Effects of Total Hip Arthroplasty on Axial Alignment of the Lower Limb in Patients with Unilateral Developmental Hip Dysplasia (Crowe type IV)

BackgroundThe aim of this study was to evaluate the influence of total hip arthroplasty on axial alignment of the lower limb in adults with unilateral developmental hip dysplasia (Crowe type IV).MethodsWe retrospectively reviewed medical records of 50 adults who underwent total hip arthroplasty, in which the acetabular cup was placed in the anatomical position. The following parameters were measured before surgery, immediately after surgery, and two years later: mechanical axis deviation (MAD), tibiofemoral angle (TFA), femoral offset, hip-knee-ankle angle (HKA), mechanical lateral distal femoral angle (LDFA), mechanical medial proximal tibial angle, height of medial femoral condyle, height of lateral femoral condyle, and leg lengthening. Length of the resected femoral segment was also recorded from medical records.ResultsPreoperative MAD, TFA, HKA, and LDFA of the ipsilateral lower limb showed significant valgus deformity. MAD of the ipsilateral lower limb and valgus inclination were significantly smaller immediately after surgery than before, while TFA, HKA, femoral offset, and LDFA were significantly larger (P < 0.05). These parameters did not differ significantly between immediately after surgery and two years later (P > 0.05). Ipsilateral extremities were extended by a mean of 2.54 cm (range, 0 to 5.35 cm). The mean length of the femoral resected segment was 3.56 cm (range, 2.03 to 5.74 cm). The contralateral lower limb showed marginally smaller MAD and medial proximal tibial angle after surgery than before, but larger LDFA, TAF, and HKA.ConclusionsIn patients with developmental hip dysplasia who underwent total hip arthroplasty with placement of the acetabular component at the level of the anatomic hip center, axial alignment of the ipsilateral lower limb was immediately altered, and valgus inclination was significantly reduced. The procedure only slightly altered the axial alignment of the contralateral lower limb.     

Transperineal Magnetic Resonance Imaging–Targeted Biopsy May Perform Better Than Transrectal Route in the Detection of Clinically Significant Prostate Cancer: Systematic Review and Meta-analysis

The diagnostic accuracy of magnetic resonance imaging (MRI)-targeted biopsy by using the transperineal (TP) versus transrectal (TR) route in the detection of clinically significant prostate cancer (csPCa) remains to be revealed. A systematic search of PubMed, Embase, Ovid, and the Cochrane Library up to April 2019 was conducted. We pooled odds ratios with 95% confidence intervals (CIs) for csPCa detected by TP and TR MRI-targeted biopsy. The relative sensitivity (or risk ratio) between TP and TR route was synthesized. We also pooled the diagnostic sensitivity of either approach using the combined biopsy results as the reference standard. A total of 328 patients with positive multiparametric MRI underwent TP MRI-targeted biopsy, and 315 patients underwent TR MRI-targeted biopsy. The TP route detected more csPCa, with a detection rate of 62.2% (204/328) compared to 41.3% (130/315) for the TR route (odds ratio = 2.37; 95% CI, 1.71-3.26). After adjusting for differences in cancer prevalence, TP MRI-targeted biopsy detected 91.3% (105/115) of csPCa compared to 72.2% (83/115) by the TR route (risk ratio = 1.26; 95% CI, 1.02-1.54). The pooled diagnostic sensitivity of the TP route (86%; 95% CI, 77-96) was better than the TR route (73%, 62-88%). The TR approach missed more csPCa located at the anterior zone of the prostate (20 vs. 3). The TP route performed better than the TR route in MRI-targeted biopsy, especially in detecting csPCa located at the anterior prostate. More large prospective randomized or head-to-head comparison studies comparing the two approaches are warranted.     

南充市居民被动吸烟及控烟现状调查

目的了解四川省南充市城乡居民被动吸烟状况及对公共场所实行禁烟规定的认知态度,为南充市禁烟法的普及提供科学依据。方法采用整群随机抽样方法,选取四川省南充市城乡15岁及其以上常住居民1 434人为调查对象,用统一规格的调查表进行一对一问卷调查。结果调查人群中被动吸烟率为85.28%,对控烟法的知晓率为70.99%,城市高于乡镇和农村,差异有统计学意义(χ2=431.468,P=0.000),仅有6.91%的被调查者认为四川省南充市禁烟令很有效,46.04%的被调查者认为作用微小,四川省南充市控烟宣传不够。结论四川省南充市城乡居民被动吸烟的水平较高,对禁烟法律的认知程度普遍较低。应加强四川省南充市城乡禁烟、控烟的健康教育,普及禁烟法的相关知识。     

川派名医傅灿冰学术经验采撷

通过对川派名医傅灿冰临床经验的整理,结合经典医案的报道,笔者将其学术经验初步总结如下:①人情练达,审时度势而宜。②随机以赴,直中纷纭错综。③正行无问,宗旨以本为主。④胸有成竹,治疗内伤如相。以期与同道共飨,将傅老学术经验传承与发扬光大。     

川陕滇乌头属药用植物资源调查

目的 调查四川、陕西、云南乌头属药用植物及附子药材主产区的资源、栽培及产地加工现状,为乌头类药材的资源保护、规范栽培、产地加工、质量控制等提供依据。方法 通过文献调研及走访产地、市场对四川、陕西、云南乌头属药材产区的乌头属植物种类、分布和附子药材情况进行调查。结果 四川、陕西、云南乌头属药用植物品种较多,分别有67、63、10个种。乌头属药材主要来自人工栽培,但基原复杂;乌头属药材新种植区域产地加工欠规范,部分存在品种间掺混现象。结论 四川、陕西、云南乌头属药用植物资源丰富,应加强资源保护、种源鉴定和新品种选育,大力推广规范栽培及产地加工,规范流通市场,建立质量溯源体系,保证用药安全。     

健康传播模式在四川农村健康教育中的应用

目的探讨适合四川农村地区的健康传播模式,为今后开展健康教育工作提供科学的依据。方法采用观察法和问卷调查法对四川省3个农村地区13岁以下儿童的女性看护人进行调查,并应用访谈法分别对三所小学进行了调查。结果电视是目前农村拥有量最多的大众传媒;调查对象最喜欢的频道为省级电视台及中央电视台;调查对象最喜欢的节目为电影和电视剧;在过去的1个月中,调查对象曾与村(乡)卫生人员或妇女干部接触的分别占45.3%和17.7%。结论采用以电视为主的大众传播与人际传播相结合、卫生与其他部门合作的方法,将对促进农村健康教育工作、提高农民健康水平起到积极的作用。     

四川省双流县镇级医疗单位特色专科创建现状调查

目的调查四川省双流县镇级医疗单位特色专科建设现状,为探索小康型乡镇卫生院特色专科建设原则、思路及标准等提供参考。方法采用自行设计的特色专科调查问卷全面调查该县24家镇级医疗单位（3家中心型卫生院、3家社区卫生服务中心及18家一般型卫生院）特色专科建设情况。使用Epidate 3.1录入数据,采用SPSS 17.0进行描述性统计及分层分析。结果该县24家镇级医疗单位中有15家（62.5%）共设立了21个特色专科;其中中医骨科最多,共9家占42.9%,其次为中医康复理疗科,共6家占28.6%。结论镇级医疗单位特色专科的创建应根据当地疾病诊治需求和医院自身条件合理规划建设,以专科建设推动特色诊疗服务参与市场竞争。中医骨科和中医康复理疗科群众基础较好,值得作为特色专科创建并推广。     

四川省2011—2019年血吸虫病疫情分析

目的 分析2011—2019 年四川省血吸虫病疫情变化特征,为今后血吸虫病防治工作提供参考。方法 收集2011—2019 年四川省血吸虫病防治工作年报资料;采用描述性统计方法分析血吸虫病疫情变化,使用独立样本的χ²检验进行组间率的比较,使用Arima模型对四川省未来3年的血防相关指标进行预测。结果 截至2019年底四川省52个区县达到血吸虫病除标准,2011—2019年四川省无新发急性血吸虫病和慢性血吸虫病病例,目前四川省现存1 526例晚血病人,2016—2019年全省有螺框出现率和活螺密度均呈下降趋势（P<0.05）。结论 2011—2019年四川省血吸虫病疫情稳定,但存在钉螺面积扩散、疫情反复等潜在风险,控制钉螺扩散、晚血救助和预防控制新发病例仍是未来工作的难点和重点。     

四川省高校教师职业倦怠状况研究

目的对四川省高校教师职业倦怠状况进行抽样调查研究,揭示四川省高校教师存在职业倦怠的程度,为四川省高校教师队伍的管理与建设提供参考。方法于2013年12月,采用美国心理学家Maslach等编制的职业倦怠量表对随机抽取的520名四川省高校教师进行问卷调查。结果 1四川省高校教师职业倦怠的平均分为(1.440±0.486)分。2在去个性化维度上,不同性别(t=3.007,df=488,P=0.003)和年龄(F=4.801,df=3,P=0.003)的高校教师之间的差异有统计学意义。3在低成就感维度上,不同年龄(F=5.808,df=3,P=0.001)、学历(F=3.672,df=3,P=0.012)、职称(F=4.215,df=3,P=0.006)和收入(F=4.799,df=4,P=0.001)的高校教师之间的差异有统计学意义。结论 1四川省高校教师的职业倦怠水平较低。2年龄在46岁以上、或学历为博士、或职称为教授,或月收入在5000元以上的高校教师较少职业倦怠。