Long-Term Functional Outcomes and Quality of Life at Minimum 10-Year Follow-Up After Fixed-Bearing Unicompartmental Knee Arthroplasty and Total Knee Arthroplasty for Isolated Medial Compartment Osteoarthritis

BackgroundThe aim of this study is to compare the long-term functional outcome and quality of life between total knee arthroplasty (TKA) and fixed-bearing unicompartmental knee arthroplasty (UKA) for the treatment of isolated medial compartment osteoarthritis.MethodsBetween 2000 and 2008, a total of 218 patients underwent primary UKA at our tertiary hospital. A TKA group was matched through 1:1 propensity score matching and adjusted for age, gender, body mass index, preoperative knee flexion, and function scores. All patients had medial compartment osteoarthritis. The patients were assessed with the range of motion, Knee Society Knee Score and Knee Society Function Score, Oxford Knee Score, Short Form-36 physical component score (PCS) and mental component score preoperatively, at 6 months, 2 years, and 10 years. Patients’ satisfaction, expectation fulfillment, and minimal clinically important difference were analyzed.ResultsThere were no differences in baseline characteristics between groups after propensity score matching (P > .05). UKA had greater knee flexion at all time points. Although the Knee Society Function Score was superior in UKA by 5.5, 3, and 4.3 points at 6 months, 2 years, and 10 years, respectively (P < .001), these differences did not exceed the minimal clinically important difference (Knee Society Knee Score 6.1). There were no significant differences in the Oxford Knee Score and Short Form-36 physical component score/mental component score. At 10 years, similar proportions of UKA and TKA were satisfied (90.8% vs 89.9%, P = .44) and had expectation fulfillment (89.4% vs 88.5%, P = .46). Between 2 and 10 years, all function scores deteriorated significantly for both groups (P < .01).ConclusionUKA and TKA are excellent treatment modalities for isolated medial compartment osteoarthritis, with similar functional outcomes, quality of life, and satisfaction at 10 years.     

女贞药用价值及其相关上市药品的研究进展

女贞Ligustrum lucidum是木犀科女贞属药用植物,其果实、叶、花等部位均可作为药用。女贞不同药用部位及单体成分具有多种功效,现已开发为多种制剂,既有中药单方制剂,也有以单体成分为主的化学药。大量研究表明,女贞相关药品被广泛用于治疗消化系统、免疫系统等疾病,且临床效果较好。通过对女贞不同药用部位的化学成分、临床应用及药理作用、女贞相关上市药品的工艺与质量、临床应用及基础研究进行综述,进而探讨女贞的潜在应用价值和开发前景,为女贞的综合开发与利用提供一定的参考。     

中药材及饮片质量等级标准研究思路和方法

中药质量评价作为保障中药材及饮片质量安全有效的有力手段,对维护人民群众身心健康、促进中药产业高质量发展具有重要意义。长久以来,中药质量多以法定检验标准为准入门槛进行低限控制,质量等级标准缺乏,致使中药质量仅能满足基本要求,而“优质优价”未能得到充分体现,导致“劣币驱逐良币”,市场公平严重受损,这很大程度影响了中药产业高质量发展。因此,开展中药质量优劣评价研究,构建中药质量等级标准体系对于全面落实“四个最严”要求、促进中医药传承创新发展、规范市场秩序、引导产业健康发展具有深远而重大的意义。对中药材质量评价现状进行概述,针对目前中药材质量评价的瓶颈问题,提出符合中医药特点的质量等级标准研究思路,包括关键质量控制指标确立、综合质量评价方法建立、质量等级标准验证等内容,以期为建立中药质量等级评价体系提供参考,助力中药产业高质量发展。     

原发性高血压患者防治依从性及血压控制达标调查

目的探讨原发性高血压患者防治依从性及血压控制达标情况,为控制原发性高血压的发展提供参考。方法选取2019年5月至2021年12月在庐江县中医院就诊的原发性高血压患者696例为研究对象,对患者进行问卷调查及体格调查,进一步分析不同人群特征、不同防治依从行为对血压控制达标的影响。结果696例原发性高血压患者中血压控制达标率为16.24%(113/696)。禁烟、限制饮酒、减少钠盐摄入、控制体重、适量运动、遵医嘱服药的依从性分别为24.86%、28.45%、64.51%、58.05%、66.38%、83.05%。多因素Logistic回归分析显示,年龄55~69岁(OR=1.567)、文化程度为高中/中专及以上(OR=2.849)、病程≤10年(OR=1.431)、禁烟依从性好(OR=1.852)、限制饮酒依从性好(OR=2.083)、减少钠盐摄入依从性好(OR=3.511)、控制体重依从性好(OR=1.145)、适量运动依从性好(OR=1.670)、遵医嘱服药依从性好(OR=1.399)的高血压患者血压控制达标的可能性较高。结论原发性高血压患者血压控制达标情况有待进一步提高,且与人群特征、防治依从项目密切相关,应针对重点人群、危险因素开展高血压综合防治,提高患者的防治依从性,促进血压控制达标。     

Consistent Forcing Scheme in the Simplified Lattice Boltzmann Method for Incompressible Flows

Considering the fact that the lattice discrete effects are neglected while introducing a body force into the simplified lattice Boltzmann method (SLBM), we propose a consistent forcing scheme in SLBM for incompressible flows with external forces. The lattice discrete effects are considered at the level of distribution functions in the present forcing scheme. Consequently, it is more accurate compared with the original forcing scheme used in SLBM. Through Taylor series expansion and Chapman-Enskog (CE) expansion analysis, the present forcing scheme can be proven to recover the macroscopic Navier-Stokes (N-S) equations. Then, the macroscopic equations are resolved through a fractional step technique. Furthermore, the material derivative term is discretized by the central difference method. To verify the results of the present scheme, we simulate with multiple forms of external force interactions including the space- and time-dependent body forces. Hence, the present forcing scheme overcomes the disadvantages of the original forcing scheme and the body force can be accurately imposed in the present scheme even when a coarse mesh is applied while the original scheme fails. Excellent agreements between the analytical solutions and our numerical results can be observed.     

Inequities in access to VA’S aid and attendance enhanced pension benefit to help Veterans pay for long‐term care

ObjectiveTo examine characteristics that are associated with receipt of Aid and Attendance (A&A), an enhanced pension benefit for Veterans who qualify on the basis of needing daily assistance, among Veterans who receive pensions.Data sourcesSecondary data analysis of 2016‐2017 national VA administrative data linked with Medicare claims.Study designObservational study examining sociodemographic, medical, and healthcare utilization characteristics associated with receipt of A&A among Veterans receiving pension.Principal findingsIn 2017, 9.7% of Veterans with pension newly received the A&A benefit. The probability of receiving A&A among black and Hispanic pensioners was 4.6 percentage points lower than for white pensioners (95%CI = −0.051, −0.042). Married Veterans receiving pension had a 4.4‐percentage point higher probability of receiving A&A (95%CI = 0.039, 0.048). Most indicators of need for assistance (eg, home health utilization, dementia, stroke) were associated with significantly higher probabilities of receiving A&A, with notable exceptions: pensioners with a diagnosis of Post‐Traumatic Stress Disorder (marginal effect = −0.029 95%CI = −0.037, −0.021) or enrolled in Medicaid (marginal effect = −0.053, 95%CI = −0.057, −0.050) had lower probabilities of receiving A&A. Unadjusted and adjusted rates of receiving A&A among Veterans receiving pension varied by VA medical center.ConclusionsThis study identified potential inequities in receipt of the A&A enhanced pension among a sample of Veterans receiving pension. Increased Veteran outreach, provider education, and VA office coordination can potentially reduce inequities in access to this benefit.     

RSV neutralization assays – Use in immune response assessment

Respiratory syncytial virus (RSV) is a leading cause of respiratory illness among children and infants worldwide, yet no licensed vaccine exists to reduce the risk of disease. At least 16 RSV vaccine candidates are currently in clinical development and many are designed to induce robust virus neutralizing immune responses. RSV neutralizing antibody (nAb)-mediated interventions such as intravenous immunoglobulin (IVIG) and palivizumab provide passive protection against serious lower respiratory tract disease due to RSV, validating nAbs as a correlate of protection. To identify correlates of protection for vaccine candidates that have demonstrated their protective efficacy, an investigator can use assays designed to measure nAb responses. However, there is no standard method of measurement; individual laboratories have developed their own methods to measure the ability of nAbs to reduce the infectivity of a defined virus dose in a variety of cell lines, leading to establishment of the broad variety of RSV neutralization assay formats currently in use.Standardizing the RSV neutralization assay is an essential step toward better assessment of nAb responses to vaccine candidates. Use of a common reference standard by all makes comparing the immunogenicity of different vaccine candidates feasible. In the context of vaccine development, the WHO 1^st International Standard for Antiserum to RSV (RSV IS) has been shown to be suitable for harmonizing results across laboratories and assay formats used to measure nAb titers to RSV/A and RSV/B in human sera.This review describes the broad variety of RSV virus neutralization assay formats currently in use and the importance of the RSV IS for harmonization of results across formats and across laboratories. It also outlines good practices for key assay components and data analysis to promote the quality and consistency of measuring RSV nAb titers in serum specimens.     

Ⅰ期双侧全髋关节置换治疗系统性红斑狼疮合并股骨头坏死的早中期疗效

目的分析Ⅰ期双侧全髋关节置换（THA）治疗系统性红斑狼疮（SLE）合并中晚期股骨头缺血性坏死（ANFH）的早中期疗效。方法中山大学附属第三医院骨科对17例SLE合并中晚期ANFH患者均行Ⅰ期双侧THA，按照ARCO分期分为ⅢB期7髋、ⅢC期12髋，Ⅳ期15髋，结合患者年龄与骨质条件选择股骨假体不同的固定方式。采用Harris评分结合SF-36评分方法进行疗效比较与随访，平均随访时间28个月。结果术后2例切口延迟愈合，1例假体脱位，1例大腿痛10月，1例急性肾衰，均经治疗后好转。6例经彩超发现无症状下肢深静脉血栓，无肺栓塞、假体深部感染发生，无肾上腺皮质危象表现，随访期间髋关节疼痛及活动度明显改善，无假体松动。Harris髋关节功能评分（平均91．6分）与术前（平均42．6分）相比差异有统计学意义（P〈0．01），SF-36评分（平均84．5分）与术前（平均51．4分）相比差异有统计学意义（P〈0．01）；不同ARCO分期病例术后Harris评分差异无统计学意义（P〉0．05）；不同假体固定方式术后Harris髋关节功能评分、SF-36评分均差异无统计学意义（P〉0．05）。结论Ⅰ期双侧人工髋关节置换术对SLE合并中晚期ANFH的早中期疗效良好，应严格掌握手术适应证和手术时机，加强围手术期处理，选择合适的假体固定方式。     

Long-term mortality in patients with myocardial infarction: impact of early treatment with captopril for 4 weeks

目的　中国心脏研究 Ⅰ (CCS 1)入选 150 0 0例急性心肌梗塞 (AMI) (发病 36小时内 )患者 ,随机口服卡托普利或安慰剂治疗 4周。结果卡托普利治疗组 4周病死率 (9 12 % )较安慰剂对照组 (9 74 % )轻微下降 (P =0 19) ,但对其远期病死率的影响尚不知晓。本研究目的是了解卡托普利早期治疗 4周 ,对远期病死率的影响。方法　选择急性期试验完成 2 0例以上的CCS 1单位进行随访 ,计划随访 80 0 0例 (MI)病人 ,实际随访 6 74 9例 ,随访率 84 4 %。结果　治疗组 (n =3391)与对照组 (n =3358)随访病人基本临床特征是可比的。平均年龄 6 3 6± 10 6岁 ;平均随访时间 2 3 4± 16 9个月 ;男性占 76 2 %。治疗组与对照组随访时心功能 (NYHA分级 )Ⅲ Ⅳ级者分别为 9 0 %与9 9% ;再梗塞发生率为 5 6 %与 6 0 % ;总心血管事件为 32 9与 34 3%。治疗组总病死率 (11 9% ;n =4 0 4 )明显低于对照组 (13 8% ;n =4 6 3) (P =0 0 3) ;心血管性死亡 (10 0 %vs 11 8% )明显减少 (P =0 0 2 ) ,其中心衰死亡(4 1%vs 5 5% )差异更显著 (P =0 0 1)。早期用卡托普利治疗 4周 ,远期可挽救生命 19/ 10 0 0人。随机前收缩压≥ 10 0mmHg者 ,治疗组远期病死率 (12 4 % )较对照组 (13 8% )明显减少 (P =0 0 4 ) ;基础心率≥     

精神分裂症氯氮平治疗前后中枢单胺递质含量的对比研究

目的 :观察氯氮平治疗精神分裂症对中枢单胺递质系统的影响。方法 :应用高效液相色谱测定 2 8例精神分裂症氯氮平治疗前后脑脊液NE、DA、5 -HT、MAPG、HVA、5 -HIAA的含量。结果 :治疗前后脑脊液中单胺神经递质及其代谢产物差异无显著性 ;应用中枢神经递质代谢产物MHPG/HVA、5 -HIAA/HVA、MHPG/ 5 -HIAA的比值作为两个中枢递质系统之间相互作用的功能态 ,发现精神分裂症治疗前MGPG/MVA明显低于治疗后 (P <0 .0 5 )。结论 :精神分裂症治疗前与治疗后相比 ,DA功能相对亢盛 ,NE功能相对低下 ,氯氮平可能是通过调整NE -DA系统的功能态而发挥治疗作用。