ObjectiveTo investigate the clinical and CT findings in patients with coronavirus disease 2019 (COVID-19).MethodsThe epidemiological data and clinical manifestations of 83 COVID-19 patients admitted to Chongqing Public Health Medical Center from January 24, 2020 to February 4, 2020 were analyzed retrospectively. According to the clinical classification, they were divided into four groups: mild group 8 patients, common group 62 patients, severe group 10 patients, and critically severe group 3 patients. The CT characteristics and their relationship with clinical classification were analyzed.ResultsThe average age of 70 mild patients was (43.7±15.0) years, 13 severe patients was (57.4±11.8) years. The average age of mild patients was lower than that of severe patients (Z=–3.185, P=0.001). The average course of mild disease was (5.5±4.2) days, lower than that of severe disease (11.8±5.0) days (Z=–3.978, P=0.000). The clinical manifestations were fever in 72 patients, cough in 60 patients, expectoration in 34 patients, asthenia in 25 patients and shortness of breath in 19 patients. Basic diseases were complicated in 16 patients. CT findings: Both lung lobes were affected in 70 patients (93.3%), pure right lung lobe was affected in 3 patients (4.0%), pure left lung lobe was affected in 2 patients (2.7%), and there was no focus in 8 patients. The total number of affected lung segments was 203 in severe type, with an average of 15.6±5.4 and 530 in the common type, with an average of 9.6±5.3. The number of the severe type was more than that in the common type (Z=–3.456, P=0.001). The focus was mainly in the posterior part, 62 in the dorsal and 65 in the posterior basal segments, 41 in the anterior part of the upper lobe, and less in the common type (P<0.05). The main lesions were ground-glass opacities in 74 patients, patchy shadow in 72 patients, piece shadow in 46 patients, strip shadows in 51 patients and consolidation in 34 patients. Among them, the common CT showed patchy shadow in 34 patients (54.8%), less than severe patients in 12 patients (92.3%) (χ2=4.880, P=0.027). There was no significant difference between the mild CT and the severe patients (P>0.05).ConclusionsThere are some radiographic characteristics in COVID-19. Chest CT is helpful for the diagnosis and the judgement of the disease.
Objective To analyze the occurrence of osteolysis in total hip arthroplasty (THA) with highly cross-linked polyethylene prosthesis during a follow-up of more than 15 years. Methods The clinical data of 84 patients (105 hips) treated with THA in the Affiliated Hospital of Kanazawa Medical University in Japan between June 2000 and April 2004 and met the selection criteria was retrospectively analyzed. There were 7 males and 77 females, aged from 41 to 75 years, with an average of 56.4 years. There were 94 hips with secondary hip osteoarthritis, 4 hips after pelvic osteotomy, 2 hips with primary hip osteoarthritis, 2 hips with traumatic hip osteoarthritis, 2 hips with osteonecrosis of the femoral head, and 1 hip with rheumatoid arthritis. According to Crowe classification, there were 79 hips of type Ⅰ, 19 hips of type Ⅱ, 6 hips of type Ⅲ, and 1 hip of type Ⅳ. The highly cross-linked polyethylene acetabular liner combined with a 26 mm zirconia femoral head were used in all patients. X-ray films were taken after operation to analyze the radiation transmission and osteolysis around the acetabular prosthesis. The vertical distance (the distance between the teardrop line at the lower edge of the pelvis and the perpendicular line of the hip rotation center), the horizontal distance (the horizontal distance between the hip rotation center and the interteardrop line and the vertical line at the lower edge of the teardrop), and the acetabular cup anteversion angle were measured at last follow-up. The acetabular and femoral osteolysis was analyzed by CT scan and three-dimensional multiplanar reconstruction (3D-MPR). Combined with X-ray film and CT results, osteolysis was evaluated according to the Narkbunnam score. Results Deep vein thrombosis of lower limbs occurred in 2 cases. All patients were followed up 15-18 years, with an average of 15.9 years. One hip dislocation and 1 periprosthetic fracture occurred postoperatively, and no acetabular loosening or prosthetic lining ruptures occurred. Except for 1 patient who had a radiolucent line in the acetabulum after operation, the other 83 patients did not show any radiolucent line in the acetabulum or the femur. None of the patients underwent hip revision. X-ray films at last follow-up showed an acetabular cup anteversion angle of −10°-39°, with an average of 22°; a vertical distance of 3.5-47.1 mm, with an average of 24.6 mm; and a horizontal distance of 22.6-48.1 mm, with an average of 31.7 mm. There was no acetabular or femoral osteolysis in all patients on X-ray films and CT 3D-MPR images at last follow-up, and the Narkbunnam score was 0 in any region. Conclusion Highly cross-linked polyethylene prosthesis does not increase the risk of long-term complications such as osteolysis after THA.