BACKGROUND:Pain is the main reason for the recovery of knee function after total knee arthroplasty. OBJECTIVE:To explore and analyze the influencing factors of pain after total knee arthroplasty.METHODS:160 patients with knee osteoarthritis underwent total knee arthroplasty. At 12, 24 and 48 hours after total knee arthroplasty, patients were evaluated with visual analogue scale (VAS) and knee function was assessed with KSS score preoperatively and 90 days postoperatively. Factors, including operation time, age, gender, body mass index, anesthesia method, and preoperative score of KSS were analyzed by Pearson correlation and multiple linear regression. These statistics method also was used to analyze the relationship between the postoperative 90 days score of KSS and postoperative VAS score at each time point. RESULTS AND CONCLUSION:(1) Pearson correlation analysis and multiple linear regression analysis showed that operation time, gender, and body mass index had been correlated positively with VAS score at 12, 24 and 48 hours postoperatively. (2) Patient age had been correlated negatively with VAS score at 12, 24 and 48 hours postoperatively. (3) VAS score at 12, 24 and 48 hours postoperatively had been correlated negatively with KSS score at 90 days postoperatively. (4) Gender, operation time, body mass index and age are al the influencing factors of the pain after total knee arthroplasty. Pain after total knee arthroplasty affects the recovery of knee function.

Objective: To develop and validate an high performance liquid chromatography coupled with electrospray tandem mass spectrometry (HPLC-ESI-MS/MS) method for simultaneously qualitative and quantitative determination of 13 major bioactive components (ferulic acid, costunolide, baicalin, paeoniflorin, tetrahydropalmatine, rutecarpine, berberine, palmatine, evodiamine, naringin, hesperidin, saikosaponin a, and saikosaponin d) in Jiawei Zuojin Pills (JZP). Methods: The chromatographic separation was performed on a Thermo Syncronis C18 column (100 mm × 4.6 mm, 3.0 μm) with a gradient elution of methanol and 0.02 mol/L ammonium acetate in water at a flow rate of 0.35 mL/min, and the injection volume was 10 μL. The 13 major bioactive components were detected using an electrospray ionization source in ESI+ and ESI- ionization mode, quantified by multiple reaction monitor (MRM) scanning at the same time. Results: The linear ranges of ferulic acid, costunolide, baicalin, paeoniflorin, tetrahydropalmatine, rutecarpine, berberine, palmatine, evodiamine, naringin, hesperidin, saikosaponin a and saikosaponin d were 2-80 μg/mL (r = 0.999 2), 0.5-20.0 μg/mL (r = 0.999 1), 3.5-140.0 μg/mL (r = 0.999 8), 1-40 μg/mL (r = 0.999 2), 0.3-12.0 μg/mL (r = 0.999 1), 1-40 μg/mL (r = 0.999 2), 3-120 μg/mL (r = 0.999 7), 2.5-100.0 μg/mL (r = 0.999 5), 0.5-20.0 μg/mL (r = 0.999 3), 0.5-20.0 μg/mL (r = 0.999 1), 1-40 μg/mL (r = 0.999 1), 0.3-12.0 μg/mL (r = 0.999 2), 0.3-12.0 μg/mL (r = 0.999 2), and the average recoveries were 99.5% (RSD = 4.11%), 98.9% (RSD = 4.88%), 100.2% (RSD = 1.08%), 99.2% (RSD = 3.23%), 99.5% (RSD = 4.13%), 99.7% (RSD = 3.23%), 98.6% (RSD = 2.78%), 99.9% (RSD = 3.12%), 101.3% (RSD = 4.53%), 98.7% (RSD = 3.43%), 99.8% (RSD = 3.58%), 97.9% (RSD = 5.22%), and 101.3% (RSD = 5.13%), respectively. The contents of 12 batches of the 13 major bioactive components were 0.324-0.383, 0.051-0.072, 3.225-3.466, 0.154-0.198, 0.015-0.062, 0.144-0.199, 2.145-2.982, 0.441-0.953, 0.032-0.099, 0.062-0.089, 0.111-0.178, 0.012-0.065, 0.011-0.069 mg/g, respectively. Conclusion: The developed method is simple, specific, and sensitive, and it can be applied for the determination of 13 major bioactive components and the quality control of JZP.

Objective To observe the changes of NF-κB and inflammatory cytokine expression after CD200 pretreatment in severe heatstroke rats for exploring whether the molecular mechanism of CD200 inhibition of severe heat stroke inflammatory response is related to NF-κB signaling pathway. Methods Forty male Wistar rats were randomly divided into control group (n=8), severe heatstroke model group (HS group, n=16), and CD200 pretreatment group (CD200 group, n=16). The HS group and the CD200 group were injected with physiological saline and CD200 recombinant fusion protein before heat exposure to prepare a classical rat heat stroke model, and the control group was placed at room temperature of 22.0±1.0 ℃. The expression of NF-κB/ p65 mRNA in lung tissue were detected at 60 min after model establishment, and serum high mobility group protein B1 (HMGB1), tumor necrosis factor alpha (TNF-α) and interleukin 6 (IL-6) were detected. The pathological changes of the lungs were observed, and the survival time of severe heatstroke rats were recorded. Results CD200 pretreatment could inhibit the expression of NF-κB/p65mRNA. Compared with the control group, the expressions of NF-κB/p65 mRNA in the HS group and CD200 group were significantly increased (P<0.05), and the expression of NF-κB/p65 mRNA in CD200 group was lower than that in HS group (P<0.05). Serum HMGB1, TNF-α and IL-6 in HS group and CD200 group were significantly higher than those in the control group (P<0.05). The HMGB1, TNF-α and IL-6 in the HS group were higher than those in the CD200 group (P<0.05). The median survival time of severe heat stroke were prolonged in the CD200 group compared with the HS group (P<0.05), and the pathomorphological changes showed that inflammation and alveolar exudation were significantly reduced in the CD200 group compared with the HS group. Conclusions CD200 pretreatment can alleviate the inflammatory response in severe heatstroke rats. The possible molecular mechanism of CD200 to relieve severe heatstroke inflammatory response may be involved with NF-κB signaling pathway, which can reduce severe disease by inhibiting the activation of NF-κB and the expression of inflammatory factors.

OBJECTIVE: To investigate the clinical feature,diagnostic and therapeutic methods of ultimobranchial fistula and cyst of thyroid. METHOD: Four cases of ultimobranchial fistula and cyst of thyroid in our hospital were reported and the relevant literatures were reviewed. RESULT: The branchial fistula and cyst of four cases were adhered to thyroid,with unclear anatomical landmarks, the function of recurrent laryngeal nerve were bad before the operation in two cases. The nerve of four cases were retained, the function of thyriod and parathyroid gland were normal and no recurrence were found. CONCLUSION Ultimobranchial fistula and cyst of thyroid is rare and is easier to be misdiagnosed and wrong treated. Surgical excision is effective for it and recurrent laryngeal nerve should be protected when performing the operation.
Cysts ; Diagnostic Errors ; Fistula ; Humans ; Parathyroid Glands ; Recurrent Laryngeal Nerve ; Thyroid Diseases ; pathology ; surgery

To analyze the impact of sublingual immunotherapy(SLIT)on the quality of life in children with allergic rhinitis.Fifty children with allergic rhinitis who have received sublingual immunotherapy were enrolled in this study.Quality of life was evaluated via measurement of VAS score and rhinoconjunctivitis quality of life questionnaire(RQLQ)before and after treatment.Twenty patients after treatment had complete remission,13 cases were partly alleviated and 17 cases had no response.The total effective rate was 66%.The Multi-VAS scores and Uni-VAS scores in each observation time point(at half a year,one year,two years after treatment)had statistically significant difference compared with that of pre-treatment with SLIT(<0.05).According to RQLQ scores,the quality of life,nasal symptoms,conjunctiva symptoms,non-nasal(ocular)symp-toms,behaviors and emotional responses were greatly improved in each time point compared with that of pretreatment(<0.05).Symptomatic treatment scores in each time point after treatment were significantly different and had a positive correlation with the scores of RQLQ(<0.05).SLIT can improve the nasal allergic symptoms,children's life quality and reduce the use of symptomatic treatment medicines.
Administration, Sublingual ; Child ; Humans ; Quality of Life ; Rhinitis, Allergic ; therapy ; Sublingual Immunotherapy ; Treatment Outcome

【Objective】 To explore the application effect of target management combined with intelligent display system on apheresis platelet donor recruitment. 【Methods】 Control group: 317 apheresis platelet donors were recruited according to the conventional appointment mode of intelligent display system from October 2020 to March 2021, with a total of 1 073 donations. Experimental group: 404 apheresis platelet donors were recruited using quantitative target management plus the intelligent display system from April 2021 to September 2021, with a total of 1 308 donations. The number of first-time donors, repeated donors, recalled donors after first-time donation, and their corresponding donations, as well as the double-dose collection rate, and the transfer-in/-out of platelet product were analyzed and compared. 【Results】 The number of first-time donors increased from 89 (28.08%) to 179 (44.31%) while repeated donors decreased from 228 (71.92%) to 225 (55.69%), all P<0.05. The number of recalled donors after first-time donation increased from 42 (45.19%) to 82 (47.81%), P>0.05.The cumulative number of first-time and repeated platelet donors increased from 149 (13.89%) to 331 (25.31%), and 924 (86.11%) to 977 (74.69%), respectively(all P<0.05). The recalled donors after first-time donation increased from 60 (40.26%) to 152 (45.92%)(P>0.05). The double-dose collection rate decreased from 24.70% (265/1 073) to 13.46% (176/1 308)(P<0.05). The proportion of transfer-in platelets decreased from 3.64% (48/1 317) to 1.52% (22/1 452), while transfer-out platelet increased from 0.23% (3/1 317) to 2.34% (34/1 452)(all P<0.05). 【Conclusion】 The intelligent display system is conducive to facilitate the development of platelet donor recruitment and ensure the clinical supply of apheresis platelets.

Objective　To elucidate the clinical effect of continuous intraventricular intracranial pressure monitoring combined with step-by-step treatment for elderly patients with acute massive cerebral infarction.Methods　Forty-six elderly patients with acute massive cerebral infarction were selected from November 2015 to October 2019.Patients according to the research requirements were randomly divided into two groups:ICP group(n=23) and control group (n=23),ICP group was given stepwise management guided by intraventricular ICP monitoring,control group was given routine drug treatment after admission,according to patients’ consciousness and the changes in pupil signs and head CT results adjusted the treatment plan.FIM scores were observed after 3 months and complications (including abnormal coagulation function,bedsore and pneumonia).Results　FIM scores of ICP group was (90.81±6.08),and FIM scores of control group was (76.56±7.82),the difference was statistically significant (P<0.05).The proportion of complications of ICP group was 17.4% (4/23),and that of control group was 78.3% (18/23),the difference was statistically significant (P<0.05).Conclusion　For elderly patients with acute massive cerebral infarction,intraventricular ICP monitoring with stepwise management is beneficial.Choosing appropriate treatment plan,reduced the occurrence of complications and improved the brain function of patients.

OBJECTIVETo observe mandibular fracture healing after synthesized bioabsorable poly-para-dioxanone (PDS) ligature fixation.

METHODSPara-dioxanone monomer was prepared by chemical reactions of metallic sodium, ethylene glycol and other raw materials. PDS was synthesized by polymerizing the purified para-dioxanone in the presence of catalyst under the conditions of negative pressure and certain temperature. PDS ligature was obtained by processing the polymer into small granules, drying and melt-extruding through a spinnerette. Eighteen adult male New Zealand rabbits were assigned randomly into two groups. After mandibular fracture models were created, reductions of the artificial fractures were accomplished by means of transosseous PDS ligatures on each of 12 rabbits in experimental group. While the other six rabbits without any internal fixation were set as control. Schedules for killing were arranged to give postoperative samples at two-week interval till 12th week.

RESULTSRadiographical and histological examinations demonstrated that all fractures fixed with PDS ligatures healed without any complication. Periosteal and cartilaginous osteogenesis was observed in newly formed external callus. In contrast, bone fragment migration and the consequent nonunion occurred in the control group. PDS ligature degraded and absorbed without interference with osseous union and healing. The tensile strength reduction of PDS ligature was prior to its absorption in vivo.

CONCLUSIONThe synthesized PDS is a colorless, flexible, themoplastic and monofilament fiber, which can be sterilized by ethylene oxide embalmment without serious loss of tensile strength. It seems that the application of this macromolecular material in internal fixation is of great worth for further study.

Absorbable Implants ; Animals ; Biodegradation, Environmental ; Bone Regeneration ; drug effects ; Fracture Fixation, Internal ; instrumentation ; methods ; Fracture Healing ; Male ; Mandibular Fractures ; physiopathology ; surgery ; Materials Testing ; Polydioxanone ; administration & dosage ; chemical synthesis ; Rabbits ; Random Allocation ; Tensile Strength

Inspection and acceptance is an important part of medical equipment management. It is a major measure to ensure that the medical equipment purchased is in accordance with the quality and quantity of the intended standards and can be used in clinical treatment timely and safely. It is also a key step to inspect the performance of the contract and the implementation of tender documents. The medical equipment inspection and acceptance is classified based on the standards of equipment validity and safety. Furthermore these problems are analyzed deeply and the solution strategies are suggested. The objectives of our study are to ensure the equipment's quality, improve woke efficiency and induce the effects on manufactures.
Equipment Safety ; Equipment and Supplies, Hospital ; Quality Control ; Risk Assessment

OBJECTIVETo explore the optimal treatment for craniocerebral trauma complicated with thoraco-abdominal injuries.

METHODSA total of 2165 cases of craniocerebral trauma complicated with thoraco-abdominal injuries admitted to our hospital between July 1993 and June 2003 were retrospectively studied. Among them, 382 cases sustained severe craniocerebral trauma (in which 167 were complicated with shock), 733 thoracic injuries, 645 abdominal injuries and 787 thoraco-abdominal injuries. On admittance, 294 cases had developed shock. With the prime goal of saving life, respiratory and circulatory systems and encephalothilipsis were especially treated and monitored. Priority in management was directed to severe or open injures rather than to moderate or closed injures. For cases with cerebral hernia due to intracranial hematoma and severe shock due to blood loss, cerebral hernia and shock were treated concurrently.

RESULTSAfter treatment, 2024 (93.49%) cases survived and the other 141 (6.51%) died. Among patients who had severe craniocerebral injury with shock and those without, 78 (46.71%) and 53 (24.56%) died, respectively. For patients who had underwent craniocerebral and thoraco-abdominal operations concurrently and those who had not, the death rates were 58.49%-65.96% and 28.57% respectively, indicating a significant difference (P<0.05).

CONCLUSIONSTreatment for hematoma hernia, shock and disturbed respiration is the key in the management of multiple trauma of craniocerebral, thoracic or abdominal injuries, especially when two or three conditions occurred simultaneously. Unless it is necessary, operations at two different parts at the same time is not recommended. It is preferred to start two concurrent operations at different time.

Adult ; Craniocerebral Trauma ; surgery ; therapy ; Encephalocele ; etiology ; therapy ; Female ; Humans ; Male ; Multiple Trauma ; surgery ; therapy ; Retrospective Studies ; Shock, Hemorrhagic ; etiology ; therapy ; Thoracic Injuries ; surgery ; therapy