OBJECTIVE: To study the therapeutic effect of treating knee arthropathy with total knee arthroplasty using rotating-platform knee prosthesis. METHODS: A total of 62 patients (74 knees) in Provincial Hospital Affiliated To Shandong University from January 2005 to January 2009 were selected, including 36 males (41 knees) and 26 females (33 knees), aged 52-79 years, mean aged 61.5 years; 28 cases with left knee, 22 cases with right knee and 12 cases of both knees. The cases were composed of 34 cases with osteoarthritis, 21 cases with rheumatoid arthritis and 7 cases with traumatic arthritis. All the patients received the total knee arthroplasty for the first time using rotating-platform knee prosthesis, no replacement of the patella. The clinical results of pre-operetion and after-operation were evaluated by the HSS knee rating score system. RESULTS: All the patients were followed-up for averaged 22 months (3-48 months) after operation. Incisions of all the cases were healed, and there was no infection and hematoma. Lower extremity deep venous thrombosis occurred in 2 cases at 3 days after operation. Swelling disappeared through drug treatment 10 days later. Pain and function of all the patients were obviously ameliorated after operation. The average HSS knee rating score was 44.99 (from 34 to 58) before total knee arthroplasty, which was improved to 88.78 (from 69 to 98), and the good-to-excellent rate was 98% (excellent 45 cases, good 16 cases, average 1 case). There were no signs of prosthetic dislocation or loosening in the X-ray films. CONCLUSION: Total knee arthroplasty using rotating-platform knee prosthesis owns advantages of easy surgical operation, tess complications, good recovery and satisfactory results in a short-term.

Objective To investigate the clinical characteristics of diabetes complicated with peripheral neu- ropathy and increase the cognition of diabetic peripheral neuropathy in clinical work.Methods The clinical data of 160 diabetic patients were analyzed with retrospective analysis.Results 118 diabetic patients had different levels neuroelectrophysiologic abnormality,and the incidence rate was 73.8 %.The cure rate of diabetic peripheral neuropa- thy was 11.0%.Conclusion The incidence of peripheral neuropathy is high in diabetic patients,neuroelec- trophysiologic examination is a sensitive index in diagnosis of diabetic peripheral neuropathy,and the therapeutic ef- fect of diabetic peripheral neuropathy is poor.

AIM: To understand the epidemiology and related factors of strabismic amblyopia of students of primary school, and to provide guidances for the prevention and control strategy.
METHODS: A total of 600 cases of primary school students of Leshan City, Jiajiang County were given vision, oblique incidence and ocular and other screening. The prevalence rate of poor eyesight of strabismus, amblyopia prevalence rate of different sexes, ages were compared, and the degree of amblyopia and strabismus of children with different types of amblyopia and whether or not had stereoscopic vision were counted.
RESULTS: The prevalence rate of amblyopia and strabismus prevalence rate were respectively 4. 0% and 2.5%;With the growth of all age, low vision of students was significantly decreased, the difference of comparison of low vision rate of each age had statistical significance (P<0. 05), but different ages, strabismus prevalence of different sexes, amblyopia prevalence were compared, the difference had no significant differences ( P>0. 05 );Ametropic amblyopia was the main type, accounting for 55. 6%, and the degree of amblyopia mainly was light, moderate; ametropic amblyopia, most of ametropic amblyopia and strabismus had stereo vision, but there were no stereopsis of most of the strabismic amblyopia and all esotropia.
CONCLUSION:Ametropic is mainly type of amblyopia, the prevalence of relationship between the incidence of strabismic amblyopia of primary school students and sexes is not obvious, but the oblique amblyopia treatment effect, such as the establishment of stereoscopic vision and the age, eye position has a close relationship, should be early discovered, early treatment.

0.37).Meanwhile a good correlation (Y=0.99X-0.18,r=0.987) was obtained. Though Westergren method correlated preferably with MICROTEST 1 (Y=0.86X+1.27,r=0.906),there was a markedly different (t=3.174,P=0.001).At last different references values were collected, according to sex and age.Male,32.5 mm/1 h(60 years old);Female, 34.03 mm/1 h(50 years old).Conclusions MICROTEST 1 correlated preferably with Westergren method.The examination by MICROTEST 1 needs small quantity of sample and fewer time.Furthermore,it has good repeatability and stability.The factors such as temperature and Hct have little influence on the results.The result suggested that it is suitable to apply MICROTEST 1 to large- scale clinical laboratory or other labs.But the reference value of ESR was influenced by age,which should be considered in clinical usage.

OBJECTIVE:To observe the clinical effect of Zweymüller bicon-threaded cup in total hip arthroplasty for treating hip rheumatoid arthritis.METHODS:A retrospective analysis was performed on 24 cases (39 hips) of rheumatoid arthritis selected at the Department of Joint surgery of the Affiliated Provincial Hospital of Shandong University,including 8 males (14 hips) and 16 females (25 hips),aged from 32 to 64 years (average 49.2 years old),course of disease being from 4 to 15 years (average 8.5 years).All the cases the state of wound healing and perioperativ complications were examined,and the position of acetabulum prosthesis was observed by X-ray film.RESULTS:All patients were followed up,and the follow-up time ranged from 14 to 62 months (average 37.5 months).They were all obtained first-stage wound healing,and two cases of gastrocnemius vein thrombus were found among them,occurred by non-operation.All patients were free from pain with stable fixation and mobility increasing.The process of osseo integration being well,the radiolucent line and radiographic loosening of acetabulum prosthesis and sedimentation of stem were not found on antero-posterior pelvis-radiograph and lateral radiograph of ipsilateral hip.The Harris hip score increased from preoperative 33.5 points (17-46 points) to postoperative 86.5 points (79-96 points) at 3 months.There were no complication appeared such as dislocation,fracture and nerve injury.rheumatoid arthritis.

OBJECTIVETo observe the effect and safety of plastering Chinese Compound Shenhuang Ointment (CSO) at Shenque (RN8) in promoting the rehabilitation of postoperative gastrointestinal dysfunction patients of qi stagnation blood stasis syndrome (QSBSS).

METHODSA prospective, multi-centered, randomized, double-blinded, controlled trial was conducted in 220 postoperative gastrointestinal dysfunction patients of QSBSS. They were randomly assigned to two groups, the CSO group (110 cases) and the placebo group (110 cases). CSO was plastered at Shenque (RN8) for 5 days after operation. The time of exhaustion, defecation, the recovery of intestinal peristalsis, integrals of TCM syndrome, and serum levels of motilin (MOT)and somatostatin (SS) were observed.

RESULTSCompared with the placebo group, the condition of exhaustion and defecation, the recovery of intestinal peristalsis on the 3rd day after operation was all improved (P < 0.05). The integrals of TCM syndrome at day 2, 3, and 4 were more significantly lowered in the CSO group than in the placebo group (P < 0.01, P < 0.05). The total effective rate of TCM syndrome was 95.3% in the CSO group, better than that in the placebo group (91.8%, P < 0.05). Compared with the placebo group, the serum MOT level increased and the serum SS level decreased at day 5 after operation in the CSO group (P < 0.05).

CONCLUSIONSThe plastering of CSO at Shenque (RN8) could advance the time of exhaustion and defecation, and improve patients' clinical symptoms. And patients could tolerate well.

Aged ; Double-Blind Method ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Gastrointestinal Diseases ; drug therapy ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Ointments ; Postoperative Period ; Prospective Studies

Osteonecrosis of the femoral head is frequently observed in patients treated with excessive corticosteroids. However, the pathogenesis of corticosteroid-induced osteonecrosis remains unclear. The purpose of this study was to investigate the role of Toll-like receptor 4 (TLR4) signaling pathway in steroid-induced femoral head osteonecrosis in rats. Male Sprague-Dawley rats were injected intramuscularly with 20 mg/kg methylprednisolone (MP) for 8 weeks, twice per week. The animals were sacrificed at 2, 4 and 8 weeks after the last MP injection, respectively, and then allocated to the 2-, 4- and 8-week model groups (n=24 each). Rats in the control group (n=12) were not given any treatment. Histopathological analysis was performed and the concentration of tartrate-resistant acid phosphatase (TRAP) in plasma was determined. The activation of osteoclasts in the femoral head was assessed by TRAP staining. The expression of TLR4, MyD88, TRAF6 and NF-κB p65 that are involved in TLR4 signaling, and MCP-1 production were detected by using real-time PCR (RT-PCR) and Western blotting. The results showed that the osteonecrosis in the femoral head was clearly observed and the concentration of TRAP in the plasma was increased in the model rats. The femoral head tissues in MP-treated rats were positive for TRAP and the intensity of TRAP staining was greater in MP-treated rats than in control rats. As compared with the control group, the mRNA expression of TLR4 signaling-related factors was enhanced significantly at 4 and 8 weeks, and the protein levels of these factors increased significantly with time. It was concluded that MP could induce the femoral head osteonecrosis in rats, which was associated with osteoclast activation via the TLR4 signaling pathway. These findings suggest that TLR4 signaling pathway plays a pivotal role in the pathogenesis of steroid-induced osteonecrosis.

BACKGROUNDAcute lung injury (ALI) is a common syndrome associated with high morbidity and mortality in emergency medicine. Cell apoptosis plays a key role in the pathogenesis of ALI. Hydrogen sulfide (H(2)S) plays a protective role during acute lung injury. We designed this study to examine the role of H(2)S in the lung alveolar epithelial cell apoptosis in rats with ALI.

METHODSSixty-nine male Sprague Dawley rats were used. ALI was induced by intra-tail vein injection of oleic acid (OA). NaHS solution was injected intraperitonally 30 minutes before OA injection as the NaHS pretreatment group. Single sodium hydrosulfide pretreatment group and control group were designed. Index of quantitative assessment (IQA), wet/dry weight (W/D) ratio and the percentage of polymorphonuclear leukocyte (PMN) cells in the bronchoalveolar lavage fluid (BALF) were determined. H(2)S level in lung tissue was measured by a sensitive sulphur electrode. Apoptosis was evaluated by terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) staining and Fas protein was measured by immunohistochemical staining.

RESULTSThe level of endogenous H(2)S in lung tissue decreased with the development of ALI induced by OA injection. Apoptosis and Fas protein in alveolar epithelial cells increased in the ALI of rats but NaHS lessened apoptosis and Fas protein expression in alveolar epithelial cells of rats with ALI.

CONCLUSIONEndogenous H(2)S protects rats from oleic acid-induced ALI, probably by inhibiting cell apoptosis.

Acute Lung Injury ; chemically induced ; drug therapy ; metabolism ; Animals ; Apoptosis ; physiology ; Epithelial Cells ; drug effects ; Hydrogen Sulfide ; metabolism ; In Situ Nick-End Labeling ; Male ; Oleic Acid ; toxicity ; Rats ; Rats, Sprague-Dawley ; Sulfides ; pharmacology ; therapeutic use

Objective To explore the clinical value of 99Tcm-MIBI G-MPI in patients diagnosed with myocardial bridging(MB) by CTA. Methods Forty-five patients with MB and 17 normal controls diagnosed by CTA(64 slices CT) were included. All patients underwent rest 99Tcm-MIBI G-MPI and 17 MB patients and 9 normal controls also underwent stress 99Tcm-MIBI G-MPI. Myocardial ischemia, function and wall motion were assessed. G-MPI results were compared with CTA results by χ2 test, Fisher exact test and t test. Results In patients with MB, the positive rate of abnormal perfusion by gated stress 99Tcm-MIBI G-MPI was 64.7% (11/17) and 41.2% (7/17) using quantitative analysis and visual evaluation respectively; while the data were 42.2% (19/45) and 22.2% (10/45) by rest G-MPI (P=0.035). The positive rate by rest G-MPI in MB patients was significant different among mural coronary arteries of different depths and different locations. By quantitative analysis of the stress G-MPI, the reversible, fixed, and mixed ischemia patients were 4 (35.3%), 6 (23.5%) and 1 (5.9%) respectively; the reversed, reversible and fixed abnormity of wall motion was found in 4 (23.5%), 4 (23.5%) and 2 (11.8%) patients respectively; the reversed, reversible and fixed wall thickening were found in 6 (35.3%), 5 (29.4%) and 1 (5.9%) patients respectively. There was no significant difference in left ventricular ejection fraction and peak filling rate between MB patients and normal controls in both rest and stress studies (t: from -0.564 to 1.292, all P>0.05). Conclusion The G-MPI may be useful for the evaluation of myocardial ischemia and myocardial function simultaneously in patients with MB.

Objective To explore whether straight guiding catheter exchange assisted by double guidewire can slove the difficult problem of the guiding catheter being unable to enter the right carotid artery in patients with carotid stenosis via circuitous approach.Methods Fifteen patients with severe carotid stenosis,admitted to our hospital from August 2005 to January 2013,were chosen in our study; they were performed straight guiding catheter exchange assisted by double guidewire.Secondary carotid sinus syndrome,puncture wound,acute coronary syndrome,cerebral infarction and cerebral hemorrhage in the postprocedural period were observed; National Institutes of Health Stroke Scale (NIHSS) scores 3 and 30 days after the surgery were recorded and compared; meanwhile,modified Rankin Scale (mRS) scores 3 months after the surgery were compared.Results With the techniques of straight guiding catheter exchange assisted by double guidewire,13 patients were successfully implanted carotid artery stent among the 15 patients.Two patients had secondary carotid sinus syndrome,3 had femoral sheath around postoperative bleeding and 1 had femoral artery fistula during the 13 patients.The NIHSS scores in 1 patient decreased after the operation,but new infarction lesion was not found in the head CT.The NIHSS scores 30 days after the surgery [11 (8-13)] were significantly lower than the preoperative NIHSS scores [14(9-17)] (Z=-10.153,P-0.000).The mRS scores 3 months after the surgery was significantly improved as compared with those before surgery (U=2.079,P=-0.045).Conclusion The application of straight guiding catheter exchange assisted by double guidewire is safe and effective in the carotid-artery stenting via circuitous approach.