BACKGROUND:It has become increasingly concerned by the industry to detailed understand the morphology of people’s knee joint, thus achieving personalized and gender differentiated total knee arthroplasty, in order to design the knee joint prosthesis that match the characteristics of Chinese people. OBJECTIVE:To measure and characterize the morphological parameters of distal femur of normal adult Chinese people by CT tomography and three-dimensional reconstruction, and to discuss the differences between male and female in morphology of distal femur. METHODS:Seventy normal Chinese adults (35 males and 35 females, aging from 21 to 60 years) received bilateral knee joint CT scan. The scanning images of distal femur which we needed were col ected and handled with three-dimensional reconstruction or Picasa 3.0 software for col ages and overlapping exposure. The posterior condylar angle, anterior condylar angle and trochlear angle were measured on the images that treated by the software, as wel as the transverse diameter of distal femur, lateral condylar height, and the ratio between them. RESULTS AND CONCLUSION:The mean posterior condylar angle of Chinese women was larger than that of Chinese men (P<0.05);the mean anterior condylar angle of Chinese men was larger than that of Chinese women (P<0.05);The transverse diameter of distal femur, lateral condylar height and the femoral surface ratio (diameter/epicondyle height) of Chinese men were larger than those of Chinese women (P<0.05). The results showed that differences exist in morphology of distal femur between Chinese and western people. Also, the differences exist between male and female in Chinese people. These differences should be concerned in the design of femoral prosthesis for Chinese people as wel as in selecting and placing of femoral prosthesis before or during the total knee arthroplasty.

Objective To investigate the clinical application of rhythmic abdominal lifting and compression cardiopulmonary resuscitation (ALC-CPR) in cardiac arrest (CA) patients with conventional cardiopulmonary resuscitation (CPR) contraindication (chest rib fracture, chest trauma, etc.).Methods The clinical data of patients with CA in emergency department of Hefei Second People's Hospital from June 2015 to December 2016 were analyzed retrospectively, and the patients with weights 40-150 kg and CA≤20 minutes, and resuscitated with ALC-CPR were selected. The vital signs and blood gas analysis indexes of patients before resuscitation and 30 minutes after return of spontaneous circulation (ROSC, after successful resuscitation) were recorded.Results A total of 19 patients with CA were treated with CPR-LW1000 type ALC-CPR apparatus for resuscitation, and with 12 males, 7 females; the age ranged from 43 to 87 years, and the average age was (70.32±13.49) years; there were 4 cases of heart disease, and 15 cases of non-heart disease. Compared with before resuscitation, the heart rate [HR (bpm): 115.05±21.70 vs. 0], mean arterial pressure [MAP (mmHg, 1 mmHg = 0.133 kPa): 66.05±11.69 vs. 0], pulse oxygen saturation (SpO2: 0.928±0.057 vs. 0.417±0.118), pH value (7.05±0.23 vs. 6.80±0.28), arterial oxygen partial pressure [PaO2 (mmHg): 65.42±19.11 vs. 42.42±10.78], HCO3- (mmol/L: 19.22±2.77 vs. 17.18±3.76) were significantly improved after successful resuscitation (allP < 0.05), and arterial blood carbon dioxide partial pressure (PaCO2) was decreased after successful resuscitation (mmHg: 53.72±13.23 vs. 57.66±14.86,P > 0.05).Conclusion Rhythmic ALC-CPR has obvious clinical value for CA patients with conventional CPR contraindication.

[Objective]To evaluate the incidence and predictors of stiff knees after primary TKA.[Method]A retrospective review was given to the data from 1216 patients undergoing primary total knee arthroplasty between October 1996 and October 2006.Forty-five stiff TKA patients with a 1-year postoperative flexion range of less than 90?was taken as treatment group.Forty-five TKA patients with greater than 90? flexion at 1 year postoperative as control group.The age,sex,body mass index,American Society of Anesthesiologists(ASA) rating,surgeon,implant type,and fixation of the control group were matched to those of the treatment group.A case-control study was conducted to determine predictive factors of stiff TKA.[Result]No significant differences were found with regard to the mean age,ratio of sex and preoperative medical comorbidities.Preoperative flexion and intraoperative flexion were predictive of ultimate postoperative flexion(P=0.001 and P=0.039,respectively).Preoperative and postoperative relatively decreased patellar heightwere significantly correlated with postoperative stiffness(P=0.001).[Conclusion]Stiffness post-TKA is multifactorial,careful attention to surgical exposure,restoring gap kinematics,minimizing surgical trauma to the patellar ligament/extensor mechanism,appropriate implant selection,and physiotherapy may all serve to reduce the incidence of post-TKA stiffness.

Objective To study the effect of nonylphenol (NP) on the fertility of mice,and assess its reproductive and developmental toxicity.Methods 128 mature KM mice weighed 22-26 g were randomly divided into three experimental groups (24,60 and 120 mg nonylphenol/kg bw respectively) and the control group (earthnut oil ),16 in each.Fertility tests were performed according to the procedure commended by EPA.Results Sperm number,sperm vitality,fertility index and pregnancy rate decreased,while rate of deformed sperm increased in dose-dependent manner at dose of 60 and 120 mg/kg bw (P

Objective To introduce and evaluate arthroscopic release technique for treatment of knee stiffness due to arthrofibrosis after total knee arthroplasty (TKA). Methods Five patients with mean age of 56 years (41－ 70 years) underwent knee arthroscopy for a history of arthrofibrosis following TKA. There was no painful stiff total knee or infected total knee in this series. All of 5 cases had good range of motion in the operation room after total knee replaced. The arthroscopy was performed at 6 months (3－ 12 months) after the TKA, and at this time the flexion was limited to 70 degrees (60－ 85 degrees).In 2 cases,the extension was limited to 10 degrees and 30 degrees. With 3 standard portals, we examined the knee joint and found the adhesions and fibrous band formed in the suprapatellar pouch and two gutters. By resection of those fibro- band and passive flexion of the knee, the satisfactory range of motion(ROM)could be achieved. For the 2 cases of extension limited, CR prothesis was replaced. We released the posterior cruciate ligaments through the anterior portals. Continuous passive motion was started immediately postoperatively at the first day. The patients were evaluated at an average time of 20 months (8－ 46 months) after the arthroscopy. Results The mean knee ROM was 116 degrees (100－ 130 degrees) at the end of arthroscopy and was 105 degrees (90－ 115 degrees)at the last review.The mean ROM was improved by 35 degrees (15－ 50 degrees). There were no complications in this series. Conclusion Arthroscopic release for the treatment of knee stiffness due to arthrofibrosis without pain and infection following TKA is a useful, reliable and safe technique, compared with closed or open procedure. The arthrolysis should be done at 3 to 6 months after the TKA in order to obtain better results.

Objective To discuss the clinical manifestation and treatment of the complications caused by injected polyacrylamde hydro-gel( PAAG) for breast augmentation. Methods This retrospective research was performed among 212 patients who undergoing breast aug-mentation with injected polyacrylamde hydrogel. The clinical manifestation and treatment outcome of the complications were analyzed and summarized,which is aim to search an effective treatment method. Results For the 212 patients,the main complications were breast multi-ple indurations (131 cases),fever (9 cases),infection (14 cases),breast pain (65 cases),PAAG displacement (28 cases) and secondary deformity or asymmetry (25 cases). 152 cases experienced one clinical symptom,the rest patients simultaneously undergone no less than two clinical symptoms. Patients were received open operation with periareolar incision ( surgery group) or vacuum absorption by needle ( aspira-tion group) for dislodging PAAG. No significant difference was found in wound healing,breast shape satisfaction and pain anesis between the two groups. Whilethe surgery group was better than the aspiration group in efficiency for taking out PAAG and the incidence of reoperation, with statistical significance. Conclusion A plenty of complications occurred after breast augmentation with injected polyacrylamde hydrogel, the method of open operation with periareolar incision is a better way for eliminating PAAG and treating the complications.

Phthalate esters (PAEs)are by far the most widely used plasticisers and are categorized as high and low,depending on their molecular weight.Because of their extensive use,humans are most likely exposed to PAEs in the workplace and home environment through direct as well as indirect sources.Injection,inhalation,intravenous injection and skin absorption are potential pathways of expo-sure.With respect to health effects,phthalates are often classified as endocrine disruptors because of their ability to interfere with the endocrine syste m in the body.Furthermore,PAEs possess reproductive toxicity because of their influence on development of the reproductive system in infancy and development and differentiation of germ cells in adults.PAEs promote pathogenesis and development of liver cancer by activating peroxisome proliferator-activated receptor (PPAR)and DNA methylation.In addition, PAEs,which inhibit the i mmune functions of macrophages and pro mote hypersensitive response,pos-sess immunotoxicity.PAEs are also carcinogens that promote pathogenesis and development of cancers including breast,ovarian and so me other cancers.

Objective To observe any differences in the morphology of the lumbar multifidus (LM) muscles between normal subjects and persons with chronic lumbar disc herniation (CLDH).Methods Thirty-two persons with CLDH and thirty-five matched,healthy controls performed various maneuvers in prone lying.Ultrasound imaging was used to measure the antero-posterior diameter (A-P),lateral diameter (Lat),cross sectional area (CSA) and flattening ratio (FR) of the bilateral LM muscles at the L4/5 level.Results In the control subjects,A-P,Lat,CSA and FR were not significantly different between the left and right sides.In those with CLDH,A-P,Lat and CSA were significantly smaller on the painful side than on the no-pain side,and this difference showed asymmetry between the two sides.Average A-P,Lat,FR and muscle CSA were all significantly smaller among the CLDH subjects on both sides compared with the controls.Conclusion CLDH induces asymmetric local atrophy of the bilateral multifidus muscles which can be detected and measured using ultrasound.

Objective Through the analysis of misdiagnosis left renal vein entrapment syndrome,to improve the understanding and reduce the misdiagnosis of this disease.Methods 82 cases of left renal vein compression syn-drome were diagnosed with ultrasound,65 cases were misdiagnosed.Clinical data of these 65 patients were analyzed.Results In 82 cases,only 11 doctors from renal department of internal medicine,pediatrics,department of urology wrote application for it.Among the 65 misdiagnosed cases,30 cases of male,female 35 cases.The age ranged from 6 to 37 years old,the average age was 16.1 years.The misdiagnosis duration ranged from 2 months to 42 months,the median time was 7 months.43 cases of low back pain or backache,urinary tract irritation in 5 cases,60 cases of abnor-mal urinalysis:a simple urinary protein in 15 cases,21 cases of simple hematuria,proteinuria,hematuria 24 cases. 31 cases were misdiagnosed as chronic glomerulonephritis,occult nephritis(asymptomatic proteinuria and hematuria syndrome)in 11 cases,acute nephritis comprehensive sign in 9 cases,7 cases of lumbar muscle strain,urinary tract infection in 4 cases,1 case of urinary tract stones,pelvic inflammatory disease in 2 cases.In the 16 cases complicated with glomerular nephritis,were treated as the glomerular nephritis before (11 cases of chronic nephritis,5 cases of asymptomatic proteinuria and hematuria syndrome).12 cases of abnormal urine fluctuation,after a delay of 3 -16 months referral doctor was diagnosed with left renal vein entrapment syndrome.Conclusion The disease has no char-acteristic clinical manifestations,and most clinicians were short in understanding of the disease,so the misdiagnosis rate is high.The clinicians should improve the understanding of the disease,in order to reduce the misdiagnosis rate.

Objective To construct the RNAi vector targeting survivin gene, in order to observe its effect on lung adenoearcinoma A549 cell radiosensitivity, and explore the possible mechanism. Methods One pair of RNA interference sequence targeting survivin gene was designed according to the eDNA sequence, the recombinant RNAi plasmid pGenesil2-survivin was constructed. After certified by enzyme digestion and sequencing, the pGenesil2-survivin plasmid was transfected into A549 cells. Survivin mRNA and protein was measured by RT-PCR and Western blot, respectively. The apoptosis was analyzed with flow cytometry. The radiosensitivity was measured by clone formation assay. Results The pGenesil2-survivin vector was successfully established. After the pGenesil2-survivin was transfeeted into A549 cells for 48 h, surviving protein and mRNA in pGenesil2 group were not obviously changed compared with that in normal group. They were increased after 5 Gy X-ray irradiation, but obviously inhibited in pGenesil2-survivin group. The cell apoptosis in pGenesil2-survivin and 5 Gy X-ray groups was obviously increased (t1 = 10.63, P < 0.001 ; t2 = 3.75 , P < 0.05), the effect was more manifest in combined group(t = 4.83, P < 0.05). D0 and Dq in normal and pC, enesil2 group were not obviously different, but those in pGenesil2-survivin group were lower. Conclusions RNAi targeting survivin gene could inhibit survivin mRNA and protein expression, enhance the A549 cell apoptosis rate and cell radiosensitivity.