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BACKGROUND: Myocardial infarction is one of the catastrophic complications after total joint arthroplasty. However, the risk factors and predictive model have not been reported in previous research after total joint arthroplasty. OBJECTIVE: To study the incidence and risk factors of myocardial infarction after total joint arthroplasty, and develop a nomogram for predicting the myocardial infarction after total joint arthroplasty. METHODS: We retrospectively reviewed the data of 5 746 patients who underwent total hip arthroplasty or total knee arthroplasty in the Affiliated Hospital of Qingdao university and the People’s Hospital of Xixiu District between September 2013 and July 2017. The baseline characteristic, preoperative comorbidities, preoperative examinations, operative data, other hospital information and follow-up data were collected, recorded and were used to analyze the risk factors of myocardial infarction. In addition, a nomogram was developed based on the independent risk factors for predicting the myocardial infarction after total joint arthroplasty, and receiver operating characteristic curve and calibration curve were used to evaluate the nomogram. RESULTS AND CONCLUSION: Forty-eight patients affected myocardial infarction within 14 days after total joint arthroplasty, and the incidence of myocardial infarction was 0.8%. Multivariate Logistic analysis indicated that age-adjusted Charlson Comorbidity Index, anesthesia type and atrial fibrillation were independent risk factors for postoperative myocardial infarction (P < 0.05). The risk of myocardial infarction in patients with age-adjusted Charlson Comorbidity Index ≥ 5 was higher than patients with age-adjusted Charlson Comorbidity Index < 5. The risk of myocardial infarction in patients receiving general anesthesia was higher than that of patients receiving epidural/lumber anesthesia. The risk of myocardial infarction in patients combined with atrial fibrillation was higher than that in patients without it. Receiver operating characteristic curve showed that the nomogram has a high degree of discrimination (AUC=0.730, 95%CI: 0.661-0.799), and the calibration curve showed that the model had a high degree of calibration. A predictive model based on age-adjusted Charlson Comorbidity Index, anesthesia type and atrial fibrillation can accurately predict the myocardial infarction following total joint arthroplasty. [ABSTRACT FROM AUTHOR]

Copyright of Chinese Journal of Tissue Engineering Research / Zhongguo Zuzhi Gongcheng Yanjiu is the property of Chinese Journal of Tissue Engineering Research and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

BACKGROUND: H2S is an important inflammatory regulator, which widely exists in various tissues and organs of human body and plays an important role in many systemic diseases. OBJECTIVE: To investigate the effect of H2S on articular cartilage degeneration in rabbit knee osteoarthritis model and to explore the therapeutic effect of H2S on osteoarthritis. METHODS: Thirty-two New Zealand white rabbits were randomly divided into four groups: blank control, osteoarthritis, H2S, and H2S inhibition groups (n=8/group). Blank control group was not treated, the other three groups were used to establish the osteoarthritis model by modified Hulth method, and were then injected with normal saline, NaHS diluent (60 μmol/L) and H2S synthase inhibitor (aminooxyacetic acid, 37.5 mg/kg; propargylglycine, 60 mg/kg) 1 mL each into the knee joint cavity once a week for 6 weeks. The study was approved by the Laboratory Animal Ethical Committee of Qingdao University, approval No. AHQU-MAL2018032. RESULTS AND CONCLUSION: (1) Pathological changes: the morphology of articular cartilage in the blank control group was normal; the degeneration of articular cartilage in the osteoarthritis group was serious; the degeneration of articular cartilage in the H2S group was mild; and the degeneration of articular cartilage in the H2S inhibition group was more serious than that in the osteoarthritis group. (2) Mankin’s score showed that the scores in the osteoarthritis, H2S and H2S inhibition groups were significantly higher than those in the blank control group (P < 0.05); the scores in the H2S group were lower than those in the osteoarthritis group, and the scores in the H2S inhibition group were significantly higher than those in the osteoarthritis group (P < 0.05). (3) Type II collagen staining showed that compared with the blank control group, the positive staining of type II collagen in the osteoarthritis group was significantly lower and unevenly distributed; the positive staining of type II collagen in H2S group was higher than that in osteoarthritis group; the positive staining of type II collagen in H2S inhibition group was significantly lower and the superficial layer was defective. (4) Compared with the osteoarthritis group, the mRNA expression levels of matrix metalloproteinase-1, matrix metalloproteinase-3 and matrix metalloproteinase-13 in articular cartilage were decreased in the H2S group, and increased in the H2S inhibition group compared with the osteoarthritis group. (5) These results show that H2S can inhibit the mRNA expression of matrix metalloproteinase-1, matrix metalloproteinase-3 and matrix metalloproteinase-13 in articular cartilage, reduce the degradation of type II collagen in articular cartilage, and protect articular cartilage in osteoarthritis. [ABSTRACT FROM AUTHOR]

Copyright of Progress in Modern Biomedicine is the property of Publishing House of Progress in Modern Biomedicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Shandong Medical Journal is the property of Shandong Medical Health Newspapers and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)