Adverse events involving hallux metatarsophalangeal joint implants: Analysis of the United States Food and Drug Administration data from 2010 to 2018

BackgroundThe prevalence of osteoarthritis of the hallux metatarsophalangeal joint (MTPJ) is 1 in 40 people over the age of 50. Surgical treatment options for MTPJ arthritis include joint preservation, joint resurfacing, and arthrodesis. Hallux MTPJ implants have evolved over the past several decades, but are associated with various complications. The aim of this study was to examine the MAUDE database to determine reported adverse events for hallux MTPJ implants.Materials and methodsThe US Food and Drug Administration’s (FDA) Manufacturer and User Facility Device Experience (MAUDE) database was reviewed from 2010 to 2018 to review voluntary reported adverse event reports for approved implants within the United States. We recorded the type of adverse event and excluded duplicate reports and those extracted from already published literature.ResultsAmong 64 reported hallux MTPJ implant adverse events, the most common modes of adverse events were component loosening (34%), infection (14.1%), component fracture (9.4%), inflammation (9.4%), and allergic reaction (7.8%). Regarding implant type, Cartiva SCI had the highest percentage of adverse events (23.4%), followed by Arthrosurface ToeMotion (20.3%), Ascension MGT (12.5%), Arthrosurface HemiCAP® (10.9%), Futura primus (9.4%), and Osteomed Reflexion (6.3%). There was an increase in reported adverse events after 2016. The MAUDE database does not report the total incidence of implant insertion.ConclusionOur study of the MAUDE database demonstrated that component loosening and infection are the most common modes of adverse events for hallux MTPJ implants. Cartiva accounted for one-fourth of the implant-related adverse events during our study period, followed by ToeMotion, and Ascension MGT implants. Continued reporting of adverse events will improve our understanding on short and long-term complications of various hallux MTPJ implants.Level of evidenceLevel IV; Case Series from Large Database Analysis; Treatment Study.     

医学影像数据库的索引及检索技术的研究

随着医学影像数据库数据量的剧增，迫切需要研究高效的索引技术以支持基于图像内容的检索。介绍了医学影像数据库索引技术的特点，比较分析了几种典型的空间数据索引方法（如R树、VA文件、A树、NB树和M树）及其作为医学图像数据库索引的性能。     

A good ligand is hard to find: Automated docking methods

Summary Many approaches have been developed for solving the docking problem: Predict the structure and binding free energy of a ligand-receptor complex given only the structures of the free ligand and receptor. We review major approaches for docking small-molecule ligands to receptors and focus on the successes and limitations of their application to drug design.     

结肠癌免疫相关 lncRNA 风险预测模型的建立

目的 分析影响结肠癌预后的免疫相关 lncRNA, 并构建预测结肠癌患者预后的相关预测模型。 方法 下载 TCGA 数据库中的结肠癌 lncRNA 表达谱, 数据经 TPM 标准化后分析所有 lncRNA 的差异性表 达, 其中缺失值的补充采用 KNN 法, 通过共表达方法提取并鉴定免疫相关 lncRNA, 然后对差异性表达的 lncRNA 进行 LASSO 回归分析, 再进行单因素和多因素 COX 回归分析。 最后使用 R 4. 0. 2 统计学软件的 ggplot2 包基于 lncRNA 风险评分与基因表达关系, 构建风险因子关联图、 KM 曲线及评价模型预测价值的 ROC 曲线。 结果 经过表达差异性分析发现, 共有 2 258 个 lncRNA 在癌和癌旁组织中差异性表达, 其中上 调的有 1 648 个, 下调的有 610 个。 选取差异表达前 100 位的免疫相关 lncRNA 进行 LASSO 回归分析, 共筛 选出 12 个 lncRNA, 再进行单因素和多因素 COX 回归分析后显示 AC092723. 1、 AC007182. 1 和 AC004947. 1 与预后明显相关, 使用 R 4. 0. 2 统计学软件构建预后风险因子关联图, ROC 曲线显示其预测 1 年、 3 年和 5 年的预测价值均较高, 其 AUC 分别为 0. 79 (95 % CI: 0. 67 ~ 0. 91), 0. 78 (95 % CI: 0. 66 ~ 0. 9), 0. 7 (95 % CI: 0. 51 ~ 0. 9)。 结论 研究使用 TCGA 公共数据库进行生物信息学分析并构建的预后模型显示有 较高的预测价值, 除具有一定的临床意义外, 对未来 lncRNA 相关结肠癌的研究也提供了一定的方向。     

Drug effects on clinical laboratory tests

Drugs and xenobiotics can affect clinical laboratory test results either by interfering with the analytical systems themselves, or by influencing endogenous constituents. National and international bodies have brought widespread recognition to this problem and have proposed protocols for its thorough scientific study. In this survey the authors discuss studies in their laboratories concerning the effects of drugs on thousands of patients undergoing a routine clinical screen. A database is described for storing both patient information and a detailed analysis of the published literature on drug effects. Analytical interferences in clinical tests must be examined in validating the procedure. However, highly specific analytical techniques are increasingly helping to reduce such interferences. Biological effects can be classified as physiological, pharmacological or toxicological. In some cases, biological effects can be used to advantage in monitoring treatment by potentially hazardous drugs, such as the cardiac glycosides. The requirement for a well-defined reference population for each drug and for access to all clinical and medical data for each patient is discussed. The need for greater awareness of the influence of drugs on clinical laboratory results is considered, together with the suggestion that the health professions should try to exploit such effects in monitoring possible toxicity problems, in defining genetic constitution and in designing medication programmes.     

药物治疗方案咨询系统的研究

目的：建立药物治疗方案咨询系统。为医院药师开展药学服务提供一种新型工具。方法：对临床疾病药物治疗方案的相关资料进行收集整理，按国际疾病分类(ICD)系统分类。使用Access建立数据库，运用VB、ASP语言、Java Script脚本语言实现前台咨询与后台数据库之间的互动。结果：建立了3650种疾病的药物治疗方案咨询系统，将疾病药物治疗方案信息资源由传统媒体转变为以光盘、网络等为载体的数字化媒体，实现了信息资源的共享和充分利用。结论：药物治疗方案咨询系统在大、中、小型医院及门诊部等医疗单位的单机、局域网和互联网上应用，证实该系统是医院药师参与临床疾病药物治疗，为病人提供药学服务，提高医疗质量的有力工具。     

中药指纹图谱数据库的研究

目的:研制中药指纹图谱数据库(DTCMF).方法:DTCMF采用Visual FoxPro(VFP)6.0编程语言编制程序.数据库包括色谱、光谱、电泳和DNA指纹谱以及X射线衍射、热分析谱等.结果:DTCMF可独立正常运行在目前常见的所有操作系统中,数据信息量大,检索系统完善,维护与更新便捷.结论:DTCMF具有通用性、实用性及易用性,为中药品质评价提供帮助与参考.     

住院病人膳食服务管理系统的开发研制

本文阐述了应用掌上电脑核心技术和数据库技术开发的住院病人膳食服务管理系统的基本实现方案