AIM To discusses pharmacological and non-pharmacological therapeutic alternatives for managing knee osteoarthritis in primary care by primary health care nurse practitioners.METHODS A case example is presented, the ev...AIM To discusses pharmacological and non-pharmacological therapeutic alternatives for managing knee osteoarthritis in primary care by primary health care nurse practitioners.METHODS A case example is presented, the evidence-based guideline recommendations of the Osteoarthritis Research Society International and the American Academy of Orthopaedic Surgeons are reviewed, and a plan of care is developed.RESULTS Osteoarthritis is the most common form of arthritis seen in primary care, and it is a major public health issue because the aging population and widespread obesity have drastically increased incidence. Osteoarthritis is clinically associated with escalating chronic pain, physical disability, and decreased quality of life. Early diagnosis of mild osteoarthritis in relatively young patients presents an opportunity for primary health care providers to manage pain, increase quality of life, and decrease risk of disability. CONCLUSION Primary health care providers can implement these recommendations in their own practices to provide care to patients with knee osteoarthritis based on current best evidence.展开更多
Background: Primary knee Osteoarthritis (OA) is the commonest articular disease in middle age and elderly people. Primary total knee replacement (TKR) is a known world-wide standard and definitive treatment of primary...Background: Primary knee Osteoarthritis (OA) is the commonest articular disease in middle age and elderly people. Primary total knee replacement (TKR) is a known world-wide standard and definitive treatment of primary knee OA following failed adequate non-operative management. It is of clinical importance to assess the clinical and functional outcome of TKR to prognosticate the severity of primary knee OA. The new (2011) knee society scoring system (nKSS) is both surgeons and patients’ assessment tool for the treatment outcome of TKR. Study Design: Prospective interventional analytical study. Aim and Objective: The aim of the study was to determine early clinical and functional outcome of primary total knee replacement in patients with primary knee osteoarthritis using nKSS. The objectives were: 1) To determine the pre-operative nKSS and post operative nKSS;2) To determine relationships between pre-operative nKSS and post operative nKSS at 6 weeks, 3, 6, 9 and 12 months;3) To determine the complication rates in patients undergoing primary TKR in the study centre. Methods: A prospective interventional study of 59 patients aged 51 to 70 years who had 67 Total Knee Replacements (TKRs) participated in the study between November 2015 to June 2018 at National Orthopaedics Hospital, Lagos, Nigeria. Patients’ sociodemographic data, pre-operative and post-operative nKSS system were recorded at 6 weeks, 3, 6, 9 and 12 months during follow up. The data were analyzed using Statistical Package for Social Science (SPSS). Results: There were 41 females and 18 males (M:F = 1:2.3). There were total of 67 TKRs with 31 right TKRs, 20 left TKRs and 8 staged bilateral TKRs. The participants’ age ranged from 51 to 70 years with the mean age of 59.5 (±8.5) years. Four patients did not complete the study due to various reasons. The remaining 55 participants completed the study period with progressive improvement of their post-operative nKSS at 6 weeks, 3, 6, 9 and 12 months post-operatively when compared with pre-operative nKSS (P value 0.5). Conclusion: This study revealed improved early clinical and functional outcome of primary total knee replacement in primary knee osteoarthritis using nKSS in all the studied patients. There is no significant negative effect of lower pre-operative nKSS (and its components) on the post-operative nKSS outcome.展开更多
A considerable portion of the population now experiences osteoarthritis of the knee,spine,and hip due to lifestyle changes.Therefore,early treatment,recognition and prevention are essential to reduce damage;neverthele...A considerable portion of the population now experiences osteoarthritis of the knee,spine,and hip due to lifestyle changes.Therefore,early treatment,recognition and prevention are essential to reduce damage;nevertheless,this time-consuming activity necessitates a variety of tests and in-depth analysis by physicians.To overcome the existing challenges in the early detection of Knee Osteoarthritis(KOA),an effective automated technique,prompt recognition,and correct categorization are required.This work suggests a method based on an improved deep learning algorithm that makes use of data from the knee images after segmentation to detect KOA and its severity using the Kellgren-Lawrence(KL) classification schemes,such as Class-I,Class-II,Class-III,and Class-IV.Utilizing ResNet to segregate knee pictures,we first collected features from these images before using the Bidirectional Long Short-Term Memory(BiLSTM)architecture to classify them.Given that the technique is a pre-trained network and doesn’t require a large training set,the Mendeley VI dataset has been utilized for the training of the proposed model.To evaluate the effectiveness of the suggested model,cross-validation has also been employed using the Osteoarthritis Initiative(OAI)dataset.Furthermore,our suggested technique is more resilient,which overcomes the challenge of imbalanced training data due to the hybrid architecture of our proposed model.The suggested algorithm is a cuttingedge and successful method for documenting the successful application of the timely identification and severity categorization of KOA.The algorithm showed a cross-validation accuracy of 78.57%and a testing accuracy of 84.09%.Numerous tests have been conducted to show that our suggested algorithm is more reliable and capable than the state-of-the-art at identifying and categorizing KOA disease.展开更多
When gene expression profile is used for gene detection,the probe on the chip can emit fluorescence with different wavelengths.Under the action of confocal laser scanner,a clear gene change image can be obtained,by wh...When gene expression profile is used for gene detection,the probe on the chip can emit fluorescence with different wavelengths.Under the action of confocal laser scanner,a clear gene change image can be obtained,by which the gene changes of the sample to be tested can be observed directly.First,the knee osteoarthritis(KOA)models of mice are established by the method of collateral ligament and meniscus resection(MLI-OA).Then,Bushen Huoxue formula is given by gavage,and ribonucleic acid(RNA)is routinely extracted and purified.Finally,the gene expression changes of KOA tissues of mice are detected by Agilent SurePrint G3 Mouse GE V2.0 gene expression profile.The results show that Bushen Huoxue formula has significant regulation effect on gene expression of KOA tissue.Among the genes with significant up-regulation effect of Bushen Huoxue formula,there are 56 genes of traditional Chinese medicine(TCM)groups up-regulated more than twice compared with model groups.Among the genes with significant down-regulation effect,there are 119 genes of TCM groups down-regulated more than twice compared with model groups.The experimental results indicate that Bushen Huoxue formula may promote the metabolism of arthritic factors and delay cartilage degeneration to treat KOA by regulating genes that are currently unknown in the pathological process of KOA.展开更多
目的:观察子午流注纳子法杵针治疗肝肾亏虚型膝痹病的临床疗效。方法:选取2022年1—12月成都中医药大学附属医院骨伤科门诊收治的肝肾亏虚型膝痹病患者72例,按照随机数字表法分为对照组和观察组,每组36例。实际纳入研究的患者对照组33...目的:观察子午流注纳子法杵针治疗肝肾亏虚型膝痹病的临床疗效。方法:选取2022年1—12月成都中医药大学附属医院骨伤科门诊收治的肝肾亏虚型膝痹病患者72例,按照随机数字表法分为对照组和观察组,每组36例。实际纳入研究的患者对照组33例、观察组34例。两组患者按照膝痹病中医诊疗常规给予杵针治疗,对照组杵针治疗的时间根据患者每日来院的时间灵活安排,多为上午时段,观察组选择十二时辰中肾经流注最旺盛的酉时(17:00-19:00)实施杵针治疗。比较两组患者治疗前后疼痛视觉模拟评分(visual analogue score,VAS)、西安大略与麦克马斯特大学骨关节炎评分量表(the western ontario and mcmaster universities osteoarthritis index,WOMAC)评分及不良反应发生情况。结果:观察组治疗后WOMAC评分低于对照组,差异具有统计学意义(P<0.05);观察组治疗后VAS评分低于对照组,差异具有统计学意义(P<0.05);观察组患者有2例、对照组患者有1例出现杵针治疗后局部皮下瘀青,两组不良反应发生情况比较,差异无统计学意义(P>0.05)。结论:子午流注纳子法杵针治疗肝肾亏虚型膝痹病,选择肾经流注旺盛的酉时进行治疗,能有效缓解患者疼痛,改善患者症状和体征,安全性高。展开更多
文摘AIM To discusses pharmacological and non-pharmacological therapeutic alternatives for managing knee osteoarthritis in primary care by primary health care nurse practitioners.METHODS A case example is presented, the evidence-based guideline recommendations of the Osteoarthritis Research Society International and the American Academy of Orthopaedic Surgeons are reviewed, and a plan of care is developed.RESULTS Osteoarthritis is the most common form of arthritis seen in primary care, and it is a major public health issue because the aging population and widespread obesity have drastically increased incidence. Osteoarthritis is clinically associated with escalating chronic pain, physical disability, and decreased quality of life. Early diagnosis of mild osteoarthritis in relatively young patients presents an opportunity for primary health care providers to manage pain, increase quality of life, and decrease risk of disability. CONCLUSION Primary health care providers can implement these recommendations in their own practices to provide care to patients with knee osteoarthritis based on current best evidence.
文摘Background: Primary knee Osteoarthritis (OA) is the commonest articular disease in middle age and elderly people. Primary total knee replacement (TKR) is a known world-wide standard and definitive treatment of primary knee OA following failed adequate non-operative management. It is of clinical importance to assess the clinical and functional outcome of TKR to prognosticate the severity of primary knee OA. The new (2011) knee society scoring system (nKSS) is both surgeons and patients’ assessment tool for the treatment outcome of TKR. Study Design: Prospective interventional analytical study. Aim and Objective: The aim of the study was to determine early clinical and functional outcome of primary total knee replacement in patients with primary knee osteoarthritis using nKSS. The objectives were: 1) To determine the pre-operative nKSS and post operative nKSS;2) To determine relationships between pre-operative nKSS and post operative nKSS at 6 weeks, 3, 6, 9 and 12 months;3) To determine the complication rates in patients undergoing primary TKR in the study centre. Methods: A prospective interventional study of 59 patients aged 51 to 70 years who had 67 Total Knee Replacements (TKRs) participated in the study between November 2015 to June 2018 at National Orthopaedics Hospital, Lagos, Nigeria. Patients’ sociodemographic data, pre-operative and post-operative nKSS system were recorded at 6 weeks, 3, 6, 9 and 12 months during follow up. The data were analyzed using Statistical Package for Social Science (SPSS). Results: There were 41 females and 18 males (M:F = 1:2.3). There were total of 67 TKRs with 31 right TKRs, 20 left TKRs and 8 staged bilateral TKRs. The participants’ age ranged from 51 to 70 years with the mean age of 59.5 (±8.5) years. Four patients did not complete the study due to various reasons. The remaining 55 participants completed the study period with progressive improvement of their post-operative nKSS at 6 weeks, 3, 6, 9 and 12 months post-operatively when compared with pre-operative nKSS (P value 0.5). Conclusion: This study revealed improved early clinical and functional outcome of primary total knee replacement in primary knee osteoarthritis using nKSS in all the studied patients. There is no significant negative effect of lower pre-operative nKSS (and its components) on the post-operative nKSS outcome.
文摘A considerable portion of the population now experiences osteoarthritis of the knee,spine,and hip due to lifestyle changes.Therefore,early treatment,recognition and prevention are essential to reduce damage;nevertheless,this time-consuming activity necessitates a variety of tests and in-depth analysis by physicians.To overcome the existing challenges in the early detection of Knee Osteoarthritis(KOA),an effective automated technique,prompt recognition,and correct categorization are required.This work suggests a method based on an improved deep learning algorithm that makes use of data from the knee images after segmentation to detect KOA and its severity using the Kellgren-Lawrence(KL) classification schemes,such as Class-I,Class-II,Class-III,and Class-IV.Utilizing ResNet to segregate knee pictures,we first collected features from these images before using the Bidirectional Long Short-Term Memory(BiLSTM)architecture to classify them.Given that the technique is a pre-trained network and doesn’t require a large training set,the Mendeley VI dataset has been utilized for the training of the proposed model.To evaluate the effectiveness of the suggested model,cross-validation has also been employed using the Osteoarthritis Initiative(OAI)dataset.Furthermore,our suggested technique is more resilient,which overcomes the challenge of imbalanced training data due to the hybrid architecture of our proposed model.The suggested algorithm is a cuttingedge and successful method for documenting the successful application of the timely identification and severity categorization of KOA.The algorithm showed a cross-validation accuracy of 78.57%and a testing accuracy of 84.09%.Numerous tests have been conducted to show that our suggested algorithm is more reliable and capable than the state-of-the-art at identifying and categorizing KOA disease.
基金National Natural Science Foundation of China(No.81673782)Shanghai Putuo District Health System“315”Project Talent Training Program(No.14Q-RC-11)。
文摘When gene expression profile is used for gene detection,the probe on the chip can emit fluorescence with different wavelengths.Under the action of confocal laser scanner,a clear gene change image can be obtained,by which the gene changes of the sample to be tested can be observed directly.First,the knee osteoarthritis(KOA)models of mice are established by the method of collateral ligament and meniscus resection(MLI-OA).Then,Bushen Huoxue formula is given by gavage,and ribonucleic acid(RNA)is routinely extracted and purified.Finally,the gene expression changes of KOA tissues of mice are detected by Agilent SurePrint G3 Mouse GE V2.0 gene expression profile.The results show that Bushen Huoxue formula has significant regulation effect on gene expression of KOA tissue.Among the genes with significant up-regulation effect of Bushen Huoxue formula,there are 56 genes of traditional Chinese medicine(TCM)groups up-regulated more than twice compared with model groups.Among the genes with significant down-regulation effect,there are 119 genes of TCM groups down-regulated more than twice compared with model groups.The experimental results indicate that Bushen Huoxue formula may promote the metabolism of arthritic factors and delay cartilage degeneration to treat KOA by regulating genes that are currently unknown in the pathological process of KOA.
文摘目的:观察子午流注纳子法杵针治疗肝肾亏虚型膝痹病的临床疗效。方法:选取2022年1—12月成都中医药大学附属医院骨伤科门诊收治的肝肾亏虚型膝痹病患者72例,按照随机数字表法分为对照组和观察组,每组36例。实际纳入研究的患者对照组33例、观察组34例。两组患者按照膝痹病中医诊疗常规给予杵针治疗,对照组杵针治疗的时间根据患者每日来院的时间灵活安排,多为上午时段,观察组选择十二时辰中肾经流注最旺盛的酉时(17:00-19:00)实施杵针治疗。比较两组患者治疗前后疼痛视觉模拟评分(visual analogue score,VAS)、西安大略与麦克马斯特大学骨关节炎评分量表(the western ontario and mcmaster universities osteoarthritis index,WOMAC)评分及不良反应发生情况。结果:观察组治疗后WOMAC评分低于对照组,差异具有统计学意义(P<0.05);观察组治疗后VAS评分低于对照组,差异具有统计学意义(P<0.05);观察组患者有2例、对照组患者有1例出现杵针治疗后局部皮下瘀青,两组不良反应发生情况比较,差异无统计学意义(P>0.05)。结论:子午流注纳子法杵针治疗肝肾亏虚型膝痹病,选择肾经流注旺盛的酉时进行治疗,能有效缓解患者疼痛,改善患者症状和体征,安全性高。
