Objective To review research advances of revision surgery after primary total hip arthroplasty (THA) for patients with Crowe type Ⅳ developmental dysplasia of the hip (DDH). Methods The recent literature on revision surgery after primary THA in patients with Crowe type Ⅳ DDH was reviewed. The reasons for revision surgery were analyzed and the difficulties of revision surgery, the management methods, and the related prosthesis choices were summarized. Results Patients with Crowe type Ⅳ DDH have small anteroposterior diameter of the acetabulum, large variation in acetabular and femoral anteversion angles, severe soft tissue contractures, which make both THA and revision surgery more difficult. There are many reasons for patients undergoing revision surgery after primary THA, mainly due to aseptic loosening of the prosthesis. Therefore, it is necessary to restore anatomical structures in primary THA, as much as possible and reduce the generation of wear particles to avoid postoperative loosening of the prosthesis. Due to the anatomical characteristics of Crowe type Ⅳ DDH, the patients have acetabular and femoral bone defects, and the repair and reconstruction of bone defects become the key to revision surgery. The acetabular side is usually reconstructed with the appropriate acetabular cup or combined metal block, Cage, or custom component depending on the extent of the bone defect, while the femoral side is preferred to the S-ROM prosthesis. In addition, the prosthetic interface should be ceramic-ceramic or ceramic-highly cross-linked polyethylene wherever possible. Conclusion The reasons leading to revision surgery after primary THA in patients with Crowe type Ⅳ DDH and the surgical difficulties have been clarified, and a large number of clinical studies have proposed corresponding revision modalities based on which good early- and mid-term outcomes have been obtained, but further follow-up is needed to clarify the long-term outcomes. With technological advances and the development of new materials, personalized prostheses for these patients are expected to become a reality.
Objective To establish a finite element model of the knee joint based on coronal plane alignment of the knee (CPAK) typing method, and analyze the biomechanical characteristics of different types of knee joints.Methods The finite element models of the knee joint were established based on CT scan data of 6 healthy volunteers. There were 5 males and 1 female with an average age of 24.2 years (range, 23-25 years). There were 3 left knees and 3 right knees. According to the CPAK typing method, the knees were rated as types Ⅰ to Ⅵ. Under the same material properties, boundary conditions, and axial loading, biomechanical simulations were performed on the finite element model of the knee joint. Based on the Von Mises stress nephogram and displacement nephogram, the peak stresses of the meniscus, femoral cartilage, and tibial cartilage, and the displacement of the meniscus were compared among different types of knee joints. Results The constructed finite element model of the knee joint was verified to be effective, and the stress and displacement results were consistent with previous literature. Under the axial load of 1 000 N, the stress nephogram showed that the stress distribution of the medial and lateral meniscus and tibial cartilage of CPAK type Ⅲ knee joint was the most uneven. The peak stresses of the lateral meniscus and tibial cartilage were 9.969 6 MPa and 2.602 7 MPa, which were 173% and 165% of the medial side, respectively. The difference of peak stress between the medial and lateral femoral cartilage was the largest in type Ⅳ knee joint, and the medial was 221% of the lateral. The displacement nephogram showed that the displacement of the medial meniscus was greater than that of the lateral meniscus except for types Ⅲ and Ⅵ knee joints. The difference between medial and lateral meniscus displacement of type Ⅲ knee joint was the largest, the lateral was 170% of the medial. Conclusion In the same type of joint line obliquity (JLO), the medial and lateral stress distribution of the knee was more uniform in varus and neutral positions than in valgus position. At the same time, the distal vertex of JLO subgroup can help to reduce the uneven medial and lateral stress distribution of varus knee, but increase the uneven distribution of valgus knee.
Objective To compare the differences of chromosome aberration and Rb 1 gene mutation among 3 cloned cells of SO-Rb50 cell line of retinoblastoma. Methods 1.Three cell cloned strains named MC2, MC3, MC4 were isolated from SO-Rb50. 2. Gbanding and karyotype analysis were performed on the llth passage cells of the 3 cell strains.3.All exons and the promoter region of the Rb gene were detected by PCR-SSCP analysis in tumor cell DNA extracted from the 3 cell strains. Results 1.Both numerical and structural chromosomal aberrations could be observed in these 3 cell strains.Several kinds of structural chromosomal aberrations were observed.The chromosome aberrations in the same passage of different cell strains were different.Aberration of chromosome 13 was rare and the aberration feature was different in the 3 cell strains.Five marker chromosomes were identified.M1,t(1;1)qter-p35∷q24-ter could befound in all cell strains.Two of them M4 and M5,have not been reported in SO-Rb50 cell line previously.2.SSCP analysis of exon 24 showed that MC411 and MC3138 had abnormal band. Conclusions The characteristics of heterogeneity of the original tumor cell line SO-Rb50are still kept during a long-term culture in vitro and the cloned strains had dynamic changes during this period.Aberration of chromosome 13 is not the only cause of RB;aberration of chromosome 1,a commom event in some neoplasias as well as in SO-Rb50, plays a meaningful role in the immortalization of this cell line. (Chin J Ocul Fundus Dis, 1999, 15: 146-148)
Objective To analyze the preoperative diagnosis and the operative methods for different types of Mirizzi syndrome (MS). Methods Eighty-six cases of MS confirmed by operation were enrolled from March 1990 to December 2008. Their laboratory examination results and X-ray appearances of endoscopic retrograde cholangiopancreatography (ERCP) were analyzed as well as B-ultrasonography (B-us), CT scan and magnetic resonance cholangiopancreatography (MRCP). According to the Csendes typing, different operative methods were adopted. Results The final diagnosis rate by ERCP for MS attained approximately 85.71% (48/56) in contrast with 17.44% (15/86) by B-us, with 9.52% (4/42) by CT scan and with 71.88%（23/32） by MRCP. Twenty cases were Csendes type Ⅰ, 43 cases were type Ⅱ, 17 cases were type Ⅲ, and 6 cases were type Ⅳ. According to the Csendes typing, the cases of type Ⅰ were treated by for the cholecystectomy or partial resection for reserving the neck of gallbladder, type Ⅱ by fistula reparation and laying up the T type drainage-tube under the fistula, and type Ⅲ and type Ⅳ by the hepaticocholangiojejunostomy and hepaticoduodenostomy. Conclusion The preoperative diagnosis for MS is very difficult, B-us may be acted as an accessory diagnostic method. ERCP and MRCP can improve the rate of preoperative diagnosis for MS strikingly. The best reasonable method of the operative therapy is selected according to the different pathologic type of MS.
ObjectiveTo explore the correlation between lipid profile and molecular typing of invasive breast cancer.MethodsThree hundreds and seventy-five patients with primary invasive breast cancer diagnosed from Breast Surgery, Affiliated Hospital of Southwest Medical University from January 2018 to June 2019. The total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), Low-density lipoprotein cholesterol (LDL-C), apolipoprotein A (ApoA), and apolipoprotein B (ApoB) concentrations were detected. Molecular classification based on the results of postoperative immunohistochemistry of breast cancer patients, compared the measured values of each subtype.ResultsThere were no significant difference in serum TG, HDL-C and ApoA among the four subtypes (P>0.05). Differences serum levels of TC, LDL-C, and ApoB among breast cancer patients of various subtypes were statistically significant (P<0.05). Serum TC concentration in the HER2 overexpression type [(5.08±1.00) mmol/L] and the triple negative type [(5.12±0.91) mmol/L] were significantly higher than the Luminal A type [(4.68±1.01) mmol/L] and the Luminal B type [(4.79± 0.93) mmol/L], P<0.05. Serum LDL-C concentration in the triple negative type [(3.14±0.88) mmol/L] was significantly higher than the LuminalA type [(2.77±0.84) mmol/L] and the LuminalB type [(2.87±0.81) mmol/L], P<0.05. Serum ApoB concentration in the Luminal B type [(0.94±0.23) g/L] was significantly lower than the triple negative type [(1.03±0.23) g/L].ConclusionThere are differences in serum TC, LDL-C and apoB concentrations among different subtypes of breast cancer, but TG, HDL-C and ApoA are not related to molecular typing of breast cancer.
Objective To investigate the incidence rate, molecular epidemiology and risk factors for methicillin-resistant Staphylococcus aureus (MRSA) infection. Methods A total of 119 Staphylococcus aureus strains isolated from January 2016 to December 2020 in general surgery of this hospital were collected retrospectively and divided into MRSA group and methicillin-sensitive Staphylococcus aureus group according to whether or not resistant to oxacillin. The clinical data of all patients infected with Staphylococcus aureus and drug sensitivity of Staphylococcus aureus were collected. Molecular typing was performed by multilocus sequence typing (MLST), resistance gene, virulence gene and biofilm gene were detected by polymerase chain reaction (PCR) method, and a case-control study was used to identify risk factors for MRSA infection. ResultsThe detection rate of MRSA was 57.98% (69/119), mainly was from pus specimens (80.67%, 96/119). The results of MLST showed that the dominant clone types were ST88 (37.68%, 26/69), ST951 (27.54%, 19/69) and ST59 (18.84%, 13/69). The results of PCR showed that the detection rates of mecA, mecC, Aac (6′ )/Aph (2′ ′ ), Aph (3)-Ⅲ, ant (4′ )- Ⅰ a, tetM, qnrA, panton-valentine leukocidin, fibronectin-binding protein A, staphylococcal enterotoxin A, staphylococcal enterotoxin B, α-hemolysins, intracellular adhesion A, staphylococcal accessory regulators A, and fibronectin-binding protein B in 69 strains of MRSA were 100%, 0.00%, 27.54%, 34.78%, 18.84%, 14.49%, 1.45%, 8.70%, 98.55%, 11.59%, 91.30%, 94.20%, 92.75%, 97.10% and 86.96%, respectively. Multivariate analysis showed that hospital transfer, wound infection, catheter related infection, drainage tube and history of cephalosporin using were risk factors for MRSA infection. ConclusionsThe detection rate of MRSA in general surgery of this hospital is high. ST88 is the most common clone type. The carrying rates of resistant-, virulence- and biofilm-related genes are high. Hospital transfer, wound infection, drainage tube, history of cephalosporin using etc. are high risk factors for MRSA infection. It is advised that invasive operation should be reduced, antibiotics should be used rationally, hand hygiene should be paid attention to, environmental sanitation disinfection should be carried out regularly, and the monitoring of MRSA bacteria should be strengthened, so as to reduce and control the infection and spread of MRSA.
ObjectiveTo investigate the association between tumor necrosis factor (TNF)-α gene polymorphism and susceptibility to chronic obstructive pulmonary disease (COPD) in eastern Heilongjiang province.MethodsA total of 347 COPD patients in the Department of Respiratory Medicine, the First Affiliated Hospital of Jiamusi University, were enrolled from January 2016 to January 2017. In the same period, 338 healthy subjects in the hospital physical examination center were selected as controls. The genotype of the two groups was analyzed by high resolution melting (HRM) and gene sequencing. The genotype and allele probability of the two groups were compared and analyzed by the SHEsis genetic imbalance haplotype analysis.ResultsBoth TNF-a –308 G/A co-dominant model and recessive model have significant differences between COPD patients and healthy subjects (P=0.036, OR 1.512, 95%CI 1.023 – 2.234; P=0.027, OR 1.202, 95%CI 1.024 – 1.741). –850G/A co-dominant model (P=0.000, OR 1.781, 95%CI 1.363 – 2.329), dominant model (P=0.000, OR 0.391 7, 95%CI 1.363 – 2.329) and hyper-dominant model (P=0.000, OR 2.680, 95%CI 1.728 – 4.156) in the two groups were statistically different. The haploid analysis and haploid genotype analysis showed statistically significant differences (all P<0.05, OR>1, 95%CI>1) at +489, –308, –850 sites by allele A, G, A, respectively between the two groups. There was a significant difference in the lung function between the –308G/A, –863C/A mutant genome and the wild type (P=0.038, P=0.02) in COPD patients according to the classification of lung function.ConclusionsA allele in TNF-α –308 and G allele in TNF-α –850 locus may be risk factors for COPD in the eastern Heilongjiang Province, and the risk of homozygous genotype is higher. +489A, –308G and –850A respectively may be the predisposing factor of COPD while the three genotypes of AGA patients were at higher risk. TNF-α –308 A allele and –863 A allele are related to lung function deterioration, and the two sites with A allele in patients with COPD indicate poor lung function.
Human chromosomes karyotyping is an important means to diagnose genetic diseases. Chromosome image type recognition is a key step in the karyotyping process. Accurate and efficient identification is of great significance for automatic chromosome karyotyping. In this paper, we propose a model named segmentally recalibrated dense convolutional network (SR-DenseNet). In each stage of the model, the dense connected network layers is used to extract the features of different abstract levels of chromosomes automatically, and then the concatenation of all the layers which extract different local features is recalibrated with squeeze-and-excitation (SE) block. SE blocks explicitly construct learnable structures for importance of the features. Then a model fusion method is proposed and an expert group of chromosome recognition models is constructed. On the public available Copenhagen chromosome recognition dataset (G-bands) the proposed model achieves error rate of only 1.60%, and with model fusion the error further drops to 0.99%. On the Padova chromosome dataset (Q-bands) the model gets the corresponding error rate of 6.67%, and with model fusion the error further drops to 5.98%. The experimental results show that the method proposed in this paper is effective and has the potential to realize the automation of chromosome type recognition.
ObjectiveTo study the feasibility of preparation of the individualized femoral prosthesis through computer assisted design and electron beammelting rapid prototyping (EBM-RP) metal three-dimensional (3D) printing technology. MethodsOne adult male left femur specimen was used for scanning with 64-slice spiral CT; tomographic image data were imported into Mimics15.0 software to reconstruct femoral 3D model, then the 3D model of individualized femoral prosthesis was designed through UG8.0 software. Finally the 3D model data were imported into EBM-RP metal 3D printer to print the individualized sleeve. ResultsAccording to the 3D model of individualized prosthesis, customized sleeve was successfully prepared through the EBM-RP metal 3D printing technology, assembled with the standard handle component of SR modular femoral prosthesis to make the individualized femoral prosthesis. ConclusionCustomized femoral prosthesis accurately matching with metaphyseal cavity can be designed through the thin slice CT scanning and computer assisted design technology. Titanium alloy personalized prosthesis with complex 3D shape, pore surface, and good matching with metaphyseal cavity can be manufactured by the technology of EBM-RP metal 3D printing, and the technology has convenient, rapid, and accurate advantages.
Objective To apply rapid prototyping (RP) technology on pre-fabricating nasoalveolar molding (NAM) appliances, and compare clinical outcomes and complications with traditional NAM appliances. Methods Between June 2014 and September 2016, 39 children with unilateral cleft lip and palate were included in study. Seventeen children (test group) had received novel NAM protocol by pre-fabricating NAM appliances using RP technology, and the other 22 children (control group) had received traditional NAM protocol. There was no significant difference in gender, age, the side of cleft lip and palate, and the width of the alveolar cleft gap before treatment between 2 groups (P>0.05). The change of width of the alveolar cleft gap, number of clinic visit, treatment time, and complications were compared between 2 groups. Results The number of clinic visit was less in test group than in control group (P<0.05). There was no significant difference in treatment time between 2 groups (P>0.05). During treatment, there was 16 children (72.2%) of skin irritation, 3 (13.6%) of mucosal ulceration, 1 (4.5%) of intraoral bleeding, 1 (4.5%) of alveolar arch T-shap asymmetry in control group. And there were 11 children (64.7%) of skin irritation, 3 (17.6%) of mucosal ulceration in test group. There was no significant difference in the incidence of complications between 2 groups (P>0.05). After treatment, the anterior alveolar cleft width, horizontal cleft width, sagittal cleft width, antero-medial alveolar ridges angle of the healthy side, angle between anterior alveolar and posterior alveolar baseline of the healthy side, perpendicular distance from buccal frenum point to sagittal line were significantly reduced when compared with the values before treatment (P<0.05). The angle between the anterior segments of two sides, angle between buccal frenum point and posterior baseline were significant increased when compared with the values before treatment (P<0.05). There was no significant difference in the differences between pre- and post-treatment of above indexes between 2 groups (P>0.05). There also was no significant difference in posterior alveolar width, the width between the middle parts of alveolar, vertical cleft width, antero-medial alveolar ridges angle of the affected side, and angle between anterior alveolar and posterior alveolar baseline of the affected side between pre- and post-treatment in each group (P>0.05). Conclusion Clinical outcome of novel approach was equivalent to traditional protocol; however, the number of clinic visit decreased. With improving of RP technology, it would provide a more consistency and convenient way for sequential treatment with cleft lip and palate.