Readmission rate and early complications in patients undergoing total knee arthroplasty:A retrospective study

BACKGROUND Total knee arthroplasty(TKA)can improve pain,quality of life,and functional outcomes.Although uncommon,postoperative complications are extremely consequential and thus must be carefully tracked and communicated to patients to assist their decision-making before surgery.Identification of the risk factors for complications and readmissions after TKA,taking into account common causes,temporal trends,and risk variables that can be changed or left unmodified,will benefit this process.AIM To assess readmission rates,early complications and their causes after TKA at 30 days and 90 days post-surgery.METHODS This was a prospective and retrospective study of 633 patients who underwent TKA at our hospital between January 1,2017,and February 28,2022.Of the 633 patients,28 were not contactable,leaving 609 who met the inclusion criteria.Both inpatient and outpatient hospital records were retrieved,and observations were noted in the data collection forms.RESULTS Following TKA,the 30-day and 90-day readmission rates were determined to be 1.1%(n=7)and 1.8%(n=11),respectively.The unplanned visit rate at 30 days following TKA was 2.6%(n=16)and at 90 days was 4.6%(n=28).At 90 days,the unplanned readmission rate was 1.4%(n=9).Reasons for readmissions included medical(27.2%,n=3)and surgical(72.7%,n=8).Unplanned readmissions and visits within 90 days of follow-up did not substantially differ by age group(P=0.922),body mass index(BMI)(P=0.633),unilateral vs bilateral TKA(P=0.696),or patient comorbidity status(30-day P=0.171 and 90-day P=0.813).Reoperation rates after TKA were 0.66%(n=4)at 30 days and 1.15%(n=8)at 90 days.The average length of stay was 6.53 days.CONCLUSION In this study,there was a low readmission rate following TKA.There was no significant correlation between readmission rate and patient factors such as age,BMI,and co-morbidity status.

Stent-assisted coiling of intracranial carotid ophthalmic segment aneurysm segment aneurysms:Long-term follow-up from a single center

Background:To evaluate the efficacy of stent-assisted coiling(SAC)for the treatment of carotid ophthalmic segment aneurysm segment aneurysms(OSAs)of the internal carotid artery(ICA)through detailed long-term follow-up of a large patient cohort.Methods:We retrospectively analyzed 88 consecutive patients with OSAs between January 2009 and January 2020 at our center.Angiographic results were evaluated using the modified Raymond grading system and clinical outcomes were evaluated using the mRS scale.The primary endpoints were major aneurysm recurrence and poor clinical outcomes for at least 18 months of follow-up.The patients were asked to attend clinical follow-up assessments and possibly undergo DSA or MR via telephone.Results:We enrolled 88 patients with 99 OSAs treated with coiling,of whom 76 were treated with SAC.The coiling procedures were successful in all 88 patients.Overall,complications occurred in 8 patients(9.1%).No procedure-related mortality was observed.67(76.1%)experienced immediate aneurysm occlusion at the end of the procedure.Long-term angiographic follow-up(18 months)was available in 45/88 aneurysms(51%)(average 18.7±5.2 months).Four patients continued their follow-up for 5 years after initial aneurysm treatment.After a clinical follow-up time of 28.7 months(range,12-51 months),85 patients(95.5%)achieved favorable clinical outcomes(mRS scores of 0-2).Conclusions:This study indicates that SAC treatment is a safe and effective therapeutic alternative for ruptured and unruptured OSAs.The procedural risks are low with relatively long-term effectiveness.

Risk stratification of renal transplant recipients using routine parameters: Implication of learning from SARS-CoV-2 into transplant follow-up program

BACKGROUND Severe acute respiratory syndrome coronavirus-2(SARS-CoV-2)infection is a global pandemic that is associated with a high risk of morbidity and mortality among recipients of solid organ transplantation.In the course of acute SARS-CoV-2 infection,various laboratory markers have been identified as predictors for high risk of mortality.AIM To risk stratify renal transplant recipients(RTxR)using general demographic parameters,comorbidities and routine laboratory markers for the severity of the disease and its outcomes.We believe that learning about these routinely monitored parameters can help us plan better strategies for the RTxR follow-up program.METHODS This present study includes RTxR who acquired SARS-CoV-2 infection from March 2020 to February 2021.We recorded the basic demographics,comorbidities and routine laboratory markers.We investigated the impact of SARS-CoV-2 infection on RTxRs and risk-stratified the progression of disease severity and outcomes in terms of recovery or mortality.RESULTS From 505 RTxRs in our renal transplant follow-up program,29(7.75%)RTxRs had PCR-positive SARS-CoV-2 infection.We recorded 8 deaths from SARS-CoV-2 infection giving an overall mortality rate of 1.6%but a significant 27.6%mortality in SARS-CoV-2 positive recipients.Age more than 68 years,non-Caucasian ethnicity and male gender were associated with a significant drop in survival probability;P≤0.001.<0.001 and<0.0001 respectively.87.5%of the deceased were diabetic;P≤0.0.0001.Estimated glomerular filtration rate of less than 26 mL/min/1.73 m2,serum albumin less than 20 g/L,Hemoglobin less than 9.6 g/L and serum calcium less than 1.70 mmol/L were all associated with significantly increased risk of mortality;P=0.0128,<0.001,<0.0001 and 0.0061 respectively.CONCLUSION This study has identified some routinely used modifiable parameters in predicting a higher risk of mortality and morbidity.This knowledge can be used in RTxR follow-up programs by addressing these parameters early to help reduce the morbidity and mortality in RTxRs.

基于格子Boltzmann模型的裂缝性储层钻井液漏失数值模拟

针对裂缝性碳酸盐岩储层钻井过程中钻井液漏失问题,基于简化的基块-裂缝双重介质物理模型,建立了描述表征单元体(REV)尺度的基块-裂缝内钻井液漏失的格子Boltzmann数学模型,数值模拟分析了钻井液漏失过程基块-裂缝内渗流场分布,揭示了不同条件下基块-裂缝内钻井液漏失行为。模拟结果表明,裂缝性致密碳酸盐岩储层中的裂缝为主要漏失空间,基块的钻井液漏失量在低值范围内随基块孔隙度增加呈指数增加。裂缝宽度越大,平均流速越大,裂缝空间内速度分布越均匀,组合裂缝总宽度相等条件下,单条裂缝的钻井液漏失速率高于多条裂缝组合情形。研究通过格子Boltzmann方法表征钻井液漏失行为,表明该方法可较好地用于分析裂缝性介质中钻井液漏失行为和裂缝至基块的跨尺度滤失过程,研究成果可为裂缝性致密储层钻井液漏失防控及储层保护提供理论依据。

2016~2020年毕节市国家级死因监测地区慢性非传染性疾病死因分析

目的:分析2016~2020年毕节市国家级死因监测地区慢性非传染性疾病死亡特征,为制定该地区慢性非传染性疾病预防控制措施提供科学依据。方法:采用粗死亡率、标准化死亡率、潜在减寿年数(potential years of life lost, PYLL)、平均减寿年数(average years of life lost, AYLL)等指标对2016~2020年毕节市国家级死因监测地区慢性非传染性疾病死亡资料进行分析。结果:2016~2020年毕节市居民慢性非传染性疾病粗死亡率为436.7/10万,年龄标化死亡率为493.16/10万,呈逐年上升趋势,男性死亡率显著高于女性;慢性非传染性疾病死亡率随着年龄的增长呈上升趋势,从65~岁年龄组开始明显升高;循环系统疾疾病占比最高(50.17%),死亡率为219.12/10万,其次是肿瘤和呼吸系统疾病;慢性非传染性疾病造成的寿命损失年PYLL为356073人年,AYLL为5.78人年,PYLL率为25.24‰。结论:2016~2020年毕节市居民慢性非传染性疾病死亡率呈上升趋势,已成为我市居民的主要死因,严重影响居民的健康和生命,应作为今后疾病防控工作的重点。

Fifty-Year-Follow-up Results Compared with Shorter Follow-up of Breast Cancer Patients Undergoing Radical Mastectomy with or without Adjuvant Radiotherapy

Background: To evaluate the effect of follow-up length on the outcome of breast cancer patients, we compared the 50- and 25-year follow-up results in terms of cure rate, overall mortality and mortalities from breast cancer, second cancer, and benign diseases. Methods: 763 patients treated for breast cancer between February 1953 and September 1976, were followed up until December 2014. They were divided into two cohorts;earlier cohort exclusively underwent radical mastectomy plus adjuvant radiotherapy, while later cohort had radical mastectomy alone. Assuming that in all patients follow-up was terminated at 50 or 25 years after diagnosis, likelihood ratio test and stratified Log-rank tests were performed to evaluate the differences in cure rate and overall survival between the two cohorts. Results: During the 50 years, radical mastectomy alone compared with radical mastectomy plus adjuvant radiotherapy is associated with a significantly higher cure rate, and higher survivals regardless of whether the death was from breast cancer, second cancer, benign causes or any causes. However, if follow-up information is limited to 25 years, the advantage of radical mastectomy alone is partly offset and the survival difference between the two cohorts becomes less significant. Conclusion: Radiotherapy to breast cancer may adversely affect not only mortality from breast cancer, but mortalities unrelated to breast cancer. Since such deaths occur later, they may fail to be detected unless follow-up is long enough. Thus, deleterious effects of radiotherapy may be underestimated. Exceedingly long follow-up is required to accurately estimate the cure rate and the long-term effect of radiotherapy.

Subjective and Objective Results of Native Anterior Vaginal Wall Repair in Local Anesthesia:A 10-Year Follow-Up

Introduction and Hypothesis: This follow-up study evaluates long-term subjective and objective outcome of native tissue anterior vaginal wall repair using local anesthesia. Methods: 72 women were operated. At 10-year follow-up anatomical results were evaluated by clinical examination. Furthermore, the women filled in a validated symptom and quality of life questionnaire. Results: Forty women (56%) completed the 10-year follow-up. Eighteen women (25%) had died within the ten-year follow-up period and fourteen women (19%) were lost to follow-up. Six (15%) of the women who came for follow-up had been reoperated for anterior vaginal wall prolapse within the 10-year follow-up period and were analysed as a separate group. Of the 40 women who came for the 10-year clinical examination none had stage 0 pelvic organ prolapse. Twenty (50%) women had stage 1, whereas, 13 (32%) had stage 2 and 1 (3%) had stage 3 pelvic organ prolapse. Ten years after surgery, 28 women (70%) had no bulge symptoms. Six (15%) of the women experienced bulge symptoms at the time of follow-up. Ten years postoperatively, 30 (75%) of the women in an overall quality of life assessment considered their condition improved after surgery. Conclusion: At 10-year follow-up 70% of women were relieved from their bulge symptoms and 75% still considered themselves better or much better than before the operation. However, 15% of women had been reoperated and 15% still experienced bulge symptoms.

1990—2019年中国乙型肝炎疾病负担分析及趋势预测

目的了解2019年中国乙型肝炎的疾病负担情况并对2020—2030年乙型肝炎的疾病负担发展趋势进行预测。方法在2019全球疾病负担研究数据库(Global Burden of Disease 2019,GBD 2019)中下载中国乙型肝炎数据。利用患病率、发病率、死亡率、伤残调整寿命年(disability-adjusted life year,DALY)、早死损失寿命年(years of life lost,YLL)、伤残损失寿命年(years lived with disability,YLD)及年龄标化率等指标描述2019年中国乙型肝炎的疾病负担情况,利用估计年百分比变化(estimated annual percentage change,EAPC)描述中国乙型肝炎疾病负担1990—2019年的变化趋势。采用R4.2.1构建贝叶斯年龄-时期-队列模型对2020—2030年中国乙型肝炎总体发病、死亡、DALY和YLD情况进行预测。结果1990—2019年中国乙型肝炎的总体疾病负担呈下降趋势,中国乙型肝炎的总体标化患病率为6566.1/10万、标化发病率为1397.3/10万、标化死亡率为8.1/10万、标化DALY率为247.7/10万、标化YLL率为241.5/10万、标化YLD率为6.2/10万,与1990年相比分别下降2.34%、2.35%、4.92%、5.15%、5.20%、2.71%。女性居民的疾病负担指标均低于同时期的男性居民。乙型肝炎的患病率在20~24岁最高,发病率在25~29岁最高,死亡率随着年龄增长而升高。根据贝叶斯模型预测,2020—2030年中国乙型肝炎发病人数约为1486.56万人,死亡人数约为11.18万人,DALY约为634.9万人年,YLD约为12.1万人年。结论尽管在1990—2019年之间中国乙型肝炎疾病负担呈下降趋势,但在2030年消除乙型肝炎病毒这一公共威胁的目标仍然面临挑战。因此,有必要扩大诊断覆盖范围、减轻患者经济负担,进一步推进健康中国建设。

2021年西藏山南市居民全因死亡监测数据分析

目的:分析2021年西藏自治区山南市居民的死亡特征,了解死亡原因及死因顺位,为制定相关防控策略提供依据。方法:利用死亡率、标化死亡率、寿命损失年数(years of life lost,YLL)、早死概率、期望寿命指标,对2021年西藏自治区山南市居民的全因死亡数据进行分析。结果:2021年西藏自治区山南市居民的总死亡率为500.3/10万(标化率1060.9/10万);男性死亡率为539.2/10万(标化率1282.5/10万),女性死亡率为462.5/10万(标化率889.5/10万),男性死亡率高于女性;总死亡YLL为35998.8年,男性为20827.0年,女性为15171.8年。居民前5位死因顺位分别是脑血管病、心脏病、恶性肿瘤、呼吸系统疾病、传染病,这5类疾病占报告死亡数的71.7%。慢性非传染性疾病占全死因的68.4%;四大类主要慢病早死概率为17.5%,男性为21.9%,女性为13.5%。山南市居民的期望寿命为75.3岁,男性为72.9岁,女性为77.7岁。结论:西藏自治区山南市居民中四大类主要慢病患者的早死概率高于全国水平,且四大类主要慢病是该市居民的主要死因。降低慢性病患者的过早死亡和YLL是预防和控制慢性病的主要目标。

顺北区块降低完井泥浆漏失方法研究

漏失井在钻完井过程中液面的降低可能导致液柱压力无法平衡地层压力而发生溢流,为了避免井控事故,起下钻及下完井管柱作业时需要定期向井筒内吊灌泥浆补液。不合理的吊灌方式将产生巨大的泥浆浪费和严重的储层污染,影响后期诱喷作业和油气井产能。以顺北区块漏失井吊灌泥浆为切入点,分析了老式吊灌方式存在的不足,通过漏失函数建立了吊灌泥浆理论模型,确定科学吊灌量,同时提出吊灌无固相油田水可行性,通过降低吊灌比重减小泥浆侵入对储层的影响。新型吊灌技术目前在顺北区块和塔河区块部分井取得了成功应用,为分公司降本增效做出贡献,也为行业内漏失井泥浆吊灌提供参考。

基于光电吸收截面指数的漏点识别及漏失参数评价

井漏会增加作业成本,延误工期,封堵漏液会影响测井资料对地层信息的响应。渤海地区第三系的砂泥岩地层井漏现象严重、漏失频次高,部分井漏失规模大,导致出现失返现象。准确定位漏失层段和预测漏失规模,进而对易漏地层开展针对性研究,可为后期钻探提供风险预警。通过光电吸收截面指数测井曲线准确定位漏失层段,利用其与瞬时漏速相关性较好预测漏速。提出采用多矿物模型分析方法计算地层中重晶石相对体积含量,将其与泥浆中重晶石实际含量结合计算漏失量。在渤海地区几大油田的现场应用表明,利用光电吸收截面指数计算的漏速和漏失量与现场实际提供的数据对比,误差较小。利用光电吸收截面指数定位漏失层段、计算漏速及漏失量的方法可用于漏点识别及漏失参数评价。

小麦品质与面条品质关系的研究

以普通机制面条为对象，研究了小麦品质指标对面条品质的影响。结果表明，蛋白质含量、面团稳定时间是影响面条蒸煮吸水率的主要品质指标，沉淀值是影响干物质失落率、蛋白质损失率的主要品质指标。干物质失落率是面条品质重要的评价指标。

不同降雨条件下非点源污染氮负荷入河系数研究

以黑河流域为研究区,利用1998年河道实测径流量、泥沙负荷和非点源污染调查资料,对所建的非点源污染模型进行了参数率定.在此基础上,分析了非点源污染负荷的坡面-入河过程,提出了非点源污染负荷的“流域损失系数-入河系数”的概念;利用研究区的资料,对不同降水条件下农田、城镇、草地、灌木及森林等土地利用类型的各亚流域氮的入河系数进行了研究,对比分析了2种计算方法(SWAT模型方法和输出系数法)所得到的氮的入河系数.结果表明,2种方法所计算的氮的入河系数均较为合理,其计算结果的Pearson相关系数为0.94722(p<0.05).此外,研究还表明,不同的降水条件和土地利用类型下氮的入河系数存在差异.对于吸附态氮,入河系数的大小排列依次为农田>城镇>草地>灌木>森林;对于溶解态氮,其入河系数的大小排列次序为农田>草地>灌木>森林>城镇.

中国人骨质疏松症诊断标准回顾性研究

目的 通过对既往国内文献复习 ,提出一种更方便、更科学的中国人骨质疏松症诊断标准。方法 检索国内期刊数据库中已发表的文献 ,摘录骨密度丢失率数据进行统计、计算、分析 ,得到不同年龄段、不同作者、使用不同型号仪器、不同部位的骨密度丢失百分率及相关曲线。结果 中国男性骨质疏松诊断标准推荐使用骨密度丢失百分率 2 5 %或 2SD ;中国女性骨质疏松诊断标准推荐使用骨密度丢失百分率 2 5 %或 2SD ;测量部位推荐使用如下顺序 :股骨颈 >前臂远端 1/ 3、1/ 10、1/ 6 >RA法手指骨 2 ,3,4中节 >股骨Troch区 ;不推荐使用股骨Ward区和腰椎侧位。结论 使用骨密度丢失百分率这个指标作为中国人骨质疏松症诊断标准非常有意义 ,值得进一步推广和深入研究。

2,3,7,8-四氯苯二噁对小鼠胚胎毒作用的研究

目的 探讨动物妊娠早期接触2 ,3 ,7,8 四氯苯二(TCDD)后造成胚胎丢失的原因以及对小鼠成活率的影响。方法 90只妊娠NHI小鼠分9组,在妊娠的第1天,第2天和第3天分别观察胚胎转移率、检测血清雌二醇和孕酮含量;2 40只妊娠NIH小鼠分2 4组,于妊娠第9天和第18天测定子宫重量,观察胚胎成活情况。结果 与正常对照组胚胎数比较,TCDD未影响胚胎转移率,但造成着床前胚胎丢失(14±4 2 0 ,4 63±6 0 9,P <0 0 1) ;不同时期染毒均可降低胚胎和胎儿成活率(P <0 0 0 1) ;血清雌二醇含量升高(P <0 0 0 1)、孕酮水平下降(P <0 0 1)。结论 TCDD对胚胎和母体均具有毒性,血清类固醇激素的改变可影响子宫功能,造成第9天胚胎成活率下降;同时TCDD具有持续毒性的特点,使出生前第18天胚胎成活数低于第9天胚胎成活数。

羊草草原枯枝落叶分解的研究——主要优势植物的分解速率和损失率

分解速率和损失率从不同侧面反映了枯枝落叶分解动态。羊草草原主要优势植物,羊草(Leymus chinensis)、拂子茅(Calamagrostis epigejos),碱蓬(Suaeda glauca)、碱茅(Puccinellia tenuiflora)、五脉山黎豆(Lathyrus quinquenervius)、碱蒿(Artemisia anethifolia)分解速率的季节变化动态近似倒“V”字型。损失率的季节变化呈“S”型,反映了枯枝落叶的失重情况。枯枝落叶的化学组成成分是造成不同种植物间分解差异的主要原因,特别是C/N比与分解快慢有密切关系。分解初期,枯枝落叶的损失符合指数衰减模型。枯枝落叶损失95％所需时间,羊草群落约为8.8a,杂类草群落约为9.7a,碱茅群落约为7.1a,碱蓬群落约为4.7a。

裂缝性地层钻井液漏失模型及漏失规律

针对裂缝性地层钻井作业时的钻井液漏失问题,采用幂律模式钻井液,将地层中裂缝看作任意倾角、可变形、裂缝面粗糙且存在滤失的二维单条裂缝模型,引入裂缝力学开度和裂缝迂曲度参数表征裂缝面粗糙度对钻井液漏失规律的影响,推导了钻井液漏失模型,并基于该模型分析了钻井液漏失规律。研究结果表明,幂律模式钻井液的剪切稀释性会造成漏失初始阶段漏失速率的升高;钻井液漏失速率随裂缝迂曲度变大而减小,随着裂缝开度增加裂缝迂曲度对钻井液漏失速率的影响降低;初始裂缝开度、裂缝倾角、裂缝面积、裂缝长度越大,钻井液漏失速率越大;矩形裂缝的钻井液漏失速率低于正方形裂缝;裂缝面滤失综合系数越大,钻井液漏失速率越高;井眼与裂缝相交于裂缝中心位置时钻井液漏失速率最高;随着井底压差增大,钻井液漏失速率明显升高;裂缝法向刚度越高,钻井液漏失速率越小。

RFC2544网络设备评测协议实现技术

RFC2544协议是评测网络设备的国际标准，因此，它的实现应该特别注重测试结果的精确性。文章简述了RFC2544协议，介绍了一种在Linux系统下实现的评测系统，并对系统实现过程中所遇到的技术难题给出了解决方案。

基于RFC2544测试的网络测试仪的设计与实现

RFC2544是当前网络互联设备性能测试普遍使用的标准。该文设计并实现了一种支持RFC2544测试的性价比较高的网络测试仪。介绍了RFC2544标准及其测试条件,通过对网络测试仪硬件结构以及软件设计的说明,阐述了该系统的工作原理,结合相关测试条件,与国外产品进行比对测试,实验结果的量化误差表明了该系统测试的精确性。