Objective:To explore the surgical techniques in posterolateral mini-incision total hip arthroplasty and clinical effcacy.
Methods:A total of 94 patients (98 hips) had posterolateral mini-incision total hip arthroplasty, from December 2006 to December 2008, and were randomly divided into a posterolateral mini-incision total hip arthroplasty group (Group A) and a conventional group of posterolateral incision for total hip arthroplasty (Group B). Forty-nine patients (50 hips) in Group A had posterolateral small incision total hip arthroplasty [26 males, 23 females, between 37.0 and 95.0 years (average 68.9 years), body mass index (BMI) between 20.3 and 29.7 (average BMI 25.4)]. Forty-ifve patients (48 hips) in Group B had the conventional posterolateral incision [27 males, 18 females, between 45.0 and 92.0 years (average 69.7 years), BMI between 18.7 and 34.1 (average BMI 26.9)]. The incision length, blood loss, drainage, operation time, and postoperative Harris scores were compared between the 2 groups.
Results:The incision length was 6.0~10.5 (average length 7.4) cm, average blood loss was 387.6 (140.0~1000.0) mL, average drainage was 143.1 (63.0~375.0) mL, average blood transfusion was 77.6 (0~400.0) mL, average operation time was 84.6 (63.0~130.0) min, and vitalock abduction angle imaging after the operation was 41.6° (averagely 38.0°~57.0°) in Group A. The incision length was 15.0~23.0 (average length 20.0) cm, average blood loss was 513.1 (210.0~1350.0) mL, average drainage was 152.3 (70.0~520.0) mL, average blood transfusion was 142.2 (0~800.0) mL, average operation time was 84.0 (71.0~115.0) min, and postoperative radiographic acetabular cup abduction angle was 42.3° (37.0°~54.0°) in Group B. The follow-up showed that the prosthesis of the 2 groups was in a good position, Harris score was significantly improved with no complications after total hip arthroplasty in the 2 groups.
Conclusion:With the correct selection of indications and adept operation skills and other circumstances, posterolateral mini-incision total hip arthroplasty may do little damage to the soft tissue with a small scar on the skin. The imaging evaluation after the operation and the Harris score show no difference between the 2 groups. Patients are satisfied with their joint function and postoperative recovery.

Objective To investigate the bettertherapeutic method and clinical efficacy of discoid meniscus injury under arthroscope.Methods Forty-one patients with discoid meniscus injury were selected as our subjects from Nov.2011 to Feb.2013,who were treated by arthroscopic surgery and performed with meniscus plasty.Thirt-eight patients were received ultra Fast-fix meniscal repair system.Joint function exercises were performed on bed within 1 month after operation.Incomplete weight bearing were performed after 1 month postoperation.After 3 month postoperation,they were permitted for full weight bearing.Results All patients were treated successfully with surgery and no postoperative complications occurred.The patients were followed up from 3.0 to 18.0 months and average was 10.5 months.The preoperative Lysholm scores were(68.28 ±8.04)) lower than that at the postoperation (88.17 ± 7.49)) and the difference were significant (t =11.59,P ＜ 0.05).Furthermore,according to Ikeuchi criterion,the outcomes were 28 cases with excellent,10 cases with good and 3 cases with general rank.Conclusion Discoid meniscus plasty and suture under arthroscope is proved to be a better approach with less trauma,recovery quickly and fewer complications.It should be a preferred method for discoid meniscus injury.

Objective To evaluatethe curative effect of the integrative treatment of point injection, warm acupuncture and Chinese medicine enema for the chronic pelvic inflammatory disease.Methods A total of 86 patients with chronic pelvic inflammatory diseasewere divided into control group and treatment group, 43 patients in each group , according to the random number table. The control group was treated by warm acupuncture combined with Chinese medicine enema, while the treatment group was treated with point injection plus the basis of control group. The levels of serum CRP, IL-1 and IL-6 were detected by enzyme linked immunosorbent assay,the plasma viscosity and hematocrit were detected by automatic blood rheological test instrument,the symptom scores of 2 groups were compared before and after treatment, the clinical efficacy was evaluated and the recurrence rate was observed. Results The clinical effective rate of treatment group patients was 97.7% (42/43), and the control group 81.4% (35/43). The difference between two groups was significant (χ2=6.081,P=0.014). After treatment, the levels of CRP (7.53 ± 3.44 mg/L vs. 10.11 ± 3.02 mg/L,t=-3.696), IL-1β (26.37 ± 13.98 pg/mL vs. 36.33 ± 4.02 pg/mL,t=-4.490) andIL-6 (23.31 ± 10.11 pg/mlvs. 29.56 ± 4.27 pg/ml,t=-3.734)in the treatment group were significant lower than those in control group (P<0.05). The scores of pain (2.13 ± 0.55vs.2.71 ± 0.62,t=-4.589), tiredness (1.07 ± 0.98 vs. 2.53 ± 0.52,t=-8.630), Body cold (1.51 ± 0.51 vs. 2.21 ± 0.67,t=-5.451), menstrual symptoms (1.27 ± 0.97 vs. 2.29 ± 0.78, t=-5.374) and total points (6.13 ± 3.94vs. 8.55 ± 1.82,t=-3.656) in the treatment group were significant lower than those in control group (P<0.05). The plasma viscosity (1.13 ± 0.25 mPa?svs. 1.41 ± 0.32 mPa?s,t=-4.521) and the red blood cells deposited (0.27% ± 0.08% vs. 0.41% ± 0.07%,t=-8.636) in the treatment group were significant lower than those in control group (P<0.05). The recurrence rate of treatment group was none, while 11.43% (4/35) in control group. Thus, the recurrence rate of treatment group was significantly lower than the control group (χ2=5.063,P=0.024). Conclusions The integrative treatment of point injection, warm acupuncture and Chinese medicine enema can reduce the level of inflammatory factors in patients with chronic pelvic inflammatory disease, improve the blood microcirculation, and reduce the recurrence rate.

Objective To establish a high throughput phenotypic test for the detection of drug re-sistance in human immunodeficiency virus(HIV)strains. Methods The gene encoding luciferase was in-activated through restriction enzyme digestion and ligation. LacZ gene was used to replace the genes encoding original protease and reverse transcriptase. pol genes were amplified from pSG3△env plasmid and cloned in-to a new backbone plasmid through infusion. The factors that might affect the results of the test were opti-mized. Results The parental backbone plasmid pNL4-3. Lac was constructed,of which the gene encoding luciferase was inactivated and bearing the LacZ gene instead of genes encoding protease and reverse tran-scriptase. Several influential factors including cell numbers(10 000 / well),virus inoculation(200 TCID50 /well)and the concentration of DEAE-dextran(15 μg/ ml)were optimized. The reproducibility of this test was confirmed by testing 12 anti-HIV drugs against 2 pseudovirus strains 8 times,presenting the coefficient of variations(CVs)from 4. 32% to 28. 46% . Six types of pseudovirus were constructed and tested against the 12 anti-HIV drugs,the results of which were compared with those by using the pSG3△env-based pseud-ovirus test. The results of the two tests presented good consistency. Conclusion The high throughput phe-notypic test based on pNL4-3. Lac plasmid,combining the advantages of pSG3△env and pNL4-3 systems, could be used to analyze the drug resistance patterns of HIV-1 infectors and screen new drugs for antiretrovi-ral therapy in a rapid and effective way.

Objective To study the homology and clinical characteristics of healthcare-associated infection(HAI) due to Pseudomonas aeruginosa (P.aeruginosa)in medical intensive care unit (MICU),so as to guide the clinical prevention of P.aeruginosa transmission and improve therapeutic effect.Methods 55 P.aeruginosa strains isola-ted from 25 patients with HAI in the MICU of a hospital in January-December 2014 were performed pulsed-field gel electrophoresis (PFGE)homology analysis and clustering analysis,clinical characteristics,antimicrobial resistance, and transmission characteristics were analyzed.Results A total of 25 patients were investigated,with an average age of (69.62±2.13)years,mean hospital stay (49.34±3.18)days;prior to the isolation of P.aeruginosa, 84.00% of patients were treated with broad-spectrum antimicrobial agents for >2 weeks,76.00% of patients had been admitted to MICU,and 52.00% had a ventilator-assisted ventilation.55 strains of P.aeruginosa were mainly A,F,H,K,N,V,and W,which were the main epidemic strains;patients infected with A,F,H and K strains all had cross in their hospital stay;PFGE profiles of isolates from 4 patients during different periods showed different strain patterns;resistance rates of P.aeruginosa to ceftazidime (72.73%), piperacillin/tazobactam (70.91%),and imipenem(70.91%)were all high,resistance rate to amikacin was the lowest(25.45%).Conclusion Management of antimicrobial agents should be strengthened in medical institutions,HAI control meas-ures should be strengthened,so as to prevent the transmission of multidrug-resistant and extensively drug-resistant bacteria in hospitals.

Objective To evaluate the effect of the integrated strategy in prevention and control of intestinal nematodiasis in Hongze County,so as to provide the evidence for formulating the control strategies and measures in the future. Methods Since 1995,the integrated strategy has been carried out for intestinal nematodiasis,and the measures included deworming,health ed?ucation,safe water,sanitation and environmental remediation. The effects of the integrated strategy were evaluated by the inves?tigations of the prevalence of soil?transmitted nematodiasis,awareness of health knowledge and behaviors of residents. Results From 1995 to 2014,601 900 person?times were administrated with deworming medication and the coverage rate of villages and towns was 100%. The benefit rate of safe water was 100%. The popularity rate of harmless toilets was 92.77%. The prevalence of intestinal nematodiasis decreased from 26.04%in 1995 to 0.56%in 2014,and the difference had statistical significance(χ2=693.54,P < 0.01). The awareness rate of health knowledge and correct rate of health behaviors increased from 43.13% and 40.94%in 1995 to 98.00%and 96.80%in 2012,respectively(χ2=181.97 and 182.14 respectively,P<0.01). Conclusion The prevalence of intestinal nematodiasis has been controlled effectively through the integrated strategy in Hongze County ,Jiang?su Province.

Objective To investigate the effect of chronic and unpredictable pre-gestational stress on the serum cortisol level of the offspring,as well as the expressions of brain-derived neurotrophic factor (BDNF) and tyrosine protein kinase B (TrkB) in hippocampus when they were 2 month old.Methods Adult female SD rats were divided randomly into 2 groups:the control group and the chronic unpredictable stress (CUS) model group.All rats were tested in the open field test and sucrose intake test before and after CUS protocol.All offspring rats were sacrificed when 2-month old.Serum cortisol (COR) levels were determined by using a standard radioimmunoassay kit.The expressions of BDNF and TrkB in hippocampus were studied by immunoreactivity quantitative analysis.Results 1.After CUS procedure,CUS group showed decreasing activities in the open field test and decreasing sucrose consumption in sucrose intake test compared to the control group and before CUS procedure.2.The serum COR levels in the female offspring rats of CUS group (128.9 ± 7.3) μg/L were higher than those of the control group (119.9 ± 9.0) μg/L,as well as the male offspring of CUS group(116.5 ± 10.9) μg/L compared with the control group(105.4 ± 10.4) μg/L,but the body weight and brain weight between the offspring of 2 groups were not statistic significance.3.Immunoreactivity quantitative analysis showed that the gray values of BDNF in the female offspring of CUS group (36.1 ± 8.5) decreased compared with the control group(42.4 ± 6.9),as well as the male offspring of CUS(39.6 ± 8.4)compared with the control group (43.7 ± 6.4).4.The gray values of TrkB in the female offspring of CUS group (47.1 ± 2.9) decreased than the control group(50.2 ± 3.9),as well as the male offspring of CUS (46.5 ± 6.7)compared with control group(50.5 ± 5.4).Conclusion Pre-gestational stress reduced the expressions of BDNF and TrkB in hippocampus of the offspring which may relate to hypothalamic pituitary adrenal.

Objective To analyze the effect of quality of life (QOL) on the prognosis of long-term survivors with nasopharyngeal carcinoma (NPC). Methods A total of 192 NPC patients treated between 1999 and 2000 and with tumor-free survival before July 2003 were enrolled in this study. All patients received QOL measurement between July and August in 2003. Measurement scales included Chinese SF-36 questionnaire and a checklist consisting of fourteen items about self-rating symptoms. The median follow-up time was 7.9S years (range 2.67-9.55 years). The effects of QOL, social demographic and clinical factors on prognosis were analyzed. Results Univariate analysis showed that QOL affected the tumor-free survival and overall survival. Multivariate analysis showed that hypomnesia was an independent prognostic factor of tumor-free survival, while trismus, headache and age were independent prognostic factors of overall survival. The younger and the better QOL had better prognosis. The other sociodemographic and clinical factors had no prognostic value. Conclusion QOL is an important factor affecting the prognosis of long-term survivors with NPC, and it should be routinely evaluated during the follow-up.

Objective To evaluate the reliability, validity and feasibility of the Chinese version of SF-36 health survey questionaire in long-term survivors of nasopharyngeal carcinoma (NPC). Methods A total of 85 long-term NPC survivors completed the Chinese version of SF-36 by either telephone or mail survey. Correlation analysis, reliability analysis and factor analysis were performed to evaluate the reliability and validity of the scale. Results The Chinese version of SF-36 was easy to complete. The split-half reliability was 0. 92 and the Cronbach's α coefficient among domains were all above 0. 70, which showed good reliability and discrimination capacity among domains. All the correlation coefficients between each item and its domain achieved or approached 0. 5, which were greater than those between the item and other domains. These results demonstrated that the Chinese version of SF-36 had good content validity and discriminatory validity. Six principal components were extracted from the scale, which could basically represent eight domains. The cumulative variance was 71.4%. Two common factors were extracted from the eight domains, which accounted for 73.3% of the variance. The Chinese version of SF-36 was able to detect differences in the quality of life between NPC patients and healthy populations. Conclusions The Chinese version of SF-36 has good feasibility, reliability and validity in evaluating the quality of life in long-term NPC survivors.

ObjectiveTo explore the experiences of treatment of aortic root aneurysm and mitral valve disease through the incision of aorta.MethodsFrom Mar.2009 to Dec.2010, sixteen patients with aortic root aneurysm and mitral valve disease were operated by transaortic incision.After the leaflets of aortic valve were excised, mitral valve replacement or plasty was performed.There were 13 males and 3 females.The age ranged from 18 to 75 years old with a mean of (40 ± 10) years.The operation procedures included Bentall plus mitral valve replacement in 12 patients, Bentall plus mitral valve plasty in 1,Bentall + total arch replacement + stent elephant trunk + mitral valve plasty in 1, Bentall plus mitral valve plasty and CABG in 1.In 12 patients underwent mitral valve replacement, 11 were using continuous suture and interrupt mattress suture in 1.Four patients underwent mitral valve plasty, the procedure of banding mitral valve leaflets junctions was used.All patients were followed up through telephone and out-patient service.Transthoracic echocardiogram was performed before discharge and 3-, 6-,12-months after operation.Follow-up including cardiac function, valvular and perioperative complications.Results There were 2 re-thoractomy because of bleeding.One patient with pulmonary infection was cured by antibiotics.No death occurred in hospital.Patients were followed-up for 1 to 19 months with a mean of (7 ±5) months.No death occurred during follow-up period.There were no valve-related complications (embolism, bleeding, mitral valve dysfunction).Heart function was improved in all patients and graded as class Ⅰ to Ⅱ (NYHA).Two patients had trace regurgitation after mitral valve plasty when discharged.One patient had mild mitral valve regurgitation was found after mitral valve replacement.There was no further valve exacerbation for above 3 patients during follow-up period.ConclusionTransanrtic mitral valve operation is feasible in patients with aortic root aneurysm and mitral valve disease.