It will cause hidden trouble on clinical application if the uroflowmeter is out of control. This paper introduces a scheme of uroflowmeter calibration device based on digital signal processor (DSP) and gear pump and shows studies of its feasibility. According to the research plan, we analyzed its stability, repeatability and linearity by building a testing system and carried out experiments on it. The flow test system is composed of DSP, gear pump and other components. The test results showed that the system could produce a stable water flow with high precision of repeated measurement and different flow rate. The test system can calibrate the urine flow rate well within the range of 9~50 mL/s which has clinical significance, and the flow error is less than 1%, which meets the technical requirements of the calibration apparatus. The research scheme of uroflowmeter calibration device on DSP and gear pump is feasible.
Objective There is few report on dynamic stabil ization for posterior cervical reconstruction. To investigate the biomechanical properties of a novel cervical spine posterior fixation using the bio-derived freeze-dried tendon in posterior cervical spine reconstruction. Methods The palmaris longus flexor tendon and metacarpal extensor tendon were collected from the death donors’ stump to prepare bio-derived tendon. Twenty fresh cervical vertebrae (C1-7) were harvested from goats and were randomly divided into 4 groups (n=5): intact group (group A); injury control group (group B); screwrods fixation group, fixed with screw-rods on C3，4 (group C); tendon reconstruction group, cross-fixed with bio-derived freezedried tendon on C3，4 bilatera facet joints (group D). The range of motion (ROM) values in flexion, extension, lateral bending, and axial rotation were measured. Results In flexion, the ROM values of group C were significantly lower than those of the other 3 groups (P lt; 0.05), and the ROM values of group B were significantly higher than those of groups A and D (P lt; 0.05). In extension, lateral bending, and axial rotation, the ROM values of group C were significantly lower than those of groups A, B, and D (P lt; 0.05), and no significant difference was found within the other 3 groups (P gt; 0.05). Conclusion The novel cervical spine posterior fixation using the bio-derived frozen-dried tendon can provide enough stabil ity in flexion motion, but it can not limit the lateral bending and axial rotation motion, which can provide dynamic stabil ization in animal model.
ObjectiveTo analyze expressions of interleukin-6 (IL-6) and microsatellite instability (MSI) in ulcerative colitis-associated colorectal cancer (UC-CRC) and investigate role of IL-6 and MSI in carcinogenesis of patients with UC.MethodsThe postoperative pathological data of patients with UC-CRC and patients with sporadic colorectal cancer (SCRC) admitted by Edong Healthcare Group from January 2013 to January 2019 were analyzed retrospectively. The expressions of MMR proteins, including hMLH1, hPMS2, hMSH2, and hMSH6, were detected by the immunohistochemical method. The serum IL-6 levels of the patients with UC, UC-CRC, SCRC and control patients (non-UC, non-UC-CRC, non-SCRC) were detected. The correlation between the IL-6 and MMR protein expression in the cancer tissue was analyzed.ResultsThere were 43 patients with UC, 17 UC-CRC, 55 SCRC, and 30 control patients. The total rate of MMR-deficient (dMMR) was 41.2% (7/17) in the patients with UC-CRC. There were significant correlations between the hMLH1 and hPMS2 protein expression deletion and between the hMSH2 and hMSH6 protein expression deletion (P<0.001). The serum level of IL-6 in the patients with UC-CRC was significantly higher than that in the patients with UC (t=4.97, P<0.001) and the patients with SCRC (t=5.26, P=0.006). The dMMR might be associated with the level of IL-6 in the patients with UC-CRC, which wasn’t associated with it in the patients with SCRC (rs=0.04, P=0.77).ConclusionsSimilar to SCRC, MSI also plays a role in occurrence and development of UC-CRC. dMMR in patient with UC-CRC is more common in co-expression deficiency of hMLH1 and hPMS2, as did hMSH2 and hMSH6. IL-6 is not involved in mechanism of MSI-related canceration of colorectal cancer, but it is speculated that IL-6 might be involved in occurrence of MSI of UC-CRC.
Objective To investigate the management of extention apparatus and cl inical results of total knee arthroplasty (TKA) of osteoarthritis. Methods Between June 2007 and June 2009, 386 patients (460 knees) with osteoarthritis received TKA, including 216 left knees and 244 right knees. There were 125 males (145 knees) and 261 females (315 knees) with an average age of 60.3 years (range, 58-85 years). The disease duration was 4-12 years (mean, 6.7 years). The X-ray films and CT scanning showed that all patients had femur-tibia joint degeneration and osteophyte formation at the edgeof joint. According to modified Burnett patellar resurfacing indication, whether or not to replace the patellar was determined, and the patellar track was determined by combining no thumb test and towel clamp traction test. Patella resurfacing was performed in 53 cases (56 knees, resurfacing group), no patella resurfacing in 333 cases (404 knees, non-resurfacing group), and lateral retinacular releasing 68 cases (72 knees). The postoperative imaging and knee society score (KSS), patellofemoral compl ications were analyzed. Results All wounds healed by first intention. All the patients were followed up 1-3 years (mean, 26 months). Deep infection occurred in 3 cases (1 case of resurfacing group and 2 cases of non-resurfacing group) at 3-7 months and they were cured after two-stage reversion. Patellofemoral compl ications occurred in 2 cases of resurfacing group (2/56, 3.57%) and in 9 cases of non-resurfacing group (9/404, 2.23%), showing no significant difference (χ2=0.38, P=0.54). There were significant differences in KSS and visual analogue scale (VAS) at 2 and 3 year after operation when compared with before operation (P lt; 0.05). No significant difference in KSS and VAS of resurfacing group and non-resurfacing group were observed at 3 years after operation (P gt; 0.05). Conclusion It is benefit for selective patellar resurfacing and the patellar tract improvement to select patellar resurfacing indication according to the multi-factor assessment and to determine the patellar tract by combining no thumb test and towel clamp traction test, which can reduce the patellofemoral compl ication rate after TKA.
Objective To analyze the main reasons of acetabular component initial instabil ity after primary total hip arthroplasty (THA) and to disscuss the prevention and management. Methods The cl inical data were retrospectively analyzed from 19 patients undergoing revision for acetabular component initial instabil ity after primary THA between January 2003 and June 2010. There were 11 males and 8 females, aged from 55 to 79 years (mean, 67.2 years). The locations were lefthip in 9 cases and right hip in 10 cases. The cementless hip prosthesis was used in 12 cases and cement hip rosthesis in 7 cases. The revisions were performed at 3 weeks to 6 months after primary THA. The reasons of early failure were analyzed. Both the coverage rate of acetabulum-bone and the Harris hip score were compared between pre- and post-revision. Results The main reason of acetabular component initial instabil ity after primary THA may be unsuitable treatment of acetabulum, improper selection of acetabular component, and incorrect place angle of acetabular component. Sciatic nerve palsy occurred in 1 case and recovered at 7 weeks after revision. Sl ight fracture of the acetabulum in 1 case and healed at 3 months after revision. All incisions healed by first intention. No infection, vessel injury, displacement of acetabular component, or deep vein thrombosis occurred. The patients were followed up 11-73 months (mean, 28 months). At last follow-up, no acetabular component instabil ity was observed. The coverage rate of acetabulum-bone was increased from 67.9% ± 5.5% before revision to 87.7% ± 5.2% after revision, showing significant difference (t=11.592，P=0.003). The Harris hip score at last follow-up (84.4 ± 4.6) was significantly higher than that at pre-revision (56.5 ± 9.3) (t=11.380，P=0.005). Conclusion Detailed surgical plan, proper choice of component, correct place angle and elaborative planning, and proficient surgical skill are necessary to achieve the initial stability of acetabular component in THA．
Objective To investigate the radiographic and clinical outcomes of dorsal intercarpal ligament capsulodesis (DILC) procedure for chronic static scapholunate dissociation. Methods Between January 2008 and January 2011, 12 patients with chronic static scapholunate dissociation were treated with DILC. Of 12 cases, 10 were male and 2 were female with an average age of 42 years (range, 20-66 years). All injuries were caused by falling. The interval from injury to surgery was 3-19 months (mean, 8 months). Physical examination at admission showed wrist tenderness and limited range of motion (ROM). Radiological examination showed that scapholunate gap was greater than 3 mm on posteroanterior view, and scapholunate angle more than 60° on the lateral view. Before operation, the grip strength was (25.4±8.2) kg; the wrist ROM was (56.7±11.5)° in flexion and (52.0±15.2)° in extension; visual analogue scale (VAS) score was 6.3±1.4; and disabilities of arm, shoulder & hand (DASH) score was 39.5±7.4. According to Garcia-Elias staging criteria, all cases were rated as stage 4, indicating that the scapholunate interosseous ligament was completely injured and reduction could easily be obtained. Eight patients had wrist instability. Results Primary healing of incision was achieved, no complication was found. All patients were followed up 13-34 months (mean, 15.9 months). During surgery, all deformities were corrected completely, but 7 patients (58%) recurred at 1 month after Kirschner wire removal. Compared with preoperative ones, the scapholunate gap, scapholunate angle, radiolunate angle, lunocapitate angle, and wrist height ratio at 1 month after Kirschner wire removal and last follow-up showed no significant difference (P > 0.05); the wrist flexion and extension ROM were significantly decreaed to (46.8±7.2)° and (42.0±9.0)° at last follow-up (P < 0.05); the grip strength was significantly increased to (32.7±9.6) kg at last follow-up (P < 0.05); VAS score and DASH score were improved to 1.7±1.0 and 8.1±8.7 (P < 0.05). Conclusion Carpal collapse will recur in short time after DILC. DILC is not the best way to treat chronic static scapholunate dissociation.
ObjectiveTo compare the effectiveness of partial versus intact posterior cruciate ligament (PCL)-retaining in total knee arthroplasty (TKA) with cruciate-retaining (CR) prosthesis.MethodsA total of 200 patients with osteoarthritis, who met the selection criteria and proposed unilateral TKA with CR prosthesis, were included in the study and randomly assigned into two groups (n=100). The patients were treated with intact retention of the double bundles of PCL in intact group and with partial resection of the anterior lateral bundle of PCL and the anterior bone island at the time of intraoperative tibial osteotomy in partial group. Patients with lost follow-up and re-fracture were excluded, and 84 cases in partial group and 88 cases in intact group were included in the final study. There was no significant difference between the two groups (P>0.05) in terms of gender, age, body mass index, course and grade of osteoarthritis, preoperative varus deformity of knee joint, flexion contracture, range of motion, clinical and functional scores of Knee Society Score (KSS). The operation time, wound drainage volume during 24 hours after operation, visual analogue scale (VAS) score at 24 hours after operation, range of motion of knee joint, clinical and functional scores of KSS, and the anteroposterior displacement of knee joint at 30° and 90° flexion positions were compared between the two groups.ResultsThere was no significant difference between the two groups in operation time, wound drainage volume during 24 hours after operation, and VAS score at 24 hours after operation (P>0.05). Patients in both groups were followed up after operation. The follow-up time was 25-40 months (mean, 30.2 months) in intact group and 24-40 months (mean, 31.8 months) in partial group. There was no significant difference in the range of motion and clinical scores of KSS between the two groups at 6, 12, and 24 months after operation (P>0.05). The functional scores of KSS were significantly higher in intact group than in partial group (P<0.05). There was no significant difference between the two groups in the anteroposterior displacement of knee joints at 30° flexion position at 6, 12, and 24 months after operation (P>0.05). When the knee was at 90° flexion position, there was no significant difference between the two groups at 6 and 12 months after operation (P>0.05), but the intact group was significantly smaller than partial group at 24 months after operation (P<0.05). Postoperative incision continued exudation in 4 patients (2 cases of partial group and 2 cases of intact group), and incision debridement in 2 patients (1 case of partial group and 1 case of intact group). No prosthesis loosening, excessive wear, or dislocation of gasket was found during follow-up.ConclusionThe double bundle of PCL plays an equally important role in maintaining the stability of the knee joint, and the integrity of PCL should be kept as much as possible when TKA is performed with CR prosthesis.
ObjectiveTo understand the cervical spine function, core stability and strength of fighter pilots, and to explore the difference of that between fighter pilots with and without neck pain.MethodsFrom October to December 2020, a double-blind design was used to test the cervical spine function, core stability and strength of fighter pilots of a certain part of the Air Force. At the same time, the area of deep cervical flexor and the thickness of transverse abdominis and multifidus muscles were measured. According to the presence or absence of neck pain in the last 3 months, they were divided into neck pain group and non-neck pain group. The cervical spine function, core stability and core strength, deep cervical flexor and transversus abdominis endurance of the two groups were compared and analyzed.ResultsA total of 38 pilots were included. There was no significant difference in age, body mass index, service life, flight time, total flight time and weekly flight time between the neck pain group and the non-neck pain group (P>0.05). There was no significant difference in cervical spine mobility between the two groups of pilots (P>0.05). The cervical flexor muscle strength [(15.5±4.9) vs. (12.1±3.0) N] and the ratio of cervical flexion/neck extension (0.6±0.1 vs. 0.5±0.1) in the non-neck pain group were higher than in the neck pain group (P<0.05). There was no significant difference in the muscle strength of other superficial cervical muscles between the two groups (P>0.05). The average value of deep neck flexor endurance in the neck pain group [25.36 mm Hg(1 mm Hg=0.133 kPa)] better than the non-neck pain group group (17.11 mm Hg) (P=0.026). There was no significant difference in test values of transverse abdominis endurance between the two groups (P>0.05). The left hip internal rotator strength [(11.9±2.6) vs. (10.0±2.1) N] and the left hip external rotator strength [(13.7±2.2) vs. (11.9±2.0) N] in the non-neck pain group were higher than in the neck pain group (P<0.05). There was no significant difference in the muscle strength of the other hip joint muscles between the two groups (P>0.05). The thickness of the right transversus abdominis in the neck pain group [(1.1±0.3) vs. (0.8±0.3) cm] was higher than that in the non-neck pain group (P<0.05). There was no significant difference in the thickness of the left transversus abdominis, the cross-sectional area of deep cervical flexor muscle and the thickness of lumbar multifidus muscle between the two groups (P>0.05).ConclusionsFighter pilots with neck pain have superficial cervical flexor muscle strength and decreased left hip internal and external rotation muscle strength, and the superficial cervical flexor and extensor muscle strength is unbalanced. Strengthening the superficial cervical flexor muscle strength, improving the balance between the superficial cervical flexor and extensor muscles, and enhancing the hip internal and external rotator muscle strength may help prevent neck pain.
ObjectiveTo investigate the effect of body mass index (BMI) on the outcome of posterior 360° fusion for single-level lumbar degenerative diseases. MethodsA retrospective study was carried on 302 cases of singlelevel lumbar degenerative diseases treated with posterior 360° fusion between September 2009 and September 2013. All patients were divided into 3 groups according to BMI: normal weight (BMI<24 kg/m2) in 105 cases (group A), overweight (24 kg/m2≤BMI< 28 kg/m2) in 108 cases (group B), and obese (BMI≥28 kg/m2) in 89 cases (group C). There was no significant difference in gender, age, disease duration, disease patterns, affected segments, preoperative Japanese Orthopaedic Association (JOA) score and Oswestry disability index (ODI) among 3 groups (P>0.05). The operation time, intraoperative blood loss, postoperative hospital stay, and complications were recorded. The lumbar function was assessed by JOA score and ODI at pre- and post-operation (at 3, 6, and 24 months). ResultsThe operation time, intraoperative blood loss, and postoperative hospital stay of group C were significantly more than those of groups A and B (P<0.05), but no significant difference was found between group A and group B (P>0.05). The patients were followed up 24-45 months. Postoperative JOA score and ODI showed significant improvements in each group when compared with preoperative ones (P<0.05), but there was no significant difference among groups at each time point after operation (P>0.05). There was no significant difference in the incidence of total complications among 3 groups (χ2=3.288, P=0.193). The incidence of incision-related complications (infection and poor healing) in group C was significantly higher than that of groups A and B (P<0.05), but no significant difference was shown between group A and group B (P>0.05). However, there was no significant difference in cerebrospinal fluid leak, pseudarthrosis formation, and revision among 3 groups (P>0.05). ConclusionPosterior 360° fusion for single-level lumbar degenerative diseases can obtain good effectiveness in patients with different BMI, but patients whose BMI was ≥28 kg/m2 have longer operation time, more intraoperative blood loss, longer hospital stay, and higher incidence of postoperative incision-related complications.
ObjectiveTo understand the effect of programmed death-1 (PD-1) inhibitors on defective mismatch repair (dMMR) / microsatellite instability-high (MSI-H) advanced colorectal cancer (CRC). MethodThe literature of recent research relevant PD-1 inhibitors in the utility for patients with dMMR/MSI-H advanced CRC was reviewed and summarized. ResultsAt present, there were many studies exploring the utility of anti-PD-1 inhibitors for the treatment of dMMR/MSI-H advanced CRC (including locally advanced CRC and metastatic CRC), and some studies were still in trials. Studies had consistently shown that the use of PD-1 inhibitors in dMMR/MSI-H advanced CRC as first-line or subsequent therapy, as well as in the neoadjuvant setting, leading to significant survival benefits. These benefits were particularly notable in cases of dMMR/MSI-H metastatic CRC with concurrent BRAF/RAS mutations and in the context of neoadjuvant immunotherapy aimed at organ preservation in locally advanced dMMR/MSI-H CRC. Moreover, there were numerous studies exploring “dual immunotherapy”, and most studies found that its efficacy was superior to that of single immunotherapy. However, the more adverse events were reported by the “dual immunotherapy” compared to the single immunotherapy. ConclusionsOverall, based on results of the literature reviewed, PD-1 inhibitors have shown significant clinical benefits in dMMR/MSI-H advanced CRC, but there are still more issues that need to be further explored, such as discovering more first-line PD-1 inhibitors, overcoming drug resistance and adverse events. Future clinical practice should prioritize more precise individualized identification and the application of more effective combination therapy regimens to further optimize outcomes for patients with dMMR/MSI-H advanced CRC.