目的 对比分析双极半髋关节置换术(BHA)与全髋关节置换术(THR)治疗股骨颈骨折(FNF)的效果。方法 回顾性收集北京中医药大学东直门医院洛阳医院2019年6月—2023年4月90例FNF患者临床资料,依照手术治疗方案差异分为两组,BHA组(45例)行BHA治疗,THR组(45例)行THR治疗,比较两组围术期指标、术前及术后3 d炎症因子水平、术后6个月髋关节活动度、术前及术后6个月生活质量[欧洲生活质量评分(EQ-5D评分)]。结果 THR组手术时间(108.76±15.33)min、下床活动时间(40.37±10.24)h、住院时间(19.02±5.11)d均较BHA组[(53.49±10.12)min、(25.92±7.15)h、(15.16±4.87)d]长(t分别为20.184、7.761、3.668,均P<0.05),术中失血量(318.69±35.14)mL、术后引流量(129.74±21.03)mL均较BHA组[(224.07±29.35)mL、(90.35±17.48)mL]多(t分别为13.863、9.663,均P<0.001);组间并发症发生率比较差异无统计学意义(P>0.05);术后3 d,BHA组血清白细胞介素-1为(17.35±3.06)pg/L、白细胞介素-6为(24.82±4.31)pg/L、C-反应蛋白为(26.17±4.59)pg/L,低于THR组的(20.16±3.48)pg/L、(27.04±5.06)pg/L、(28.90±5.12)pg/L(t分别为4.068、2.241、2.663,均P<0.05);两组术后6个月髋关节内旋、屈曲、外旋、外展、内收活动度及EQ-5D评分对比差异均无统计学意义(均P>0.05)。结论 与THR相比,BHA能减少FNF患者围术期失血量,降低术后炎症因子表达水平,缩短手术及下床活动时间,促进恢复。
Objective To compare and analyze the effects of bipolar hemihip replacement(BHA)and total hip replacement(THR)in the treatment of femoral neck fracture(FNF).Methods The clinical data of 90 patients with FNF in the Luoyang Hospital,Dongzhimen Hospital,Beijing University of Chinese Medicine,from June 2019 to April 2023 were retrospectively collected.The patients were divided into two groups according to the difference in surgical treatment plan.The BHA group(45 cases)received BHA treatment,and the THR group(45 cases)received THR treatment.The perioperative indicators,preoperative and postoperative inflammatory factor levels,postoperative hip joint mobility at six months,preoperative and postoperative quality of life [European Quality of Life Scale(EQ-5D score)]were compared between the two groups.Results The operation time(108.76±15.33)min,ambulation time(40.37±10.24)h,and hospitalization time(19.02±5.11)d in the THR group were longer than those in the BHA group [(53.49±10.12)min,(25.92±7.15)h,(15.16±4.87)d](t=20.184,8.630,3.668,respectively,all P<0.05).The intraoperative blood loss(318.69±35.14)mL and postoperative drainage volume(129.74±21.03)mL were both higher than those in the BHA group [(224.07±29.35)mL,(90.35±17.48)mL](t=13.863,9.663,respectively,all P<0.001).There was no significant difference in the incidence of complications between the groups(P>0.05).Three days after surgery,the serum levels of interleukin-1,interleukin-6,and C-reactive protein in the BHA group were(17.35±3.06)pg/L,(24.82±4.31)pg/L,and(26.17±4.59)pg/L,respectively,which were lower than those in the THR group(20.16±3.48)pg/L,(27.04±5.06)pg/L,and(28.90±5.12)pg/L(t=4.068,2.241,2.663,respectively,all P<0.05).There was no significant difference in the range of motion of internal rotation,flexion,external rotation,abduction,and adduction of the hip joint and EQ-5D scores between the two groups at six months after surgery(all P>0.05).Conclusions Compared with THR,BHA can reduce perioperative blood loss in FNF patients,reduce postoperative inflammatory factor expression level,shorten operation and ambulation time,and promote recovery.
人工智能(AI)这一新兴技术的出现和应用给炎症性肠病(IBD)的诊断带来了巨大的变革。越来越多的研究着手于开发基于机器学习(ML)和深度学习(DL)的诊断模型,并获得了良好的诊断性能,尤其是在IBD的图像诊断,卷积神经网络(CNN)等模型由于其出色的图像分析能力,在内镜检查和组织病理检查等方面具有十分可观的发展前景。近年来AI诊断模型的应用越发广泛,但与此同时,关于算法、数据库及其应用方面仍存在一些难以忽视的局限性。本文将主要就图像识别方面对AI在IBD诊断中的应用进行综述,以期为IBD精准图像诊断领域下步研究提供参考。
As an emerging technology,artificial intelligence(AI)has brought great changes to the precise diagnosis of inflammatory bowel disease(IBD).More and more researches have developed diagnostic models which are based on machine learning(ML)and deep learning(DL)and obtained satisfactory diagnostic performance.Especially in the image diagnosis of IBD,convolutional neural network(CNN)and other models have considerable development prospects in endoscopy and histopathology due to their excellent image analysis capabilities.In recent years,the application of AI diagnostic models has become more and more widespread,but at the same time,there are still some limitations about algorithms,databases and their applications that cannot be ignored.This review mainly focused on the application of AI in IBD diagnosis from the aspect of image recognition,to provide a reference for IBD diagnosis towards precision medicine.
炎症性肠病(IBD)是一种以反复腹痛、腹泻、血便和体重降低为主要表现的慢性特发性性疾病,主要分为溃疡性结肠炎与克罗恩病两种类型。近年来,IBD的患病率随着城市化和工业化进展迅速升高,给中国和全球的公共健康带来沉重的负担。随着人类基因组技术的发展,越来越多的证据表明,遗传学因素在IBD发病过程中起着不可或缺的作用。在亚欧人群中,通过大规模全基因组关联研究现已明确了320个IBD易感基因位点。IBD易感基因在影响机体的细胞代谢、免疫功能调节、肠道上皮屏障和微生物清除等多个方面发挥着重要作用。本文就IBD相关易感基因及其多态性的研究进展进行综述,从基因层面揭示IBD发病的分子机制,并对探索IBD因人而异的个性化治疗方案提供帮助。
Inflammatory bowel disease(IBD)is a chronic idiopathic disease characterized by recurrent abdominal pain,diarrhea,bloody stools,and weight loss.Ulcerative colitis and Crohn’s disease represent the two main types of IBD.In recent years,the prevalence of IBD has increased rapidly with the advancement of industrialization,imposing a heavy burden on public health in China and globally.Currently,with the development of genomics,a growing body of evidence suggests that genetic factors play an indispensable role in the pathogenesis of IBD.In the Eurasian population,320 IBD susceptibility gene loci have been identified through large-scale genome-wide association studies.IBD susceptibility genes play a crucial role in various aspects affecting cellular metabolism,immune function regulation,intestinal epithelial barrier,and microbial clearance.This article reviews the susceptibility genes and their polymorphisms associated with IBD,revealing the molecule mechanisms of IBD from gene perspectives and contributing to the development of personalized treatment strategies tailored to individual IBD patients.