urinary arsenic level and serum testosterone in Chinese men aged 18 to 79 years]. Zhonghua Yu Fang Yi Xue Za Zhi 2023; 57:686-692. [PMID: 36977566 DOI: 10.3760/cma.j.cn112150-20221110-01095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 03/30/2023]
Abstract
Objective: To investigate the association between the urinary arsenic level and serum total testosterone in Chinese men aged 18 to 79 years. Methods: A total of 5 048 male participants aged 18 to 79 years were recruited from the China National Human Biomonitoring (CNHBM) from 2017 to 2018. Questionnaires and physical examinations were used to collect information on demographic characteristics, lifestyle, food intake frequency and health status. Venous blood and urine samples were collected to detect the level of serum total testosterone, urine arsenic and urine creatinine. Participants were divided into three groups (low, middle, and high) based on the tertiles of creatinine-adjusted urine arsenic concentration. Weighted multiple linear regression was fitted to analyze the association of urinary arsenic with serum total testosterone. Results: The weighted average age of 5 048 Chinese men was (46.72±0.40) years. Geometric mean concentration (95%CI) of urinary arsenic, creatinine-adjusted urine arsenic and serum testosterone was 22.46 (20.08, 25.12) μg/L, 19.36 (16.92, 22.15) μg/L and 18.13 (17.42, 18.85) nmol/L, respectively. After controlling for covariates, compared with the low-level urinary arsenic group, the testosterone level of the participants in the middle-level group and the high-level group decreased gradually. The percentile ratio (95%CI) was -5.17% (-13.14%, 3.54%) and -10.33% (-15.68%, -4.63). The subgroup analysis showed that the association between the urinary arsenic level and testosterone level was more obvious in the group with BMI<24 kg/m2 group (Pinteraction<0.05). Conclusion: There is a negative association between the urinary arsenic level and serum total testosterone in Chinese men aged 18-79 years.
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Affiliation(s)
- Y W Li
- China CDC Key Laboratory of Environment and Population Health/National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Z Li
- China CDC Key Laboratory of Environment and Population Health/National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - H C Song
- China CDC Key Laboratory of Environment and Population Health/National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - L Ding
- China CDC Key Laboratory of Environment and Population Health/National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - S S Ji
- China CDC Key Laboratory of Environment and Population Health/National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - M Zhang
- China CDC Key Laboratory of Environment and Population Health/National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Y L Qu
- China CDC Key Laboratory of Environment and Population Health/National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Q Sun
- China CDC Key Laboratory of Environment and Population Health/National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Y D Zhu
- China CDC Key Laboratory of Environment and Population Health/National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - H Fu
- China CDC Key Laboratory of Environment and Population Health/National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - J Y Cai
- China CDC Key Laboratory of Environment and Population Health/National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - C F Li
- School of Public Health, Anhui Medical University, Hefei 230032, China
| | - Y Y Han
- China CDC Key Laboratory of Environment and Population Health/National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - W L Zhang
- China CDC Key Laboratory of Environment and Population Health/National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - F Zhao
- China CDC Key Laboratory of Environment and Population Health/National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Y B Lyu
- China CDC Key Laboratory of Environment and Population Health/National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - X M Shi
- China CDC Key Laboratory of Environment and Population Health/National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
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Liu WKT, Cheung A, Fu H, Cheung MH, Chan PK, Chiu KY. Isolated Liner Exchange in Total Hip Arthroplasty at a Mean of 13 Years of Follow-up: Does Fixation Technique Matter? J Arthroplasty 2022; 38:893-898. [PMID: 36493971 DOI: 10.1016/j.arth.2022.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 11/21/2022] [Accepted: 11/28/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Isolated liner exchange is an option to address polyethylene wear after total hip arthroplasty (THA). The liner can be fixed with either the original locking mechanism or cemented into the acetabular cup. Whether the method used for liner fixation has any bearing on the outcomes in the first and second decade after surgery is still unclear. METHODS Data for all patients who had undergone isolated liner exchange surgery in our institution between April 1995 and January 2015 were retrieved. Patients were classified according to the type of polyethylene liner (conventional or highly crosslinked polyethylene) and the locking mechanism used (original locking mechanism or cemented). Survivorship and revision rates were compared among different subgroups. A total of 118 isolated liner exchanges were performed and patients had a mean duration of follow-up of 13 years (range, 5 to 25). RESULTS Overall estimated mean survivorship was 17 years. Use of highly crosslinked polyethylene (HXLPE) had a lower re-revision rate compared to conventional liners (10.5 versus 46.9%) (P < .001). The re-revision rate of exchanges using HXLPE was not affected by the type of fixation (original locking mechanism 11.1 versus cement 10.0%, P = .868). Conversely, using the original locking mechanism with a conventional liner had a higher re-revision rate compared to cemented conventional liners (58.3 versus 12.5%) (P = .024). CONCLUSION HXLPE liners should be used in insert exchange surgery whenever possible. Re-revision rate of exchanges using HXLPE was not affected by the fixation technique used. Cementing an insert into an acetabular component is associated with good survivorship at a mean of 13 years follow-up.
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Affiliation(s)
- Wai Kiu Thomas Liu
- Department of Orthopaedics and Traumatology, Queen Mary Hospital, Hong Kong
| | - Amy Cheung
- Department of Orthopaedics and Traumatology, Queen Mary Hospital, Hong Kong
| | - Henry Fu
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong
| | - Man Hong Cheung
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong
| | - Ping Keung Chan
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong
| | - Kwong Yuen Chiu
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong
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Yang F, Wei Y, Sun C, Yuan M, Zeng W, Liu C, Fu H. Pinoxaden Degradation Characteristics of Acinetobacter pittobacter and Prediction of Related Genes. Microbiology (Reading) 2022. [DOI: 10.1134/s002626172210109x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
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25
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Chiang CY, Lin HH, Fu H. Assessment of TB patient cost – what about the mitigation strategy? Int J Tuberc Lung Dis 2022; 26:1101-1103. [DOI: 10.5588/ijtld.22.0543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Affiliation(s)
- C-Y. Chiang
- Division of Pulmonary Medicine, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan, Division of Pulmonary Medicine, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical
University, Taipei, Taiwan, International Union Against Tuberculosis and Lung Disease, Paris, France
| | - H-H. Lin
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan, Global Health Program, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - H. Fu
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
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Hu YT, Fu H, Yang DF, Wang X, Xu WB. [Comparative study of decompression of unilateral biportal endoscopic compared to laminectomy with fusion and internal fixation in the treatment of severe lumbar spinal stenosis]. Zhonghua Yi Xue Za Zhi 2022; 102:3281-3287. [PMID: 36319180 DOI: 10.3760/cma.j.cn112137-20220720-01583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Objective: To compare the clinical efficacy of unilateral biportal endoscopy unilateral laminotomy for bilateral decompression (UBE-ULBD) to posterior lumbar interbody fusion (PLIF) in the treatment of severe lumbar spinal stenosis (SLSS). Methods: The clinical data of 64 patients with SLSS treated with PLIF and UBE-ULBD in Dalian Central Hospital Affiliated to Dalian Medical University from April 2018 to April 2021 were collected and divided into UBE group and PLIF group according to the different surgical procedures. There were 30 cases in the UBE group, including 12 males and 18 females, aged (69.8±6.8) years. There were 34 patients in the PLIF group, including 15 males and 19 females, aged (69.3±6.3) years. The operation time, intraoperative blood loss, surgical complications, the volume of drainage, transfusion, post-operative bed rest time, postoperative hospital stay, surgical costs of both groups were recorded and analyzed. The visual analogue scales (VAS) of back/leg pain (pre-operation and 1 d, 1 month, 6 month, 12 month post-operation) and Oswestry disability index (ODI) (pre-operation and 1 month, 6 month, 12 month post-operation) were used to determine the outcome. And the dural sac cross-sectional area (DSCA) and Schizas grade of both groups preoperatively and 6 month postoperatively were recorded. Results: The operation time in the UBE group was (69.2±8.0) min, it was lower than that in the PLIF group (139.0±15.3) min (P<0.05). The intraoperative blood loss and drainage in the UBE group were (19.5±5.6) ml and (15.0±10.8) ml, which were both lower than those in the PILF group [(212.4±34.1) ml and (169.6±43.8) ml] (both P<0.05). The postoperative bed rest time and hospital stay in the UBE group were (1.8±0.7) days and (3.0±0.9) days, which were both shorter than those in the PLIF group [(4.5±1.4) days and (7.1±1.7) days] (both P<0.05). The surgical cost was also lower in the UBE group than that in the PLIF group [RMB,(18.4±1.0) thousands yuan vs (33.9±2.4) thousands yuan, P<0.05]. In addition, no patient received blood transfusion in the UBE group. Dural sac tear occurred in 2 cases in the UBE group and in 3 cases in PLIF group; nerve root injury and infection occurred in one case in the PLIF group, respectively. In the PLIF group, the VAS of back pain was not significantly improved 1 day after operation when compared with that before the operation, but it significantly improved 1 month, 6 months and 1 year after operation (all P<0.05). The VAS for back pain at 1 day after operation and ODI at 1 month after operation in the UBE group were significantly superior to those in the PLIF group (both P<0.05), while there was no significant difference between the two groups in the VAS for back pain at 1 month, 6 months and 1 year after operation and ODI at 6 months and 1 year after operation. Both groups got significant canal expansion after the surgery and the PLIF group showed larger canal expansion extent (all P<0.05). Both groups improved significantly after surgery in the Schizas grade, there were 25 cases in UBE group improved to grade A, 5 cases to grade B while 30 cases in PLIF group improved to grade A, 4 cases to grade B, but there was no significant difference between the two groups (P>0.05). Conclusion: ULBD-UBE could achieve full decompression of the whole spinal canal with limited structures damage in treating SLSS. Compared with PLIF, UBE-ULBD could get complete decompression as well as less iatrogenic damage, it may be an ideal alternative surgical technique for SLSS with less invasion.
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Affiliation(s)
- Y T Hu
- Graduate School of Dalian Medical University, Dalian 116044, China
| | - H Fu
- Graduate School of Dalian Medical University, Dalian 116044, China
| | - D F Yang
- Department of Spinal Surgery, Dalian Central Hospital, Dalian Medical University, Dalian 116033, China
| | - X Wang
- Graduate School of Dalian Medical University, Dalian 116044, China
| | - W B Xu
- Department of Spinal Surgery, Dalian Central Hospital, Dalian Medical University, Dalian 116033, China
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27
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Peacock CJH, Fu H, Asopa V, Clement ND, Kader D, Sochart DH. The effect of Nickel hypersensitivity on the outcome of total knee arthroplasty and the value of skin patch testing: a systematic review. Arthroplasty 2022; 4:40. [PMID: 36050799 PMCID: PMC9438335 DOI: 10.1186/s42836-022-00144-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 08/08/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
To assess the Nickel sensitizing potential of total knee arthroplasty (TKA), explore the relationship between hypersensitivity and clinical outcomes, and evaluate the utility of skin patch testing pre- and/or postoperatively.
Materials and methods
A literature search was performed through EMBASE, Medline and PubMed databases. Articles were screened independently by two investigators. The level of evidence of studies was assessed using the Oxford Centre for Evidence-Based Medicine Criteria and the quality evaluated using the Methodological Index for Non-randomized Studies and Cochrane risk-of-bias tools.
Results
Twenty studies met the eligibility criteria, reporting on 1354 knee arthroplasties. Studies included patients undergoing primary or revision TKA, pre- and/or postoperatively, and used patch testing to identify Nickel hypersensitivity. Prevalence of Nickel hypersensitivity ranged from 0% to 87.5%. One study compared the prevalence of Nickel hypersensitivity in the same patient group before and after surgery and noted newly positive patch test reactions in three patients (4.2%). Three studies reported lower prevalence of Nickel hypersensitivity in postoperative patients compared to preoperative ones. Seven studies suggested that hypersensitivity might cause adverse clinical outcomes, but six did not support any relationship. Seven studies recommended preoperative patch testing in patients with history of metal allergy, and nine concluded that testing may be valuable postoperatively.
Conclusions
Patients undergoing TKA with no prior history of metal hypersensitivity do not seem to be at an increased risk of developing Nickel hypersensitivity, and there is conflicting evidence that patients with pre-existing hypersensitivity are more likely to experience adverse outcomes. Patch testing remains the most commonly used method for diagnosing hypersensitivity, and evidence suggests preoperative testing in patients with history of metal allergy to aid prosthesis selection, and postoperatively in patients with suspected hypersensitivity once common causes of implant failure have been excluded, since revision with hypoallergenic implants may alleviate symptoms.
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Peacock C, Liu P, Gurung B, Fu H, Phoon K, Afzal I, Sochart D, Kader D, Asopa V. P12 Sustainability: staff knowledge of which items of waste can be recycled in the orthopaedic operating theatre. Br J Surg 2022. [DOI: 10.1093/bjs/znac231.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Abstract
Introduction
NHS England generates over 20 million tonnes of CO2 per year, representing 4% of the nation's greenhouse gas emissions. One third of all hospital waste comes from operating theatres. Our aim was to investigate the degree of knowledge of sustainable waste segregation amongst theatre staff in an elective orthopaedic centre and identify ways to improve their waste segregation practice.
Methods
Over a one-week period, 20 randomly selected theatre staff of different roles, completed a questionnaire asking them which disposal bin 11 commonly used orthopaedic theatre items should be placed in – general waste or recycling. After initial data collection, posters specifically identifying recyclable items were created and displayed in each operating theatre. Following this intervention, data was re-collected from another 20 randomly selected theatre staff using the same questionnaire.
Results
Results from the initial questionnaire showed general waste and recyclable items were correctly identified by staff in 65% (78/120 responses) and 59% (59/100 responses), respectively. Following the educational intervention, the percentage of correct responses increased to 68.3% (82/120 responses) and 85% (85/100 responses); i.e. staff knowledge of what can go into a recycling bin improved by 36%.
Conclusion
Educating staff by placing posters in the operating theatre can improve knowledge of what orthopaedic theatre items can be recycled and is a simple and effective way of producing sustainable change in surgery. Guiding and empowering individuals to exercise sustainable practice in the operating theatre will help the NHS to overcome the significant challenge of achieving net zero carbon by 2045.
Take-home message
Educating staff by placing posters in the operating theatre is a simple and effective way of improving waste segregation practice and will help the health service to overcome the significant challenge of achieving net zero carbon.
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Affiliation(s)
- C Peacock
- Southwest London Elective Orthopaedic Centre , Epsom
| | - P Liu
- Southwest London Elective Orthopaedic Centre , Epsom
| | - B Gurung
- Southwest London Elective Orthopaedic Centre , Epsom
| | - H Fu
- Southwest London Elective Orthopaedic Centre , Epsom
| | - K Phoon
- Southwest London Elective Orthopaedic Centre , Epsom
| | - I Afzal
- Southwest London Elective Orthopaedic Centre , Epsom
| | - D Sochart
- Southwest London Elective Orthopaedic Centre , Epsom
| | - D Kader
- Southwest London Elective Orthopaedic Centre , Epsom
| | - V Asopa
- Southwest London Elective Orthopaedic Centre , Epsom
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Abstract
BACKGROUND The use and the optimal timing of tourniquet during primary total knee arthroplasty (TKA) is controversial. Most previous studies failed to show clinically significant differences in different strategies. The aim of this study was to determine how three strategies of tourniquet application affect the outcome in TKA patients. METHODS This was a prospective randomized controlled study. Patients who undergo TKA were randomized into one of the three groups (1:1:1 ratio): tourniquet inflated from skin incision to cement hardening, tourniquet from cement application to hardening, and tourniquet from skin incision to skin closure. The perioperative blood loss, limb swelling, and complications were recorded. The level of hemoglobin, hematocrit, C-reactive protein (CRP), interleukin (IL)-6, creatine kinase (CK), and lactate dehydrogenase (LDH) were determined. Patients' thigh and TKA wound pain, Knee Society knee score (KSKS) and Knee Society functional assessment (KSFA) scores, and rehabilitation parameters were evaluated. RESULTS A total of 90 patients were enrolled. The baseline characteristics were comparable. We only found significant difference in the intraoperative blood loss (skin to cement: 58.7 ± 36.1 mL, cement-only: 147.8 ± 107.9 mL, skin to skin: 16.3 ± 13.1 mL, p < 0.0001). There were no statistical differences in postoperative drainage, thigh/knee circumference, change of hemoglobin/hematocrit, CRP, IL-6, CK, and LDH on day 1 to day 4 after surgery. The thigh/TKA wound Visual Analogue Scale scores, KSKS score, KSFA score, and rehabilitation parameters were not significantly different at up to 6-month follow-up. No thromboembolic events were noted. CONCLUSION Our results revealed that there was no best tourniquet strategy in TKA. Different tourniquet methods can be utilized based on surgeon preference without affecting outcomes.
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Affiliation(s)
- Chaofan Zhang
- Department of Orthopaedics and Traumatology, Queen Mary Hospital, Hong Kong SAR, China.,Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong SAR, China.,Department of Orthopaedic Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Chun Hoi Yan
- Department of Orthopaedics and Traumatology, Queen Mary Hospital, Hong Kong SAR, China.,Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong SAR, China
| | - Ping Keung Chan
- Department of Orthopaedics and Traumatology, Queen Mary Hospital, Hong Kong SAR, China.,Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong SAR, China
| | - Henry Fu
- Department of Orthopaedics and Traumatology, Queen Mary Hospital, Hong Kong SAR, China.,Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong SAR, China
| | - Kwong Yuen Chiu
- Department of Orthopaedics and Traumatology, Queen Mary Hospital, Hong Kong SAR, China.,Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong SAR, China
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30
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Li T, Zhang H, Chan PK, Fung WC, Fu H, Chiu KY. Risk factors associated with surgical site infections following joint replacement surgery: a narrative review. Arthroplasty 2022; 4:11. [PMID: 35490250 PMCID: PMC9057059 DOI: 10.1186/s42836-022-00113-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 12/31/2021] [Indexed: 11/17/2022] Open
Abstract
Background Surgical site infection following joint replacement surgery is still a significant complication, resulting in repeated surgery, prolonged antibiotic therapy, extended postoperative hospital stay, periprosthetic joint infection, and increased morbidity and mortality. This review discusses the risk factors associated with surgical site infection. Related risk factors The patient-related factors include sex, age, body mass index (BMI), obesity, nutritional status, comorbidities, primary diagnosis, living habits, and scores of the American Society of Anesthesiologists physical status classification system, etc. Surgery-related factors involve preoperative skin preparation, prolonged duration of surgery, one-stage bilateral joint replacement surgery, blood loss, glove changes, anti-microbial prophylaxis, topical anti-bacterial preparations, wound management, postoperative hematoma, etc. Those risk factors are detailed in the review. Conclusion Preventive measures must be taken from multiple perspectives to reduce the incidence of surgical site infection after joint replacement surgery.
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Affiliation(s)
- Tao Li
- Department of Joint Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Haining Zhang
- Department of Joint Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Ping Keung Chan
- Department of Orthopaedics &, Traumatology Queen Mary Hospital, The University of Hong Kong, 102 Pok Fu Lam Road, Hong Kong SAR, China.
| | - Wing Chiu Fung
- Department of Orthopaedics &, Traumatology Queen Mary Hospital, The University of Hong Kong, 102 Pok Fu Lam Road, Hong Kong SAR, China
| | - Henry Fu
- Department of Orthopaedics &, Traumatology Queen Mary Hospital, The University of Hong Kong, 102 Pok Fu Lam Road, Hong Kong SAR, China
| | - Kwong Yuen Chiu
- Department of Orthopaedics &, Traumatology Queen Mary Hospital, The University of Hong Kong, 102 Pok Fu Lam Road, Hong Kong SAR, China
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31
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Lee LS, Chan PK, Wen C, Fung WC, Cheung A, Chan VWK, Cheung MH, Fu H, Yan CH, Chiu KY. Artificial intelligence in diagnosis of knee osteoarthritis and prediction of arthroplasty outcomes: a review. Arthroplasty 2022; 4:16. [PMID: 35246270 PMCID: PMC8897859 DOI: 10.1186/s42836-022-00118-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Accepted: 02/17/2022] [Indexed: 11/15/2022] Open
Abstract
Background Artificial intelligence is an emerging technology with rapid growth and increasing applications in orthopaedics. This study aimed to summarize the existing evidence and recent developments of artificial intelligence in diagnosing knee osteoarthritis and predicting outcomes of total knee arthroplasty. Methods PubMed and EMBASE databases were searched for articles published in peer-reviewed journals between January 1, 2010 and May 31, 2021. The terms included: ‘artificial intelligence’, ‘machine learning’, ‘knee’, ‘osteoarthritis’, and ‘arthroplasty’. We selected studies focusing on the use of AI in diagnosis of knee osteoarthritis, prediction of the need for total knee arthroplasty, and prediction of outcomes of total knee arthroplasty. Non-English language articles and articles with no English translation were excluded. A reviewer screened the articles for the relevance to the research questions and strength of evidence. Results Machine learning models demonstrated promising results for automatic grading of knee radiographs and predicting the need for total knee arthroplasty. The artificial intelligence algorithms could predict postoperative outcomes regarding patient-reported outcome measures, patient satisfaction and short-term complications. Important weaknesses of current artificial intelligence algorithms included the lack of external validation, the limitations of inherent biases in clinical data, the requirement of large datasets in training, and significant research gaps in the literature. Conclusions Artificial intelligence offers a promising solution to improve detection and management of knee osteoarthritis. Further research to overcome the weaknesses of machine learning models may enhance reliability and allow for future use in routine healthcare settings.
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Affiliation(s)
- Lok Sze Lee
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong, China
| | - Ping Keung Chan
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong, China.
| | - Chunyi Wen
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - Wing Chiu Fung
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong, China
| | - Amy Cheung
- Department of Orthopaedics and Traumatology, Queen Mary Hospital, Hong Kong, China
| | | | - Man Hong Cheung
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong, China
| | - Henry Fu
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong, China
| | - Chun Hoi Yan
- Department of Orthopaedics and Traumatology, Gleneagles Hospital Hong Kong, Hong Kong, China
| | - Kwong Yuen Chiu
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong, China
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Choi B, Fu H, Ogunmwonyi I, Gargan K. 225 First Contact: A Series of Zoom-Based, Virtual on Call Shifts. Br J Surg 2022. [DOI: 10.1093/bjs/znac039.141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Aim
COVID-19 has resulted in reduced exposure to on-call shifts where medical students could increase confidence and proficiency in task prioritisation and decision making. Existing ‘simulated on-calls’ provide a substitute in a controlled environment, however in person teaching has also been limited by COVID-19. Our virtual on-call sessions use ZOOM to replicate the higher-level learning experiences normally conferred by live simulation.
Method
We designed a series of virtual ‘on-calls’ for medical students. Participants were ‘on-call’, receiving ‘bleeps’ which were ‘answered’ by calling a facilitator via ZOOM. The facilitator would roleplay a scenario and the ‘Electronic Patient Record’ (EPR) on Google Forms contained patient notes and observations. Students needed to collect information from the facilitator and document a management plan into the EPR. Participants received ‘bleeps’ of varying complexity, urgency and relevance and were expected to prioritise and triage tasks accordingly. Evaluation was via a pre/post session quiz with separate feedback forms.
Results
23 students from 18 universities participated. Students reported increased confidence in managing on-call scenarios, and average scores improved in the post session quiz. Positive feedback was paid to the variety of scenarios, the EPR system and the feeling of realism elicited from the need to triage and prioritise jobs.
Conclusions
Our framework uses readily accessible technology to provide interactive learning experience. Feedback suggested students engaged in higher order learning and thinking, achieving our stated aims. We aim to incorporate technologies such as automation software which will allow for a scalable, free, and accessible virtual on call.
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Affiliation(s)
- B. Choi
- National Surgical Teaching Society, London, United Kingdom
| | - H. Fu
- National Surgical Teaching Society, London, United Kingdom
| | - I. Ogunmwonyi
- National Surgical Teaching Society, London, United Kingdom
| | - K. Gargan
- National Surgical Teaching Society, London, United Kingdom
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Su J, Qin Z, Fu H, Luo J, Huang Y, Huang P, Zhang S, Liu T, Lu W, Li W, Jiang T, Wei S, Yang S, Shen Y. Association of prenatal renal ultrasound abnormalities with pathogenic copy number variants in a large Chinese cohort. Ultrasound Obstet Gynecol 2022; 59:226-233. [PMID: 34090309 DOI: 10.1002/uog.23702] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 05/12/2021] [Accepted: 05/21/2021] [Indexed: 06/10/2023]
Abstract
OBJECTIVES To assess the clinical utility of prenatal chromosomal microarray analysis (CMA) in fetuses with abnormal renal sonographic findings, and to evaluate the association of pathogenic or likely pathogenic copy number variants (P/LP CNVs) with different types of renal abnormality. METHODS This was a retrospective study of fetuses at 14-36 weeks screened routinely for renal and other structural abnormalities at the Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region. We retrieved and analyzed data from fetuses with abnormal renal sonographic findings, examined between January 2013 and November 2019, which underwent CMA analysis using tissue obtained from chorionic villus sampling (CVS), amniocentesis or cordocentesis. We evaluated the CMA findings according to type of renal ultrasound anomaly and according to whether renal anomalies were isolated or non-isolated. RESULTS Ten types of renal anomaly were reported on prenatal ultrasound screening, at a mean ± SD gestational age of 24.9 ± 4.8 weeks. The anomalies were diagnosed relatively late in this series, as 64% of cases with an isolated renal anomaly underwent cordocentesis rather than CVS. Fetal pyelectasis was the most common renal ultrasound finding, affecting around one-third (34.32%, 301/877) of fetuses with a renal anomaly, but only 3.65% (n = 11) of these harbored a P/LP CNV (comprising: isolated cases, 2.37% (4/169); non-isolated cases, 5.30% (7/132)). Hyperechogenic kidney was found in 5.47% (n = 48) of fetuses with a renal anomaly, of which 39.58% (n = 19) had a P/LP CNV finding (comprising: isolated cases, 44.44% (16/36); non-isolated cases, 25.00% (3/12)), the highest diagnostic yield among the different types of renal anomaly. Renal agenesis, which accounted for 9.92% (n = 87) of all abnormal renal cases, had a CMA diagnostic yield of 12.64% (n = 11) (comprising: isolated cases, 11.54% (9/78); non-isolated cases, 22.22% (2/9); unilateral cases, 11.39% (9/79); bilateral cases, 25.00% (2/8)), while multicystic dysplastic kidney (n = 110), renal cyst (n = 34), renal dysplasia (n = 27), crossed fused renal ectopia (n = 31), hydronephrosis (n = 98), renal duplication (n = 42) and ectopic kidney (n = 99) had overall diagnostic rates of 11.82%, 11.76%, 7.41%, 6.45%, 6.12%, 4.76% and 3.03%, respectively. Compared with the combined group of CMA-negative fetuses with any other type of renal anomaly, the rate of infant being alive and well at birth was significantly higher in CMA-negative fetuses with isolated fetal pyelectasis or ectopic kidney, whereas the rate was significantly lower in fetuses with isolated renal agenesis, multicystic dysplastic kidney or severe hydronephrosis. The most common pathogenic CNV was 17q12 deletion, which accounted for 30.14% (22/73) of all positive CMA findings, with a rate of 2.51% (22/877) among fetuses with an abnormal renal finding. Fetuses with 17q12 deletion exhibited a wide range of renal phenotypes. Other P/LP CNVs in the recurrent region that were associated with prenatal renal ultrasound abnormalities included 22q11.2, Xp21.1, Xp22.3, 2q13, 16p11.2 and 1q21, which, collectively, accounted for 2.17% (19/877) of the fetuses with prenatal renal anomalies. CONCLUSIONS In this retrospective review of CMA findings in a large cohort of fetuses with different types of renal ultrasound abnormality, the P/LP CNV detection rate varied significantly (3.03-39.58%) among the different types of kidney anomaly. Our data may help in the decision regarding whether to perform prenatal genetic testing in fetuses with renal ultrasound findings. Specifically, prenatal CMA testing should be performed in cases of hyperechogenic kidney, regardless of whether or not the anomaly is isolated, while it should be performed postnatally rather than prenatally in cases of fetal pyelectasis. © 2021 International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- J Su
- Department of Genetic and Metabolic Central Laboratory, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Guangxi Birth Defects Prevention and Control Institute, Nanning, China
| | - Z Qin
- Department of Genetic and Metabolic Central Laboratory, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Guangxi Birth Defects Prevention and Control Institute, Nanning, China
| | - H Fu
- Department of Clinical Genetics, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - J Luo
- Department of Genetic and Metabolic Central Laboratory, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Guangxi Birth Defects Prevention and Control Institute, Nanning, China
| | - Y Huang
- Department of Ultrasound Examination, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - P Huang
- Department of Genetic and Metabolic Central Laboratory, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Guangxi Birth Defects Prevention and Control Institute, Nanning, China
| | - S Zhang
- Department of Genetic and Metabolic Central Laboratory, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Guangxi Birth Defects Prevention and Control Institute, Nanning, China
| | - T Liu
- Department of Genetic and Metabolic Central Laboratory, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Guangxi Birth Defects Prevention and Control Institute, Nanning, China
| | - W Lu
- Department of Genetic and Metabolic Central Laboratory, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Guangxi Birth Defects Prevention and Control Institute, Nanning, China
| | - W Li
- Department of Genetic and Metabolic Central Laboratory, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Guangxi Birth Defects Prevention and Control Institute, Nanning, China
| | - T Jiang
- Department of Genetic and Metabolic Central Laboratory, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Guangxi Birth Defects Prevention and Control Institute, Nanning, China
| | - S Wei
- Department of Genetic and Metabolic Central Laboratory, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Guangxi Birth Defects Prevention and Control Institute, Nanning, China
| | - S Yang
- Department of Ultrasound Examination, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Y Shen
- Department of Genetic and Metabolic Central Laboratory, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Guangxi Birth Defects Prevention and Control Institute, Nanning, China
- Division of Genetics and Genomics, Boston Children's Hospital, Department of Neurology, Harvard Medical School, Boston, MA, USA
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Zhang C, Niu D, Zhang L, Li X, Fu H. Plant functional traits shape growth rate for xerophytic shrubs. Plant Biol (Stuttg) 2022; 24:205-214. [PMID: 34693599 DOI: 10.1111/plb.13317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 06/28/2021] [Indexed: 06/13/2023]
Abstract
Trade-offs exist for xerophytic shrubs between functional traits, involving in water loss and assimilate accumulation, can contribute to its survival and growth rate regulation in arid environments. However, growth analysis based on plant functional traits has been focused on the study of herbs and woody species. It is still unclear how the functional traits of xerophytic shrubs regulate their growth rate. In this study, we selectedeight xerophytic shrubs as samples to analyze the regulation process of the functional traits of shrubs on growth rate. Plants were cultivated for three years, and three harvests (every one year) were carried out. Factors explaining between-species differences in relative growth rate (RGR) varied, depending on whether different ages were considered. The results showed that RGR was positively correlated with net assimilation rate, but there was a significant negative correlation with leaf area ration (LAR), specific leaf area (SLA), and leaf biomass ratio in the age 1. However, in the age 2, RGR showed a significant positive correlation with the morphological traits (i.e., leaf area ration and specific leaf area), but not with physiological traits (i.e., net assimilation rate) and leaf biomass allocation. Our results suggested that the fluctuation of environmental factors affects the regulation path of the plant functional traits on RGR of xerophytic shrubs. However, the analysis of causality model showed that no matter in which age, net assimilation rate and leaf area ration principally drive the variation in RGR among xerophytic shrubs.
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Affiliation(s)
- C Zhang
- State Key Laboratory of Grassland Agro-ecosystems, Key Laboratory of Grassland Livestock Industry Innovation, Ministry of Agriculture and Rural Affairs, Engineering Research Center of Grassland Industry, Ministry of Education, College of Pastoral Agriculture Science and Technology, Lanzhou University, Lanzhou, 730020, PR China
| | - D Niu
- State Key Laboratory of Grassland Agro-ecosystems, Key Laboratory of Grassland Livestock Industry Innovation, Ministry of Agriculture and Rural Affairs, Engineering Research Center of Grassland Industry, Ministry of Education, College of Pastoral Agriculture Science and Technology, Lanzhou University, Lanzhou, 730020, PR China
| | - L Zhang
- State Key Laboratory of Grassland Agro-ecosystems, Key Laboratory of Grassland Livestock Industry Innovation, Ministry of Agriculture and Rural Affairs, Engineering Research Center of Grassland Industry, Ministry of Education, College of Pastoral Agriculture Science and Technology, Lanzhou University, Lanzhou, 730020, PR China
| | - X Li
- State Key Laboratory of Grassland Agro-ecosystems, Key Laboratory of Grassland Livestock Industry Innovation, Ministry of Agriculture and Rural Affairs, Engineering Research Center of Grassland Industry, Ministry of Education, College of Pastoral Agriculture Science and Technology, Lanzhou University, Lanzhou, 730020, PR China
| | - H Fu
- State Key Laboratory of Grassland Agro-ecosystems, Key Laboratory of Grassland Livestock Industry Innovation, Ministry of Agriculture and Rural Affairs, Engineering Research Center of Grassland Industry, Ministry of Education, College of Pastoral Agriculture Science and Technology, Lanzhou University, Lanzhou, 730020, PR China
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Chan PK, Fung WC, Lam KH, Chan W, Chan VWK, Fu H, Cheung A, Cheung MH, Yan CH, Chiu KY. The application of close incisional negative pressure wound therapy in revision arthroplasty among asian patients: a comparative study. Arthroplasty 2021; 3:38. [PMID: 35236484 PMCID: PMC8796595 DOI: 10.1186/s42836-021-00094-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 08/16/2021] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Peri-prosthetic joint infection (PJI) was one of the main causes of revision of arthroplasty. In order to reduce wound complications and surgical site infections, close incisional negative pressure wound therapy (ciNPWT) has been introduced into arthroplasty. This study was designed to review the clinical benefits of the application of ciNPWT in revision arthroplasty. METHODS This was a single-centre retrospective comparative study approved by the Institutional Review Board. Patients, who underwent revision total knee arthroplasty or revision total hip arthroplasty at the author's institution from January 2016 to October 2019, were included in this study. The ciNPWT cohort included all eligible patients, who underwent operations from January 2018 to October 2019, with the use of ciNPWT(n = 36). The control cohort included all eligible patients, who underwent operations from January 2016 to December 2017 with the use of conventional dressing(n = 48). The incidences of wound complications were compared to both cohorts. RESULTS There was a statistically significant difference in the rate of superficial surgical site infection (SSI) between control cohort and ciNPWT cohort (12.5% in control vs 0% in ciNPWT, p = 0.035). However, there was no statistically significance of the overall wound complication rate for both cohorts. (14.6% in control vs 8.3% in ciNPWT, p = 0.504). CONCLUSIONS The application of ciNPWT could result in a lower rate of superficial surgical site infection when compared with conventional dressing among the patients undergoing revision total knee and total hip arthroplasties. TRIAL REGISTRATION UW19-706.
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Affiliation(s)
- Ping Keung Chan
- Department of Orthopaedics and Traumatology, Queen Mary Hospital, Hong Kong SAR, China.
| | - Wing Chiu Fung
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong SAR, China
| | - Kar Hei Lam
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong SAR, China
| | - Winnie Chan
- Department of Nursing, Queen Mary Hospital, Operation Theatre Services, Hong Kong SAR, China
| | - Vincent Wai Kwan Chan
- Department of Orthopaedics and Traumatology, Queen Mary Hospital, Hong Kong SAR, China
| | - Henry Fu
- Department of Orthopaedics and Traumatology, Queen Mary Hospital, Hong Kong SAR, China
| | - Amy Cheung
- Department of Orthopaedics and Traumatology, Queen Mary Hospital, Hong Kong SAR, China
| | - Man Hong Cheung
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong SAR, China
| | - Chun Hoi Yan
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong SAR, China
| | - Kwong Yuen Chiu
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong SAR, China
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36
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Cheung A, Chan PK, Fu H, Cheung MH, Chan VWK, Yan CH, Chiu KY. Total knee arthroplasty is safe for patients aged ≥80 years in Hong Kong. Hong Kong Med J 2021; 27:350-354. [PMID: 34706985 DOI: 10.12809/hkmj208942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION Total knee arthroplasty (TKA) is an efficacious operation that improves pain and function in patients with knee arthritis. Because of the population ageing trend in Hong Kong, there is a need to determine the safety profile of TKA in older patients. This study examined the age of patients who underwent TKA in the past 10 years in Hong Kong; the aim was to investigate the mortality safety profile and clinical outcomes of TKA in patients aged ≥80 years. METHODS This study included all patients who underwent primary TKA in the Hospital Authority (HA) from 2010 to 2019. Incidences of 30-day, 90-day, and 1-year mortality were established. Clinical outcomes of patients aged ≥80 years in one cluster of HA hospitals were assessed. RESULTS Between 2010 and 2019, 25 040 TKA procedures were conducted in all HA hospitals; 2491 were conducted in patients aged ≥80 years. The median age at operation was higher during 2015-2019 than during 2010-2014 (70 vs 69 years; P<0.001); furthermore, an increase was observed in the proportion of patients aged ≥80 years at the time of operation. Incidences of 30-day, 90-day, and 1-year mortality were 0.156%, 0.35%, and 1.09%, respectively. CONCLUSIONS In this first study to examine the safety profile of TKA in older patients in Hong Kong, the mean age at the time of TKA and proportion of patients aged ≥80 years have steadily risen in the past decade. Even in older patients, TKA is a reasonably safe procedure.
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Affiliation(s)
- A Cheung
- Department of Orthopaedics and Traumatology, Queen Mary Hospital, Hong Kong
| | - P K Chan
- Department of Orthopaedics and Traumatology, Queen Mary Hospital, Hong Kong
| | - H Fu
- Department of Orthopaedics and Traumatology, Queen Mary Hospital, Hong Kong
| | - M H Cheung
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong
| | - V W K Chan
- Department of Orthopaedics and Traumatology, Queen Mary Hospital, Hong Kong
| | - C H Yan
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong
| | - K Y Chiu
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong
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Lee LS, Chan PK, Fung WC, Cheung A, Chan VWK, Cheung MH, Fu H, Yan CH, Chiu KY. Lessons learnt from the impact of COVID-19 on arthroplasty services in Hong Kong: how to prepare for the next pandemic? Arthroplasty 2021; 3:36. [PMID: 34977467 PMCID: PMC8418902 DOI: 10.1186/s42836-021-00093-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 08/17/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Arthroplasty services worldwide have been significantly disrupted by the pandemic of coronavirus disease 2019 (COVID-19). This retrospective comparative study aimed to characterize its impact on arthroplasty services in Hong Kong. METHODS From January 1 to June 30, 2020, the patients of "COVID-19 cohort" underwent elective total hip or knee replacement in Hong Kong public hospitals. The cohort was compared to the "control cohort" during the same period in 2019. Data analysis was performed to compare the two cohorts' numbers of operations, hospital admission, orthopaedic clinic attendances, and waiting time. RESULTS A total of 33,111 patient episodes were analyzed. During the study period, the elective arthroplasty operations and hospitalizations decreased by 53 and 54%, respectively (P < 0.05). Reductions were most drastic from February to April, with surgical volume declining by 86% (P < 0.05). The primary arthroplasty operations decreased by 91% (P < 0.05), while the revision operations remained similar. Nevertheless, 14 public hospitals continued performing elective arthroplasty for patients with semi-urgent indications, including infection, progressive bone loss, prosthesis loosening, dislocation or mechanical failure of arthroplasty, and tumor. At the institution with the highest arthroplasty surgical volume, infection (28%) was the primary reason for surgery, followed by prosthesis loosening (22%) and progressive bone loss (17%). The orthopaedic clinic attendances also decreased by 20% (P < 0.05). Increases were observed in waiting time and the total number of patients on the waiting list for elective arthroplasty. CONCLUSIONS Despite the challenges, public hospitals in Hong Kong managed to continue providing elective arthroplasty services for high-priority patients. Arthroplasty prioritization, infection control measures, and post-pandemic service planning can enhance hospital preparedness to mitigate the impact of current and future pandemics.
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Affiliation(s)
- Lok Sze Lee
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong, China
| | - Ping Keung Chan
- Department of Orthopaedics and Traumatology, Queen Mary Hospital, Hong Kong, China
| | - Wing Chiu Fung
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong, China
| | - Amy Cheung
- Department of Orthopaedics and Traumatology, Queen Mary Hospital, Hong Kong, China
| | | | - Man Hong Cheung
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong, China
| | - Henry Fu
- Department of Orthopaedics and Traumatology, Queen Mary Hospital, Hong Kong, China
| | - Chun Hoi Yan
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong, China
| | - Kwong Yuen Chiu
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong, China
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Xu K, Wang XD, Yang ZG, Xu HY, Xu R, Xie LJ, Wen LY, Fu H, Yan WF, Guo YK. Quantification of peak blood flow velocity at the cardiac valve and great thoracic vessels by four-dimensional flow and two-dimensional phase-contrast MRI compared with echocardiography: a systematic review and meta-analysis. Clin Radiol 2021; 76:863.e1-863.e10. [PMID: 34404516 DOI: 10.1016/j.crad.2021.07.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 07/15/2021] [Indexed: 02/08/2023]
Abstract
AIM To objectively examine the agreement and correlation between four-dimensional (4D) flow magnetic resonance imaging (MRI) and traditional two-dimensional (2D) phase-contrast (PC) MRI with the reference standard of Doppler echocardiography for measuring peak blood velocity at the cardiac valve and great arteries, and to assess if 4D flow MRI offers an advantage over the traditional 2D method. MATERIALS AND METHODS The literature was searched systematically for studies that evaluate the degree of correlation and agreement between 4D flow MRI or 2D PC MRI and Doppler retrieved from PubMed, EMBASE, and the Cochrane Library. A meta-analysis was conducted to determine the peak velocity pooled bias with 95% limits of agreement (LoA) and correlation coefficient (r) for 4D flow MRI and 2D PC MRI compared with Doppler. RESULTS Ten studies that compared 4D flow MRI with Doppler and 12 studies that compared 2D PC MRI with Doppler were included. 4D flow MRI showed an underestimation with bias and 95% LoA of -0.09 (-0.41, 0.24) m/s (p=0.079) while 2D PC MRI showed a poorer agreement with a bias and 95% LoA of -0.25 (-0.53, 0.03), p=0.596. 4D flow MRI and 2D PC MRI showed a strong correlation with R=0.80 (95% CI 0.75, 0.84; p<0.001) and R=0.83 (95% CI 0.79, 0.87; p<0.001), respectively. CONCLUSION In this meta-analysis, 4D flow MRI provides improved assessment of peak velocity when compared with traditional 2D PC MRI. 4D flow MRI can be considered an important complement or substitute to Doppler echocardiography for peak velocity assessment.
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Affiliation(s)
- K Xu
- Department of Radiology, Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China
| | - X D Wang
- Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Z G Yang
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - H Y Xu
- Department of Radiology, Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China
| | - R Xu
- Department of Radiology, Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China
| | - L J Xie
- Department of Radiology, Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China
| | - L Y Wen
- Department of Radiology, Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China
| | - H Fu
- Department of Radiology, Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China
| | - W F Yan
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Y K Guo
- Department of Radiology, Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China.
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Li H, Sui X, Wang Z, Fu H, Wang Z, Yuan M, Liu S, Wang G, Guo Q. A new antisarcoma strategy: multisubtype heat shock protein/peptide immunotherapy combined with PD-L1 immunological checkpoint inhibitors. Clin Transl Oncol 2021; 23:1688-1704. [PMID: 33792840 PMCID: PMC8238772 DOI: 10.1007/s12094-021-02570-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Accepted: 02/07/2021] [Indexed: 12/11/2022]
Abstract
Osteosarcoma, a common malignant tumor in orthopedics, often has a very poor prognosis after lung metastasis. Immunotherapy has not achieved much progress in the treatment because of the characteristics of solid tumors and immune environment of osteosarcoma. The tumor environment is rather essential for sarcoma treatment. Our previous study demonstrated that heat shock proteins could be used as antitumor vaccines by carrying tumor antigen peptides, and we hypothesize that an anti-osteosarcoma effect may be increased with an immune check point inhibitor (PD-L1 inhibitor) as a combination treatment strategy. The present study prepared a multisubtype mixed heat shock protein osteosarcoma vaccine (mHSP/peptide vaccine) and concluded that the mHSP/peptide vaccine was more effective than a single subtype heat shock protein, like Grp94. Therefore, we used the mHSP/peptide vaccine in combination with a PD-L1 inhibitor to treat osteosarcoma, and the deterioration of osteosarcoma was effectively hampered. The mechanism of combined therapy was investigated, and AKT expression participates with sarcoma lung metastasis. This study proposed an antisarcoma strategy via stimulation of the immune system as a further alternative approach for sarcoma treatment and elucidated the mechanism of combined therapy.
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Affiliation(s)
- H. Li
- Institute of Orthopedics, Chinese PLA General Hospital, Beijing Key Laboratory of Regenerative Medicine in Orthopedics, Key Laboratory of Musculoskeletal Trauma War Injuries, PLA, No. 28 Fuxing Road, Haidian District, Beijing, 100853 China
- Changzhi Second People’s Hospital, Changzhi, 046000 Shanxi China
| | - X. Sui
- Institute of Orthopedics, Chinese PLA General Hospital, Beijing Key Laboratory of Regenerative Medicine in Orthopedics, Key Laboratory of Musculoskeletal Trauma War Injuries, PLA, No. 28 Fuxing Road, Haidian District, Beijing, 100853 China
| | - Z. Wang
- Institute of Orthopedics, Chinese PLA General Hospital, Beijing Key Laboratory of Regenerative Medicine in Orthopedics, Key Laboratory of Musculoskeletal Trauma War Injuries, PLA, No. 28 Fuxing Road, Haidian District, Beijing, 100853 China
| | - H. Fu
- School of Medicine, Nankai University, Tianjin, 300071 China
| | - Z. Wang
- Institute of Orthopedics, Chinese PLA General Hospital, Beijing Key Laboratory of Regenerative Medicine in Orthopedics, Key Laboratory of Musculoskeletal Trauma War Injuries, PLA, No. 28 Fuxing Road, Haidian District, Beijing, 100853 China
| | - M. Yuan
- Institute of Orthopedics, Chinese PLA General Hospital, Beijing Key Laboratory of Regenerative Medicine in Orthopedics, Key Laboratory of Musculoskeletal Trauma War Injuries, PLA, No. 28 Fuxing Road, Haidian District, Beijing, 100853 China
| | - S. Liu
- Institute of Orthopedics, Chinese PLA General Hospital, Beijing Key Laboratory of Regenerative Medicine in Orthopedics, Key Laboratory of Musculoskeletal Trauma War Injuries, PLA, No. 28 Fuxing Road, Haidian District, Beijing, 100853 China
| | - G. Wang
- Department of Microbiology and Immunology, Shanxi Medical University, Taiyuan, 030001 Shanxi China
| | - Q. Guo
- Institute of Orthopedics, Chinese PLA General Hospital, Beijing Key Laboratory of Regenerative Medicine in Orthopedics, Key Laboratory of Musculoskeletal Trauma War Injuries, PLA, No. 28 Fuxing Road, Haidian District, Beijing, 100853 China
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Fu H, Garrett B, Tao G, Cordingley E, Ofoghi Z, Taverner T, Sun C, Cheung T. Virtual Reality–Guided Meditation for Chronic Pain in Patients With Cancer: Exploratory Analysis of Electroencephalograph Activity. JMIR Biomed Eng 2021. [DOI: 10.2196/26332] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Background
Mindfulness-based stress reduction has demonstrated some efficacy for chronic pain management. More recently, virtual reality (VR)–guided meditation has been used to assist mindfulness-based stress reduction. Although studies have also found electroencephalograph (EEG) changes in the brain during mindfulness meditation practices, such changes have not been demonstrated during VR-guided meditation.
Objective
This exploratory study is designed to explore the potential for recording and analyzing EEG during VR experiences in terms of the power of EEG waveforms, topographic mapping, and coherence. We examine how these measures changed during a VR-guided meditation experience in participants with cancer-related chronic pain.
Methods
A total of 10 adult patients with chronic cancer pain underwent a VR-guided meditation experience while EEG signals were recorded during the session using a BioSemi ActiveTwo system (64 channels, standard 10-20 configuration). The EEG recording session consisted of an 8-minute resting condition (pre), a 30-minute sequence of 3 VR-guided meditation conditions (med), and a final rest condition (post). Power spectral density (PSD) was compared between each condition using a cluster-based permutation test and across conditions using multivariate analysis of variance. A topographic analysis, including coherence exploration, was performed. In addition, an exploratory repeated measures correlation was used to examine possible associations between pain scores and EEG signal power.
Results
The predominant pattern was for increased β and γ bandwidth power in the meditation condition (P<.025), compared with both the baseline and postexperience conditions. Increased power in the bandwidth was evident, although not statistically significant. The pre versus post comparison also showed changes in the θ and α bands (P=.02) located around the frontal, central, and parietal cortices. Across conditions, multivariate analysis of variance tests identified 4 clusters with significant (P<.05) PSD differences in the δ, θ, β, and γ bands located around the frontal, central, and parietal cortices. Topographically, 5 peak channels were identified: AF7, FP2, FC1, CP5, and P5, and verified the changes in power in the different brain regions. Coherence changes were observed primarily between the frontal, parietal, and occipital regions in the θ, α, and γ bands (P<.0025). No significant associations were observed between pain scores and EEG PSD.
Conclusions
This study demonstrates the feasibility of EEG recording in exploring neurophysiological changes in brain activity during VR-guided meditation and its effect on pain reduction. These findings suggest that distinct altered neurophysiological brain signals are detectable during VR-guided meditation. However, these changes were not necessarily associated with pain. These exploratory findings may guide further studies to investigate the highlighted regions and EEG bands with respect to VR-guided meditation.
Trial Registration
ClinicalTrials.gov NCT00102401; http://clinicaltrials.gov/ct2/show/NCT00102401
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Zhang H, Fu H, Fu X, Zhang J, Zhang P, Yang S, Zeng Z, Fu N, Guo Z. Glycosylated hemoglobin levels and the risk for contrast-induced nephropathy in diabetic patients undergoing coronary arteriography/percutaneous coronary intervention. BMC Nephrol 2021; 22:206. [PMID: 34078303 PMCID: PMC8173735 DOI: 10.1186/s12882-021-02405-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 05/16/2021] [Indexed: 12/18/2022] Open
Abstract
Backgrounds Diabetes mellitus is an independent risk factor for Contrast-induced nephropathy (CIN) in patients undergoing Coronary arteriography (CAG)/percutaneous coronary intervention (PCI). Glycosylated hemoglobin (HbA1c) is the gold standard to measure blood glucose control, which has important clinical significance for evaluating blood glucose control in diabetic patients in the past 3 months. This study aimed to assess whether preoperative HbA1c levels in diabetic patients who received CAG/PCI impacted the occurrence of postoperative CIN. Methods We reviewed the incidence of preoperative HbA1c and postoperative CIN in 670 patients with CAG/PCI from January 1, 2020 to October 30, 2020 and divided the preoperative HbA1c levels into 5 groups. Blood samples were collected at admission, 48 h and 72 h after operation to measure the Scr value of patients. Categorical variables were compared using a chi-square test, and continuous variables were compared using an analysis of variance. Fisher’s exact test was used to compare the percentages when the expected frequency was less than 5. Univariable and multivariable logistic regression analysis was used to exclude the influence of confounding factors, and P for trend was used to analyze the trend between HbA1c levels and the increased risk of CIN. Results Patients with elevated HbA1c had higher BMI, FBG, and LDL-C, and they were more often on therapy with hypoglycemic agents, Insulin and PCI. They also had higher basal, 48 h and 72 h Scr. The incidence of CIN in the 5 groups of patients were: 9.8, 11.9, 15.2, 25.3, 48.1%. (p < 0.0001) The multivariate analysis confirmed that in the main high-risk subgroup, patients with elevated HbA1C levels (≥8.8%) had a higher risk of CIN disease. Trend test showed the change of OR (1.000,1.248,1.553,2.625,5.829). Conclusions Studies have shown that in diabetic patients undergoing CAG/PCI, elevated HbA1c is independently associated with the risk of CIN, and when HbA1c > 9.5%, the incidence of CIN trends increase. Therefore, we should attach great importance to patients with elevated HbA1c at admission and take more active measures to prevent CIN.
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Affiliation(s)
- H Zhang
- Clinical College of Chest,Tianjin Medical University, Tianjin, China.,Department of Cardiology, Tianjin Chest Hospital, No. 261, Taierzhuang South Road, Jinnan District, Tianjin, 300222, China
| | - H Fu
- Tianjin Medical University, Tianjin, China
| | - X Fu
- Tianjin Medical University, Tianjin, China
| | - J Zhang
- Department of Cardiology, Tianjin Chest Hospital, No. 261, Taierzhuang South Road, Jinnan District, Tianjin, 300222, China
| | - P Zhang
- Department of Cardiology, Tianjin Chest Hospital, No. 261, Taierzhuang South Road, Jinnan District, Tianjin, 300222, China
| | - S Yang
- Department of Cardiology, Tianjin Chest Hospital, No. 261, Taierzhuang South Road, Jinnan District, Tianjin, 300222, China
| | - Z Zeng
- Tianjin Medical University, Tianjin, China
| | - N Fu
- Department of Cardiology, Tianjin Chest Hospital, No. 261, Taierzhuang South Road, Jinnan District, Tianjin, 300222, China.
| | - Z Guo
- Department of Cardiology, Tianjin Chest Hospital, No. 261, Taierzhuang South Road, Jinnan District, Tianjin, 300222, China.
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Fu H, Nie SP, Bai R. [Impact of iron deficiency on prognosis of heart failure patients with preserved ejection fraction]. Zhonghua Xin Xue Guan Bing Za Zhi 2021; 49:479-486. [PMID: 34034382 DOI: 10.3760/cma.j.cn112148-20210104-00018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the impact of iron deficiency (ID) on prognosis in heart failure patients with preserved ejection fraction (HFpEF). Methods: A total of 215 consecutive patients with HFpEF, who visited the cardiovascular outpatient department of Beijing Anzhen Hospital, were enrolled in this prospective study. The plasma ferritin level and transferin saturation were measured. Patients were divided into two groups: ID group and non-ID group. ID patients were further divided into absolute ID subgroup and functional ID subgroup. Patients were followed up to 1 year. The endpoints of the study were all-cause mortality and rehospitalization for heart failure (HF). The independent predictors of outcome were determined by Cox regression model. The quality of life of patients was evaluated at the end of the follow-up. Results: The age of this patient cohort was (67±8) years, 39.1% patients were male. The prevalence of ID was 54.4%. Within one year of follow-up, 37 patients (17.2%) died and 70 patients (32.6%) were rehospitalized for HF. Compared to non-ID group, patients in ID group were older, had higher heart rate, lower plasma hemoglobin level and estimated glomerular filtration rate (eGFR) value, had a higher prevalence of anemia and chronic kidney disease (P all<0.05). Kaplan-Meier curves showed that all-cause mortality and rehospitalization for HF in HFpEF patients with ID were higher than patients without ID, and prognosis was similar between patients with absolute ID and functional ID. Multivariable regression analysis showed that ID was an independent predictor for all-cause mortality and rehospitalization for HF in HFpEF patients. The of 6 minutes walking distance was shorter ((356.0±98.3)m vs. (389.2±94.3)m, P=0.023), and the value in Kansas city cardiomyopathy questionnaire was lower ((58.06±10.43) m vs. (61.51±11.64) m, P = 0.039) in patients with ID than patients without ID. Conclusion: In patients with chronic HFpEF, ID is an independent predictor for all-cause mortality and rehospitalization for HF at one year of follow-up, independent of the types of ID.
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Affiliation(s)
- H Fu
- Emergency and Critical Care Center, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - S P Nie
- Emergency and Critical Care Center, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - R Bai
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
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Chan PK, Cheung SL, Lam KH, Fung WC, Chan VWK, Cheung A, Cheung MH, Fu H, Yan CH, Chiu KY. Use of a modular hip dual-mobility articulation in patients with high risk of dislocation: a relatively small-sized acetabulum in Asian patients may limit its use. Arthroplasty 2021; 3:7. [PMID: 35236462 PMCID: PMC8796556 DOI: 10.1186/s42836-020-00066-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 12/21/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Dual-mobility hip component is widely used in Europe and North America, because it effectively reduces hip dislocation in primary and revision total hip arthroplasties. However, reports were limited on the use of dual-mobility articulation in Asian populations. PURPOSE The aim of this retrospective study was to review the use of modular dual-mobility hip articulation in Asian patients with the high risk factor for hip dislocation. We also discussed the potential concern on the use of dual-mobility articulation in Asian patients. METHODS From Jan 2018 to June 2019, 17 patients were included in this study. The mean age of the patients was (73.8 ± 9.5) years (range: 57-88 years). The mean size of acetabular cup and modular DM liner were (49.5 ± 3.4) mm (range, 46-58 mm) and (40.7 ± 3.4) mm (range, 38-48 mm), respectively. The mean follow-up period was (15.8 ± 3.9) months (range, 11-24 months). The primary outcome was the rate of hip dislocation. The secondary outcomes included the Harris Hip Score. Differences were considered statistically significant at p < 0.05. RESULTS Hip dislocation, loosening, peri-prosthetic fractures, or intra-prosthetic dislocation was not found in the series. The mean preoperative and postoperative Harris Hip Scores were 42.2 ± 17.2 (range, 15-80) and 74.7 ± 13.5 (range, 52-97), respectively, giving a mean improvement of 32.5 ± 17.2 (range, 4-72). The improvement was statistically significant (p < 0.05). CONCLUSIONS In Asian patients with high risk of hip dislocation, the use of modular dual-mobility hip component produces promising outcomes without hip dislocation, but the relatively small-sized acetabulum may limit it widespread application in other populations worldwide. TRIAL REGISTRATION HKUCTR-2913 .
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Affiliation(s)
- Ping Keung Chan
- Department of Orthopaedics & Traumatology, Queen Mary Hospital, The University of Hong Kong, 102 Pok Fu Lam Road, Hong Kong, Hong Kong SAR.
| | - Sum Lik Cheung
- Department of Orthopaedics & Traumatology, Queen Mary Hospital, The University of Hong Kong, 102 Pok Fu Lam Road, Hong Kong, Hong Kong SAR
| | - Kar Hei Lam
- Department of Orthopaedics & Traumatology, Queen Mary Hospital, The University of Hong Kong, 102 Pok Fu Lam Road, Hong Kong, Hong Kong SAR
| | - Wing Chiu Fung
- Department of Orthopaedics & Traumatology, Queen Mary Hospital, The University of Hong Kong, 102 Pok Fu Lam Road, Hong Kong, Hong Kong SAR
| | - Vincent Wai Kwan Chan
- Department of Orthopaedics & Traumatology, Queen Mary Hospital, The University of Hong Kong, 102 Pok Fu Lam Road, Hong Kong, Hong Kong SAR
| | - Amy Cheung
- Department of Orthopaedics & Traumatology, Queen Mary Hospital, The University of Hong Kong, 102 Pok Fu Lam Road, Hong Kong, Hong Kong SAR
| | - Man Hong Cheung
- Department of Orthopaedics & Traumatology, Queen Mary Hospital, The University of Hong Kong, 102 Pok Fu Lam Road, Hong Kong, Hong Kong SAR
| | - Henry Fu
- Department of Orthopaedics & Traumatology, Queen Mary Hospital, The University of Hong Kong, 102 Pok Fu Lam Road, Hong Kong, Hong Kong SAR
| | - Chun Hoi Yan
- Department of Orthopaedics & Traumatology, Queen Mary Hospital, The University of Hong Kong, 102 Pok Fu Lam Road, Hong Kong, Hong Kong SAR
| | - Kwong Yuen Chiu
- Department of Orthopaedics & Traumatology, Queen Mary Hospital, The University of Hong Kong, 102 Pok Fu Lam Road, Hong Kong, Hong Kong SAR
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Zhang J, Yin S, Chen L, Ma Y, Wang M, Fu H, Wu Y, Tian W, Qiu S, Su G. A study on the dynamic characteristics of the secondary loop in nuclear power plant. Nuclear Engineering and Technology 2021. [DOI: 10.1016/j.net.2020.11.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Chan VW, Chan PK, Fu H, Cheung MH, Cheung A, Yan CH, Chiu KY. Preoperative optimization to prevent periprosthetic joint infection in at-risk patients. J Orthop Surg (Hong Kong) 2021; 28:2309499020947207. [PMID: 32851909 DOI: 10.1177/2309499020947207] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Periprosthetic joint infection (PJI) remains an important complication with devastating consequences after total joint arthroplasties. With the increasing number of arthroplasties worldwide, the number of PJI will increase correspondingly with a significant economic burden to our healthcare system. It is likely impossible to completely eradicate PJI; hence, assessment and optimization of its risk factors to preventing such a disastrous complication will be the key. There are many strategies to prevent PJI in the preoperative, intraoperative, or postoperative phases. The preoperative assessment provides a unique opportunity to screen and diagnose underlying comorbidities and optimize modifiable risk factors before elective surgeries. In this review, we will focus on current literature in preoperative assessment of various modifiable risk factors and share the experience and practical approach in our institution in preoperative optimization to reduce PJI in total joint arthroplasties.
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Affiliation(s)
- Vincent Wk Chan
- Division of Joint Replacement Surgery, Department of Orthopaedics and Traumatology, The University of Hong Kong, 26473Queen Mary Hospital, Hong Kong, SAR, China
| | - P K Chan
- Division of Joint Replacement Surgery, Department of Orthopaedics and Traumatology, The University of Hong Kong, 26473Queen Mary Hospital, Hong Kong, SAR, China
| | - H Fu
- Division of Joint Replacement Surgery, Department of Orthopaedics and Traumatology, The University of Hong Kong, 26473Queen Mary Hospital, Hong Kong, SAR, China
| | - M H Cheung
- Division of Joint Replacement Surgery, Department of Orthopaedics and Traumatology, The University of Hong Kong, 26473Queen Mary Hospital, Hong Kong, SAR, China
| | - A Cheung
- Division of Joint Replacement Surgery, Department of Orthopaedics and Traumatology, The University of Hong Kong, 26473Queen Mary Hospital, Hong Kong, SAR, China
| | - C H Yan
- Division of Joint Replacement Surgery, Department of Orthopaedics and Traumatology, The University of Hong Kong, 26473Queen Mary Hospital, Hong Kong, SAR, China
| | - K Y Chiu
- Division of Joint Replacement Surgery, Department of Orthopaedics and Traumatology, The University of Hong Kong, 26473Queen Mary Hospital, Hong Kong, SAR, China
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Fu H, Tsao C, Chou N, Yu H, Chen Y, Chou H, Wang C. Outcome of Urgent Desensitization in Sensitized Heart Transplant Recipients. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Ren ZF, Du MF, Fu H, Liu J, Xia FY, Du HN, Liu N. MiR-200c promotes proliferation of papillary thyroid cancer cells via Wnt/β-catenin signaling pathway. Eur Rev Med Pharmacol Sci 2021; 24:5512-5518. [PMID: 32495886 DOI: 10.26355/eurrev_202005_21336] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To investigate the potential effects of miR-200c on proliferation and apoptosis of papillary thyroid cancer (PTC) cells. MATERIALS AND METHODS Micro ribonucleic acid-200c (miR-200c) inhibitor was transfected to down-regulate miR-200c expression. Cell counting kit-8 (CCK-8), colony formation experiment, and flow cytometry were used to detect the effects of miR-200c knockdown on proliferation and apoptosis of Butylated Hydroxytoluene 101 (BHT101) cells. The dual-luciferase reporter gene assay was conducted to detect whether miR-200c directly binds to the target gene. After knocking down miR-200c, quantitative reverse transcription-polymerase chain reaction (qRT-PCR) and Western blotting analysis were performed to detect changes of target genes regarding messenger RNA (mRNA) and protein. Western blotting analysis was also adopted to detect gene expression of Wnt/β-catenin signaling pathway-related proteins. RESULTS Compared with those in control group, the proliferation and clone formation ability of BHT101 cells in miR-200c knockdown group were significantly inhibited (p<0.05), while the apoptosis rate increased markedly (p<0.05). Dachshund Family Transcription Factor 1 (DACH1) was the direct target gene of miR-200c. After miR-200c knockdown, the expression levels of Wnt/β-catenin signaling pathway members (including c-Myc, β catenin and cyclin D1) all decreased. CONCLUSIONS MiR-200c is a tumor suppressor miRNA, which promotes proliferation of PTC cells and activates Wnt/β-catenin signaling pathway by directly regulating the corresponding target protein, DACH1.
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Affiliation(s)
- Z-F Ren
- Department of Head and Neck Surgery, Linyi Cancer Hospital, Linyi, China.
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Leung TKC, Lau WWH, Fung WC, Chan VWK, Cheung A, Cheung MH, Fu H, Yan CH, Chan PK, Chiu KY. Is there difference and correlation between medial and lateral tibial plateau coronal obliquity in native knee? A radiographic study. Journal of Orthopaedics, Trauma and Rehabilitation 2021. [DOI: 10.1177/22104917211056940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background/Purpose Knee joint line is commonly defined as a tangent to medial and lateral tibial plateaus in various radiographic measurements. We aim to investigate radiographic differences between medial and lateral knee joint line coronal obliquity. It has significant implication on radiographic analysis following unicompartmental knee arthroplasty. Methods We analysed the knee radiographs of 48 young patients (mean age 25.1 + /-5.6 years) with 50 anterior cruciate ligament-deficient knees. Medial and lateral tibial plateau coronal obliquity were defined as angles between femoral knee joint line and the tangent to articular surface of each tibial plateau. Mediolateral differences and linear correlation were analysed. Results Significant difference was found between medial (mean = -1.5, SD = 2.4 degrees) and lateral obliquity (mean = + 0.6, SD = 3.0 degrees) ( p < 0.001). The mean mediolateral difference was 3.1 degrees (SD = 2.8, range 0–11.8 degrees), without significant correlation (r = 0.085, p = 0.56). Conclusion Mediolateral differences exist in knee joint line obliquity. Each compartment should be considered separately when measuring knee joint line obliquity.
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Affiliation(s)
- Thomas Ka Chun Leung
- Department of Orthopaedics and Traumatology, Queen Mary Hospital, Hong Kong, China
- Department of Orthopaedics and Traumatology, University of Hong Kong, Hong Kong, China
| | - Will Wai Hong Lau
- Department of Orthopaedics and Traumatology, Queen Mary Hospital, Hong Kong, China
- Department of Orthopaedics and Traumatology, University of Hong Kong, Hong Kong, China
| | - Wing Chiu Fung
- Department of Orthopaedics and Traumatology, Queen Mary Hospital, Hong Kong, China
- Department of Orthopaedics and Traumatology, University of Hong Kong, Hong Kong, China
| | - Vincent Wai Kwan Chan
- Department of Orthopaedics and Traumatology, Queen Mary Hospital, Hong Kong, China
- Department of Orthopaedics and Traumatology, University of Hong Kong, Hong Kong, China
| | - Amy Cheung
- Department of Orthopaedics and Traumatology, Queen Mary Hospital, Hong Kong, China
- Department of Orthopaedics and Traumatology, University of Hong Kong, Hong Kong, China
| | - Man Hong Cheung
- Department of Orthopaedics and Traumatology, Queen Mary Hospital, Hong Kong, China
- Department of Orthopaedics and Traumatology, University of Hong Kong, Hong Kong, China
| | - Henry Fu
- Department of Orthopaedics and Traumatology, Queen Mary Hospital, Hong Kong, China
- Department of Orthopaedics and Traumatology, University of Hong Kong, Hong Kong, China
| | - Chun Hoi Yan
- Department of Orthopaedics and Traumatology, Queen Mary Hospital, Hong Kong, China
- Department of Orthopaedics and Traumatology, University of Hong Kong, Hong Kong, China
| | - Ping Keung Chan
- Department of Orthopaedics and Traumatology, Queen Mary Hospital, Hong Kong, China
- Department of Orthopaedics and Traumatology, University of Hong Kong, Hong Kong, China
| | - Kwong Yuen Chiu
- Department of Orthopaedics and Traumatology, Queen Mary Hospital, Hong Kong, China
- Department of Orthopaedics and Traumatology, University of Hong Kong, Hong Kong, China
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Ju D, Teng T, Bai G, Fu H, Qiu S, Zhao X, Sun Y, Shi B. The role of protein restriction and interaction with antibiotics in the regulation of compensatory growth in pigs: growth performance, serum hormone concentrations, and messenger RNA levels in component tissues of the endocrine growth axis. Domest Anim Endocrinol 2021; 74:106524. [PMID: 32810657 DOI: 10.1016/j.domaniend.2020.106524] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 04/08/2020] [Accepted: 07/10/2020] [Indexed: 11/26/2022]
Abstract
The present study investigated the effects of protein restriction and antibiotics on the hypothalamus-pituitary-liver growth axis during the compensatory growth of growing and finishing pigs. Growth performance, serum hormones, and messenger RNA (mRNA) levels of hormones and their receptors in growth axis tissues were recorded for analyses. A total of 64 piglets (large white × Landrace × Duroc cross) with an initial weight of 10.07 ± 0.14 kg were randomly divided into 4 treatment groups of 16 piglets per group. The dietary treatments consisted of 2 protein levels (14% and 20%) and 2 antibiotic levels (no antibiotics and 20 mg/kg colistin sulfate with 50 mg/kg kitasamycin) in a 2 × 2 factorial arrangement. The study was performed over 30 d for the first stage (S1, restriction phase) and 74 d for the second stage (S2, realimentation phase). The 4 treatment diets were maintained throughout the duration in the restriction phase. The 4 groups were fed the same diet in the realimentation phase. The trial period totaled 104 d. Protein restriction decreased BW, average daily food intake, and ADG in weaning pigs (P < 0.01) and induced compensatory growth after feeding a normal diet during the growth of finishing pigs. Average daily gain increased during the last phase of compensatory growth (P < 0.01). Protein restriction increased serum GH and leptin (LEP) and the mRNA levels of liver IGF-1 receptor (IGF-1-R; P < 0.01) but decreased serum IGF-1 (P < 0.01) and the mRNA levels of liver GH receptor (GH-R; P < 0.01) and IGF-1 (P < 0.05) in weaning piglets. Serum GH was increased, but serum IGF-1 was decreased during the realimentation phase (P < 0.05). Antibiotics increased the mRNA levels of GHRH (P < 0.05) and decreased somatostatin (P < 0.01) in the hypothalamus of weaning pigs. Protein restriction and antibiotics had no interactions across the entire trial. In conclusion, the slowing of growth caused by early protein restriction may be compensated for in the later stages of pig raising, and the mechanism of compensation is related to the regulation of GH, IGF-1, GH-R, and IGF-1-R.
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Affiliation(s)
- D Ju
- Institute of Animal Nutrition, Northeast Agricultural University, Harbin 150030, China
| | - T Teng
- Institute of Animal Nutrition, Northeast Agricultural University, Harbin 150030, China
| | - G Bai
- Institute of Animal Nutrition, Northeast Agricultural University, Harbin 150030, China
| | - H Fu
- Institute of Animal Nutrition, Northeast Agricultural University, Harbin 150030, China
| | - S Qiu
- Institute of Animal Nutrition, Northeast Agricultural University, Harbin 150030, China
| | - X Zhao
- Institute of Animal Nutrition, Northeast Agricultural University, Harbin 150030, China
| | - Y Sun
- Institute of Animal Nutrition, Northeast Agricultural University, Harbin 150030, China
| | - B Shi
- Institute of Animal Nutrition, Northeast Agricultural University, Harbin 150030, China.
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Yang Z, Fu H, Li H, Wang JR, Xu HY, Xie LJ, Yang MX, Zhang L, Yang ZG, Guo YK. Late gadolinium enhancement is a risk factor for major adverse cardiac events in unrecognised myocardial infarction without apparent symptoms: a meta-analysis. Clin Radiol 2020; 76:79.e1-79.e11. [PMID: 33012499 DOI: 10.1016/j.crad.2020.07.038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 07/28/2020] [Indexed: 02/08/2023]
Abstract
AIM To assess the prognostic role of unrecognised myocardial infarction (UMI) detected at late gadolinium enhancement cardiac magnetic resonance imaging (LGE-CMRII). MATERIALS AND METHODS Electronic databases including PubMed, EMBASE, Medline, and Cochrane were searched systematically for studies exploring the predictive value of UMI detected by LGE-CMRI for major adverse cardiac events (MACEs) and all-cause mortality in patients without apparent symptoms. Pooled hazard ratios (HRs) along with their 95% confidence intervals (CIs) were obtained from a random-effects model. Subgroup analyses were performed according to the different participants and outcomes. RESULTS Eight studies (2,009 participants) were identified comprising 442 patients with UMI detected at LGE-CMRI and 1,567 without UMI. The presence of UMI on LGE was associated with a significantly increased risk for MACEs (HRs: 3.44, 95% CI: 2.06 to 5.75; p<0.001) and all-cause mortality (HRs: 2.43, 95% CI: 1.00 to 5.87; p=0.05). In the subgroup analysis, the presence of UMI on LGE remained significantly associated with the risk of MACEs in patients with suspected coronary artery disease (HRs: 3.82, 95% CI: 2.49 to 5.85; p<0.01) and diabetes mellitus (HRs: 4.97, 95% CI: 3.02 to 8.18; p<0.01). CONCLUSION The presence of UMI detected by LGE-CMRI is associated with an increased risk of MACEs and all-cause mortality in patients without symptoms. LGE-CMRI could provide important prognostic information and guide risk stratification in patients with UMI.
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Affiliation(s)
- Z Yang
- Department of Radiology, Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China; Department of Radiology, Chengdu Fifth People's Hospital, Chengdu, China
| | - H Fu
- Department of Radiology, Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China
| | - H Li
- Key Laboratory of Obstetrics & Gynecology and Pediatric Disease and Birth Defects of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China
| | - J-R Wang
- Department of Radiology, Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China
| | - H-Y Xu
- Department of Radiology, Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China
| | - L-J Xie
- Department of Radiology, Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China
| | - M-X Yang
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - L Zhang
- Department of Radiology, Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Z-G Yang
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China.
| | - Y-K Guo
- Department of Radiology, Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China.
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