BACKGROUND:Skin preparation before surgery has been described as a preventive measure for reducing infections following total knee arthroplasty.OBJECTIVE:To investigate the prophylactic effect of skin preparation on the infections after total knee arthroplasty.METHODS:A total of 422 patients (493 knees) who were candidate for primary total knee arthroplasty,including 98 males and 327 females.They were from 40 years old to 84 years old,averaging 60 years old.According to the different ways of preoperative skin preparation,the patients were divided into 3 groups,razor skin preparation group (n=290 patients,331 knees),dehairing agent skin preparation group (n=74 patients,88 knees),and skin cleaning on the surgical morning group (n=61 patients,74 knees);the limb infections after replacement were observed.RESULTS AND CONCLUSION:All patients were followed up for 0.5-5.5 years,with an average of 3.9 years.The infection incidence after total knee arthroplasty in the razor skin preparation group,dehairing agent skin preparation group,skin cleaning on the surgical morning group were 1.81%,2.27%,1.35%,respectively.It is indicated that there is no significant difference in the infection rate of skin preparation by different methods following total knee arthroplasty.

Objective To observe the clinical effects of the homemade medicated and dietary compound granules in treating sub-health insomnia with deficient cultivation of heart-spirit. Methods Sixty qualified patients were randomly divided into treatment group and control group, 30 cases in each group. The treatment group was given homemade medicated and dietary compound granules(mainly composed of Semen Ziziphi Spinosae, Radix Codonopsis, Sclerotiium Poriae Circum Radicem Pini, Radix Polygalae, Flos Rosae Rugosae, Plumula Nelumbinis, Fructus Ziziphi Jugubae, and Arillus Longan). The control group was given Oryzanol powder. The course of treatment lasted for half a month. Before and after treatment, the scores of Pittsburgh Sleep Quality Index(PSQI) and the traditional Chinese medicine(TCM)symptom rating scale were observed, and the clinical efficacy of the two groups were also evaluated. Results After treatment for half a month and after suspension of medicine for half a month , (1) the total effective rate of the treatment group was higher than that of the control group (P<0.05);(2) the total PSQI scores , sleep quality scores , falling asleep time scores , and daytime function disorder scores were decreased in the treatment group (P < 0.01 compared with those before treatment) , but the scores of each PSQI item in the control group stayed unchanged (P > 0.05). The total PSQI scores , sleep quality scores , falling asleep time scores, and daytime function disorder scores of the treatment group were lower than those of the control group (P<0.01);(3) the total scores of TCM symptoms as well as the scores of dreaminess and susceptibility to awakening, palpitation and amnesia, lassitude and weakness, poor appetite, pale complexion, vertigo and dizziness, abdominal distension and loose stools were declined in the treatment group (P < 0.05 or P < 0.01 compared with those before treatment). Conclusion Medicated and dietary compound granules are effective on improving sleep quality, shortening time to fall asleep, improving sleep disorder, increasing the efficiency of daytime function, improving patients’ mental state entirely, and maintaining the short-term curative effect.

AIM:To develop the quality standard for Capsicum Rheumatism Gel(Fructus Capsici extract,menthol,borneol). METHODS:HPLC was used to determine capsaicin in Capsaicum Rheumatism Gel.The se-(paration) was performed on zorbax C_(18) column with methanol-water-phosphoric acid (70∶30∶0.085) as a mobile phase.The flow rate was 0.8 mL/min,and the detection wavelength was at 280 nm.Menthol and borneol contents in Capsaicum Rheumatiosm Gel were determined by GC and naphthalene was adopted as internal standard substance. RESULTS:There was a good linear relationship for capsaicin at a range of 0.082 65-0.578 55 ?g and the average revovery was 97.86% with RSD=1.28%.There were good liner relationships for menthol and borneol at a range of 0.081 0-1.053 ?g,0.080 8-1.050 4 ?g and the average revovery was 98.668%,97.536%. CONCLUSION:The method proves to be simple,precise and reproducible and is suitable for quantitative control of Capsicum Rheumatism Gel.

Objective To evaluate the causes,prevention and treatment of mesh infection after abdominal wall hernia mesh repair.Methods The clinical data of 14 mesh infections admitted from De-cember 1997 to December 2013 were analyzed retrospectively.There were one case of inguinal hernia with Lichtenstein repair,eleven cases of inguinal hernia with preperitoneal repair,one case of incisional hernia with Bard Composix Mesh and 1 case of parastomal hernia with mesh repair above the abdominal muscle. Based on prothetic materials and infection status,the infection meshes were removed in 4 cases and open dressing change were operated in 10 cases.Results All patients were healed and discharged without peri-operative death.There was no hemorrhage and bladder injury during the procedures.The time of dressing change ranged from 3 weeks to 6 months,with a median of 4 weeks.All patients were followed up for 8 to 64 months.One patient had a recurrence of abdominal incisional hernia.Conclusion There are many fac-tors related to mesh infection after mesh repair and preventing mesh infection is the most important.Once the infection occurs,the management should be individualized.Antibiotic treatment and surgical drainage can be effective in most polypropylene mesh(PPM)infection However,infected expanded polytetrafluoro-ethylene(ePTFE)mesh should be removed completely.

Objective: To investigate the effect of tumor specific antigen of HCA520 on the proliferation of HEK293 cells and to obtain some functional implications for HCA520. Methods: MTT assay was performed with HEK293 stable cell lines transfected with pcDNA3-HCA520-flag construct. Cytokines probably involved in HCA520 enhanced proliferation were screened by RT-PCR, and effect of these cytokines on the HEK293 cell proliferation was further confirmed by MTT assay. Results: HCA520 significantly promoted the proliferation of HEK293 cells, which was at least partially attributed to the up-regulation of IL-6 in HEK293 cells by HCA520. Conclusion: HCA520 might accelerate tumorigenesis by promoting proliferation of cancerous cells.

Objective:To determine whether dexmedetomidine (Dex) improves oxygenation and lung mechanics in patients with moderate chronic obstructive pulmonary disease (COPD) during lung cancer surgery.Methods:Fifty-six patients with moderate COPD were randomly allocated to a control group and a Dex group (n=28 each).In the Dex group,dexmedetomidine was given as an initial loading dose at 1.0 μg/kg lasting for 10 min followed by a maintenance dose at 0.5 μg/(kg-h) during OLV while the control group was administered an equal volume of 0.9％ saline accordingly.Results:Patients in the Dex group had a significantly higher oxygenation index (P＜0.05) and higher dynamic lung compliance at Dex-30 and Dex-60 (P＜0.05) compared with those in the control group.In the Dex group,oxygenation index in the postoperative period was significantly higher (P=0.025) and postoperative complications were lower than those in the control group.Conclusion:Dex administration may provide dinically relevant benefits by improving oxygenation index and lung mechanics,and reducing postoperative pulmonary complications in patients with moderate COPD underwent lung cancer surgery.

Objective; To express and purify HCA518 protein and prepare its monoclonal antibody ( McAb). Methods: The HCA518 protein was expressed with gene recombinant technique in prokaryotic system and purified with nickel chelate nitrilotriacetic acid(Ni-NTA) affinity chromatography column. Hybridoma cell lines that secreted anti-HCA518 McAb were established by cells fusion and screened by enzyme linked immunosorbent assay( ELISA). The specificity of anti-HCA518 McAb wa3 identified by Western blot assay. The HCA518 protein in tumor cells was stained by immunoflourescence assay. Results: Rcombinant HCA518 protein was expressed with a purity of 98%. Two hybridoma cell lines was selected and anti-HCA518 McAb was purified from mice ascites. The titers of anti HCA518 McAb in ascites were 1?10-4 and 5?10-4 respectively. The antibody belonged to IgG2b subtype and IgM. Anti-HCA518 McAb specifically reacted with recombinant HCA518 protein and tumor cells'nuclear protein (P100). The HCA518 protein was mainly located in cell nucleus. Conclusion: Stable hybridoma cell lines that secreted anti-HCA518 McAb have been established and anti HCA518 McAb was prepared with high specificity. It has important significance for detecting HCA518 protein in tumor tissues and determining malignant proliferation status of tumor cells and predicting its prognosis.

Objective To explore the correlation of patient-controlled sedation of dexmedetomidine and Narcotrend values. Methods Forty patients with lower limb surgery were enrolled. Until CSEA block fixed , the electronic pump ran the patient-controlled sedation of dexmedetomidine. The parameter of electronic pump was set as follows: load dose 2 mL + background dose 1.5 mL/h + single dose 0.5 mL + locktime 20 s. The heart rate , mean arterial pressure, pressing times, effective times, OAA/S sedation scores and NI values were determined. Results At T4 point, the patients reached appropriate sedation. At T4 ~ T9 OAA/S scores kept 3 to 4. From T5 point, NI values showed significant decrease. After the T7 point. OAA/S scores and NI values reached the plateau time of (7.5 ± 1.8) min and (13.1 ± 3.4) min, OAA/S scores of 1, 2, 3, 4, respectively, corresponding roughly with NI values 95 to 100, 90 to 94, 65 to 89, 40 to 64. The correlation coefficient was 0.58. The time of NI values significant decreased in the younger group and in the elderly group, with (10.2 ± 1.6) min and (14.4 ± 2.2) min. In T5~ T9 point, NI values of the younger group were significantly lower than those in the elderly group. Conclusion Relevant relationships are observed between dexmedetomidine patient-controlled sedation depth and the narcotrend values under CSEA.

Objective To investigate the effects of dipeptidyl peptidase 4(DPP-4) inhibitor on serum adiponectin (APN) and high sensitivity C-reactive protein (hs-CRP) in patients with type 2 diabetes mellitus.Methods 45 cases were type 2 diabetes were collected from department of endocrinology,wuxi second People's hospital of jiangsu province from January 2015 to April 2015.45 patients with type 2 diabetes mellitus were randomly divided into treatment group (n=23) and control group (n =22) , treatment group was treated with metformin combined with DPP-4 inhibitor and control group was treated without DPP-4 inhibitor.Before and after treatment,fasting plsma glucose(FPG),postprandial 2h glucose(2hPG),adiponectin, hs-CRP and homeostasis model assessment for insulin resistance(HOMA-IR) were measured.Results Adiponectin was significantly higher in treatment group than before(P<0.05),FPG,2hPG,hs-CRP and HOMA-IR were significantly lower than before(P<0.05).Adiponectin in treatment group was significantly higher than control group post-treatment(P<0.05).2hPG,hs-CRP and HOMA-IR in treatment group were siginificantly lower than control group post-treatment (P<0.05).Conclusion DPP-4 inhibitor could improve insulin resistance in type 2 diabetes mellitus by increasing serum adiponectin and decreasing serum Hs-CRP and HOMA-IR.

AIM: To observe the effect of (IFN-?1b) on morphology and the expression of connective tissue growth factor (CTGF) in hepatic stellate cells (HSC). METHODS: HSC were cultured in vitro, and were treated with (IFN-?1b) and TGF-?_1. The changes of HSC on morphology were observed, and the expression of CTGF in HSC was assessed using reverse transcription-polymerase chain reaction (RT-PCR). RESULTS: Phenomenon of apoptosis were observed in HSC treated with IFN-?1b. The expression of CTGF in HSC was decreased after treatment with (IFN-?1b) in control and TGF-?1-triggered groups. CONCLUSION: (IFN-?1b) is able to induce the apoptosis and suppress the expression of CTGF in HSC.