BACKGROUND: The distal femur resection in total knee arthroplasty is commonly made using a fixed angle relative to an intramedullary rod. Does a fixed distal femur resection angle influence radiographic alignment in primary total knee arthroplasty? OBJECTIVE: To research the femoral mechanical-anatomical angle in Chinese and how it affects the femoral component angle and postoperative mechanical alignment for total knee arthroplasty. METHODS: Totally 109 cases (148 knees) underwent primary total knee arthroplasty. One surgeon used a fixed resection angle of 5° (group A; n=56 cases, 76 knees). The second surgeon adjusted the resection angle according to preoperative coronal alignment, using 5° for neutral/mild varus, 6° for more severe varus, 4° for mild valgus and 3° for severe valgus knees (group B; n=53 cases, 72 knees). Preoperative hip-knee-ankle angle, femoral mechanical-anatomical angle, postoperative hip-knee-ankle angle, femoral component angle and tibial component angle were measured from standing hip-knee-ankle angle radiographs. For postoperative hip-knee-ankle angle, 177°-183° were considered as neutral mechanical axis. For femoral and tibial component angles, the target results were 88°-92°.RESULTS AND CONCLUSION: (1) There was no statistically significant difference between groups in postoperative hip-knee-ankle angle (group A: (178.78±3.57)°, group B: (178.23±2.78)°; P=0.302) and good rate of hip-knee-ankle angle (group A: 62%, group B: 65%). (2) The mean femoral mechanical-anatomical angle was (6.70±1.34)°preoperatively. There was no significant difference in the good rate of hip-knee-ankle angle (hip-knee-ankle angle < 7°:69%; hip-knee-ankle angle ≥7°: 55%; P=0.108) postoperatively. There was a statistically significant difference about good rate of femoral component angle between different femoral mechanical-anatomical angle angles (femoral mechanical-anatomical angle < 7°: 76%; femoral mechanical-anatomical angle ≥7°: 39%; P < 0.01). (3) There was a statistically significant correlation between preoperative femoral mechanical-anatomical angle and postoperative hip-knee-ankle angle (r=?0.42, P < 0.01) and postoperative femoral component angle (r=?0.58, P < 0.01). (4) The mean femoral mechanical-anatomical angle was larger than foreign values. When the resection angle less than femoral mechanical-anatomical angle, the femoral component may tend to be varus which could affect the lower extremity mechanical alignment. For the larger femoral mechanical-anatomical angle, we advise to adjust the resection angle according to measured value preoperatively.

Objective To study the effects of the different concentrations of ethanol extracts of Smilax China on ear edema in mice and granuloma in rats,and to provide an evidence for optimizing the extraction process. Methods Effects of different concentrations of ethanol extracts of Smilax China on the xylene-induced ear edema in mice and the cotton ball-induced granuloma hyperplasia in rats were tested . Results Compared with the model controls,70% ethanol extracts of Smilax China at high,medium and low doses significantly inhibited ear edema in mice (t=2. 58,P<0. 05;t=2. 28,P<0. 05;t=2. 17,P<0. 05) and reduced the granuloma hyperplasia in rats(t=5. 28,P<0. 01;t=5. 24,P<0. 01;t=5. 17,P<0. 01). Conclusion The 70% ethanol extracts of Smilax China at three doses present the most active antiinflammatory effect,confirmed in both mice ear edema and rats granuloma models.

A method of complete acid hydrolysis combined with high performance anion exchange chromatography and pulsed amperometric detection was developed for the monosaccharide composition analysis of arabinoxylan from the seeds of Plantago asiatica L. The parameters including hydrolysis methods, acid types, acid concentration, hydrolysis temperature, hydrolysis time and placement time, which would affect the hydrolysis process, were optimized. The results showed that it would have a better hydrolysis effect for polysaccharide from the seeds of Plantago asiatica L. with 2 mol/L H2 SO4 in an atmospheric oil bath at 120℃for 2 hours. However, the placement time for diluted solution of the hydrolyzed polysaccharide should be less than 6 hours. The polysaccharide was mainly composed of Arabinose (8. 89%) and Xylose (41. 52%) and Galacturonic acid (0. 73%). Glcuronic acid (3. 44%) was detected simultaneously, and there were also trace amounts of Galatose and Glucose. The results were reproducible. Other arabinoxylans from Panicummiliaceum L. shell, Avena sativa L. bran and Hordeum vulgare L. were taken for monosaccharide compositions analysis under the optimal hydrolysis conditions and the analysis results were good. This study would provide a good reference for monosaccharides composition analysis of arabinoxylans from various sources.

Objective: To detect the mutation of epidermal growth factor receptor (EGFR) gene in peripheral blood of non-small cell lung cancer (NSCLC) patients in Yunnan area with Super-ARMS, and to explore its correlation with clinicopathological characteristics. Methods: A total of 222 blood samples from patients with NSCLC were collected between January 2017 to December 2018 in the Molecular Diagnostic Center of Yunnan Cancer Hospital. The EGFR gene mutation in peripheral blood samples was detected by SuperARMS, and the relationship between EGFR gene mutation and clinicopathological features was analyzed. Meanwhile, the independent risk factors influencing EFGR mutation were also analyzed. Results: In the peripheral blood of 222 NSCLC patients, there were 81 cases (36.5%) with EGFR gene mutation. Among them, exon 19 deletion and L858R gene point mutation were the most common (75.3% of total mutation); female patients had a higher mutation rate than male patients (45.9% vs 27.0%); patients <60 years old had a higher incidence of mutation than patients≥60 years old (43.2% vs 28.8%) (P<0.05 or P<0.01); moreover, patients with no history of smoking, no history of radical surgery, adenocarcinoma, advanced stage and no history of chemotherapy had higher incidence of EGFR mutation (43.9% vs 21.6%, 39.2% vs 21.2%, 43.9% vs 4.8%, 39.7% vs 23.3% and 44.0% vs 23.5%) (P<0.05 or P<0.01). Multivariate logistic analysis showed that young, no smoking history, adenocarcinoma and no surgical history were independent risk factors for EGFR gene mutation (all P<0.01). Conclusion: In the peripheral blood of patients with NSCLC in Yunnan, the mutation rate of EGFR gene is higher in patients with age<60 years old, adenocarcinoma and non-smoking. Super-ARMS method is more sensitive in the detection of EGFR mutation in peripheral blood of lung cancer patients.

Objective: To investigate the effects of tibial component slope change after microplasty (MP) Oxford unicompartmental knee arthroplasty (UKA) on short-term clinical outcome. Methods: A total of 116 patients(128 UKAs)underwent UKA in Department of Orthopaedic Surgery of China-Japan Friendship Hospital between January 2014 and December 2015 were retrospectively reviewed. Totally 100 patients (108 UKAs) were finally included in the study. There were 31 males and 69 females, aging from 47 to 90 years (mean 67.2 years). The mean height was (161.9±8.4) cm and the mean body mass index (BMI) was (26.2±3.3) kg/m². The posterior tibial slope (PTS) at preoperative and postoperative were measured on the lateral radiograph. The postoperative PTS were divided into five groups (<3°, 3° to 5°, 5° to 7°, 7° to 9° and>9°). The Oxford Knee Score (OKS) was recorded. Pearson correlation analysis, ANOVA and t test were used to analyze data. Results: All operations were successfully accomplished and there were no transfusion, infection, thrombus and other complications. There was 1 patient accepted revision because of bearing dislocation. Compared to preoperative, the PTS decreased (6.5°±2.2° vs.9.6°±3.4°) postoperative, there was statistical difference (t=9.053, P<0.01). Only 3 patients were beyond the recommended range (2° to 12°). A total of 82 patients (86 UKAs) were followed up. The follow-up time was 1 to 2.9 years (mean 2 years). The OKS was 43.0±4.1 (mean 31 to 48). The PTS increased in 12 patients (12 UKAs) postoperative, the mean OKS was 40.5±5.2. The PTS decreased in 70 patients (74 UKAs), the mean OKS was 43.4±3.8. There were significant difference in OKS (t=2.347, P=0.021). There were no significant difference in OKS between the five groups. There were positive correlation between postoperative PTS and preoperative PTS (r=0.201, 95%CI: 0.001 to 0.396, P=0.037), there were no correlations between postoperative PTS and hight and BMI. There were negative correlations between OKS and postoperative PTS (r=-0.255, 95%CI: -0.063 to -0.427, P=0.018) and PTS change (r=-0.292, 95%CI: -0.08 to -0.475, P<0.01). Conclusions Satisfying PTS can be obtained by use of Oxford MP instrumentation. The clinical outcome of the postoperative PTS decreased was relatively better. Too large posterior slope of the tibial implant should be avoided.

Objective To analyze the blood lipid levels of patients with psoriasis vulgaris (PsV) in Qinghai, China, and their correlation with clinical features, lesion area and severity. Methods A retrospective analysis was performed on the data of 185 PsV patients (PsV group). Another 185 healthy individuals were randomly selected as control group. The comorbidity prevalence of psoriasis was compared between the two groups. The blood lipid levels, lesion area scores, lesion severity scores, Psoriasis Area and Severity Index (PASI) scores and Dermatology Life Quality Index (DLQI) scores were compared between PsV patients from high-altitude areas (>3 000 m) and those from relatively low-altitude areas (2 000 to 3 000 m). The influencing factors of dyslipidemia comorbidity in PsV patients from high-altitude areas were analyzed. Results The prevalence of hypertension, diabetes, fatty liver, dyslipidemia, obesity and hyperuricemia in the PsV group was higher than that in the control group, with statistically significant differences (P < 0.05). Multivariate logistic regression analysis showed that body mass index (BMI) ≥25.0 kg/m², comorbidity with diabetes and history of alcohol consumption were risk factors for comorbid dyslipidemia in PsV patients from high-altitude areas (P < 0.05). The total serum cholesterol, low-density lipoprotein cholesterol (LDL-C), lesion area scores, lesion severity scores, PASI scores and DLQI scores were higher in PsV patients from high-altitude areas compared to those from relatively low-altitude areas, with statistically significant differences (P < 0.05). Conclusion There are significant differences in lesion area and severity among PsV patients from different altitudes and with different blood lipid levels. BMI≥25.0 kg/m², comorbidity with diabetes and history of alcohol consumption are risk factors for comorbid dyslipidemia in PsV patients from high-altitude areas.

OBJECTIVETo study the mechanism that mediates the therapeutic effect of the bioactive fraction of Baqia (Smilax china) on chronic pelvic inflammatory disease (CPID).

METHODSSeventy rats were randomized into CPID model group, sham-operated group, normal control group, Jingangteng capsule group, and high-, medium-, and low-dose Baqia groups. Rat models of CPID were established by inducing chemical burns of the uterus and corresponding treatments were administered. After 14 days of treatment, the rat uterus was observed for swelling and inhibition rate, and the expressions of tumor necrosis factor-α (TNF-α) and interleukin-4 (IL-4) in the uterine tissues were determined using enzyme-linked immunosorbent assay.

RESULTSThe bioactive fraction of Baqia at the 3 doses obviously reduced the inflammatory cells in the endometrium, promoted epithelial cell proliferation, and ameliorated congestion and edema of the serosa. High and medium doses of Baqia bioactive fraction significantly decreased uterus swelling rate of the rats (P<0.01). All the 3 doses of the Baqia bioactive fraction obviously decreased uterine TNF-α content (P<0.01) and significantly increased uterine IL-4 expression level (P<0.05), and IL-4 up-regulation was especially obvious in high and medium dose groups (P<0.01).

CONCLUSIONBaqia bioactive fraction can ameliorate uterine swelling, lower uterine TNF-α and increase IL-4 expressions in rats with CPID, which may be a pharmacological mechanism underlying its therapeutic effect on CPID and cervical adhesion.

Animals ; Chronic Disease ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Female ; Interleukin-4 ; metabolism ; Pelvic Inflammatory Disease ; drug therapy ; metabolism ; Rats ; Rats, Sprague-Dawley ; Smilax ; chemistry ; Tumor Necrosis Factor-alpha ; metabolism ; Uterus ; drug effects ; metabolism

OBJECTIVETo determine the effective fraction of Smilax for treatment of chronic pelvic inflammatory disease (CPID) by pharmacodynamic screening as the basis for further development of sarsaparilla preparations.

METHODSThe chemical fractions of Smilax were administered intragastrically in rat models of CPID induced by injecting phenol mucilage into the uterus to observe the therapeutic effects. The anti-inflammatory effects of different extract fractions from Smilax were tested in mice with xylene-induced ear edema and in rats with cotton-ball-induced granuloma.

RESULTSHigh-dose ethyl acetate extract of Smilax could obviously inhibit uterus inflammation in rats with CPID, showing also strong anti-inflammatory effects against ear edema in mice and granuloma in rats (P<0.01). The moderate dose of ethyl acetate extract also obviously ameliorated the inflammation. Both the ethyl acetate extract fraction and the total extract fraction of Smilax showed anti-inflammatory effects, while the former produced strong effects while the latter has only weak actions.

CONCLUSIONThe ethyl acetate extract fraction of Smilax is the effective fraction to produce anti-inflammatory and anti-CPID effects.

Animals ; Anti-Inflammatory Agents ; therapeutic use ; Drug Evaluation, Preclinical ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Mice ; Mice, Inbred Strains ; Pelvic Inflammatory Disease ; drug therapy ; Rats ; Rats, Sprague-Dawley ; Smilax

Objective To detect the expression level of ki-67 in gastric adenocarcinoma tissues,and to analyze the correlation be-tween ki-67 and clinicopathological parameters of tumor and its clinical significance.Methods A total of 113 patients with gastric ade-nocarcinoma undergoing surgery in the Affiliated Hospital of Xuzhou Medical University from January 2016 to December 2019 were select-ed.The expression level of ki-67 in gastric adenocarcinoma and paracancerous tissues were detected by immunohistochemical method.The positive expression rates of ki-67 in gastric adenocarcinoma tissues and paracancerous tissues were compared and the correlation be-tween the positive expression of ki-67 in gastric adenocarcinoma tissues and the clinicopathological characteristics of gastric adenocarcino-ma was analyzed;Kaplan-Meier survival curve was used to analyze the correlation between ki-67 levels and the prognosis of patients.COX regression model was established for multivariate prognostic analysis.Results The positive expression rate of ki-67 in gastric ade-nocarcinoma tissues was higher than that in the paracancerous tissues(74.34％vs 38.94％),and the difference was statistically signifi-cant(P＜0.05).Tumor diameter≥5cm(P=0.046),vascular invasion(P=0.028)both increase the positive expression rate of ki-67 in gastric adenocarcinoma tissues.Median survival time of patients with high ki-67 expression level(≥50％)was significantly lower than that of patients with low ki-67 expression level(＜50％),and the difference was statistically significant(P=0.0361).Multivari-ate COX regression analysis showed that TNM stage(P=0.029)and high ki-67 leve(≥50％,P=0.026)were independent risk factosr affecting the prognosis of gastric adenocarcinoma patients.Conclusion The positive expression of ki-67 is closely related to the occur-rence and development of gastric adenocarcinoma,which has important reference value to predict the progression and prognosis of gastric adenocarcinoma.

Objective To study the mechanism that mediates the therapeutic effect of the bioactive fraction of Baqia (Smilax china) on chronic pelvic inflammatory disease (CPID). Methods Seventy rats were randomized into CPID model group, sham-operated group, normal control group, Jingangteng capsule group, and high-, medium-, and low-dose Baqia groups. Rat models of CPID were established by inducing chemical burns of the uterus and corresponding treatments were administered. After 14 days of treatment, the rat uterus was observed for swelling and inhibition rate, and the expressions of tumor necrosis factor-α(TNF-α) and interleukin-4 (IL-4) in the uterine tissues were determined using enzyme-linked immumsorbent assay. Results The bioactive fraction of Baqia at the 3 doses obviously reduced the inflammatory cells in the endometrium, promoted epithelial cell proliferation, and ameliorated congestion and edema of the serosa. High and medium doses of Baqia bioactive fraction significantly decreased uterus swelling rate of the rats (P<0.01). All the 3 doses of the Baqia biaoactive fraction obviously decreased uterine TNF-αcontent (P<0.01) and significantly increased uterine IL-4 expression level (P<0.05), and IL-4 up-regulation was especially obvious in high and medium dose groups (P<0.01). Conclusion Baqia bioactive fraction can ameliorate uterine swelling, lower uterine TNF-α and increase IL-4 expressions in rats with CPID, which may be a pharmacological mechanism underlying its therapeutic effect on CPID and cervical adhesion.