Objective To investigate the methodology and efficacy evaluation of ceramic on ceramic hip prosthesis in total hip arthroplasty for young patients. Methods The cl inical data from 65 patients (75 hips) who received ceramic on ceramic hip prosthesis for total hip arthroplasty between February 2004 and September 2006, including unilateral replacementin 55 cases and bilateral replacement in 10 cases. Of 65 patients, there were 41 males and 24 females with an average age of 43.2 years (range, 18-56 years), including 6 cases of femoral head comminuted fractures, 44 cases of aseptic necrosis femoral head, 7 cases of developmental dysplasia of hip with osteoarthritis, 3 cases of congenital dislocation of hip, 2 cases of traumatic arthritis secondary to postoperative acetabulum fracture, 1 case of rheumatoid arthritis, and 2 cases of ankylosing spondyl itis. The Harris score was 54.3 ± 6.7. The disease duration was 1 year and 4 months to 10 years and 7 months with an average of 3 years and 2 months. Results Heal ing of incision by first intention was achieved in all patients; no dislocation, infection, and deep venous thrombosis of lower l imbs occurred. All patients were followed up 3 years and 2 months to 5 years and 7 months with an average of 4 years and 9 months. The Harris score was significantly improved to 89.0 ± 9.4 at last follow-up, showing significant difference when compared with preoperative one (P lt; 0.01). The mean eversion angle and anteversion angle of the acetabular component were (43.6 ± 8.4)° and (21.5 ± 3.5)°, respectively. In follow-up period, no prosthetic loosening, subsidence, dislocation, and ceramic component fracture occurred. Osteolysis was not found in all the cases. Conclusion Ceramic on ceramic hip prosthesis in total hip arthroplasty for young patients can effectively decrease the compl ications of prosthetic loosening and subsidence caused by wearing of joint interface; the surgical skill is important in decreasing dislocation and fraction of ceramic on ceramic hip prosthesis.
Objective To evaluate the short-term cl inical outcomes of metal-on-metal total hi p resurfacing arthroplasty in treating osteonecrosis of the femoral head (ONFH) in young and middle-aged patients and to compare with patients of hip osteoarthritis at the same period. Methods From July 2006 to October 2008, 33 patients (45 hips) with ONFH (ONFH group) and 39 patients (45 hips) with osteoarthritis (osteoarthritis group) were treated with metal-on-metal total hipresurfacing arthroplasty. In ONFH group, there were 18 males (27 hips) and 15 females (18 hips) with an average age of 42.7 years (range 19-58 years), including 22 left hips and 23 right hips. The causes were trauma (4 cases), glucocorticoid (25 cases), drugs (2 cases), alcohol (1 case), and psoriasis (1 case). According to Steinberg classification, there were 10 hips at stage III, 18 hips at stage IV a, 13 hips at stage IV b, and 4 hips at stage IV c. The Harris score was 52.0 ± 4.6. The disease course was 1-12 years. In osteoarthritis group, there were 26 males (30 hips) and 13 females (15 hips) with an average age of 47.1 years (range 42-65 years), including 17 left hips and 28 right hips. The causes were degenerative arthritis (23 cases), trauma (11 cases), and ankylosing spondyl itis (5 cases). The Harris score was 57.0 ± 3.8. The disease course was 3-17 years. There were no significant differences in general data between two groups (P gt; 0.05). Results All incisions achieved heal ing by first intention without compl ications of infection and thrombosis of deep vein of lower extremities. The patients were followed up for 26 months in ONFH group and 28 months in osteoarthritis group. Femoral neck fracture occurred in 1 case of osteoarthritis group after 4 months, who received total hip arthroplasty; no compl ication of prosthesis loosening, dislocation, incision infection, osteonecrosis, and bone absorption occurred in other patients. At last follow-up, the Harris scores were 93.0 ± 5.5 in ONFH group and 94.0 ± 2.4 in osteoarthritis group, showing no significant difference between two groups (P gt; 0.05); but there were significant differences between pre- and post-operation (P lt; 0.01). Conclusion The cl inical short-term outcomes ofmetal-on-metal total hip resurfacing arthroplasty to treat ONFH are satisfactory. It can achieve similar outcomes to that ofosteoarthritis group. More cases and long-term follow-up are needed to investigate long-term cl inical outcomes.
ObjectiveTo systematically evaluate the correlation between interpersonal stress and suicidal ideation. MethodsThe PubMed, EMbase, Cochrane Library, CBM, WanFang Data and CNKI databases were searched to collect studies on the correlation between interpersonal pressure and suicidal ideation from database inception to April 27, 2022. Two researchers independently screened the literature, extracted data and assessed the risk of bias of the included studies. Meta-analysis was then performed using Stata 14.0 software. ResultsA total of 42 studies including 3 cohort studies, and 39 cross-sectional studies, with a total sample size of 193 810 participants were included. Meta-analysis showed that the risk of suicidal ideation was higher in people who had experienced interpersonal pressure than in people who had not (OR=2.11, 95%CI 1.99 to 2.23, P<0.01). Subgroup analysis showed that people in the Americas who had experienced interpersonal pressure were more strongly associated with suicidal ideation than people in other regions of the studied area. Young adults in the study who had experienced interpersonal pressure were more strongly associated with suicidal ideation than other studied age groups; People who had experienced partner pressure were more strongly associated with suicidal ideation than those who had experienced other types of interpersonal pressure. ConclusionThis study shows that people who have experienced interpersonal pressure are at greater risk of suicidal ideation, and there are certain differences among study areas, subjects and types of interpersonal pressure. Due to the limited quantity and quality of the included studies, more high-quality studies are needed to verify the above conclusion.
Objective To evaluate the therapeutic outcome of artificial total hip arthroplasty (THA) with collum femoris preserving for hip joint desease in young and middle-aged patients. Methods From March 2002 to March 2005, 26 cases (31 hips) of hip joint disease were treated with artificial THA with collum femoris preserving, including 19 males (23 hips)and 7 females (8 hips) and aged 32-48 years with an average of 37 years. In 31 hips, 17 left hips and 14 right hips were involved. There were 9 cases of osteoarthritis of the hip joint caused by avascular necrosis of the femoral head (ANFH), 7 cases of ANFH, 3 cases of femoral head necrosis caused by dysplasia of acetabular, 1 case of osteoarthritis of the hip joint caused by ankylosing spondyl itis, and 2 cases of rheumatoid arthritis; the course of disease was 2-11 years (5.6 years on average). Two cases of femoral neck fracture (Garden IV), and 2 cases of non-union femoral neck fractures (1 for Garden III and 1 for Garden IV), the course of disease was 5 days, 24 months, and 26 months. The prime symptoms were pain, difficult walk and l imp. All patients were taken X-ray to exclude osteoporosis. Results The right distal femur prosthesis of a bilateral patient cracked owing to excessive amputation of collum femoris, and fracture healed after symptomatic treatment. All the incisions healed by first intention and no compl ications occurred. All patients were followed up for 4-7 years, with an average of 5.6 years. One case had poor hip function because he did not follow rehabil itation procedure, and the others achieved good outcome with normal gait. One case complained of persistent pain 6 months after operation, and was rel ieved by administration of some non-steroidal antiinflammatory drugs and anti-osteoporosis drugs 6 months later. The X-ray films after operation and at last follow up showed good location of prosthesis and no bone resorption. Harris score at last follow-up was 91.31 ± 0.77, and it was significantly higher than that before operation (50.88 ± 0.90), (P lt; 0.05). The excellent and good rate was 93.5% (excellent in 11 hips, good in 18 hips, and fair in 2 hips). Conclusion Artificial THA with collum femoris preserving can retain more bone, be easier for revision, and has an excellent outcome.
【摘要】 目的 評價青年人頸動脈彩色多普勒超聲檢查的臨床意義，并探討青年人腦梗死與頸動脈粥樣硬化的關系。 方法 2008年2月-2011年3月，對256例青年腦梗死患者進行頸動脈彩色多普勒超聲檢測，選擇性別和年齡匹配的健康青年143例作對照組，比較兩組人群頸動脈彩色多普勒超聲特點的差異。 結果 腦梗死組頸動脈粥樣硬化斑以中等、強回聲斑塊為主，斑塊積分、血管壁內-中膜厚度（ITM值）及斑塊檢出率（34.77%，89例）均明顯高于對照組（Plt;0.01）；腦梗死組頸動脈硬化狹窄率及血栓發生率明顯高于對照組（Plt;0.05，lt;0.01）。 結論 青年腦梗死患者頸動脈粥樣硬化及血栓形成發生率均高，提示青年腦梗死患者的發病主要原因與動脈粥樣硬化有關。IMT值的增加、斑塊的檢出率及形態學特征等是頸動脈病變與腦梗死發生的有意義的檢測指標，在青年人腦梗死的防治中是有參考意義較大的超聲學指標。【Abstract】 Objective To assess the clinical significance of color Doppler ultrasonography in examining carotid arteries of young patients, and explore the relationship between cerebral infarction and carotid arteriosclerosis in young patients. Methods A total of 256 patients with cerebral infarction and 143 people without cerebral infarction diagnosed between February 2008 and March 2011 were assessed by color doppler ultrasonography. The ultrasonic characteristics of the two groups were compared and analyzed. Results Plaques incidence in cerebral infarction group was 81.43% which was higher than that in the control group. The most common sites of plaque formation were common carotid artery (CCA) bifurcate and the initial segment of internal carotid artery (ICA) in young people with cerebral infarction. In the cerebral infarction group, the rate of middle-echoic plaques was higher than that in the control group (Plt;0.05). The rate of low-grade carotid stenosis was higher in the cerebral infarction group than that in the control group (Plt;0.05). Conclusions Cerebral infarction occurrence in young people is closely correlated to carotid artery atherosclerosis. Ultrasonography can provide objective evidences for preventing and treating cerebral infarction.
ObjectiveTo evaluate the effectiveness of modified Ilizarov hip reconstruction in the treatment of hip instability.MethodsThe clinical data of 13 young patients with hip diseases treated with modified Ilizarov hip reconstruction between January 2010 and March 2018 were retrospectively analyzed. There were 2 males and 11 females, aged from 14 to 34 years, with an average age of 24.2 years. There were 1 case of hip dysplasia and dislocation due to spinal bifida, 3 cases of hip dysplasia after pyogenic arthritis of the hip, 2 cases of developmental dysplasiaof the hip (DDH) accompanying femoral head necrosis who rejected hip replacement, 6 cases of young DDH refused to undergo hip replacement, and 1 case of bilateral hip dysplasia with dislocation due to sputum cerebral palsy. The disease duration was 2-20 years, with an average of 8.5 years. Preoperative Trendelenburg sign was positive in 12 cases and negative in 1 case. The preoperative Harris score of hip joint was 53.5±8.9 and the unequal length of lower limbs was (46.08±15.73) mm. Postoperative Harris hip score and patients' satisfaction with effectiveness evaluated according to their self scoring were used to assess the effectiveness.ResultsAll 13 patients were followed up 1-5 years, with an average of 2.6 years. Five patients developed postoperative needle infection, which improved after dressing change; 7 patients had limited knee joint activity and improved after knee joint function training. The Trendelenburg sign was negative at 1 year after operation, and the patient’s hip pain symptoms were relieved or disappeared. The Harris hip score of patients at 1 year after operation was 84.5±6.1, which was significantly improved when compared with preoperative one (t=－10.538, P=0.000). According to Harris hip score, the effectiveness results were excellent in 4 cases, good in 5 cases, and fair in 4 cases, with an excellent and good rate of 69.2%. The unequal length of lower limbs was (15.38±7.27) mm, which was significantly better than that before operation (t=11.826, P=0.000). At last follow-up, the patients' satisfaction score was 80%-95%, with an average of 88%.ConclusionModified Ilizarov hip reconstruction can be used to treat young patients with hip disease who are unsuitable or refuse to undergo artificial hip replacement. Its effectiveness is reliable, and it has unique advantages in limb limp improvement and limb shortening correction.
Objective To study the application and the curative effect of compressed screw and sartorius bone flap in treating femoral neck fractures in youth or middle age. Methods From February 1996 to December 2004, 86 patients with femoral neck fracture were treated by open reduction compressed screw and sartorius bone flap, aging from 21 to 49 years. Fracture was caused by traffic accident in 35 cases, fall from height in 27 cases and fall in 24 cases. Accoding to Garden classification, 23 cases were type Ⅱ, 25 cases were type Ⅲ, and 15 cases were type Ⅳ. We analyzed fracture healing and evaluate function by observation of the postoperative X-ray films. Results Of the 86 patients, 62 were followed up 6 months to 7 years (2 years and 5 months on average). According to Weijie’s criterion for nonunion and necrosis offemoral head, nonunion occurred in 4 cases; the healing rate of fracture was 93.5%. In healed patients, necrosis of femoral head occurred in 7 cases (11.3%) after 3 years. The results of hip joint function evaluation were excellent in 44 cases, good in 8 cases, fair in 6 cases and poor in 4 cases; and the excellent and good rate was 83.9%. Conclusion Compressed screw and sartorius bone flap was simple and effective for femoral neck fractures in youth or middle age.
The management of middle-aged and youth hypertension has become a challenge in clinical practice. The hypertension group of the Chinese Society of Cardiology published the expert consensus on the management of hypertension in young and middle-aged Chinese population in 2019. This paper interprets the key contents of the consensus and provides references for management of young and middle-aged hypertension.
