OBJECTIVE: To avoid the infection induced by the clinical application of total parenteral nutrition solution( TPN) . METHODS: The experience of quality control and etiological examination in the preparation and application of TPN for 62 patients in our hospital were analyzed retrospectively. RESULTS & CONCLUSION: The key to reduce the incidence of infection in the preparation and application of TPN is to keep the infection source under control.

[Objective] To study the application and clinical result of extended trochanteric osteotomy in hip joint revision.[Methods]Thirteen hips in 13 patients who were treated with extended trochanteric osteotomy in hip joint revision from 2003 to 2007 were followed-up for an average time of 32.3 months.The revision reasons,Harris score,osteotomed length,and the oeteotomed union time were analyzed.[Results]The average preoperative Harris score of all patients was 38(24~68),the average postoperative Harris score was 77(57-100),with the improvement of 39 points.The average osteotomed length from the tip of great trochanter to distal osteotomy site was 12.4 cm(9~15.1 cm).The osteotomy sites were healed in 11 patients at 3 months and 2 patients at 6 months after operation.[Conclusion]Extended trochanteric osteotomy is useful in hip joint revision.After osteotomy femoral prosthesis and cement could be taken out easily,and the osteotomy site could be healed easily.

Objective To study the protective effect of oxygen carrying liquid to brain tissue after hypertensive intracerebral hemorrhage in rats.Methods Collagenase and heparin were injected into the caudate nucleus of rats by stereotactic operation to induce a hemorrhage model,we observed the water content of brain,the morphology of the brain,the change of cerebral blood flow (CBF) and biochemical markers in each group.Results Group B without oxygen carrying liquid had more serious injury than group A with oxygen carrying liquid.Water content of brain tissue in group B (80.55?0.80%) was higher than group A (77.94?1 16%),group B had higher MBP levels(0.87?0.44 ng/ml) than group A (0.54?0.19 ng/ml), group B had higher NSE levels (1.74?0.68 ng/ml) than group A (1.19?0 49 ng/ml),There was remarkable difference in the two groups.Conclusion The oxygen carrying liquid had fine protective effect to the brain tissue around the hematoma after hypertensive intracerebral hemorrhage.

Objective To explore the clinical character,diagnosis and treatment principals of pyeloureteritis glandularis and cystitis glandularis.Methods The clinical manifestation,character of imageology and endoscopy images of the case for one year follow-up were analyzed and the relevant literatures were reviewed.Results During one year follow-up,there was no clinical symptoms and any progress on imageology.The patient is still in close following-up.Conclusions According to literatures,cystitis glandularis is not common in clinical,and it should be paid more attention by clinicians.There were a few reports about the ureteritis glandularis.Pelvis,ureter and bladder have the same epithelial tissue,pyelitis glandularis is very rare,up to now there is no efficient treatment ways.

BACKGROUND:Tranexamic acid administered either in intra-articular route or in intravenous route can significantly reduce blood loss during total knee arthroplasty. Recent studies are stil controversial in application mode of tranexamic acid in the clinic.
OBJECTIVE:To compare the clinical outcomes of tranexamic acid in intra-articular route and intravenous route during total knee arthroplasty.
METHODS:PubMed, OVID, Web of Science, and EMBASE were searched to identify randomized control ed trials concerning the comparison of tranexamic acid in intra-articular route and intravenous route during total knee arthroplasty published before 1 May 2015. Transfusion rate, hemoglobin decline, drainage volume and thromboembolic complication rate were considered as indexes to evaluate the clinical effect, for meta-analysis.
RESULTS AND CONCLUSION:Six randomized control ed trials involving 847 patients were included. Meta-analysis results showed no significant difference between intra-articular and intravenous administration of tranexamic acid in terms of transfusion rate, hemoglobin decline, drainage volume, total blood loss, and thromboembolic complication rate. Subgroup analysis for dose regimen showed that when occlusion time of drainage tube was<2 hours. Intra-articular route of tranexamic acid showed high drainage volume and hemoglobin decline compared with the intravenous route of tranexamic acid (P<0.01). Results confirmed that during total knee arthroplasty, clinical effects of intra-articular and intravenous routes of tranexamic acid are similar during total knee arthroplasty. Moreover, it is recommended that occlusion of drainage tube can be conducted for 2 hours in intra-articular route of tranexamic acid.

BACKGROUND:Crowe IV developmental dysplasia of the hip is rarely seen clinical y. However, when treated with routine total hip arthroplasty, severe deformities in the bone and soft tissue can lead to high rate of operation failure and increased occurrence of complications. Total hip arthroplasty in combination with subtrochanteric osteotomy may be an option to resolve this problem.
OBJECTIVE:To retrospectively analyze the clinical outcome and safety of Crowe IV developmental dysplasia of the hip treated by the combination of total hip arthroplasty and subtrochanteric osteotomy in 17 cases.
METHODS:Twenty-one hips (17 cases) of Crowe IV developmental dysplasia of the hip treated by the combination of total hip arthroplasty and subtrochanteric osteotomy were retrospectively analyzed and fol owed for at least 2 years from January 2006 to June 2011. Complications, hip function, and radiological changes were evaluated.
RESULTS AND CONCLUSION:The mean fol ow-up period was (48.0±20.5) months. Harris’s score was increased postoperatively (P<0.05). The main complains were lower limb length discrepancy, difficulty in standing up from squatting, muscle weakness, and soft tissue tightness. One greater trochanter fracture occurred and was fixed by hook plate fixation. There were four femoral shaft splits treated by cerclage. One patient represented with femoral nerve palsy and got partial recovery until the latest fol ow-up. There was no deep infection, dislocation or prosthesis loosening. Crowe IV developmental dysplasia of the hip could be effectively treated by total hip arthroplasty in combination with subtrochanteric osteotomy, which requires high surgical techniques to control the complications. Further fol ow-up is required for long-term results.

Objective To investigate normal patellar morphology,then to explore its possible instructive significance in the design of patella prosthesis for Chinese people and in the process of resurfacing patella.Methods CT scan examinations were performed in 60 normal knees (left or right knee was selected randomly； scan region,from half proximal tibia to half distal femur) of 60 healthy Chinese adults (32 males,28 females； age range,18-54 years； mean age,33.7 years),then mimics software was used to reconstruct the 3-D morphology of each patella and new coronal and sagittal planes were created.Each patella's height,width,thickness,the position of the dome,the ratio of height/width,and the residual thickness after patella was resected at the level of the subchondral bone of the lateral facet during the stimulating process of patella resurfacing were measured or calculated.Results Patella of Chinese male:height 31.95±2.77 mm,width 45.02±2.70 mm,thickness 22.38 ±1.63 mm,the residual thickness after patella was resected 13.18±1.62 mm； Patella of Chinese female:height 28.72±2.17 mm,width 39.57±2.57 mm,thickness 19.88±1.36 mm,the residual thickness after patella was resected 11.20±1.20 mm.Significant differences existed between male and female for all the above four parameters.Patella of Chinese male:the ratio of width/height 1.42 ±0.11,the position of the dome (medial 42.9％)； Patella of Chinese female:the ratio of width/height 1.38±0.10,the position of the dome (medial 42.6％).No significant differences existed between male and female for the above two parameters.Conclusion The patella of Chinese people is small,thin and slim,especially in Chinese female.These findings should be considered in selecting or designing patella prosthesis to fit the Chinese people.For Chinese female,more attention should be paid to keep appropriate residual thickness after the patella was resected during the process of patella resurfacing.

This histochemical binding of horseradish peroxidase labeled peanut agglutinin (HRP?PNA) to paraffin sections of 18 cases of pancreatic cancer was investigated with 5 case of normal pancreas and 8 pancreatitis as the control. The PAN receptor was not found in the normal pancreas, but it appeared in 15 cases of pancreatic cancer (82%). Three cases of pancreatitis presented positive stainings of PNA binding (37%). There were 3 kinds of PNA binding forms: (1) linear distribution along the gland of carcinoma cells; (2) round staining with the ductal epithelium; and (3) diffuse scattering with an increased dot staining. There was a good relationship between the staining degree and cell differentiation. The positive staining increased when the cell was transformed from inflammation to carcinogenesis, and decreased from well differentiation to poorly differentiation.

Institutions and management for some key processes in medical equipment management are described. Desired effect is achieved in practice. Good and efficicent medical equipment management is one of the important factors to guarantee medical quality in hospital. Medical equipment management should be improved with the equipment development.

Objective To evaluate the clinical outcome of Vancouver B2 and B3 periprosthetic femoral fractures treated with uncemented modular stems.Methods From September 2011 to April 2014,Twenty-four patients (12 males and 12 females,with the average age 63 years,ranging from 28 to 85 years) with periprosthetic femoral fractures (16 Vancouver B2 and 8 Vancouver B3) were treated with uncemented modular stems.Revision arthroplasty was conducted in all cases by using modular stems with 12 cerclage wirings and 11 great trochanter claw plates.One patient was treated with revision arthroplasty without additional fixations.Extended trochanter osteotomy was performed on 11 patients.Cortical strut allograft was used in 9 patients with severe femoral bone loss.Intraoperative complications including vascular or nerve injury and systemic complications including cardiovascular events,cerebrovascular events and deep vein thrombosis were recorded.Severe postoperative complications such as nonunion,re-fracture,periprosthetic joint infection and dislocation were recorded.The clinical outcome was evaluated by Harris score,Visual Analogue Score and Parker Mobility Score.The radiological outcome was taken to observe the healing status,stem subsidence and stability of the prosthesis.Results Two patients were lost to follow-up.Twenty-two patients were clinically followed-up.Radiological data was recorded in 16 patients.The average follow-up was 33 months (range,12-68 months).All fractures healed within 6 months.The average Harris score improved from 4.0± 1.1 preoperatively to 78.8± 16.2 postoperatively (t=-20.195,P=0.000).The mean Parker Mobility Score improved from 0.5±0.9 preoperatively to 7.0± 1.8 postoperatively (t=-14.835,P=0.000).The mean Visual Analogue Score decreased from 6.4± 1.2 preoperatively to 2.0± 1.5 postoperatively (t=10.879,P=0.000).No nonunion,infection or dislocation was found.One patient underwent re-operation because of re-fracture.Eight mm of prosthesis subsidence was observed in one case at 3 months postoperatively,and reached stable fixation at 6 months postoperatively without further subsidence.Conclusion Uncemented modular stems can achieve distal fixation and implant stability of periprosthetic femoral fractures while retaining optimal biomechanics of the hip.Assisted by femoral reconstruction techniques such as extended trochanter osteotomy,cortical strut allograft,great trochanter claw plates and cerclage wiring,revision arthroplasty using uncemented modular stems could realize optimal outcomes in treating Vancouver B2 and B3 periprosthetic femoral fractures.