【Abstract】 Objective To investigate the protective effect of early motion on articular cartilage after joint allograft by performing a controlled trial between different post-operation strategies after joint allograft in an animal model. Methods Twenty hemi-knee joints were harvested from 10 6-month-old New Zealand white rabbits (male or female, weighing 2.5-3.0 kg); 10 hemi-knee joints by deep frozen treatment (donors) were transplanted to unilateral knee joints (recipients) of 10 6-month-old Chinchilla rabbits (male or female, weighing 2.5-3.0 kg), which were divided into early motion group (n=5) and sustained fixation group (n=5); and 10 hemi-knee joints were used as blank control (n=5) and frozen control (n=5). The articular cartilage of allogenic joints was detected by X-ray film, gross, and histology at 6 weeks after operation. Results Gross observation: no obvious limitation of joint movements was observed in early motion group, but obvious limitation in sustained fixation group. X-ray films: the bone ends between donor and recipient healed well with good paraposition and alignment on the operation day and 2 weeks after operation; at 6 weeks, angulation deformity was observed in early motion group of 3 rabbits, and paraposition and alignment were satisfactory in sustained fixation group. Histological observation: HE staining showed that the chondrocytes had normal quantity and morphology with few nuclear fragmentation and karyolysis in early motion group, but the quantity of chondrocytes sharply decreased with dissolved nuclei and numerous fibrous tissues in the cartilage matrix in sustained fixation group. The cell survival rate of the early motion group (49.66% ± 2.15%) was significantly higher than that of the sustained fixation group (20.68% ± 1.24%) (P lt; 0.05). Scanning electron microscopy observation: nuclear membrane was intact with chromatin condensation and edema of mitochondria and rough surfaced endoplasmic reticulum in early motion group, and that the membrane of chondrocyte vanished with blurring border between chondrocyte and matrix, rupture of nuclear membrane and the disappearance of chromatin and organelles could be found in sustained fixation group. Conclusion Early motion has protective effect on articular cartilage after joint allograft, but cannot completely prevent degeneration of the allogenic articular cartilage.
【Abstract】 Objective To explore the reasons of tendon adhesions post tendon allograft. Methods From May1990 to June 2000, 85 cases receiving tendon allograft were given tenolysis because of tendon adhesions. There were 76 males and 9 females, with an average age of 24.5 years (8-46 years). Injury was caused by machine in 38 cases, electric in 32 cases, cut in 4 cases, explosion in 4 cases and extremity mutilation in 7 cases; including 66 cases of flexor tendon deficit and 19 cases of extensor tendon deficit. Six cases had 1 tendon deficit, 79 cases had tendon deficit of more than 2. The defect region ranged from I to V. The total mobil ity of the joint was less than 220° in 73 cases. The impairment of skin, bone, nerve and vascular were treated before tendon allograft. Results Because TAM was less than 50% of TPM, the patients were given tenolysis 4-15 months after operation. And the mobil ization began at the first day after operation to improve the range of active movement. Patients were followed up 7-17 years (mean 12.7 years). TAM and TPM were in accord. Mean total mobil ity of joint was200°. Conclusion The serious of primary hurt is the important factors of tendon adhesion. Improvement of tendon selected, treatment and early mobil ization can rel ieve the tendon adhesion.
ObjectiveTo investigate the effects of thyroid globulin antibody (TgAb) and thyroid peroxidase antibody (TPOAb) statuses on central lymph node (CLN) metastasis in patients with differentiated thyroid cancer (DTC).MethodsA retrospective analysis was performed on 526 patients with DTC confirmed by pathology from nine participating institutions, who underwent the bilateral thyroidectomy plus bilateral CLN dissection. The clinicopathologic characteristics of different TGAb and TPOAb statuses of patients with DTC were compared, and whether the TGAb and TPOAb statuses were the independent risk factors of CLN metastasis in DTC patients or not was analyzed.ResultsAll of 526 patients with DTC were included in this study, 152 were males and 374 were females. The age was (44±11) years old. There were 63 cases of TgAb＋TPOAb＋, 60 cases of TgAb＋TPOAb－, 30 cases of TgAb－TPOAb＋, and 373 cases of TgAb－TPOAb－. It was found that there was a significant difference in the gender among the four different antibody statuses of patients, that was, women with abnormal antibodies were more common (P<0.001), not found that there were related to the tumor size, blood vessel invasion, nerve invasion, CLN metastasis, tumor multifocality, and bilateral tumor or not (P>0.050). In this study, there were 389 cases of CLN with metastasis and 137 cases of CLN without metastasis. The results of multivariate analysis found that the age and gender of the patients were the independent risk factors (P<0.001), but didn’t find the TgAb and TPOAb Statuses and other factors were related to the CLN metastasis (P>0.050).ConclusionsStatuses of TGAb and TPOAb aren’t obviously associated with CLN metastasis in patients with DTC, which is inconsistent with other studies. It needs to be further researched after expanding existing sample size and determining new predictive factors.
Implantable cardioverter defibrillator (ICD) is the most effective measure to prevent sudden cardiac death. However, ICD patients frequently have problems such as decline of exercise tolerance and quality of life, anxiety and depression after operation, which require cardiac rehabilitation (CR). A considerable amount of studies have proved that CR is an effective secondary prevention measure for patients with cardiovascular disease. Its safety and effectiveness have been supported by evidence-based medicine research, which can prevent the recurrence of cardiovascular events, reduce the readmisson rate, and promote healthy behavior and active lifestyle formation of patients, so as to improve the quality of life of patients. This review mainly summarized the necessity, safety, exercise program and economic benefits of CR in ICD patients.
At present, transeatheter aortic valve replacement is an effective treatment for elderly patients with severe aortic valve stenosis. Cardiac rehabilitation after transeatheter aortic valve replacement can effectively improve cardiopulmonary endurance and exercise capacity, and improve the quality of life. In order to better carry out cardiac rehabilitation for patients undergoing transeatheter aortic valve replacement, the Structural Heart Disease Professional Committee of Chinese College of Cardiovascular Physicians has drawn up Expert Consensus on Motor Rehabilitation after Transeatheter Aortic Valve Replacement. This consensus mainly elaborates the specific implementation process and methods of cardiac rehabilitation from three time periods of perioperative rehabilitation, outpatient rehabilitation and home rehabilitation. This article will interpret the main content of the consensus.
Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by deficits in social communication and repetitive behaviors. With the rapid development of computer vision, visual behavior analysis aided diagnosis of ASD has got more and more attention. This paper reviews the research on visual behavior analysis aided diagnosis of ASD. First, the core symptoms and clinical diagnostic criteria of ASD are introduced briefly. Secondly, according to clinical diagnostic criteria, the interaction scenes are classified and introduced. Then, the existing relevant datasets are discussed. Finally, we analyze and compare the advantages and disadvantages of visual behavior analysis aided diagnosis methods for ASD in different interactive scenarios. The challenges in this research field are summarized and the prospects of related research are presented to promote the clinical application of visual behavior analysis in ASD diagnosis.
Acute kidney injury is a worldwide public health issue, and its treatment and management strategies continue to advance. In addition to traditional kidney replacement therapy, research in recent years has been focused on whole organ engineering and biofabrication of kidney assistive devices and bioinjections for in-body regeneration. Hydrogel materials show great potential in renal tissue engineering because of their good biocompatibility, thermal stability and controllable biochemical and mechanical properties. This article reviews the application of various hydrogel materials in renal tissue engineering to promote kidney regeneration and discusses the characteristics and applications of natural hydrogels and synthetic hydrogels, which is expected to further promote their clinical applications.
In this paper, systematic reviews, randomized controlled trials and other relevant studies on surgical and adjuvant therapy following operative therapy in renal cancer were identified by searching the Guidelines International Network, ACP Journal Club, the Cochrane Library （Issue 3, 2005 ） , MEDLINE, EMBASE and CBMdisc （ from 1996 to Sept. 2005）. In operative therapy, we found no study comparing operative therapy with no treatment or adjuvant therapy alone; A meta-analysis of cytoreductive nephrectomy in patients with metastatic renal cancer showed adjuvant therapy following nephrectomy was more effective than adjuvant therapy alone; a review comparing radical nephrectomy with nephron-sparing surgery in small-volume renal tumors found similar effectiveness between the two procedures. In the adjuvant therapy following nephrectomy, ten RCTs found adjuvant cytokine therapy （Interferon and Interleukin-2 ） and 5-FU not effective in the adjuvant setting, and could increase adverse reaction; Four RCTs found adjuvant vaccine therapy effective in the adjuvant setting with only a few side effects.
【摘要】 目的 了解行肾切除手术疾病谱、疾病的临床表现及诊治方法的演变，探讨避免肾脏切除保留肾单位的术式，以期提高对肾脏疾病的诊治水平。 方法 回顾性分析泌尿外科1955年1月－2001年12月收治入院22 603例患者的临床资料，对其中行肾切除手术的1 952例进行分析。根据肾切除手术病因，将疾病分为3类:肾肿瘤、肾结核、其他疾病。将47年分为5个时段:50、60、70、80、90年代。应用平均值、构成比、中位数、率等对各项指标进行统计学分析。 结果 5个时段年平均入院人数与年均切肾率呈上升趋势。疾病谱构成中肾肿瘤共计663例，占33.97%；肾结核共计599例，占30.69%；其他疾病共计690例，占35.35%。肾肿瘤与其他疾病的例数及构成比分别随着年代的推进不断增加。而肾结核则未显示出该特点。各年代3类疾病发病年龄（中位数）在肾肿瘤、肾结核与其他疾病亦沉陷；体检发现疾病自70年代分别为1.10%、5.10%、8.80%。 结论 90年代后，肾切除手术的术式更加标准和成熟，保留肾单位的肾脏手术正在受到临床的重视和推广。【Abstract】 Objective To study the spectrum of diseases subjected to nephrectomy, to find out the clinical manifestations of the diseases, to summarize the evolvement of operational technology of kindney removal, to discuss the method of nephron sparing surgery in the purpose of avoiding nephrectmoy and reducing the operational risk, and to promote the level of diagnosing and treating nephropathy. Methods There were 1 952 cases of nephrectomy selected in the total 22 603 cases treated in the Department of Urology from January 1955 to December 2001. According to the diseases subjected to the surgery, these 1 952 cases were assigned into 3 groups: renal tumor group, renal tuberculosis group and other diseases group. The 47 years from 1955 to 2001 were divided into 5 periods: the 1950s (1955-1960), 60s (1961-1970), 70s (1971-1980), 80s (1981-1990) and 90s (1991-2001). Indexes such as average, proportion, median, and ratio were analyzed statistically. Results From the 1950s to 1990s, the number of patients undergoing nephrectomy increased from period to period. Among the diseases causing the surgery, the number of renal tumor cases was 663 (33.97%), the number of renal tuberculosis cases was 599 (30.69%), and the number of other disease cases was 690 (35.35%). The number and proportion of renal tumor and other disease cases increased from year to year, while the nuber of renal tuberculosis cases did not show this feature. The median age of patients treated with nephrectomy increased year by year, and the patient’s age of renal tumor was older than that of renal tuberculosis and other diseases. The proportion of patients whose diseases were found out by physical examination since the 1970s was respectively 1.10%, 5.10% and 8.80%. Conclusion Since the 1990s, the technology of nephrectomy has become maturer and more standardized, and nephron sparing surgery has caught more attention and has been applied more in clinics.
Sleep status is an important indicator to evaluate the health status of human beings. In this paper, we proposed a novel type of unperturbed sleep monitoring system under pillow to identify the pattern change of heart rate variability (HRV) through obtained RR interval signal, and to calculate the corresponding sleep stages combined with hidden Markov model (HMM) under the no-perception condition. In order to solve the existing problems of sleep staging based on HMM, ensemble empirical mode decomposition (EEMD) was proposed to eliminate the error caused by the individual differences in HRV and then to calculate the corresponding sleep stages. Ten normal subjects of different age and gender without sleep disorders were selected from Guangzhou Institute of Respirator Diseases for heart rate monitoring. Comparing sleep stage results based on HMM to that of polysomnography (PSG), the experimental results validate that the proposed noninvasive monitoring system can capture the sleep stages S1–S4 with an accuracy more than 60%, and performs superior to that of the existing sleep staging scheme based on HMM.