The Leukocyte Esterase Strip Test has Practical Value for Diagnosing Periprosthetic Joint Infection After Total Knee Arthroplasty: A Multicenter Study

Background

Leukocyte esterase (LE) was recently reported to be an accurate marker for diagnosing periprosthetic joint infection (PJI) as defined by the Musculoskeletal Infection Society (MSIS) criteria. However, the diagnostic value of the LE test for PJI after total knee arthroplasty (TKA), the reliability of the subjective visual interpretation of the LE test, and the correlation between the LE test results and the current MSIS criteria remain unclear.

Comparisons of the prevalence and correlation factors of chronic kidney disease between the old urban and rural residents in MinHang district of Shanghai

Objective To compare the prevalence and correlation factors of chronic kidney disease (CKD) in urban and rural areas in Minhang district of Shanghai through the social economic and clinical data of the elderly population. Methods Jiangchuan Street and Pujiang town were randomly selected to represent the urban and rural population in Minhang district of Shanghai, respectively. Based on the over-60-year old people health examination program, 6151 objectives with complete clinical-epidemiological data and bio-chemical index were investigated. The prevalence of CKD in urban and rural areas was compared, and the correlation factors for the urban and rural CKD were evaluated by multiple logistic regression analysis. Results (1) The survey objectives with an average age of (69.57±7.04) years, including 4345 cases of the city residents and 1806 cases of rural residents, were enrolled. The age structures of urban and rural showed differences, population over 80 years old account for 13.1% of the rural total, significantly higher than 7.4% in the urban population (P＜0.001). (2) The prevalence rates of diabetes, hyperuricemia, hyperlipidemia and hyperlipidemia in urban residents were higher than those in rural residents, which were 26.4% vs 13.7%, 9.9% vs 2.3%, 53.7% vs 37.4%, 51.4% vs 15.6% (all P＜0.01). The awareness rates of kidney disease and hyperlipidemia showed significant differences in urban and rural areas, which were 32.9% vs 44.2%, 84.6% vs 62.8% (all P＜0.01). Compared with those in rural areas, the treatment rates of hypertension and high blood lipids in urban residents were increased (all P＜0.01). (3) The prevalence of CKD was 23.4%. Female CKD prevalence was higher than male, respectively 26.3% and 18.5% (P＜0.01). In urban CKD prevalence was 22.2%, lower than 25.2% in rural. The prevalence rate of hematuria in urban areas was lower than in rural areas, but the prevalence rate of decline in renal function was higher (all P＜0.05). With the increase of age, the prevalence rate of CKD was increased (P＜0.01). (4) Age (OR=1.072), smoking history (OR=1.543), previous history of kidney disease (OR=1.351), diabetes (OR=1.373), hyperuricemia (OR=2.498), obesity (OR=1.364), history of interventional therapy (OR=1.896) had positive correlation with CKD in city elderly population, while the higher education (OR=0.676, OR=0.604) and drinking (OR=0.585) had negative correlation (all P＜0.05). Age (OR=1.032), female (OR=1.860) had positive correlation with CKD in rural elderly population (all P＜0.05). Conclusions CKD has been a common chronic progressive disease of the aged in Minhang district. The prevalence of CKD is higher in urban areas than in rural. Age is a common factor for CKD in urban and rural. Previous smoking, history of kidney disease, diabetes, hyperuricemia, obesity, history of interventional therapy, education and drinking have correlation with urban CKD patients. Female has correlation with rural CKD population.     

胃癌细胞多药耐药相关蛋白质筛选鉴定的蛋白质组学研究

目的 在胃癌细胞株SGC7901及稳定的耐药细胞株SGC7901/VCR中寻找与胃癌多药耐药(MDR)直接相关的蛋白质,观察其功能.方法 胃癌细胞株SGC7901和稳定的耐药细胞株SGC7901/VCR培养后提取总蛋白,采用蛋白质组学技术(双向凝胶电泳和基质辅助激光解吸电离-飞行时间质谱鉴定)筛选并鉴定差异表达的蛋白质,并应用蛋白印迹试验法对鉴定出的部分蛋白质在胃癌细胞株中的表达进行验证.结果 在两种细胞株中找到表达差异明显的蛋白质点9个,经质谱分析,7种蛋白质得到鉴定,为S60核糖体蛋白L23、电压依赖性阴离子选择性通道蛋白1、锌指蛋白394、角蛋白Ⅰ型细胞骨架9、核糖核酸3'-端磷酸化酶1、matrin型锌指蛋白2、Sideroflexin-1.这些蛋白质与胃癌MDR直接相关.蛋白印迹试验法检测部分蛋白质在胃癌细胞株中的表达,与蛋白质组学所得结果一致.结论 胃癌细胞SGC7901和SGC7901/VCR蛋白质表达存在差异.

Abstract：

Objective To investigate multidrug resistance related proteins in human gastric carci noma cell lines SGC7901 and SGC7901/VCR by comparative proteomics.Methods After culture,the holoproteins of human gastric carcinoma cell lines SGC7901 and GC7901/VCR were extracted,and then measured by two-dimensional gel electrophoresis and matrix assisted laser desorption/ionization time-offlight mass spectrometry (MALDI-TOF-MS).Some proteins obtained through proteomics were tested by Western blotting in the cell lines.Results There were different proteins in these 2 human gastric carcinoma cell lines.Nine different protein spots were found in these 2 gastric carcinoma cell lines,and 7 spots were identified by MALDI-TOF-MS,and these proteins were 60S ribosomal protein L23 ( RL23),voltagedependent anion-selective channel protein-1 (VDAC1),zinc finger protein (ZNF) 394,keratin,type Ⅰcytoskeletal 9 ( KIC9),RNA 3' -terminal phosphate cyclase 1 ( RTC1 ),zinc finger matrin-type protein 2,Sideroflexin-1.These proteins had a direct relationship with multidrug resistance in gastric carcinoma.Results of Western blotting about protein expression were in consonance with those of proteomics.Conclusion Different proteins were found in human gastric carcinoma cell lines SGC7901 and SGC7901/VCR.     

全弓置换和支架象鼻手术治疗A型主动脉夹层时左锁骨下动脉的处理分析

目的 总结选择性结扎左锁骨下动脉、仅重建无名动脉和左颈总动脉方法在A型主动脉夹层全弓置换和支架象鼻手术中应用的临床经验.方法 2008年1月至2010年6月,29例A型主动脉夹层患者在接受全弓置换和支架象鼻手术时,因左锁骨下动脉显露困难,术中将其直接结扎.本组男性21例,女性8例,年龄19～55岁,平均年龄(44±12)岁.其中急性夹层12例,亚急性夹层4例,慢性夹层13例.所有患者依据术前影像学和术中循环、压力指标判断患者大脑Willis环和双侧椎动脉的侧支循环情况,如侧支良好,则直接结扎左锁骨下动脉、仅重建无名动脉和左颈总动脉;如果侧支不足,则结扎后加行升主动脉-左腋动脉旁路术.结果 29例手术均顺利完成,1例术后死于肺部感染,其余恢复顺利.术后左上肢血压(78±17)mmHg(1 mmHg=0.133 kPa),明显低于右上肢的(126±24)mmHg(P＜0.01),但左侧指氧饱和度、皮温、肌力及感觉运动功能与右侧相比无明显差异.随访1～27个月,无左锁骨下动脉盗血综合征与左上肢肌萎缩发生.结论 在对A型主动脉夹层行全弓置换和支架象鼻手术时,如果动脉瘤体较大、左锁骨下动脉位置较深、显露困难时,可以在充分评估侧支循环的前提下直接予以结扎,可简化手术操作和手术难度,术后无明显不良后果.

Abstract：

Objective To summarize the experiences of ligating left subclavian artery(LSA)in total arch replacement and stented elephant trunk implantation for Stanford type A aortic dissection patients with difficulty in exposing the LSA. MethodsTotal arch replacement and stented elephant trunk implantation were performed on 79 consecutive patients from January 2008 to June 2010. Twenty-nine cases of the cohort undertook LSA ligation due to bad exposure. There were 21 males and 8 females patients, aged from 19 to 55 years with a mean of(44 ± 12)years. There were 12 acute dissections, 4 sub-acute dissections and 13 chronic dissections. Based on thoroughly evaluation of the Willis' circle and bilateral vertebral arteries through pre-operative imaging and inrto-operative circulative parameters, if the collateral circulation was considered sufficient, LSA was ligated directly and only the innominate artery and carotid artery were reconstructed; if considered insufficient, an additional bypass from ascending aorta to left axillary artery was performed. Results All the 29 operations were completed successfully. There was one patient died from pulmonary infection and the others recovered well. Blood pressure of left arms were lower than right postoperatively[(78 ± 17)mmHg vs.(126 ± 24)mmHg, 1 mmHg = 0. 133 kPa, P ＜ 0. 01], but oxygen saturation, skin temperature and strength of the left hand were normal compared to the right. All the survived patients have been followed 1-27 months and none of them presented with any symptoms of left subclavian artery steal syndrome and ischemia of left arms. Conclusions Ligation of LSA under strict evaluation of collateral circulation could be safe in Type A dissection patients with bad exposure due to big ascending aortic aneurysm and will simplify the procedure significantly.     

口腔黏膜卷管分期修复幼儿期先天性尿道下裂

目的 探讨修复幼儿期先天性尿道下裂的手术方法.方法 矫直阴茎后,应用口腔黏膜卷管游离移植预制缺损段尿道,二期进行吻接,同时应用以阴囊动脉为蒂的阴囊筋膜皮瓣覆盖创面,皮瓣范围包括阴囊中缝区在内的阴囊区域.结果 2007年1月至2010年5月,于临床应用42例.手术过程顺利,应用口腔黏膜卷长3.0～4.0 cm,直径0.6～0.8 cm;阴囊筋膜皮瓣最宽1.5cm,最长3.0 cm.术后除2例患者出现阴囊皮瓣远端血运障碍而漏尿,术后1～2周内经换药后自行愈合外,其余患者均一期愈合.术后有26例获得随访,时间为6个月至3年,阴茎无弯曲,自行排尿通畅,无尿道狭窄及尿瘘,阴茎外形良好.结论 应用口腔黏膜卷管游离移植预制缺损段尿道,二期尿道吻接,同时应用血运良好的阴囊筋膜皮瓣覆盖创面,是一种修复幼儿期尿道下裂的良好方法.

Abstract：

Objective To discuss the treatment of congenital hypospadias in infancy. Methods After correction of chordee, the tubed oral mucosa was used to prefabricate urethra in penis as free graft.The uretheral anastomosis was performed at the second stage. The scrotum fascia flap, pedicled with scrotal artery, was transferred to cover the penile defect. Results From Jan. 2007 to May 2010, 42 cases were treated. The tubed oral mucosa was 3.0-4.0 cm in length ,and 0. 6-0. 8 cm in diameter. The maximum size of scrotum flap was 1.5 cm × 3.0 cm. Uretheral fistula happened in two cases due to necrosis at the distal end of scrotal flap, which was healed spontaneously after dressing for 1-2 weeks. Primary healing was achieved in all the other cases. After operation, the 26 cases have been visited for 6 months to 3 years, no urethra fistula , narrow and the penis curved. There is an universal urinate for oneself and a good form.Conclusions The tubed oral mucosa can be used to prefabricate urethera, which is anastomosed at the second stage. The tubed oral mucosa combined with scrotal fascial flap which has a reliable blood supply,is very suitable for hypospadias in infancy.     

磁共振化学位移成像对肾上腺肿瘤的诊断（附18例报告）

目的：评价磁共振（magnetic resonance,MR）化学位移成像（chemical shift imaging,CSI）对肾上腺腺瘤的诊断价值。方法：回顾分析我院18例肾上腺肿瘤患者,术前均进行了MR-CSI检查,对其病历资料及MR图象进行分析。结果：12例肾上腺腺瘤在MR—CSI同相位、反相位序列的检查中,均表现为反相位不同程度的信号减低,6例非腺瘤性病变反相位上不表现为明显的信号降低。结论：MR—CSI对肾上腺腺瘤与非腺瘤性病变的诊断与鉴别诊断具有重要价值。     

Y形软骨闭合与否对青少年特发性脊柱侧凸患者矫形疗效及并发症的影响

目的 探讨作为评估脊柱生长潜能指标的Y形软骨是否闭合对女性青少年特发性脊柱侧凸(AIS)患者单纯后路矫形内固定融合手术疗效及并发症的影响.方法 选取2003年6月至2007年10月行单纯后路矫形内固定融合术的女性胸弯AIS患者40例,其中手术时Y形软骨开放者16例(OTRC组),平均年龄11.8岁,冠状面主弯Cobb角平均53.3°,矢状面后凸平均27.7°;Y形软骨闭合者24例(CTRC组),平均年龄13.7岁,冠状面主弯Cobb角平均49.6°,矢状面后凸Cobb角平均27.8°.所有患者均于全身麻醉下行单纯后路矫形内固定融合术.对两组患者的术后及末次随访时冠状面胸主弯Cobb角、矢状面后凸Cobb角及并发症进行分析.结果 OTRC组和CTRC组术后平均随访27和26个月(P=0.74).两组患者术后平均Cobb角分别为22.2°和20.7°(P＝0.34),平均矫正率分别为58.3%和57.7%(P=0.83),末次随访时平均Cobb角为24.8°和21.1°(P＝0.05),平均矫正丢失率分别为5.3%和1.0%(P=0.01).矢状面上两组患者术后平均后凸Cobb角分别为22.5°和23.9°(P=0.49),平均矫正5.2°和3.9°(P=0.63),末次随访平均后凸Cobb角20.8°和24.7°(P＝0.04),平均丢失-1.7°和0.8°(P=0.01).OTRC组患者随访过程中出现冠状面Cobb角矫正丢失和矢状面后凸Cobb角减小.OTRC组2例实施选择性胸弯融合术的Lenke I型患者出现远端"附加现象",而CTRC组无远端"附加现象"发生.结论 Y形软骨是否闭合对女性AIS患者行单纯后路矫形内固定融合术短期疗效无明显影响,但OTRC组容易矫正丢失.OTRC或许是远端"附加现象"的危险因素.

Abstract：

Objective To investigate the effect of potential spinal growth on the posterior-only spinal instrumentation of adolescent idiopathic scoliosis (AIS) . Methods From June 2003 to October 2007 ,40 patients received posterior-only spinal instrumentation. Croup of open triradiate cartilage (Croup A) included 16 female AIS patients with mean age of 11. 8, and group of closed triradiate cartilages (Croup B)covered 24 female AIS patients with mean age of 13. 7. The mean preoperative Cobb angles of Croup A and B were S3. 3° and 49. 6° respectively, and the mean kyphosis in the sagittal plane was 27. 7° and 27. 8° respectively. Results The post-operative Cobb angles were 22. 2° (Group A) vs. 20. 7° (Group B) (P =0. 34) with correction rate of 58. 3% (Group A) vs. 57. 7% (Group B) (P = 0. 83). The mean Cobb angles at final follow-up were 24. 8°(Group A) vs. 21. l°(Group B) (P=0. 05) with the correction loss of 5.3% (Group A) vs. 1.0% (Group B) (P=0. 01). In the sagittal plane, the average post-operative kyphosis was 22. 5° (Group A) vs. 23. 9° (Group B) (P = 0.49) with correction of 5. 2° (Group A) vs.3.9°(GroupB) (P = 0.63). The mean kyphosis at final follow-up was 20. 8° (Group A) vs. 24.7°(Group B) (P=0.04) with the correction loss of - 1. 7°(Group A) vs. 0.8°(Group B)(P=0.01). Group A showed obvious correction loss in the coronal plane and decrease of kyphosis in the sagittal plane. Adding on phenomenon was found in 2 cases with Lenke type I with selected fusion in Group A, but not in Group B. Conclusions Although similar post-operative correction is found in AIS patients with OTRC or CTRC, the loss of correction and "adding on phenomenon" are more likely to happen in patients with OTRC.     

The efficacy of photon-initiated photoacoustic streaming in the removal of calcium silicate-based filling remnants from the root canal after rotary retreatment

The aim of the study was to evaluate the efficacy of photon-initiated photoacoustic streaming (PIPS) in the removal of filling remnants from root canals after rotary phase of retreatment and to examine the difference in the amount of residual material considering the type of sealer. Thirty-six extracted single-rooted human teeth were instrumented and randomly divided into three groups according to the filling material used: group 1: EndoSequence BC Sealer (Brassler, USA), group 2: MTA Fillapex (Angelus Solucoes Odontologicas, Londrina, Brasil), and group 3: AH Plus sealer (Dentsply DeTrey, Konstanz, Germany). Cold lateral condensation technique was used. After 2 weeks, the root canals were retreated with a rotary phase retreatment system (ProTaper Universal Retreatment, Maillefer, Ballaigues, Switzerland), followed by Er:YAG laser-activated irrigation (photon-initiated photoacoustic streaming, PIPS). The specimens were scanned in a micro-computed tomographic (micro-CT) device after root canal filling, after the rotary retreatment, and after the PIPS. There was significant reduction in the amount of filling material after the rotary phase of retreatment in all groups (p < 0.05), the highest in the MTA Fillapex group (p < 0.001) and no difference between the EndoSequence BC and the AH Plus (p = 0.608). There was significant reduction of the filling remnants after the PIPS in all groups (p < 0.05). The MTA Fillapex was the most easily removed during rotary phase of the retreatment, and there were no differences in the amount of the remaining filling material between EndoSequence BC and the AH Plus groups after rotary phase of the retreatment. The PIPS improved the removal of filling remnants in all groups.     

颈椎前路减压cage与zero-p椎间植骨融合内固定治疗单节段脊髓型颈椎病的疗效比较

目的比较颈椎前路减压cage椎间植骨融合钛板内固定与zero-p椎间植骨融合内固定治疗单节段脊髓型颈椎病的临床疗效及并发症情况。方法纳入自2013-06—2015-06诊治的110例单节段脊髓型颈椎病,采用颈椎前路减压cage椎间植骨融合钛板内固定治疗55例(cage组),采用颈椎前路减压zero-p椎间植骨融合内固定治疗55例(zero-p组)。比较2组手术时间、术中出血量、住院时间,术后12个月JOA评分、NDI指数、颈椎曲度、颈椎节段高度及植骨融合率,术后1周、3个月吞咽困难发生例数。结果所有患者均获得(22.78±3.10)个月随访。2组手术时间、术中出血量、住院时间比较差异无统计学意义(P0.05)。2组术后12个月JOA评分、NDI指数、颈椎曲度、颈椎节段高度、植骨融合率差异无统计学意义(P0.05)。zero-p组术后1周、3个月吞咽困难发生例数少于cage组,差异有统计学意义(P0.05)。结论颈椎前路减压cage椎间植骨融合钛板内固定与zero-p椎间植骨融合内固定治疗单节段脊髓型颈椎病均可取得满意的临床疗效,但zero-p椎间植骨融合内固定术后吞咽困难发生的风险明显较低,其安全性更符合临床需要。