BACKGROUND:Usual y, amount of bleeding during replacement and drainage amount after replacement were recorded to evaluate the amount of bleeding in patients with arthroplasty. These are dominant blood loss. Studies demonstrated that recessive blood loss exceeded 50%of total amount. OBJECTIVE:To compare the blood loss during total knee arthroplasty under high negative pressure drainage and common negative pressure drainage and to assess the effect of high negative pressure drainage on hidden blood loss in total knee arthroplasty.
METHODS:A total of 60 patients undergoing lateral total knee arthroplasty were equal y divided into high negative pressure drainage group and conventional drainage group (control group). We calculated the total blood loss (dominant blood loss and hidden blood loss) and blood transfusion amount with the Gross equation. The recovery after surgery and complications were compared.
RESULTS AND CONCLUSION:In high negative pressure drainage group, the total blood loss was (646±184) mL and the hidden blood loss was (215±128) mL. In the control group, the total blood loss was (867±296) mL and the hidden blood loss was (457±268) mL. The total blood loss and hidden blood loss in the high negative pressure drainage group were significantly less than those in the control group (P<0.05). The average blood transfusion amount was 224 mL in the high negative pressure drainage group and 467 mL in the control group. Fol owing unilateral total knee arthroplasty, total blood loss, hidden blood loss and blood transfusion amount after arthroplasty were less in the high negative pressure drainage group than those in the control group. In particular, the decrease in hidden blood loss was helpful to observe and treat the pathogenetic condition and to avoid potential risk, and benefits the recovery of knee joint function after surgery.

BACKGROUND: Pdor findings have demonstrated that body mass of Minority students aged 18-22 years old in Guangxi Zhuang Autonomous Region of China is slightly lower than concurrent nationwide level.OBJECTIVE: To further investigate the information with respect to healthy status including somatotype and body mass of 2 645 Minority students in Guangxi Zhuang Autonomous Region of China and to search for correlated influencing factors.DESIGN, TIME AND SETTING: A follow-up investigation was performed in the Guangxi University for Nationalities between December 2004 and December 2007.PARTICIPANTS: A total of 2 645 college students consisting of 1 337 males and 1 308 females who received health examination between years 2003 and 2005 in Guangxi University for Nationalities were recruited into this study. They were aged 18-20 years and were from 15 nationalities.METHODS: According to Health Standard of Students' Constitution (Tdal Program) formulated by the Ministry of Education of China and General Administration of Sport of China, examination indices included somatotype, skills, and physical constitution.Physical functions and body mass index (BMI) of 2 645 Minority students were followed up. MAIN OUTCOME MEASURES: Body height, body mass, vital capacity, bending forward while in a sitting position, standing long jump, and BMI.RESULTS: ①The mean increase rate of body height and body mass across 3 years for male college students in Grade 2003 in Guangxi University for Nationalities was 2.45% higher than the concurrent nationwide mean level, and somatotype development was in the peak phase; in addition, female students presented with a little thin body shape, demonstrating slightly poor somatotype development. ②When newly recruited into university, the vital capacity of male and female students was very poor,which was greatly lower than the concurrent nationwide level. Three years later, the vital capacity was increased by 11.55% and 27.72% for male and female students, respectively, both of which was higher than corresponding concurrent nationwide level.③ The function of bending forward while in a sitting position of male and female students was higher than the corresponding concurrent nationwide level. The function of bending forward while in a sitting position of male students tended to increase year by year, while the concurrent nationwide level of male students was gradually decreased, and the concurrent nationwide level of rural female students was gradually increased.④The function of standing long jump was greatly improved. The mean increase rate across 3 years was 18.15%, which was 2.61% higher than the concurrent nationwide level. The general standing long jump function of female students was poorer compared to the corresponding concurrent nationwide level. ⑤The general BMI of male and female Minority students was a little lower than the corresponding concurrent nationwide level (P< 0.01).CONCLUSION: All recruited 2 645 Minority students were in the peak of development, and the function of vital capacity was poorer compared to the concurrent nationwide level. BMI distribution was different in female and male students, and there were more female students presenting with lower body mass than male students, demonstrating a general poor nutritional state of college students.

[Objective]To find out the reason of patellar clunk syndrome after total knee replacement and define its countermeasure.[Method]From January 2001 to December 2004,total knee replacements were performed on 57 cases(82 knees).Patellar clunk syndromes were found in 14 knees.The reason was analyzed.[Result]The reason of patellar clunk syndrome was abnormality of patellofemoral tracking,including type intercondylar notch and type trochlear groove.[Conclusion]The problem of patellofemoral joint is very important in total knee replacement.With adopting accurate technique of cutting and component implantation,perfecting the design of prostheses,patellar clunk syndrome could be avoided completely.

BACKGROUND: Suture silk or steel ring, Kirschner wire tension wire, modified AO band and screw are always used to treat patellar fractures. These methods cause large wound, slow fracture healing and limited joint function. OBJECTIVE: To analyze the therapeutic effect of Ti-Ni shape memory alloy clamp on patellar fractures. DESIGN, TIME AND SETTING: Retrospective analysis was performed at the Luoyang Hospital of Orthopedics and Traumatics from June 2001 to June 2006. PARTICIPANTS: 121 patients of patellar fractures (123 knees), 78 males (80 knees) and 43 females (43 knees), aged 38.3 years (range 21–67 years). There were 47 cases with left patellar fracture, 72 cases with right and 2 with bilateral; 53 knees were transverse,36 knees were comminuted, 32 avulsion, and 2 vertical fracture; 23 cases were injured by direct violence, and 98 by indirect violence. METHODS: Vertical incisions were made to expose fractures. The deep layer of the tendinous membrane was remained. The fracture was repositioned and the lacerated retinaculum and tendinous membrane were sutured. After the vertical diameter of the patella was measured, suitable clamp was selected and placed. After well repositioned, heat saline gauze was used to make the clamp reposition and fix the fractures. The incision was finally closed. MAIN OUTCOME MEASURES: Material and host responses; functional assessment of the patella fractures using Bostman. RESULTS: 121 cases were followed-up for 8 months8. All fractures were healed. No infection occurred. A little displacement of fractures occurred in 4 cases, early traumatic arthritis in 1 case, and slippage of the clamps in 2 cases. According to the functional assessment of the patella fractures of Bostman, the excellent results were 107 knees, and good were 16 knees. CONCLUSION: Ti-Ni shape memory alloy clamps exhibit reliable fixation, with soft tissue remaining, which is important to retain the blood supply of the patella. Moreover, it accelerates the healing of fractures.

[Objective] To investigate the effect of Bao Xin Kang (BXK) on levels of cyclic adenosine monophosphate (cGMP) and cyclic guanosine monophosphate (cAMP) in vascular smooth muscle of rats with myocatdial hypertrophic heart failure and to explore its mechanism. [Methods] Fifty rats were randomly allocated to five groups: normal control group (Group A) , model group (Group B) , digoxin group (Group C), large - dose BXK group (Group D) and small - dose BXK group (Group E). Rat models with myocardial hypertrophic heart failure were established by subcutaneous injection of isoprenaline for 13 days. Radioimmunoassay was used to measure the levels of cAMP, cGMP and the ratio of cAMP/cGMP in vascular smooth muscle. The body weight and the weight of heart, liver and lung were measured and his-tomorphologic features of heart, liver and lung also examined. [Results] The levels of cAMP and cGMP and the heart index (heart weight /body weight) and the liver index (liver weight/body weight) in Group B were increased as compared with those in Group A (P

[Objective] To observe levels of plasma endothelin (ET) and calcitonin gene - related peptide (CGRP) in rats with myocardial hypertrophic heart failure affected by Yang Xin Kang (composed of Radix Ginseng, Radix Ophio-pogonis, Radix flicis Pubescetis, etc.) and its mechanism. [Methods] Rat models with myocardial hypertrophic heart failure was established by subcutaneous injection of isoprenaline for 13 days. Fifty rats were allocated to five groups: normal control (Group A), model (Group B), digoxin (Group C), high dosage of Yang Xin Kang (Group D) and low dosage of Yang Xin Kang (Group E). ET and CGRP levels were measured by radioimmunoassay method. [Results] ET level in Group B was higher and CGRP level lower than those in Group A (P

OBJECTIVETo observe the protective effect of acupuncture preconditioning at "Jiaji" (EX-B 2) on acute myocardial ischemia-reperfusion injury (MIRI) in the rats and explore the mechanism.

METHODSFifty Wistar rats were randomly divided into a control group, a model group, a Jiaji group, a Neiguan group and a Quchi group, 10 rats in each one. In the Jiaji group, the Neiguan group and the Quchi group, electroacupuncture was given for preconditioning at "Jiaji" T4~T5 (EX-B 2), "Neiguan" (PC 6) and "Quchi" (LI 11) for 7 days before modeling. In the control group and the model group, the regular feeding was given, without any acupuncture. At the end of acupuncture, except the control group, ligating the left anterior descending coronary artery (LAD) was adopted to duplicate MIRI models in the rest groups. Electrocardio-gram (ECG) was monitored and ST-segment shift was analyzed. HE staining method was adopted to observe the morphology of cardiac tissue in the rats of the groups. The transmission electron microscope was used to observe myocardial cell ultrastructure. WST-1 method was used to determine the activity of serum superoxide dismutase (SOD), TBA method was used to determine the content of serum malondialehyde (MDA) and the real-time fluorescent quantitative PCR method to determine the expressions of Nrf 2 in ischemic myocardial tissue and downstream HO-1 gene.

RESULTSCompared with the control group, after LAD ligation, ST-segment was elevated and depressed in ECG apparently after reperfusion in the rest groups (all<0.05). The ST-segment elevation in the Jiaji group and the Neiguan group was less than that in the model group (both<0.05). Compared with the model group, SOD activity was increased apparently in the Jiaji group and the Neiguan group (both<0.05), and MDA content was reduced apparently (both<0.05). The effects in the Jiaji group were better than those in the Neiguan group (both<0.05). Pathologically, "Jiajia" (EX-B 2) and "Neiguan" (PC 6) all improved the morphology of cardiac tissue and cell ultrastructure. The effects in the Jiaji group were much more significant and the improvements in the Quchi group were not apparent. Compared with the control group, the expressions of Nrf 2 and HO-1 gene in myocardial tissue were down-regulated in the model group (both<0.05). Those were up-regulated apparently in the Jiaji group and the Neiguan group as compared with the model group (<0.05,<0.01). The up-regulation times of the expressions of Nrf 2 and HO-1 gene in the Jiajia group were the highest in comparison.

CONCLUSIONSAcupuncture preconditioning at "Jiaji" (EX-B 2) has the protective effect on cardiac ischemia and reperfusion damage, which is probably relevant with the up-regulation of Nrf 2-ARE pathway expression, the activation of endogenous anti-oxidative pathway, the improvement of oxygen free radical scavenging capacity and the alleviation of lipid peroxide damage.

Objective To investigate the clinical value of 99Tcm-methoxyisobutylisonitrile (MIBI) double-phase imaging in differential diagnosis of bone lesions in tumor patients,which was indefinite in 99Tcm-methylene diphosphonate (MDP) bone imaging,and evaluate the correlation between 99Tcm-MIBI imaging and chemotherapy efficacy.Methods Fifty-two tumor patients (23 males,29 females,mean age 58 years) with bone isolated lesions(≤3) found by 99Tcm-MDP bone scintigraphy was enrolled from June 2014 to November 2015.Since the results of 99Tcm-MDP imaging were indefinite,99Tcm-MIBI double-phase (10 min and 30 min after injection of 99Tcm-MIBI) SPECT/CT imaging was then performed within 1 week.The final diagnosis was made according to results of more than two imaging modalities (CT,MRI,PET/CT) and/or follow-up (≥6 months).The diagnostic efficacy of 99Tcm-MIBI SPECT/CT imaging was calculated.The clinical dataof chemotherapy were also collected.Patients with bone metastasis were grouped as the treatment response.Retention index (RI) of metastatic lesions was calculated and compared between different groups using two-sample t test.The relationship between RI and chemotherapy efficacy was investigated by Spearman correlation analysis.Results A total of 12 benign lesions and 84 malignant lesions were eventually diagnosed.The sensitivity,specificity,positive predictive value (PPV),negative predictive value (NPV) and Youden index of 99Tcm-MIBI imaging were 96.43％(81/84),83.33％(10/12),97.59％(81/83),76.92％(10/13),and 0.80,respectively.The RI was statistically different between complete remission (CR)+partial remission (PR) group and stable disease (SD) + progressive disease (PD) group:-0.142± 0.036 vs-0.384± 0.067 (t =2.367,P＜0.05).The RI of 99Tcm-MIBI in bone metastases was positively correlated with the chemotherapy efficacy (rs =0.78,P＜0.01).Conclusions 99Tcm-MIBI imaging is helpful in differential diagnosis of bone lesions with indefinite diagnosis by 99Tcm-MDP bone imaging in tumor patients.99Tcm-MIBI RI of bone metastasis may predict the therapeutic response of chemotherapy efficacy.

Objective:To investigate the characteristics of anxiety and depression of postgraduates in military medical university under public health emergencies.Methods:By means of self-rating anxiety scale (SAS) and self-rating depression scale (SDS), 944 postgraduate students of a military medical university were investigated to analyze their characteristics of anxiety and depression. SPSS 25.0 was used to statistically analyze the collected data.Results:①The positive rates of anxiety and depression were respectively 8.03% and 8.25%. ②The positive rate of anxiety of male postgraduates was significantly higher than that of female postgraduates ( P=0.035). ③The positive rate of anxiety of serviceman students was significantly higher than that of civilian students ( P=0.022). ④There was no statistical difference in the positive rates of anxiety and depression among postgraduates in different areas ( P > 0.05). ⑤The levels of anxiety and depression of left-behind children were significantly higher than those of unleft-behind children ( P=0.000, P=0.018). ⑥The levels of anxiety and depression of postgraduate students were lower than those of undergraduate students ( P=0.000, P=0.002). Conclusion:Under the outbreak of public health emergencies, anxiety and depression occur in the postgraduates. To strengthen the mental health maintenance of postgraduates in military medical university during the outbreak, it is necessary to pay more attention on the mental health of military students, males and who were left-behind children before.

【Objective】 To investigate the serological characteristics and gene mutation mechanism of RhD variant blood donors in Zhengzhou. 【Methods】 From January 2023 to December 2023, 1 619 RhD-negative blood donors sent to our laboratory were selected for the study, and RhD negative confirmation test and RhCE phenotype detection were applied by tube method and microcolumn gel indirect antiglobulin test method. RHD gene amplification and Sanger sequencing were used to detect RhD variant sample genotypes. 【Results】 A total of 69 cases of RhD variants were detected in the RhD negative confirmation test, with a proportion of 4.26%(69/1 619).The RhCE phenotypes were ccEe, Ccee, CcEe and CCee.There were 17 genotypes and 15 phenotypes of the D variant.The RHD^*weak partial 15 allele was the most frequent(33 cases), with a frequency of 47.83%(33/69), and the main phenotype was the ccEe. This was followed by the RHD^*DVI.3 allele in 20 cases with a frequency of 28.99%(20/69) and the predominant phenotype was Ccee. The RHD^*weak partial 15/RHD^*01EL.01 heterozygote was found in 3 cases with a frequency of 4.35%(3/69), all with the CcEe phenotype. Other rare genotypes were present in 13 cases with a frequency of 18.84%(13/69). Antibody screening was positive in 3 cases with a frequency of 4.35%(3/69). Two cases of female blood donors, both with history of pregnancy and childbirth, were identified as anti-D; one case of male donor was anti-M. 【Conclusion】 The RHD^*weak partial 15 genotype was the most common among the RhD variants in blood donors in Zhengzhou, followed by the RHD^*DVI.3 genotype. It plays an important role in guaranteeing the safety of blood supply and guiding precision transfusion.