Failures of the Dual Articular knee prosthesis due to fracture of the polyethylene post

The Dual Articular (DA) total knee replacement was designed for revision and complex primary knee arthroplasty. A number of these knees failed due to fracture of the polyethylene post. We aimed to identify the proportion of DA prostheses that failed in this manner in our hospital.The hospital database was interrogated to identify all patients undergoing revision total knee replacement under the care of one surgeon from 1995 to 2007. Case notes were then reviewed to collect information about the history surrounding the knee surgery, and determine the patient's weight at the time of surgery. Telephone follow-up was carried out to obtain complete contemporary data.Forty-eight prostheses were implanted into 39 patients (21 male, 18 female). Thirty-two of the prostheses were DA and of these, 7 underwent arthroscopy or arthrotomy to reveal a fracture of the polyethylene post (22%). T-tests showed no statistical difference in age (p = 0.73) or weight (p = 0.79) between the group of DA patients with fractured posts and those without. Six of the 7 fractures were in male patients (Chi-squared; p = 0.01). Patients complained of pain, clicking and instability at a mean of 7 years post-surgery. Sixteen DA2000 prostheses were implanted, but none of these had failed due to a fractured polyethylene post.A high proportion of DA prostheses failed due to post fracture. We recommend that patients with DA prostheses be kept under review to detect failures early. Pain, clicking and instability should be investigated with arthroscopy and the tibial insert exchanged as appropriate.     

抗黏附多肽的聚乙二醇化研究

目的 观察聚乙二醇化抗黏附多肽酪-异亮-甘-丝-精(YIGSR)对人肝癌高转移细胞株MHCC97H体外基质黏附抑制能力和在大鼠血清体外的降解.方法 将甲氧基聚乙二醇丙醛10000(mPEGALD10000)与YIGSR在PH4到6,摩尔比1:1到10:1条件下偶联成聚乙二醇化YIGSR(PEG-YIGSR).比较两者的基质黏附抑制能力及在SD大鼠血清中的降解速率.结果 修饰率可以达到99.9%以上,PEG-YIGSR的黏附抑制率达19.5%,且呈时间剂量依赖关系.PEG-YIGSR在大鼠血清中的降解速度明显慢于YIGSR,药时曲线下面积(AUC)分别为(1249±36)mg/min·L~(-1)和(1146±47)mg/min·L~(-1).结论 PEG-YIGSR保留了抗肿瘤细胞黏附的作用,且在体外血清中的降解速率减慢,有助于延长YIGSR发挥作用的时间.     

Application of dynamic neural networks in the modeling of drug release from polyethylene oxide matrix tablets

The main objective of this study was to demonstrate the possible use of dynamic neural networks to model diclofenac sodium release from polyethylene oxide hydrophilic matrix tablets. High and low molecular weight polymers in the range of 0.9–5 × 10⁶ have been used as matrix forming materials and 12 different formulations were prepared for each polymer. Matrix tablets were made by direct compression method. Fractions of polymer and compression force have been selected as most influential factors on diclofenac sodium release profile. In vitro dissolution profile has been treated as time series using dynamic neural networks. Dynamic networks are expected to be advantageous in the modeling of drug release. Networks of different topologies have been constructed in order to obtain precise prediction of release profiles for test formulations. Short-term and long-term memory structures have been included in the design of network making it possible to treat dissolution profiles as time series. The ability of network to model drug release has been assessed by the determination of correlation between predicted and experimentally obtained data. Calculated difference (f₁) and similarity (f₂) factors indicate that dynamic networks are capable of accurate predictions. Dynamic neural networks were compared to most frequently used static network, multi-layered perceptron, and superiority of dynamic networks has been demonstrated. The study also demonstrated differences between the used polyethylene oxide polymers in respect to drug release and suggests explanations for the obtained results.     

复方聚乙二醇电解质散用于肠道清洁准备的效果观察

目的:观察复方聚乙二醇电解质散用于肠道清洁准备的效果。方法:178例拟进行肠道清洁准备的患者,随机分成试验组(使用复方聚乙二醇电解质散)与对照组(使用甘露醇),比较2组肠道清洁度、不良反应和依从性。结果:试验组与对照组的肠道清洁度有效率分别为100.0%、94.2%(P>0.0.05),不良反应发生率分别为8.7%、27.9%(P<0.05),完全依从率分别为96.7%、80.2%(P<0.05)。结论:复方聚乙二醇电解质散用于肠道清洁准备效果好,不良反应少,患者依从性高,适合临床推广应用。     

复方聚乙二醇电解质散在结肠镜检查前肠道准备的临床观察

目的：评价口服复方聚乙二醇电解质散在结肠镜检查前肠道准备的效果和安全性。方法：将61例行结肠镜检查及治疗的患者随机分为研究组及对照组。研究组口服复方聚乙二醇电解质散清洁肠道,对照组口服甘露醇清洁肠道。对肠道清洁的效果、患者服药后的不良反应及耐受性进行比较。结果：研究组肠道清洁度、不良反应发生率及耐受性方面均优于对照组。结论：口服复方聚乙二醇电解质散清洁肠道效果佳、安全性好,是临床患者结肠镜检查前肠道准备的理想方法。     

Disengagement of tibial insert locking pin in total knee arthroplasty - A rare failure case report

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.     

利那洛肽联合复方聚乙二醇电解质散在门诊患者肠道准备中的临床应用

目的 探讨利那洛肽联合复方聚乙二醇电解质散（polyethylene glycol electrolytes powder,PEG）用于门诊患者肠镜检查前肠道准备的安全性及有效性。方法 选取2020年8月至2021年8月于台州市中心医院（台州学院附属医院）行肠镜检查的150例患者为研究对象,按照不同的肠道准备方法将其分为3L PEG组（50例）、4L PEG组（50例）和3L PEG+利那洛肽组（50例）。通过Boston肠道准备评分量表（Boston bowel preparation scale,BBPS）评价三组患者的肠道准备效果,并比较三组患者的不良反应及对肠道准备方案的满意度。结果 3L PEG组患者的左半结肠、横结肠、右半结肠评分及BBPS总评分均显著低于4L PEG组和3L PEG+利那洛肽组（P<0.05）;4L PEG组患者的左半结肠、横结肠、右半结肠评分及BBPS总评分与3L PEG+利那洛肽组比较,差异均无统计学意义（P>0.05）。3L PEG+利那洛肽组患者的首次排便时间明显短于3L PEG组和4L PEG组（F=18.860,P<0.001）。4L PEG组患者的满意度低于3L PEG组和3L PEG+利那洛肽组（P<0.05）,3L PEG+利那洛肽组患者的满意度最高。4L PEG组患者的不良反应发生率显著高于3L PEG组和3L PEG+利那洛肽组（P<0.05）。结论 肠镜检查前使用利那洛肽联合PEG进行肠道准备,可提高患者肠道准备质量,降低服药中的不良反应,缩短首次排便时间,提高患者的满意度,值得临床推广应用。     

Folate receptor targeted imaging using poly (ethylene glycol)-folate: in vitro and in vivo studies

The aim of this study was to ascertain the folate receptor (FR) targetability by an in vitro study and to acquire FR-targeted images in vivo models by using synthetic folate conjugates. PEG-folate was synthesized and labeled with (99m)Tc and fluorescein isothiocynate (FITC). Cell uptake studies were carried out in KB cells (FR-positive) and A549 cells (FR-negative) using FITC- and the (99m)Tc-labeled conjugates. The radiolabeled conjugate was intravenously injected to KB tumor xenografted mice. After it was injected, gamma images were recorded at 30 min, 1, 2, 3 and 4 hr. Cell uptake studies showed a difference between the KB cells and the A549 cells by flow cytometry analysis and gamma counting. On in vivo images, the tumor-to-normal muscle ratio was greater than 4. It ascertained that the PEG-folate conjugate specifically binds to the FR expressed on tumor cells in vitro. Moreover, it was possible to acquire the FR-targeted gamma images using PEG-folate conjugates in tumor models.