PdPb nanocrystals have drawn considerable attention due to their excellent catalytic properties, while their practical applications have been impeded by the severe degradation of activity, which is caused by the adsorption of intermediates (especially CO) during the operation. Herein, we first present porous PdPb alloys with the incorporation of amorphous Pb(OH)2 species as highly active and stable electrocatalysts. Alloying Pd with Pb species is initially proposed to optimize the Pd-Pd interatomic distance and adjust the d-band center of Pd. Importantly, the amorphous Pb(OH)2 species are beneficial to promoting the formation of OHad and the removal of COad. Therefore, PdPb-Pb(OH)2 catalysts show a mass activity of 3.18 A mgPd-1 and keep excellent stability for the ethanol oxidation reaction (EOR). In addition, further CO stripping and a series of CO poisoning experiments indicate that PdPb-Pb(OH)2 composites possess much better CO tolerance benefiting from the tuned electronic structure of Pd and surface incorporation of Pb(OH)2 species.
ObjectiveThis study aims to investigate the effects of sudden load changes (expected and unexpected imbalance) on the activity of muscles of the lumbar spine and their central motor control strategy in military personnel with or without chronic low back pain (LBP).DesignBilateral sudden imbalance was examined (2 × 2 factorial design).SettingThe 117th PLA Hospital, Hangzhou, ChinaParticipantsTwenty-one male subjects with lower back pain and 21 male healthy control subjects were active members of the Nanjing Military Region land forces.Outcome measuresIndependent variables: LBP vs. healthy controls and imbalance anticipation (expected and unexpected imbalance). Dependent variables: rapid reaction time (RRT) and intensity of rapid reaction (IRR) of bilateral lumbar (L3–L4) erector spinae (ES), lumbar (L5–S1) multifidus (MF), and abdominal external oblique muscles.ResultsUnder expected or unexpected sudden imbalance conditions, subjects with LBP demonstrated significantly greater IRR than healthy controls in ipsilateral and contralateral ES and MF, respectively (P < 0.05 for all). IRR of contralateral ES was significantly larger than that of the ipsilateral ES. A significant group effect of RRT of both ipsilateral and contralateral ES muscles and a significant time expectation effect on RRT of contralateral MF muscles were also observed. RRT of the contralateral ES muscles was significantly lower than that of the ipsilateral ES muscles (P < 0.001).ConclusionsSudden imbalance prolonged RRT of selected trunk muscles in patients with chronic LBP. The activation amplitude increased. The results may provide a theoretical basis for a study on the pathogenesis of chronic LBP.
To evaluate the feasibility and short-term effectiveness of bilateral percutaneous balloon kyphoplasty through unilateral transverse process-extrapedicular approach for osteoporotic vertebral compression fracture (OVCF) of lumbar.A retrospective analysis was made on the clinical data of 93 patients with OVCF of lumbar who met the selection criteria between January 2018 and June 2019. According to the different surgical methods, they were divided into group A (44 cases, treated with bilateral percutaneous balloon kyphoplasty through unilateral transverse process-extrapedicular approach) and group B [49 cases, treated with percutaneous kyphoplasty (PKP) via bilateral transpedicle approach]. There was no significant difference in gender, age, body mass index, T value of bone mineral density, injury cause, fractured level, time from injury to operation, comorbidities, and preoperative Cobb angle of injured vertebra, visual analogue scale (VAS) score, and Oswestry disability index (ODI) between the two groups ( P>0.05). The operation time, intraoperative fluoroscopy times, bone cement injection amount, and incidence of bone cement leakage were recorded and compared between the two groups; Cobb angle of the injured vertebrae, VAS score, and ODI were measured before operation, at 2 days and 1 year after operation. The contralateral distribution ratio of bone cement was calculated according to the anteroposterior X-ray film at 2 days after operation.The operation time and the intraoperative fluoroscopy times in group A were significantly less than those in group B ( P<0.05). There was no bone cement adverse reactions, cardiac and cerebrovascular adverse events, and no complications such as puncture needles erroneously inserted into the spinal canal and nerve injuries occurred in the two groups. Bone cement leakage occurred in 6 cases and 8 cases in groups A and B, respectively, all of which were asymptomatic paravertebral or intervertebral leakage, and no intraspinal leakage occurred; the bone cement injection amount and incidence of bone cement leakage between the two groups showed no significant differences ( P>0.05). The contralateral distribution ratio of bone cement in group A was significantly lower than that in group B ( t=2.685, P=0.009). Patients in both groups were followed up 12-20 months, with an average of 15.3 months. The Cobb angle of the injured vertebrae, VAS score, and ODI in the two groups were significantly improved at 2 days after operation, however, the Cobb angle of the injured vertebra at 1 year after operation was significantly lost when compared with the 2 days after operation, the VAS score and ODI at 1 year after operation were significantly further improved when compared with the 2 days after operation, the differences were all significant ( P<0.05). There was no significant difference in the Cobb angle of the injured vertebrae, VAS score, and ODI between the two groups at each time point after operation ( P>0.05).Bilateral percutaneous balloon kyphoplasty through unilateral transverse process-extrapedicular approach is comparable to bilateral PKP in short-term effectiveness with regard to fracture reduction, reduction maintenance, pain relief, and functional improvement. It has great advantages in reducing operation time and radiation exposure, although it is inferior in bone cement distribution.探讨采用经横突-椎弓根外侧入路单侧穿刺双侧球囊扩张经皮椎体后凸成形术（percutaneous kyphoplasty，PKP）治疗腰椎骨质疏松性椎体压缩骨折（osteoporotic vertebral compression fracture，OVCF）的可行性及近期疗效。.回顾分析 2018 年 1 月—2019 年 6 月符合选择标准的 93 例腰椎 OVCF 患者临床资料，根据手术方式不同分为 A 组（44 例，行经横突-椎弓根外侧入路单侧穿刺双侧球囊扩张 PKP 治疗）和 B 组（49 例，行双侧经椎弓根入路 PKP 治疗）。两组患者性别、年龄、体质量指数、骨密度 T 值、致伤原因、损伤节段、受伤至手术时间、合并基础疾病及术前伤椎 Cobb 角、疼痛视觉模拟评分（VAS）、Oswestry 功能障碍指数（ODI）等一般资料比较差异均无统计学意义（ P>0.05）。记录并比较两组患者手术时间、术中透视次数、骨水泥注入量、骨水泥渗漏率；术前、术后 2 d 及术后 1 年伤椎 Cobb 角、VAS 评分和 ODI。根据术后 2 d 正位 X 线片计算骨水泥对侧分布率。.A 组手术时间、术中透视次数均显著少于 B 组（ P<0.05）。两组患者术中、术后均无骨水泥不良反应及心、脑血管不良事件发生，无穿刺针误入椎管及神经损伤等并发症。A、B 组分别有 6 例和 8 例发生骨水泥渗漏，均为无症状性椎旁或椎间隙渗漏，无椎管内渗漏发生；两组骨水泥注入量及骨水泥渗漏率比较差异均无统计学意义（ P>0.05）。A 组骨水泥对侧分布率显著低于 B 组（ t=2.685， P=0.009）。两组患者均获随访，随访时间 12～20 个月，平均 15.3 个月。两组术后 2 d 伤椎 Cobb 角、VAS 评分和 ODI 均较术前显著改善，但术后 1 年伤椎 Cobb 角较术后 2 d 有显著复位丢失，VAS 评分和 ODI 较术后 2 d 进一步改善，差异均有统计学意义（ P<0.05）；术后各时间点两组间伤椎 Cobb 角、VAS 评分和 ODI 比较差异均无统计学意义（ P>0.05）。.与双侧入路 PKP 比较，经横突-椎弓根外侧入路单侧穿刺双侧球囊扩张 PKP 在骨折复位、复位维持、疼痛缓解以及功能改善方面可取得相当的近期疗效；虽然在骨水泥分布均匀程度方面稍逊于双侧入路 PKP，但在减少手术时间及术中 X 线透视方面更有优势。.
Objective To investigate related factors affecting the development of depression in uremia patients.Methods Research subjects were 120 uremia patients hospitalized in our hospital from January 2007 to May 2011.At the same time,100 non-uremia patients were selected as control.Symptoms of depression were measured with the self-rating depression scale (SDS).Results When a comparison was made between the research group and the control group,it was found that uremia patients had a significantly higher incidence of depression than the non-uremia patients.Female uremia patients,having an age of over 60 years old and higher education level,receiving hemodialysis,with little understanding of prognosis and long course of disease,and without public medical care,were more susceptible to depression.Conclusions In the course of treatment,great attention should be paid not only to the treatment of uremia itself,but also to the mental status of the patients,and positive psychological intervention should be made for better treatment results.
Key words:
Uremia; Depression; Related analysis
Background Low back pain (LBP) is a major medical and social problem among working populations and is associated with high medical expense, loss of productivity, and disability. The aim of this study is to investigate the prevalence of LBP among soldiers and evaluate the possible causative factors in military training. The results may provide an insight into changes needed in military training that will reduce the occurrence of LBP among soldiers. Methods A cross-sectional survey was conducted in a group of young soldiers in China to estimate the prevalence of LBP and evaluate possible causative factors in military training. Results The survey was distributed to 1659 soldiers, of whom 1624 responded. LBP was reported by 425 of the 1624 (26.2%) soldiers. The prevalence of LBP was higher in the armored force (51.3%) than in the artillery (27.5%) or infantry (11.9%). A multivariate logical regression analysis identified night training, 5 km cross-country race, and grenade-throwing training as military training risk factors for LBP. Conclusions The relatively high incidence of LBP among soldiers was related to night training, 5 km racing, and grenade throwing. Modifications in these training methods should enhance the health of recruits and lower the incidence of LBP.
Background The uptake of proven stroke treatments varies widely. We aimed to determine the association of evidence‐based processes of care for acute ischemic stroke ( AIS ) and clinical outcome of patients who participated in the HEADPOST (Head Positioning in Acute Stroke Trial), a multicenter cluster crossover trial of lying flat versus sitting up, head positioning in acute stroke. Methods and Results Use of 8 AIS processes of care were considered: reperfusion therapy in eligible patients; acute stroke unit care; antihypertensive, antiplatelet, statin, and anticoagulation for atrial fibrillation; dysphagia assessment; and physiotherapist review. Hierarchical, mixed, logistic regression models were performed to determine associations with good outcome (modified Rankin Scale scores 0–2) at 90 days, adjusted for patient and hospital variables. Among 9485 patients with AIS, implementation of all processes of care in eligible patients, or “defect‐free” care, was associated with improved outcome (odds ratio, 1.40; 95% CI, 1.18–1.65) and better survival (odds ratio, 2.23; 95% CI , 1.62–3.09). Defect‐free stroke care was also significantly associated with excellent outcome (modified Rankin Scale score 0–1) (odds ratio, 1.22; 95% CI , 1.04–1.43). No hospital characteristic was independently predictive of outcome. Only 1445 (15%) of eligible patients with AIS received all processes of care, with significant regional variations in overall and individual rates. Conclusions Use of evidence‐based care is associated with improved clinical outcome in AIS . Strategies are required to address regional variation in the use of proven AIS treatments. Clinical Trial Registration URL : https://www.clinicaltrials.gov . Unique Identifier: NCT 02162017.
Objective
To study the postoperative survival rate of elderly patients with hip fracture at different time and its related factors.
Methods
We conducted the follow-up studies of 255 elderly hip fracture patients from June 2008 to June 2011 in our hospital. The survival rates of patients at 6 months, 1, 2 and 3 years after operation and their related factors were studied.
Results
The survival rate was 96.5%, 89.8%, 78.0% and 69.4% at 6 months, 1, 2 and 3 years after operation respectively in 255 elderly hip fracture patients. Survival analysis showed that many kinds of preoperative comorbidities, low albumin level, old age and severe anemia were the risk factors for survival. Good activity of daily living before injury was a protective factor for survival. Gender, fracture type, the American Society of Anesthesiologists (ASA) classification, time from injury to surgery, anesthesia type, surgical approach, operative time, blood loss and hospital stay periods had no effect on survival after operation.
Conclusions
The survival rate in elderly patients with hip fracture after surgery is affected by many factors. Preoperative comorbidities, anemia and hypoalbuminemia should be actively treated, the activity of daily living should be improved by the directed therapy and rehabilitation, in order to improve the survival rate in elderly patients with hip fracture.
Key words:
Hip Fracture; Survival analysis; Risk factors
Objective To investigate the efficacy of locking proximal femoral plate (LPFP) in treatment of unstable femoral intertrochanteric fractures. Methods A total of 32 patients with unstable femoral intertrochanteric fractures were operated via Watson-Jones approach. According to the Evans classification, there were 16 patients with type Ⅲ fractures, 10 with type Ⅳ fractures and 6 with type Ⅴ fractures. The data of bone healing time and hip function scores according to Harris hip function score system were recorded for evaluating treatment outcomes. Results All the patients were followed up for an average 12.5 months, which showed fracture union within mean 10.4 weeks. There were no hip varus deformation, internal fixation failure and avaacular necrosis of femoral head, with total excellence rate of 84% according to Harris hip function score system. Conclusions LPFP is characterized by correspondence with configuration of proximal femur, stable fixation, less disturb to blood supply of femoral head, and hence is an effective treatment method for unstable femoral intertrochanteric fractures.
Key words:
Femoral fractures; Fracture fixation; internal; Locking proximal femoral plate
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