Objective To analyze contribution of varus knee with osteoarthritis and investigate the role of soft tissue balance in total knee replacement ( TKR) of that. Methods One hundred cases (145 varus knees) were operated with TKR. There were 18 males (25 knees) and 82 females (120 knees), with the average age of 64.6 years, from 45 to 80 years old. During the operation, accurate osteotomy and soft tissue balance was made to correct the varus knee joint. The contribution angles of varus knee was measured on weight bearing X ray images pre and postoperatively, in order to evaluate the results of the combination of the osteotomy and soft tissue balance. Results The gross varus angle was average 9.2? ? 3.1? , ranging from 5? to 30? preoperatively. In the total angle, the varus angle caused by soft tissue imbalance was 53.2% , the osseous varus angles caused by the tibia varus was 22.8% , the osseous varus angles caused by tibia plateau destruction was 24.0% . The measurement of the postoperative X ray films suggested that the average angle of the tibia plateau osteotomy was 4.3? , obtaining the correction of 27.9% of the total varus angle, and the angles corrected by soft tissue balance was 10.7? ,getting the correction of 72.1% of the total varus angle. According to HSS score system, the preoperative score was 38 points, ranging from 5 to 57, and postoperative scores was 87 points, ranging from 75 to 90. Conclusion The contribution of varus knee with osteoarthritis were include: 1) Bony structural varus angle composed of tibial varus and tibial plateau destruction; 2) Collateral ligaments and soft tissue imbalance around the knee. Articular surface destruction and soft tissue imbalance are the main contribution of varus knee. For TKR of varus knees like this, besides accurate osteotomy, correct soft tissue balance is the key of the operation. [

Objective To confirm the role of HLA B2704 in the pathogenesis of psoriasiform dermatosis by investigating the phenotype of skin diseases in HLA B2704 transgenic mice.Methods The transgenic positive mice were screened and identified by PCR,dot blot and Southern blot hybridization.HE and Immunohistochemistry staining of the diseased mice skin were performed to detect the pathological changes and expression of HLA B2704.Results Six transgenic positive mice developed obvious psoriasiform dermatosis.Histologically,the skin was massively thickened by psoriasiform hyperplasia and keratinization.HLA B2704 antigen was highly expressed on the cell surface.Conclusion HLA B2704 heavy chain can induce the psoriasiform dermatosis in the transgenic mice.

Objective To discuss operative treatment of the postoperative infection after total hip arthroplasty. Methods 11 cases of infected hip arthroplasty, 6 males and 5 females, with a mean age of 63 years old (from 54 to 71 years), were treated operatively in our department. Their preoperative mean Harris score was 33 (from 25 to 40), and their mean erythrocyte sedimentation rate (ESR) was 61 mm/h (from 34 to 80 mm/h). Bacterial cultures and drug susceptibility tests were carried out before and during operation. One- stage revision was performed for 6 cases, and two- stage revision was performed for 5 cases. Of the 11 cases, 2 were classified as early postoperative infection and 9 as late chronic infection. Preoperative microorganism cultures of joint aspiration or pus in sinus were positive in 8 cases but negative in 3 cases. 5 had staphylococcus epidermidis infection, 2 had escherichia coli infection and 1 had staphylococcus aureus infection. Results No recurrence of infection was found after a mean follow- up period of 17 months (from 12 to 31 months). ESR and blood tests after operation revealed nothing abnormal. The mean Harris score increased significantly to 84.2 (from 79 to 92) after revision (P