Objective: To determine the overlapping area of the femoral condyle facet on which the patellofemoral and tibiofemoral joint surfaces move and to measure the pressures on such area in order to better design the length of femoral trochlea prosthesis in patellofemoral arthroplasty. Methods: Eight fresh cadaver knees were mounted on Instron 8501 biomechanics tester,and simulated physiologically weight-bearing situation of knee from standing to flexion position. Such overlapping area was drawed up with stain method and the contact pressures were measured with Fuji pressure film. Results: There existed an overlapping contact area on the femoral condyle facet within the patellofemoral contact area when knee flexion was 75? or larger. The tibiofemoral contact pressure was higher than the patellofemoral pressure in the area. Conclusion: The femoral trocher prosthesis should cover the whole contact area of patellofemoral joint.

Objective To analyze anemia in patients with chronic heart failure changes in relevant indicators.Methods 48 chronic heart failure patients(observation group)and 48 healthy people(control group).were erolled the peripheral blood red blood cell count(RBC),hemoglobin(Hb),hematocrit(Hct)and other anemia-related indicators were measured.Results The results of the observation group RBC,Hb,Hct,were(3.37 ±0.49)× 1012/L,(103.64±14.33)g/L,(0.31 ±0.08)respectively,the control group were(4.64 ±0.51)× 1012/L,(121.33 ±17.69)g/L,(0.37 ± 0.07),between the two groups were statistically significant(t =4.46、3.06、4.18,P =0.02,0.04,0.04);treatment,symptoms of heart failure in observation group mitigation,RBC is(3.76 ± 0.58)× 1012/L,compared with the control group the difference was significant(t =0.48,P =0.03); observation group Hb,Hct were (123.77 ± 17.26)g/L,(0.37 ± 0.05),and were not significantly different with the amtrol gronp(P =0.06,0.11).Conclusion Elderly patients with anemia associated with heart failure were lower than healthy people,heart failure and anemia had,a significant correlation with aremia.

Objective To compared the posterior slop between tibial plateau and meniscus in Chinese population for determining the angle of tibial osteotomy during total knee replacement(TKA).Methods Posterior slop of tibial plateau and meniscus in sixty Chinese volunteers were measured on sagital view of MRI image.Results The values of posterior slop of tibial plateau and meniscus were 9.87??1.56?and 0.96??0.09?,respectively.The two angle revealed remarkable difference (P

Objective To study the expression of cyclooxygenase-2,epithelial cadherin and vascular endothelial growth factor-c in colorectal cancer and its significance. Methods Seventy-seven patients with colorectal cancer were detected the expression of COX-2, E-ca nd VEGF-c by immunohistochemical SP method. Results COX-2 positive expression in colorectal cancer tissue was 24.7%; E-ca positive expression rate of 68.8%; VEGF-c expression rate of 84.4%. COX-2 in highly differentiated cancer tissues was significantly higher than in poorly differentiated ones (P ＜0. 05); E-ca in the tubular adenocarcinoma was higher than in the mucous glands cancer and other types of cancer ( P ＜ 0. 05 ); The Positive expression rate of E-ca in the stage Ⅰ + Ⅱ was significantly higher than stage Ⅲ + Ⅳ (P ＜0. 005). COX-2 protein expression and VEGF-c expression was negatively correlated (P ＜ 0. 05 ). Conclusion Combined detection of COX-2,VEGF-c and E-ca is helpful to recognize the occurrence, development and tratment of colorectal cancer.

Objective To evaluate total gastrectomy and regular lymph node dissection for the treatment of advanced cardiac cancer. Methods Three hundred and eighty-seven patients with advanced cardiac cancer underwent total gastrectomy D2+ procedure. The relationships between depth of invasion, lymph node metastasis,the number of metastastic lymph nodes dissected and postoperative survival rate were analyzed. Results The 3-year and 5-year survival rates were 47.3% and 34.2% , respectively. Metastatic rate of N3 lymph node was 4. 8% and 15. 2% in advanced cardiac patients of PT3 and PT4, respectively. Survival rates significantly decreased along with the increase of lymph node metastasis. The 3-year and 5-year survival of patients who had less than 15 lymph nodes dissected was significantly poorer than those who had more than 15 lymph nodes dissected, respectively. The postoperative complication rate and mortality rate of the two groups were 14. 2% and 2. 52% , respectively. Conclution To improve the quality of life and survival rate, D2 + radical total gastrectomy should be performed for advanced cardiac cancer, and when indicated resection of spleen and/or body and tail of the pancreas should be performed.

Objective To study changes of serum IL-17 and IL-35 levels in patients with heart failure. Methods 60 patients with heart failure (observation group)were selected as research subjects.60 patients accord-ing to different severity were divided into acute period heart failure (34 cases)and stable stage heart failure (26 ca-ses);60 patients graded according to the NYHA standards were divided into 24 cases of heart failure with grade Ⅱ, 20 cases of grade Ⅲ ,16 cases of grade Ⅳ.According to the different primary diseases :expansion cardiomyopathy group (20 cases in group A),the coronary heart disease group (group B,24 cases),hypertensive heart disease group (group C,16 cases).During the same period,42 healthy elderly people in our hospital were selected as control group. The serum IL-17,IL-35 levels were tested,and the serum IL-17,IL-35 levels in patients with heart failure were ana-lyzed.Results Serum level of IL-17 in the observation group was higher than the control group,and the difference was significant [(15.61 ±4.02)pg/mL vs (9.49 ±3.96)pg/mL,t =9.018,P <0.01].Serum level of IL-35 in the observation group was significantly lower than that of the control group,and the difference was significant[(52.78 ± 4.29)pg/mL vs (61.49 ±4.81)pg/mL,t =11.963,P <0.01].The level of serum IL-17 in acute stage of patients with heart failure was higher than that of stable heart failure,and the difference was significant (t =6.278,P <0.01);IL-35 level in serum of patients with heart failure in acute phase was lower than that of stable heart failure,the difference was significant (t =9.529,P <0.01).With the increase in heart failure grade,serum IL-17 level showed a rising trend,and the differences among three groups had statistical differences (F =6.098,P <0.01);serum IL-35 level decreased,and the differences among three groups had statistical differences(F =8.978,P <0.01).The serum IL-17 level of A group was higher than that in B group and C group,there were significant differences (F =6.096, P <0.01),the serum IL-17 level between B group and C group had no statistical difference (t =0.172,P >0.05). The serum IL-35 level of A group was lower than that of B group and C group,there were significant differences (F =8.978,P <0.01),the serum IL-35 level between B group and C group had no statistical difference (t =0.208,P >0.05).Serum IL-17 and serum IL-35 level was negatively correlated (r =-0.429,P =0.009).Conclusion High expression of IL-17 in elderly patients with heart failure,while IL-35 decreased in elderly patients with heart failure, IL-17,IL-35 are closely related to the senile congestive heart failure and the severity of illness.Serum IL-17 is nega-tively correlated with the level of serum IL-35.

Objective To explore the prognostic value for cardiovascular events of elevated NT-proBNP in coronary heart disease(CHD) patients with metabolic syndrome(MS).Methods The level of NT-proBNP was measured in 165 CHD patients with MS diagnosed by coronary angiography.After 2 years follow-up,we recorded the corresponding cardiovascular events in those patients.Results The NT-proBNP level was much higher in ACS group than that in SCHD group( P ＜ 0.01 ).There were totally 45 events after 2 years.After adjustment of traditional risk factors including hypertension,diabetes,smoking history and high sensitivity C reactive protein( hs-CRP),Cox proportional hazard analysis indicated that high NT-proBNP level( ＞ 111.58ng/L)was an independent risk factor for future events (relative risk 2.67,P ＜0.01 ).Conclusion Elevated NT-proBNP level might be one of the independent risk factor for cardiovascular events in CHD patiens with MS.

Objective To explore the predictive value of microvessel density(MVD)and blood vessel invasion(BVI)in hepatic metastasis from early-stage rectal cancer.Methods MVD and BVI in the tumor tissue from 380 patients with stage I and II rectal cancer was determined by immunohistochemical S-P method with anti-CDIOS antibody and anti-CD34 antibody,respectively.Multinomial logistic regression was performed to analyze the predictive value of MVD and BVI in hepatic metastasis from early-stage rectal cancer.Results CD105 was expressed in newborn blood vessels,not in normal blood veseels.in the rectal cancer tissue.MVD was correlated with histological type and infiltration depth(P＜0.05).Besides histological type and infiltration depth,BVI was also correlated with histological grade.Multivariate analysis revealed that histological type,tumor infiltration depth,BVI,adjuvant therapy,and MDV were independent predictors of hepatic metastasis from rectal cancer.The risk of hepatic metastasis in patients with postive expression of either MVD or BVI or both were significant higher than that in patients with low expression of MVD and those without BVI expression[hazard ratio(95%CI),4.210(2.182-11.214)].Conclusion BVI and MVD are independent predictors of hepatic metastasis from stage I and II rectal cancer.Combined detection of MVD and BVI may help to predict the clinical outcome of patients with early-stage rectal cancer.

Objective To investigate the effects of reducing the auditory organ dose by limitation of sub regional auditory organ in IMRT plan. Methods Total 223 cases of nasopharyngeal carcinoma patients were divided into group A and group B. In group A, the IMRT plans of 114 patients were designed by limiting overall auditory organ dose. In group B, the IMRT plans of 109 patients were designed by limiting sub regional auditory organ dose. According to the Clinical prescription, the IMRT plans were designed. Paried t?test was difference between groups. Results By comparing the two groups of auditory organ dose, in all stages, the tympanic cavity Dmean average in group B decreased by T1 vs. 17?? 7%,T2 vs. 22?? 4%,T3 vs. 15?? 7% and T4 vs. 14?? 2% ( P= 0?? 000,0?? 000,0?? 000,0?? 000);cochlea Dmean average decreased by T1 vs. 11?? 0%, T2 vs. 20?? 1%, T3 vs. 10?? 0% and T4 vs. 9?? 0%(P= 0?? 004,0?? 000,0?? 007,0?? 036);vestibule Dmean average decreased by T1 vs. 22?? 6%, T2 vs. 31?? 8%, T3 vs. 20?? 6% and T4 vs. 21?? 4%, significantly less than in group A (P= 0?? 000,0?? 000,0?? 000,0?? 000). The bony portion of eustachian tube Dmean average in group B decreased were not significantly less than in group A (decreased by 3?? 4%,6?? 8%,3?? 6%,0?? 1%;P= 0?? 291, 0?? 006,0?? 155,0?? 963). Conclusions In IMRT plan, optimization on dose limitation of sub regional auditory organs were used to reduce the auditory organ dose and decrease the radiation damage to auditory organ.

BACKGROUND: Most of the patients suffered from degenerative lumbar instability are treated by exposure both sides and bilateral pedicle screw fixation,which bring highly operative risk,large blood loss and great medical expenditure to patients.OBJECTIVE: To explore the clinical efficacy of single cage plus unilateral pedicle screw placement for treating lumbar degenerative instability.METHODS: Totally 51 cases with lumbar degenerative instability underwent single cage plus unilateral pedicle screw placement were selected,including 32 males and 19 females,aged ranging from 41 to 72 years.47 cases had single segment involved and 4cases had two segments involved.All cases experienced unilateral laminectomy and transforamenal lumbar interbody fusion.The therapeutic effect was assessed by Japanese Orthopaedic Association(JOA)score system.RESULTS AND CONCLUSION: The blood loss was 90-430 mL.The surgical time was 100 minutes(85-120 minutes)for single segment and 150 minutes(120-170 minutes)for double segments.The patients were allowed to early ambulation at 2-3 days after operation.Two cases did not get improvement on back-leg pain,but there was no abnormality from CT and MRI recheck,one case felt pain relieved after anti-symptom treatment for 3 months while the other did not relieve.The average JOA scores at pre-operation and 1 year follow-up was 11(7-13 scores)and 25(18-27 scores),respectively.The total improvement rate of JOA was larger than 50%.44 cases were evaluated as fusion and 7 cases as possible fusion.The average fusion time was 5.4 months(4.3-7.1 months).Postoperative X-ray showed no evidence of pedicle screw loosening,broken,or cage displacement.Single cage plus unilateral pedicle screw placement is characterized by simple operation,small blood loss,short operation and few interference to spine,which is a better method for treating lumbar degenerative instability.