Periprosthetic joint infection (PJI) is a devastating complication after total joint arthroplasty.Currently,PJI is the main cause for knee revision and the third reason for hip revision.Accurate diagnosis is of quite importance for patients with potential in revision surgery.However,there is no test alone can achieve both perfect sensitivity and specificity in diagnosis of PJI.The following diagnostic methods still have irreplaceable role,including erythrocyte sedimentation rate (ESR),C reactive protein (CRP) test,synovial white blood cell count and polymorphonuclear percentage,bacteria culture and histology analysis.Some novel diagnostic techniques,such as leucocytes esterase strip test,show advantages in diagnosing as fast,convenient and cost-saving.Synovial biomarkers,such as α-defensin,have promising prospect with both high sensitivity and specificity.Among various diagnostic methods,bacteria culture and drug sensitivity test can guide the therapy of PJI.Thus,it is crucial to improve the positive rate of bacteria culture.With the development of technology,sonication and polymerase chain reaction (PCR) will be the future research highlights.Although the imaging technologies,such as labeled leukocyte imaging and 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET),have been progressed in the past years,most of them are still in controversy.Further researches are still needed in the future.

Objective To investigate the application of ureteral catheter in complicated gynecological laparoscopic surgery for the prevention of ureteral injury . Methods A total of 182 cases of gynecological laparoscopic surgery performed from January 2009 to November 2011 were selected as study group .Bilateral ureteral catheters were inserted under cystoscopy , and then laparoscopic surgery was performed under the instruction of the catheter .The catheter was immediately removed after the surgery .A total of 200 cases of laparoscopic surgery were selected as control group and preoperative ureteral catheterization was not applied in this group .The incidence rate of ureteral injury was compared between the two groups . Results The success rate of bilateral ureteral catheterization in the study group was 98.9%(180/182)and no ureteral injury occurred .In the control group, ureteral injury was found in 2 cases, which were converted to open surgery for ureter repair and double J stent was retained .The 2 cases recovered 2 months after the surgery.Bladder injury was found in 2 cases during the surgery , which received immediate repair assisted by surgeons from the department of urinary surgery and recovered 2 months after postoperative catheterization . No statistical difference was found in complication rate between the two groups ( P=0.125 ) . Conclusion The application of ureteral catheterization in complicated gynecological laparoscopic surgery can reduce the risk of intraoperative ureteral injury .

OBJECTIVE:To establish a RP-HPLC method for the determination of the content of chlorhexidine acetate in daobian suppository.METHODS:The determination was performed on Diamonsil C_(18)column,The mobile phase consisted of acetonitrile-water-triethylamine(30:70:0.5,with pH adjusted to 3.0 by phosphoric acid)at a flow rate of 1.0 mL?min~(-1),The detective wavelength was 260 nm,the sample size was 20?L and the column temperature was maintained at 30℃. RESULTS:The linear range of Chlorhexidine Acetate was 1.092～13.10?g?mL~(-1)(r=0.999 9)and its average recovery was 98.29%(RSD=2.16%,n=9).CONCLUSIONS:The method is simple and accurate,and it can be used for the determination of the content of chlorhexidine acetate in daobian suppository.

[Objective]To evaluate the clinical outcome of the Ribbed anatomic cementless prosthesis.[Method]A total of 1436 hips in 956 patients undergone THR with Ribbed anatomic cementless prosthesis were reviewed.Between March 1997 and September 2005,1 249 hips in 832 patients were available for clinical and radiological follow-up.The mean follow-up period was 6.7 years with a minimum of 2 and a maximum of 10.5 years.The patients were evaluated with Harris Hip Score and radiographic analysis.[Result]The mean Harris Hip Score increased from 34.7 preoperatively to 91.5 postoperatively.Excellent and good functional improvement was seen in 96.3% of the operated patients.There was neither periprosthetic osteolysis nor evidence of loosening on follow-up radiographs.[Conclusion]Ribbed anatomic cementless prosthesis is found to be performing well with good clinical and radiological result.

Objective To discuss the curative effect of arthroscopiclly assisted radiofrequency tenotomy of the sternocleidomastoid muscle for the treatment of congenital muscular torticollis in teenagers. Methods A total of 12 patients (right, 4 patients; left, 8 patients) were enrolled in the study. A 3-mm skin incision was made at the site 5 cm below the sternoclavicular joint. A dissector was inserted through the incision to perform blunt dissection subcutaneously until the attachment points of the sternocleidomastoid muscle. After a subcutaneous operative space 3 cm ? 3 cm in size was created, a 30? wide-angle arthroscope was placed. Another incision was located at the site 5 cm below the mid-clavicle for placing the bipolar radiofrequency probes (Arthrocare 2000). Under the assistance of arthroscopy, the sternocleidomastoid muscle was severed from the attachment at the both sides. Results The operation time was 15~30 min (mean, 20 min). No intraoperative hemorrhage or vascular and nervous injuries were observed. Follow-up for 5~10 months (mean, 7 months) in the 12 patients found normal appearance and no recurrence or diplopia. Conclusions Arthroscopiclly assisted radiofrequncy therapy for congenital muscular torticollis is characterized by simplicity of manipulation, micro-invasion, and satisfactory curative effect.

[Objective]To evaluate the safety outcome of the 12 patients with simultaneous multiple joint replacement(≥3) in the recent three years.[Method]The complication rates,blood loss,transfusion volume,and hospital stay were analyzed in details.[Result]The mean operating time was 9 hours and 8 minutes(6 hours and 25 minutes to 12 hours).The mean overall volume of blood loss was 3140ml(1 000 ml-5 600 ml.Complications included reactive digestive ulcer in one case,acetabular component position error in one case,and deep infection in one hip of one case.[Conclusion]Simultaneous multiple joint replacement is an alternative protocol to the patients with multiple joint disorders.finished under a single aesthesia and in a single hospital stay.So the overall economical cost will be decreased,and rehabilitation being accelerated.Disadvantages include serious trauma,increased blood loss,and complications may be some how increased.

Objective To study the application of debridement with arthroscopy in acetabular dysplasia with osteoarthritis. Methods Thirty-two cases in 48 hips acetabular dysplasia with osteoarthritis debrided under the arthroscopy. In this group, male 9 and female 23, the mean age was 38.1 years old (range, 28-52 years old), the left side for 9, right side for 7 and bilateralis for 16. In the 48 hips, X-ray showed that comparatively large acetabular draw with normal position of femoral head in 21 cases (28 hips), large acetabular draw with femoral head lateral shift slightly but did not exceed 1/3 of femoral head in 11 cases (20 hips).MRI demonstrated that intraarticular fluid in 28 hips, subcartilage anormal signal of acetabular and femoral head at weight loading region in 10 hips, signal interruption of glenoid lip of hip in 10 hips. The procdure which included to remove of osteophyma, loose body and hyperplasia synovial membrane, degenerated cartilage on the stress areas of the hip joint, wear and tear of glenoid lip. Results The perianal skin in 2 patients suffered dysesthesia because of the over traction during operation. They recovered 7 days postoperation. Dysesthesias twenty-eight patients (36 hips) were follow-up with an average of 23 months (range, 6 months-3.5 years). After debridement and lavage, the patients released from pain, restored function and the range of the motion. According to VAS evaluation system for pain, the preoperative score was 5-9, with an average of 6.8; the postoperative score was 4-6, with an average of 2. According to Harris hip joint score evaluation system, preoperative score was 58.8?6.15, postoperative score was 89.6?11.3. The excellent in 20, good in 4, fair in 3 and poor in 1. The excellent and good result was up to 85.7%. Conclusion Selectivity debridement and lavage were effective methods for osteoarthritis hip joint acetabular dysplasia. It can delay the developing of course of disease; improve clinical symptom and elevate quality of life.

OBJECTIVE:To investigate the dissolubility of commercial metformin hydrochloride tablets from different manufactories.METHODS:The in vitro dissolubility of 14 kinds of commercial metformin hydrochloride tablets was determined by basket method and the dissolution parameters were analyzed with variance analysis method.RESULTS:The in vitro dissolubility of 14 kinds of metformin hydrochloride tablets fitted to the request of ChP2000,but the dissolution parameters were different.CONCLUSION:The statistical results indicate that there are significant differences between products from different factories(P

Objective To compame the lumbar hemp-epidural block anesthesia choose different combination puncture point in pregnancy on laboratory intraoperative anesthetic effect.Methods 110 maternals classified for ASA Ⅰ～Ⅱof lactation,according to random number tables were divided into two groups,Ⅰ group lumbar puncture points for L2-3 clearance,Ⅱ group of lumbar puncture points to L3-4 clearance.Both groups the waist hemp-epidural joint block anesthesia downlink cesarean section,and two sets of anesthesia effect-acting period,after the baby born of 1 min Apgar score before anesthesia,the average arterial blood pressure(MAP)change,the lowest rate,adjust the number,surgical operation bed at the start of the plane,need anesthesia epidural anesthesia,medication found during hypotension and breathing difficulties incidence,intraoperative nausea and vomiting adverse events were compared.Results The operations of the two groups were successful,and there were no complications in postoperation maternal and newborn.Difficulty breathing rate,hypotension incidence,the incidence of nausea and vomiting were obviously higher than Ⅱ groups was statistically significant lying-in woman,difference(2 cases,1 case,x2=14.7,11.5,all P＜0.01).Need to adjust surgery beds in the number,epidural drugs significantly higher than the average Ⅱ group Ⅰ group(38.2%,47.3%,25.5%,x2=12.5,14.8,18.4,all P＜0.01).Conclusion In cesarean section in the operation,lumbar hemp-epidural joint block anesthesia choose L3-4 puncture,can reduce anesthesia cause nausea,vomiting hypotension,spinal cord injury and taper adverse reactions such as the incidence,in safer surgery under general anesthesia successfully completed cesarean section.

Objective To identify the biomarkers associated closely with migraine by proteomics analysis of cerebrospinal fluid (CSF).MethodsForty-five patients were involved in the present study and they were divided into the following two groups:25 with migraine (5 with aura and 20 without aura) were assigned to migraine group,and 20 with giddiness or peripheral neuropathy were assigned to control group.The patients' CSF was collected,and the protein of CSF was extracted by acetone precipitation.The two-dimensional electrophoresis (2D-PAGE) with immobilized pH gradient (IPG) was performed to display the differently expressed protein spots.These spots were then identified by two-dimensional liquid chromatography and tandem mass spectrometry (2D-LC/MS-MS),and semi-quantitatively analyzed by Western blotting.ResultsDifferences were found in the results of 2D-PAGE between migraine group and control group.Ten spots of 9 kinds of proteins were successfully identified,of which 7 spots were down regulated,including transthyretin (TTR),CBX6 53 kDa protein (CBX6),agrin precursor (AGRN),FAM3C precursor (FAM3C),neuronal pentraxin receptor (NPR),dermcidin-isform2 (DCD) and albumin (ALB);whereas junction plakoglobin (JUP) and H2A histone family,member J (H2AFJ) were up-regulated.The results of Western blotting revealed that the net protein retention (NPR) in migraineurs group (0.3351?0.0275) was obviously decreased compared with that of control group (0.8854?0.0957,P