Objective To analyze chemical drugs included in the National Essential Medicines List (EML) of China, to provide reference on how to improve the selection criteria and strengthen management and supply of essential medicines. Methods Dosage form, specification and manufacturers of 201 kinds of chemical drugs included in the EML were retrieved through SFDA website, data collection and analysis were conducted using Excel software. Results Domestic chemical drugs in EML involved 24 kinds of dosage forms, 644 kinds of specifications, 37 854 kinds of drugs for sales, and 2 908 manufacturers. Imported chemical drugs in EML involved 12 kinds of dosage forms, 43 kinds of specifications, 113 kinds of drugs for sales, and 53 manufacturers. Included drugs were primarily normal dosage forms while chemical drugs had many different specifications. Medicines duplication in production was serious and the distribution in market was unbalanced. The sole and exclusive dosage form variety lacked of effective evidence. Selection mechanism and reevaluation needed to be developed. Conclusion It is suggested to include drug specification in EML, and refer to spectrum of diseases for detailed selection mechanism of essential drugs, reevaluation of the listed drugs and formulate strict drug bidding rules so as to optimize EML.
Objective To explore the therapeutic effect of micro-autologous fat transplantation (MAFT) based on anatomical sub-unit principle of mid-face deep fat tissue in mid-face volumetric augmentation operation. Methods From August 2014 to February 2016, 46 patients suffering volumetric defect of mid-face were divided into the research group and the control group with 23 in each. The MAFT method was used in the two groups. Patients in the research group underwent fat transplatation based on anatomical sub-unit principle of mid-face deep fat tissue, of whom 16 accepted fat transplantaion in suborbicularis oculi fat area, 23 in deep media cheek fat area and 13 in buccal fat area. Patients in the control group accept conventional fat transplantation method; the fat granule were uniformly transplanted to the deep and superficial mid-face fat tissue. The curative effiency and patients' satisfaction were compared between the two groups. Results The curative effiency and patients' satisfaction of the research group (91.3%, 82.6%) were better than those of the control group (60.9%, 43.5%), and there were significant differences (P<0.05). All patients were followed up for 6 months to 2 years, with an average of 1 year. No complication occurred in both groups. Conclusion The MAFT operation based on anatomical sub-unit principle of mid-face deep fat tissue could precisely perform mid-face volumetric augmentation and rejuvenation.
ObjectiveTo investigate the short-term effectiveness of derotational distal femoral osteotomy (DDFO) combined with medial patellofemoral ligament (MPFL) reconstruction in treatment of recurrent patellar dislocation with excessive femoral anteversion angle (FAA≥30°). MethodsBetween June 2017 and August 2019, 17 patients with recurrent patellar dislocation with FAA≥30° were treated with DDFO and MPFL reconstruction. There were 5 males and 12 females, aged 14-22 years, with an average of 17.7 years. The patella dislocated for 2 to 8 times (mean, 3.6 times). The disease duration was 2-7 years (mean, 4.6 years). The patellar apprehension tests were positive. Preoperative pain visual analogue scale (VAS) score, Lysholm score, Tegner score, and Kujala score were 4.2±1.1, 47.8±8.1, 3.6±1.1, and 56.8±5.7, respectively. FAA, mechanical lateral distal femoral angle (mLDFA), lateral patella displacement (LPD), tibial tuberosity-trochlear groove distance (TT-TG) were (34.9±3.4)°, (85.8±3.0)°, (13.7±3.8) mm, and (23.1±2.1) mm, respectively. ResultsAll incisions healed by first intention, and there was no complications such as knee stiffness, infection, and re-dislocation of the patella. All patients were followed up 13-25 months, with an average of 17.7 months. The imaging review showed that 1 case of osteotomy did not union, and achieved satisfactory results after the secondary revision and strengthening fixation; the osteotomies of other patients healed completely after 3 to 4 months of operation. The patellar apprehension tests were negative. At last follow-up, the FAA, mLDFA, LPD, and TT-TG were (15.6±2.7)°, (83.0±2.1)°, (5.0±2.6) mm, and (20.5±2.5) mm, respectively; the VAS score, Lysholm score, Tegner score, and Kujala score were 2.4±1.4, 93.4±7.8, 6.8±1.5, and 89.0±8.0, respectively. There were significant differences in the above indicators between pre- and post-operation (P<0.05). ConclusionDDFO combined with MPFL reconstruction for the recurrent patellar dislocation with excessive FAA (≥30°) can achieve good short-term effectiveness, significantly reduce knee pain, and improve function.
Objective To develop a kind of biological artificial knee joint prosthesis with stereo mesh surface for rabbit, to observe its function after being implanted into rabbit knee joint and to evaluate its biomechanical property.Methods Thirty adult New Zealand rabbits were randomized into experimental and control groups (n=15), total left knee arthroplasty was performed in both groups, no patella replacement was performed. Biological artificial knee joint prosthesis with stereo mesh surface was self-designed. The adjacent 4/5 surface of femur and tibia stem of the prosthesis was covered by stainlesssteel stereo mesh, the inner surface of femur condyles and tibia plateau was welded with two layers of stainless steel stereo mesh, then the prosthesis underwent biological fixation in the experimental group. Meanwhile, prosthesis having smooth marrow internal stem, femoral condyle and tibial plateau internal surface and sharing the same shape and size with the experimental group were prepared and fixed with bone cement in the control group. The postoperative general condition of animal was observed. At 1, 3 and 6 months after operation, the rabbits were killed for gross observation, X-ray examination was conducted to observe the fixation condition of prosthesis and heal ing condition, the range of motion (ROM) of knee joints was tested, biomechanics test was carried out and the maximum shear strength of prosthesis bone interface was calculated. Results In each group, there was 1 rabbit died and new one was added during the second experiment. The others survived till the end of the experiment and crawled normally 7 days after operation. For the excellent and good rate concerning the recovery of ROM of the knee joint at 1, 3 and 6 months after operation, the experimental group was 60%, 80% and 80%, respectively, and the control group was 60%, 80% and 60%, respectively, indicating there were no significant differences between two groups (P gt; 0.05). For the experimental group, the gross observation showed large quantities of bone reconstruction, X-ray films indicated the prosthesis fitted well, with sol id fixation and without dislocation and lossening；while for the control group, the gross observation showed no bone reconstruction, X-ray films displayed the location of prosthesis was good, with sol id fixation and without dislocation and loosening. Radiolucent zone around the femur prosthesis and stress shileding occured 6 months after operation. For the maximum shear strength, the experimental group was less than the control group at 1 month after operation; and it was higher than the control group at 3 and 6 months after operation, indicating there were significant differences betweentwo groups (P lt; 0.01). Conclusion The fixation strength of the biological artificial knee joint prosthesis with stereo meshsurface is better than that of the bone cement prosthesis in rabbits at 3 and 6 months after operation.
Objective To summarize the best evidence of preoperative prehabilitation for patients undergoing total joint replacement/total knee replacement (THA/TKA), and to provide reference for clinical work in the context of enhanced recovery after surgery (ERAS), in order to speed up the postoperative rehabilitation process of patients undergoing THA/TKA. Methods Up To Date, BMJ Practice, National Institute for Health and Care Excellence, Cochrane Library, JBI Evidence-Based Health Care Center Database, Guidelines International Network, www.guide.medlive.cn, PubMed, China National Knowledge Infrastructure, VIPdata, and WanFang Data were searched by computer for literature about preoperative prehabilitation of THA/TKA patients. The retrieval time was from the establishment of the databases to May 31, 2022. The quality of the included literature was evaluated by 2 researchers with evidence-based training. Results A total of 11 publications were included, including 1 guideline, 3 expert consensuses, 3 systematic reviews, and 4 randomized controlled trials, covering 6 aspects of multidisciplinary team, patient education, drug management, nutritional guidance, index control, and exercise intervention. A total of 16 best evidences of preoperative prehabilitation in patients with THA/TKA were extracted, including 9 A-level recommendations and 7 B-level recommendations. Conclusions THA/TKA prehabilitation includes various comprehensive interventions. With the development of ERAS in orthopaedics, the best evidence extracted can be used by clinical staff for THA/TKA. Evidence-based evidence is provided for patients to formulate prehabilitation programs.
Objective To explore a new surgical treatment of patients with severe congenital heart disease associated with tracheal or bronchial stenosis. Methods We retrospectively analyzed clinical data of 32 patients with severe pulmonary blood increased congenital heart disease complicated with tracheal or bronchial stenosis in our hospital between June 2010 and June 2014. There were 18 males and 13 females with an average age of 14.6±4.0 months and a weight of 8.8±3.0 kg. Results Average hospital stay was 12 days. Duration of intraoperative cardiopulmonary bypass was 65.0±21.0 min. Duration of aortic interruption was 42.0±16.0 min. Duration of postoperative ventilator was 25.0±18.0 h. ICU retention time was 4.0±1.8 d. All patients were survived. On the 9th day after surgery, the X-ray chest film revealed that the cardio-thoracic ratio was reduced compared with pre-operation but no statistical significance (P>0.05). Left ventricular end-diastolic dimension (LVEDD) was decreased (P<0.05). Pulmonary artery pressure was lower (P<0.01). The velocity of bloodstream in pulmonary artery was approximately normal. The computed tomography angiography (CTA) on the 9th day after surgery revealed that diameter of pulmonary artery in all patients reduced compared with that of pre-operation (P<0.01). Tracheal diameter of 28 patients returned to normal level and 3 patients had residual mild tracheal stenosis. All preoperative atelectasis recovered to normal level. All patients recovered completely. When the patients were followed up for 6 months to 4 years, the patients grew healthily and no abnormity occurred. Conclusion For the patients with tracheal or bronchial stenosis related to severe congenital heart disease,it is necessary to adopt surgical procedure to relieve the pressure of trachea or bronchus.The bronchial decompression surgery is a perfect and effective method for the patients with tracheal or bronchial stenosis related to severe congenital heart disease.