Objective To investigate clinical effects of arthroscopic synovectomy combined with radiofrequency vaporization for the treatment of rheumatoid synovitis of the knee joint.Methods In 36 cases of rheumatoid gonarthritis with chronic synovitis of the knee joint,with simultaneous administration of regular medication,we had applied arthroscopic synovectomy combined with radiofrequency vaporization to remove the hyperplastic synovium and pannus through standard anteromedial and anterolateral approaches, and superolateral and superomedial approaches.In 21 out of 36 cases,diseased synovium in the posterior compartment was resected via additional posteromedial and posterolateral approaches.A systematic rehabilitation program was practiced 3 days after operation. Results All the 36 cases were followed for 4~26 months(mean,16 months).Clinical effects evaluation showed "excellent" in 21 cases,"good" in 13 cases,and "fair" in 2,with a total excellent-or-good rate of 94.4%(34/36).The knee joint function scores were significantly elevated from 58.6?5.3 preoperatively to 91.6?5.8 postoperatively(t=2.723,P=0.003).The Lysholm scores were significantly elevated from 42.3?3.8 preoperatively to 90.2?4.4 postoperatively(t=2.437,P=0.001).Conclusions Combined use of arthroscopic synovectomy with radiofrequency vaporization for the treatment of rheumatoid gonarthritis has advantages of minimal trauma,little blood loss,and rapid recovery of joint function.The procedure can effectively control the progression of rheumatoid arthritis and restore the knee joint function to the greatest possible extent.

ObjectiveTo observe the changes of expression of aquaporin-1(AQP-1)and AQP-4 in drowned and postmortem immersed rats’lungs.MethodsThirty healthy male Wistar rats were randomly divided into drowning group, postmortem immersion group and cervical dislocation group. The morpho-logical changes of rats’lungs were observed using HE staining. The mRNA and protein expressions of AQP-1 and AQP-4 in rats’lungs were detected by real-time PCR, immunohistochemistry and Western blotting, respectively.ResultsThe results of immunohistochemistry and the Western blotting showed that the protein expression of AQP-1 of the drowning group was higher than the postmortem immersion group and the cervical dislocation group(P<0.05). The result of immunohistochemistry showed that the protein expression of AQP-4 of the drowning group was higher than the postmortem immersion group and the cervical dislocation group(P<0.05)while no difference were detected among the three of them by Western blotting(P>0.05). The mRNA expressions of AQP-1 and AQP-4 in rats’lungs of the drown-ing group was significantly higher than the postmortem immersion group(P<0.05).ConclusionThe in-crease of mRNA and protein expressions of AQP-1 and AQP-4 in lungs of rats with cute lung injury of the drowning group would be useful for differentiating vital drowning from postmortem immersion.

Objective To analyze the incidence and clinical features of urothelial tumors in renal allograft recipients.Methods A retrospective analysis of 1042 patients received renal allografts who had taken immunosuppression for at least six months between 2006 and 2011 in The First Centre Hospital of Tianjin was performed.Results Eleven cases of uroepithelial tumors were diagnosed in the 1042 cases of renal transplantation ( 1.06％ ),of whom 9 cases were noticed by hematuria ( 81.8 ％ ),2 cases ( 18.2％ ) by medical examination.Six patients were diagnosed with multifocal urothelial carcinomas.Surgery was performed on all the patients with renal tumors and followed by chemotherapy or radiotherapy.Conclusion Malignancies in urinary tract after renal transplantation should be bore in mind.Early diagnosis is very important.The treatment options include reducing immunosuppressive agents and removing tumor lesions completely.

ObjectiveTo compare the clinical effect of percutaneous iliosacral screws osteosynthesis (PISO) and open reduction internal reconstruction plate fixation in treating unstable pelvic fractures combined with sacroiliac joint dislocation,and evaluate their safety and practicality.MethodsFrom March 2004 to October 2010,37 patients with vertical unstable pelvic fractures were admitted to our department.Twenty cases were treated with percutaneous sacroiliac screw fixation and 17 cases were performed opened reduction and internal reconstruction plate fixation under C-arm X-ray's guide.The perioperative parameters and postoperative imaging indexes were compared and analyzed.ResultsAll patients were followed up for 6 months to 26 months,with an average of 15 months.There were statistical significances between the PISO group and open reduction internal fixation group in operation time,blood loss,postoperative pain,mean fever time and hospital stay.The two groups showed no significant difference on postoperative X-evaluation of reduction effect.The average healing time was 3.2 months and the difference was not statistically significant between two groups.PISO group had no complications such as infection,bent nails or broken nails.ConclusionThrough compared and analyzed the two groups in treating unstable pelvic fractures,the percutaneous sacroiliac screw fixation has been proved for a kind of ideal minimally invasive surgery method because of locating exactly,less damage and blood loss,milder pain and quicker recovery.But it demands higher operation techniques.Adequate preoperative preparation and postoperative patients' cooperation can reduce complications incidence.The second group of anterior reconstruction plate or T-shape plate to fix vertically unstable pelvic fractures at same time shows a good result of stabilization.