Objective To discuss the recent advancement of total knee arthroplasty (TKA) in the aspects of prosthesis selection, and compare the cl inical effect of every kind of knee prostheses so as to provide more information for cl inical appl ication. Methods The l iterature concerning prosthesis selection was extensively reviewed, and the methods and data were analyzed and summarized. Results The major disputes consisted of posterior cruciate retained versus excised,fixed-bearing versus mobile-bearing, high-flex versus standard implants and patella resurfacing versus nonresurfacing for TKA. Every kind of knee prostheses displayed safety and effectiveness in early and medium term follow-up, no significant differences were found in cl inical results. Conclusion Prosthesis selection in TKA should be overall considerated, and the merits of every kind of prostheses should be judged with long-term follow-up results.
Large sample-size registries have become a necessary complement to randomized controlled trials. This study introduced the registries in the field of clinical application of implantable cardioverter defibrillator, especially the two large registries of the US NCDR ICD and Boston Scientifićs ALTITUDE, described the current status and future direction, thus to guide such registry researches in China.
Electrocardiogram (ECG) signals are easily disturbed by internal and external noise, and its morphological characteristics show significant variations for different patients. Even for the same patient, its characteristics are variable under different temporal and physical conditions. Therefore, ECG signal detection and recognition for the heart disease real-time monitoring and diagnosis are still difficult. Based on this, a wavelet self-adaptive threshold denoising combined with deep residual convolutional neural network algorithm was proposed for multiclass arrhythmias recognition. ECG signal filtering was implemented using wavelet adaptive threshold technology. A 20-layer convolutional neural network (CNN) containing multiple residual blocks, namely deep residual convolutional neural network (DR-CNN), was designed for recognition of five types of arrhythmia signals. The DR-CNN constructed by residual block local neural network units alleviated the difficulty of deep network convergence, the difficulty in tuning and so on. It also overcame the degradation problem of the traditional CNN when the network depth was increasing. Furthermore, the batch normalization of each convolution layer improved its convergence. Following the recommendations of the Association for the Advancements of Medical Instrumentation (AAMI), experimental results based on 94 091 2-lead heart beats from the MIT-BIH arrhythmia benchmark database demonstrated that our proposed method achieved the average detection accuracy of 99.034 9%, 99.498 0% and 99.334 7% for multiclass classification, ventricular ectopic beat (Veb) and supra-Veb (Sveb) recognition, respectively. Using the same platform and database, experimental results showed that under the comparable network complexity, our proposed method significantly improved the recognition accuracy, sensitivity and specificity compared to the traditional deep learning networks, such as deep Multilayer Perceptron (MLP), CNN, etc. The DR-CNN algorithm improves the accuracy of the arrhythmia intelligent diagnosis. If it is combined with wearable equipment, internet of things and wireless communication technology, the prevention, monitoring and diagnosis of heart disease can be extended to out-of-hospital scenarios, such as families and nursing homes. Therefore, it will improve the cure rate, and effectively save the medical resources.
Objective To explore the clinical application effects of cervical advancement flaps in repairing mandibular scars. Methods A retrospective analysis was performed on the clinical data of patients with mandibular scars admitted to the Department of Plastic and Burn Surgery of West China Hospital of Sichuan University between January 2018 and July 2020. The lateral X-ray images of the patients were analyzed before and 2 weeks after surgery, and the differences in the mento-cervical angles and the cervico-mental angles before and after surgery were compared. Results A total of 21 patients were included, including 7 males and 14 females. At admission, all patients had a mandibular scar area of (3-7) cm × (3-6) cm, and underwent primary repair with cervical advancement flaps. All patients had good postoperative skin flaps survival, primary wound healing, and obvious mento-cervical angle and cervico-mental angle. The preoperative mento-cervical angle was (110.24±9.47)°, and at 2 weeks post surgery, the mento-cervical angle was (98.39±4.95)°, with a statistically significant difference (P<0.05). The preoperative cervico-mental angle was (134.15±6.00)°, and at 2 weeks post surgery, the cervico-mental angle was (126.44±3.60)°, with a statistically significant difference (P<0.05). Conclusion The neck advancement flap is an effective surgical method for treating simple mandibular scar, which is simple and can improve the appearance of the jaw and neck.