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Total Knee Arthroplasty (TKA) has seen many advancements over the years. One such advancement is development of locking mechanism for polyethylene insert in modular implants. It aims to reduce micro motion and wear problems. Disengagement of locking pin from insert after primary TKA without trauma is rare complication. The author describes a rare case of disengagement of the polyethylene insert locking pin in primary total knee arthroplasty. Disengagement of the locking clip was observed 8 months after index operation without any trauma.  相似文献   
3.
目的:探讨胆汁槟榔维B1胶囊联合复方聚乙二醇电解质散在电子肠镜检查前肠道准备中的应用效果。方法:选取2017年1月至2017年12月来我院行电子肠镜检查的180例病人为研究对象,并随机等分为A、B、C三组,A组病人于肠镜检查前6 h口服3盒复方聚乙二醇电解质散;B组病人于肠镜检查前1 d口服胆汁槟榔维B1胶囊;C组患者在检查前1 d口服胆汁槟榔维B1胶囊,并于肠镜检查前6 h口服3盒复方聚乙二醇电解质散。比较三组病人的排便次数、肠道清洁效果、肠道清洁范围、气泡量及不良反应发生情况。结果:C组病人肠道清洁效果、肠道清洁范围、气泡产生量显著优于A、B组,差异具有统计学意义(P<0.05),肠道清洁效果与气泡产生量A组与B组差异无统计学意义(P>0.05);排便次数B、C组少于A组(P<0.05),且B组少于C组,差异有统计学意义(P<0.05);不良反应发生情况B组低于A、C组(P<0.05),A组与C组差异无统计学意义(P>0.05)。结论:胆汁槟榔维B1胶囊联合复方聚乙二醇电解质散行肠道准备可明显提高肠道清洁效果、肠道清洁范围、降低气泡产生量,并且不良反应发生率不高于单独使用复方聚乙二醇电解质散,能够取得更加满意的肠道准备效果,可在肠镜检查前肠道准备中广泛推广。  相似文献   
4.
目的观察胃肠动力药莫沙必利联合二甲硅油散在慢性便秘患者行电子结肠镜检查前肠道准备过程中的应用效果。 方法选取徐州医科大学附属淮安医院拟行电子纤维结肠镜检查的慢性便秘患者300例,采用随机数字表法分为A组(复方聚乙二醇电解质散联合二甲硅油散)150例、B组(在A组的基础上联合莫沙必利口服)150例。采用Boston肠道量表进行肠道准备质量的评分、肠道气泡量表用于评估肠道内气泡的数量,并记录患者肠道准备时间,进镜时间及退镜时间、不良反应发生情况以及肠道疾病检出情况。 结果AB组2组实际完成肠镜检查过程分别为143例和146例,B组BBPS大于6分的比例明显高于A组(χ2=5.141,P<0.05);B组肠道泡沫量评中I、Ⅱ级所占比例明显高于A组(χ2=5.851,P<0.05)。且肠道准备所用时间、不良反应发生率及肠道病变检出率,B组也明显优于A组,差异有统计学意义(P<0.05)。 结论莫沙必利联合二甲硅油散作为肠道准备用药可以明显提高慢性便秘患者肠道清洁质量的同时显著减少肠腔内气泡的产生,也能减少肠道准备所用时间、降低不良反应发生率、提高肠道病变的检出率。  相似文献   
5.
BACKGROUND Acute pancreatitis(AP) is a sudden inflammatory process of the pancreas that may also involve surrounding tissues and/or remote organs. Inflammation and parenchymal cell death are common pathological features of this condition and determinants of disease severity. Polyethylene glycols(PEGs) are nonimmunogenic, non-toxic water-soluble polymers widely used in biological, chemical, clinical and pharmaceutical settings.AIM To evaluate the protective effect of a 35-k Da molecular weight PEG(PEG35) on the pancreatic damage associated to cerulein-induced acute pancreatitis in vivo and in vitro.METHODS Wistar rats were assigned at random to a control group, a cerulein–induced AP group and a PEG35 treatment group. AP was induced by five hourly intraperitoneal injections of cerulein(50 μg/kg/bw), while the control animals received saline solution. PEG35 was administered intraperitoneally 10 minutes before each cerulein injection in a dose of 10 mg/kg. After AP induction, samples of pancreatic tissue and blood were collected for analysis. AR42 J pancreatic acinar cells were treated with increasing concentrations of PEG35 prior to exposure with tumor necrosis factor α(TNFα), staurosporine or cerulein. The severity of AP wasdetermined on the basis of plasma levels of lipase, lactate dehydrogenase activity, pancreatic edema and histological changes. To evaluate the extent of the inflammatory response, the gene expression of inflammation-associated markers was determined in the pancreas and in AR42 J-treated cells. Inflammation-induced cell death was also measured in models of in vivo and in vitro pancreatic damage.RESULTS Administration of PEG35 significantly improved pancreatic damage through reduction on lipase levels and tissue edema in cerulein-induced AP rats. The increased associated inflammatory response caused by cerulein administration was attenuated by a decrease in the gene expression of inflammation-related cytokines and inducible nitric oxide synthase enzyme in the pancreas. In contrast, pancreatic tissue m RNA expression of interleukin 10 was markedly increased. PEG35 treatment also protected against inflammation-induced cell death by attenuating lactate dehydrogenase activity and modulating the pancreatic levels of apoptosis regulator protein BCL-2 in cerulein hyperstimulated rats. Furthermore, the activation of pro-inflammatory markers and inflammationinduced cell death in pancreatic acinar cells treated with TNFα, cerulein or staurosporine was significantly reduced by PEG35 treatment, in a dose-dependent manner.CONCLUSION PEG35 ameliorates pancreatic damage in cerulein-induced AP and AR42 J-treated cells through the attenuation of the inflammatory response and associated cell death. PEG35 may be a valuable option in the management of AP.  相似文献   
6.
BACKGROUND Bowel preparation in children can be challenging.AIM To describe the efficacy, safety, and tolerability of sodium picosulfate, magnesium oxide, and citric acid(SPMC) bowel preparation in children.METHODS Phase 3, randomized, assessor-blinded, multicenter study of low-volume, divided dose SPMC enrolled children 9-16 years undergoing elective colonoscopy. Participants 9-12 years were randomized 1:1:1 to SPMC ? dose × 2, SPMC 1 dose × 2, or polyethylene glycol(PEG). Participants 13-16 years were randomized 1:1 to SPMC 1 dose × 2 or PEG. PEG-based bowel preparations were administered per local protocol. Primary efficacy endpoint for quality of bowel preparation was responders(rating of ‘excellent' or ‘good') by modified Aronchick Scale. Secondary efficacy endpoint was participant's tolerability and satisfaction from a 7-item questionnaire. Safety assessments included adverse events(AEs) and laboratory evaluations.RESULTS 78 participants were randomized, 48 were 9-12 years, 30 were 13-16 years. For the primary efficacy endpoint in 9-12 years, 50.0%, 87.5%, and 81.3% were responders for SPMC ? dose × 2, SPMC 1 dose × 2, and PEG groups, respectively. Responder rates for 13-16 years were 81.3% for SPMC 1 dose × 2 and 85.7% for PEG. Overall, 43.8% of participants receiving SPMC 1 dose × 2 reported it was ‘very easy' or ‘easy' to drink, compared with 20.0% receiving PEG. Treatment-emergent AEs were reported by 45.5% of participants receiving SPMC 1 dose × 2 and 63.0% receiving PEG.CONCLUSION SPMC was an efficacious and safe for bowel preparation in children 9-16 years, with comparable efficacy to PEG. Tolerability for SPMC was higher compared to PEG.  相似文献   
7.
目的:观察揿针、聚乙二醇4000散联合生物反馈疗法治疗功能性便秘的临床疗效。方法:选取102例功能性便秘患者,按随机数字表法分为对照组和观察组各51例。对照组采用揿针联合聚乙二醇4000散治疗,观察组在对照组基础上加用生物反馈疗法治疗。观察患者治疗后便秘症状改善情况及肛门直肠动力、肛门直肠感觉和生活质量的变化,比较2组临床疗效。结果:观察组总有效率96.08%,高于对照组的80.39%(P<0.05)。治疗后,2组便秘症状评分均较治疗前降低,观察组便秘症状评分低于对照组,差异均有统计学意义(P<0.05)。治疗后,2组直肠最低敏感量、最大耐受量、直肠顺应性均较治疗前降低,观察组以上3项指标值均低于对照组,差异均有统计学意义(P<0.05)。2组治疗前后直肠静息压、肛门括约肌压力比较,差异均无统计学意义(P>0.05)。治疗后,2组躯体不适、心理社会不适、担心和焦虑、满意度及总分均较治疗前降低,观察组躯体不适、心理社会不适、担心焦虑、满意度及总分均低于对照组,差异均有统计学意义(P<0.05)。结论:揿针、聚乙二醇4000散联合生物反馈疗法治疗功能性便秘,可改善患者的便秘症状、肛门直肠动力、肛门直肠感觉及生活质量,提高治疗效果。  相似文献   
8.
BACKGROUND Polyethylene(PE) particles produced by wear of the acetabular insert are thought to cause osteolysis and thereby aseptic loosening of the implant in total hip arthroplasty(THA). As highly cross-linked polyethylene(HXLPE) is presumed to give lower wear rates, in vivo studies are needed to confirm this.AIM To compare the wear of REXPOL, a HXPLE, with conventional PE within the first five years after implantation using Roentgen stereophotogrammetric analysis(RSA).METHODS Patients were randomised to receive either a HXLPE(REXPOL) or a conventional PE insert during primary THA. RSA images were obtained directly postoperative and after 6 wk, 12 wk, 6 mo, 12 mo, 24 mo and five years. Functional outcomes were assessed using the Hip Injury and Osteoarthritis Outcome Score and Harris Hip Score at baseline and five years after surgery.RESULTS The HXLPE(REXPOL) showed less wear in the latero-medial direction. Significant wear rates of conventional PE were seen in the latero-medial and center-proximal direction and in volume and corrected volume, whereas the REXPOL did not show these outcomes over time. Improvement from baseline in functional outcome did not significantly differ.CONCLUSION Total 3 D wear is less in THAs inserted with a REXPOL inlay than a conventional PE inlay after five years. This study confirms, for the first, that the REXPOL HXLPE inlay is preferred to standard PE.  相似文献   
9.
目的 用响应面法对马来酰亚胺活化相对分子质量40 000的聚乙二醇(polyethylene glycol,PEG)(MAL-PEG40K)修饰胰高血糖素样肽1类似物(glucagon-like peptide-1 analog,GLP-1a)的反应条件进行优化。方法 对GLP-1a浓度、GLP-1a/MAL-PEG40K摩尔比、反应液pH值、反应温度、反应时长进行单因素试验。以前3个条件为自变量, PEG修饰率为响应值,根据中心组合试验设计原理,研究各自变量及其交互作用对PEG修饰率的影响。通过高效液相色谱法分析PEG修饰率,依据回归分析确定各反应条件的最优值。 结果 GLP-1a与MAL-PEG40K的最佳反应条件为:GLP-1a浓度2.5 mg/ml,GLP-1a/MAL-PEG40K摩尔比1∶1.25,反应液pH 8,反应温度4 ℃,反应时长60 min。该优化条件下,GLP-1a的PEG修饰率可达91.0%。结论 响应面法获得了GLP-1a与MAL-PEG40K的最佳反应条件。  相似文献   
10.
背景 肠道清洁对于结肠镜检查的准确性和安全性有重要意义,部分临床随机对照研究认为聚乙二醇电解质散联合莫沙必利可提高结肠镜前肠道准备的清洁效果和安全性,但此类研究结果不一致且存在一定争议性,有必要对此类研究进行系统评价。目的 旨在系统评价聚乙二醇电解质散联合莫沙必利对比单纯应用聚乙二醇电解质散在肠镜检查前行肠道准备的有效性与安全性。方法 计算机检索中国知网(CNKI)、万方数据知识服务平台、中文科技期刊数据库(VIP)、中国生物医学文献数据库(CMB)、PubMed、EMBase、Cochrane Library等数据库,检索时间为建库到2018年6月,全面收集聚乙二醇电解质散联合莫沙必利用于结肠镜检查前肠道准备的临床随机对照试验。由2名研究人员各自独立完成文献阅读,按照文献纳入、排除标准进行文献筛选、资料提取。采用RevMan 5.3软件进行Meta分析,采用GRADE profiler 3.6软件对Meta分析结局指标进行证据分级。结果 共纳入14篇文献,Meta分析结果显示,在肠道准备有效性方面,两亚组观察组肠道准备有效率均高于对照组〔RR=1.15,95%CI(1.06,1.25),P=0.000 8;RR=1.03,95%CI(1.01,1.06),P=0.02〕;在安全性方面,观察组总不良反应发生率〔RR=0.54,95%CI(0.44,0.67),P<0.000 01〕、恶心发生率〔RR=0.48,95%CI(0.39,0.60),P<0.000 01〕、呕吐发生率〔RR=0.46,95%CI(0.32,0.65),P<0.000 1〕、腹胀发生率〔RR=0.36,95%CI(0.26,0.50),P<0.000 01〕均低于对照组。两组腹痛发生率和息肉检出率比较,差异无统计学意义〔RR=0.79,95%CI(0.58,1.08),P=0.14;RR=0.90,95%CI(0.74,1.10),P=0.32〕。结论 聚乙二醇电解质散联合莫沙必利行肠道准备的有效性和安全性均优于单纯应用聚乙二醇电解质散。在未来需要高质量文献纳入以进一步证实本研究结果。  相似文献   
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