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Combination of C-reactive protein and fibrinogen is useful for diagnosing periprosthetic joint infection in patients with inflammatory diseases

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Chinese Medical Journal 2022年第16期135卷 1986-1992页

作者： Hong Xu Jinwei Xie Xufeng Wan Li Liu Duan Wang zongke zhou Department of Orthopedic Surgery Orthopedic Research InstituteWest China HospitalSichuan UniversityChengduSichuan 610041China Department of Orthopedic Surgery West China School of NursingWest China HospitalSichuan UniversityChengduSichuan 610041China

Background:The screening of periprosthetic joint infection(PJI)in patients with inflammatory diseases before revision arthroplasty remains *** C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),plasma fbrinogen(FIB),monocyte/lymphocyte ratio,and neutrophil/lymphocyte ratio(NLR)can help screening PJI,but their values in patients with infammatory diseases have not been ***:Patients with inflammatory diseases who underwent revision hip or knee arthroplasty at West China Hospital,Sichuan University,from January 2008 to September 2020 were divided into infected and non-infected groups based on the 2013 International Consensus Meeting *** and specificity of the tested biomarkers for diagnosing infection were determined based on receiver operating characteristic(ROC)curves,and optimal cutoffs were determined based on the Y ouden *** diagnostic ability of these biomarkers was re-assessed after combining them with each ***:A total of 62 patients with inflammatory diseases were studied;of them 30 were *** area under the ROC curve was 0.813 for CRP,0.638 for ESR,0.795 for FIB,and 0.656 for *** optimal predictive cutoff of CRP was 14.04 mg/L with a sensitivity of 86.2%and a specificity of 68.7%,while FIB had a sensitivity of 72.4%and a specificity of 81.2%with the optimal predictive cutoff of 4.04 g/*** combinations of CRP with FIB produced a sensitivity of 86.2%and specificity of 78.1%.Conclusion:CRP with a slightly higher predictive cutoff and FIB are useful for screening PJI in patients with inflammatory diseases,and the combination of CRP and FIB may further improve the diagnostic values.

关键词： Periprosthetic joint infection C-reactive protein Fibrinogen Diagnosis Revision arthroplasty

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人工全髋关节置换术围术期疼痛管理

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中国修复重建外科杂志 2019年第9期33卷 1190-1195页

作者：肖强周宗科四川大学华西医院骨科

目的综述人工全髋关节置换术(total hip arthroplasty,THA)中多模式镇痛方案各个部分可选择方法,以期为临床实践中实现患者个体化镇痛提供指导。方法广泛查阅近年国内外THA多模式镇痛方案相关文献,结合作者所在医疗中心THA围术期疼痛管... 详细信息

目的综述人工全髋关节置换术(total hip arthroplasty,THA)中多模式镇痛方案各个部分可选择方法,以期为临床实践中实现患者个体化镇痛提供指导。方法广泛查阅近年国内外THA多模式镇痛方案相关文献,结合作者所在医疗中心THA围术期疼痛管理方案进行总结。结果 THA术后疼痛是影响患者满意度的重要因素,因此疼痛管理是THA患者围术期管理的重点之一。目前THA围术期疼痛管理采用多模式镇痛,即在疼痛传导通路的不同层次采取措施,包括切口冰敷、给予非甾体消炎药物、局部浸润麻醉、周围神经阻滞、椎管内麻醉、中枢性镇痛药等。结论 THA围术期多模式镇痛方式较多,临床上应根据患者具体情况选择安全有效的镇痛方式,即实现个体化镇痛。

关键词：人工全髋关节置换术多模式镇痛围术期

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X-ray image characteristics and related measurements in the ankles of 118 adult patients with Kashin-Beck disease

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Chinese Medical Journal 2014年第13期127卷 2479-2483页

作者： Zeng Yi zhou zongke Shen Bin Yang Jing Kang Pengde zhou Xuan Zou Ling Pei Fuxing Department of Orthopedic Surgery Department of Radiology West China Hospital West China Medical School SichuanUniversity Chengdu Sichuan 610041 China

Background Kashin-Beck disease （KBD） is a chronic,degenerative osteoarthropathy that causes severe skeletal *** many researchers have proven that almost all KBD patients who showed an increaseing proximo-distal gradient had radiographic abnormalities of the ankle,few detailed description of radiographic changes in the ankles of patients with KBD has been reported,especially for variable measurements of ankle *** purpose of this study was to demonstrate the radiographic characteristics of the ankles of adult KBD *** One hundred and eighteen adult KBD patients from september to October 2010 in Rongtang county in China were examined with lateral radiographs of the right *** morphological abnormalities in the talus,calcaneus,navicular bone,distal tibia,and joint space were analyzed,and the calcaneus length,height,length-height ratio,tuber angle,front angle,plantar angle,and distal tibia anteroposterior （AP） length were measured using Riepert＇s *** Eighty-one patients （68.6％） had abnormal ankle radiographs; 72 （88.9％） patients had talus changes,69 （85.2％） patients had calcaneus changes,28 （34.6％） patients had navicular bone changes,and 48 （59.2％） patients had distal tibia *** 118 KBD patients,the average calcaneus length was 7.4 cm,height was 4.3 cm,and the length-height ratio was *** calcaneus tuber angle was 28.2°,front angle was 38.0° and the plantar angle was 74.2°.The distal tibia anteroposterior length was 4.05 *** with 50 normal adults （control group）,significant differences were found for the calcaneus length,the calcaneus length-height ratio,and the distal tibia AP *** Patients with KBD have characteristic abnormalities on ankle radiographs; talus depression and deformity,calcaneus shortening deformity,and distal tibia deformity with AP length widening were the most typical changes.

关键词： kashin-beck disease ankle X-ray film

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A pre-operative high-protein diet can improve the serum albumin levels of patients undergoing total knee arthroplasty

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Chinese Medical Journal 2023年第4期136卷 491-493页

作者： Hong Xu Li Liu Jinwei Xie Duan Wang Zeyu Huang zongke zhou Department of Orthopaedic surgery West China HospitalSichuan UniversityChengduSichuan 610041China Department of Orthopaedic Surgery West China HospitalSichuan University/West China School of NursingSichuan UniversityChengduSichuan 610041China

To the Editor:Malnutrition is associated with an increased risk of complications after total knee arthroplasty(TKA),including persistent wound drainage,delay of wound healing,superficial surgical site and even deep periprosthetic joint infections,and intensive care unit admission.[1]Albumin(ALB)is the most abundant protein in human plasma and is considered a reliable and sensitive biomarker of nutritional status and *** malnutrition,low serum ALB levels are not only associated with various post-operative complications following TKA including pulmonary infection,renal impairment,superficial and deep infections,unplanned intubation,and even mortality;but also associated with increased treatment costs,longer length of stay and higher risk of readmission.[2]

关键词： superficial wound operative

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人工全髋关节置换术治疗化脓性髋关节炎后遗骨关节病的研究进展

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中国修复重建外科杂志 2020年第1期34卷 139-144页

作者：覃勇志周宗科广安市人民医院骨科四川广安638000 四川大学华西医院骨科成都610041

目的总结人工全髋关节置换术(total hip arthroplasty,THA)治疗化脓性髋关节炎后遗骨关节病的研究进展。方法广泛查阅国内外近年相关文献,就THA治疗化脓性髋关节炎后遗骨关节病的时机、髋臼侧及股骨侧处理方法以及假体类型选择等方面进... 详细信息

目的总结人工全髋关节置换术(total hip arthroplasty,THA)治疗化脓性髋关节炎后遗骨关节病的研究进展。方法广泛查阅国内外近年相关文献,就THA治疗化脓性髋关节炎后遗骨关节病的时机、髋臼侧及股骨侧处理方法以及假体类型选择等方面进行总结分析。结果THA是治疗化脓性髋关节感染后遗骨关节病的有效手段,为避免感染复发,建议感染静止期达10年以上时手术。此类患者可能存在髋臼侧发育不良,髋臼覆盖率差,行THA时可选择高位造臼、髋臼内陷截骨、结构性植骨、Cage、钽金属垫块或3D打印假体等方式处理;股骨侧可能存在股骨髓腔细小、股骨颈前倾角增大、颈干角增大、大转子延长和骨质差等问题,行THA时可通过股骨截骨及选择合适型号假体进行处理。化脓性髋关节炎后遗骨关节病患者多较年轻,为获得更好的远期假体生存率,首选非骨水泥型假体。结论THA可有效治疗化脓性髋关节炎后遗骨关节病,但手术难度大、手术并发症相对较多,术者应有充分认识。

关键词：化脓性髋关节炎后遗症人工全髋关节置换术

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Long-term results of synovectomy in total knee arthroplasty:a prospective,randomized controlled trial

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Chinese Medical Journal 2023年第1期136卷 73-81页

作者： Weinan Zeng Zeping Yu Simeng Wang Anjing Chen Yiping Zeng Qingjun Yang Yujuan Li Qi Li zongke zhou Department of Orthopedics Orthopedic Research InstituteWest China HospitalSichuan UniversityChengduSichuan 610041China Department of Orthopedics Chongqing General HospitalUniversity of Chinese Academy of SciencesChongqing 400014China Department of Radiology West China HospitalSichuan UniversityChengduSichuan 610041China

Background:Synovectomy has been introduced into total knee arthroplasty(TKA)with the aim of relieving pain and inflammation of the ***,there are no long-term,comparative data to evaluate the effect of synovectomy in *** study was aimed at assessing pain,function,and complications in patients undergoing synovectomy during TKA for osteoarthritis(OA)at long-term ***:This was a prospective randomized controlled trial of 42 consecutive patients who underwent staged bilateral *** undergoing the first-side TKA were allocated to receive TKA with or without synovectomy followed by a 3-month washout period and crossover to the other strategy for the opposite-side *** overall efficacy of both strategies was evaluated by determination of blood loss,the Knee Society score(KSS),and knee inflammation conditions during a 3-month postoperative *** postoperative pain,range of motion(ROM),and complications were sequentially evaluated to compare the two groups until 10 years after ***:At the 10-year follow-up,both groups had a similarly significantly improved ROM(114.88±9.84°vs.114.02±9.43°,t=0.221,P=0.815)and pain relief with no differences between the two groups(1.0[1.0]vs.1.0[1.5],U=789.500,P=0.613).Similar changes in total blood loss,KSS,and knee inflammation were found in both groups during 3 months postoperatively(P>0.05).Additionally,there was no significant difference regarding complications and satisfaction between the two groups(P>0.05).Conclusions:Synovectomy in conjunction with TKA for primary OA does not seem to provide any benefit regarding postoperative pain,ROM,and satisfaction during a 10-year *** addition,it may not result in more blood loss and increased incidence of long-term *** on our long-term findings,it should not be performed *** registration:Chinese Clinical Trial Registry,ChiCTR-INR-16008245;https://***/***?proj=13334.

关键词： Randomized controlled trial Synovectomy Clinical outcomes Total knee arthroplasty

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Effects of tranexamic acid on vascular occlusive events and perioperative resuscitation in patients with atrial fibrillation undergoing total joint arthroplasty

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Chinese Medical Journal 2022年第19期135卷 2354-2356页

作者： Shangkun Tang zongke zhou Jing Yang Pengde Kang Bin Shen Fuxing Pei Xiaojun Shi Department of Orthopedics Orthopedic Research InstituteWest China HospitalSichuan UniversityChengduSichuan 610041China.

To the Editor:Tranexamic acid(TXA)has recently become popular for use in orthopedic surgeries owing to its efficacy in reducing blood loss,transfusion rates,and mortality without increasing the risk of deep venous *** Although the ideal dosage and route for TXA administration remain unclear,it has become one of the most important parts of the perioperative blood conservation ***,it remains controversial to prescribe TXA to patients with cardiovascular diseases,because of prothrombotic and proconvulsant effects,which potentially increases cardiovascular risk.

关键词： patients dosage cardiovascular

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线性规划法在氧化铝工业供矿中的应用

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轻金属 2002年第8期 18-22页

作者：周宗科任云翔中州铝厂河南焦作454174

通过对线性规划法确定的优化供矿方案与实际供矿情况的对比 ,说明线性规划的优化供矿方案可以成熟地应用于氧化铝厂供矿计划的编排和实际供矿安排中 ,其经济效益和稳定指标作用十分突出。

关键词：氧化铝线性规划最优方案指标优化供矿铝土矿

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Comparative Study on the Trans-Province Transfer of the Multiple Trauma Patients after Sichuan Earthquake

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Open Journal of Earthquake Research 2016年第1期5卷 7-19页

作者： Guodong Liu Shan Ou Jun Qiu Danfeng Yuan Zhihuan Yang zongke zhou Yuan Yao Suxing Wang Xiuzhu Zhang Wuchao Wang Dawei Liu Zhengguo Wang Jihong zhou Department 8 Research Institute of Surgery Daping Hospital Third Military Medical University Chongqing China Department of Anesthesiology Chengdu First People’s Hospital Chengdu China State Key Laboratory of Trauma Burns and Combined Injury Research Institute for Traffic Medicine Research Institute of Surgery Daping Hospital Third Military Medical University Chongqing China Department of Orthopedics West China Hospital of Sichuan University Chengdu China Department of Emergency Center for Traffic Injury No. 117th Hospital of PLA Hangzhou China

Background: Trans-province transfer of the patients has been successfully carried out and has greatly relieved the burden of the hospitals in Sichuan Province after Sichuan earthquake. The aim of the study was to retrospectively analyze the efficacy and feasibility of the trans-province transfer of the multiple trauma patients after Sichuan earthquake. Methods: A retrospective and descriptive analysis was conducted based on the medical records of the multiple trauma patients (ISS ≥ 16) transferred to the Grade 3A hospitals outside Sichuan province. The patients were divided into two groups based on the distance to Sichuan province, i.e., Group A (the seismic patients transferred to Chongqing) and Group B (the seismic patients transferred to the other provinces/ municipalities). A comparison was done in aspects of distance of transfer, time from injury to transfer, vital signs, the infection rates (at transfer and on discharge), injury severity and prognostic indices (cure rate, disability rate and mortality). Results: The distance between Chengdu and the other places was at a wide range of 313 - 1653 km, whereas the time from injury to transfer showed no statistical difference between groups (P > 0.05). There were no significant differences between both groups with respects to patient demographics, injury mechanism, time from injury to transfer, vital signs, infection rate and injury severity. The prognostic indices showed no significant difference, except for FIM scores (P < 0.05). Conclusions: The results of the study indicate that the different distance of the transfer of the multiple trauma patients does not aggravate the severity or deteriorate the prognosis, which proves that the medical supportive transfer system is acceptable, effective and worthy of further implementation in China, which may be ascribed to the advanced transportation system and high level of therapeutic capacity of the hospitals. In the meantime, attention should be paid to psychological in

关键词： Earthquake Hospital Transfer Vital Signs Injury Severity Score Prognosis

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静脉铁剂在骨科围手术期缺铁性贫血中的应用进展

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中华骨与关节外科杂志 2023年第1期16卷 85-89页

作者：杜泽周宗科四川大学华西医院骨科成都610041

骨科手术患者常出现围手术期贫血;最常见的是缺铁性贫血(IDA)。术前和术后贫血都会对患者的预后产生不良影响。在确定并治疗IDA病因的同时,补充铁剂可以从根本上纠正贫血。本文基于既往研究,对骨科患者围手术期IDA的概况及危害、围手术... 详细信息

骨科手术患者常出现围手术期贫血;最常见的是缺铁性贫血(IDA)。术前和术后贫血都会对患者的预后产生不良影响。在确定并治疗IDA病因的同时,补充铁剂可以从根本上纠正贫血。本文基于既往研究,对骨科患者围手术期IDA的概况及危害、围手术期IDA管理的指南和共识推荐、静脉铁剂的分类及特点、静脉铁剂临床应用的有效性及安全性、静脉铁剂的药物经济学评价进行总结分析,旨在明确静脉铁剂在骨科围手术期IDA中的应用价值,为临床工作中合理选择铁剂提供借鉴和参考。

关键词：静脉铁剂骨科围手术期缺铁性贫血

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