[Objeetive] To assess the reproducibility and accuracy of four ratios used to measure patellar height,named the Blackburne-Peel,Caton Deschamps,Insall-Salvati and modified Insall-Salvati,before and after totalknee arthroplasty.[Methods]The patellar height was measured,by means of the four ratios,on the pre-and post-operative lateral radiographs of 44 patients(45 knees)who had undergone total knee arthroplasty.Two independent observers measured the films sequentially,in identical conditions,totally 720 measurements per observer.[Results]Before operation there was greater interobserver variation using either the Insall-Salvati or modified Insall-Salvati ratios than that when using the Caton-Deschamps or Blackburne-Peel methods.This was due to difficulty in identifying the insertion of the patellar tendon.Before operation,there was a minimal difference in reliability between these methods.After operation the interobserver difference was greatly reduced using both the Caton-Deschamps and Blackburne-Peel methods,which used the prosthetic joint line,compared with the Insall-Salvati and modified Insall-Salvati,which refered to the insertion of the patellar tendon.[Conclusion]The theoretical advantage of using the Insall-Salvati and modified Insall-Salvati ratios in measuring true patellar height after total knee arthroplasty needs to be balanced against their significant interobserver variability and inferior reliability when compared with other ratios.

To investigate the mechanism of aldosterone in the induction of hypertensive myocardial fibrosis, we compared the changes of the incorporation rate of 3H proline, the contents of cardiac tissue collagen, and the activities of the cardiac mitogen activated protein kinase (MAPK) in the spontaneous hypertensive rats (SHRs) untreated and treated with a competitive antagonist of the aldosterone receptorspironolactone (spiron), and also in normotensive rats. The results showed that the incorporation of 3H proline incubating with the myocardial tissue slices significantly increased at three time points (at 4,6,8 h), that the tissue collagen contents and the activities of tissue MAPK also increased in SHRs than in SHRs treated with spiron and in normotensive rats. It suggests that aldosterone stimulates the cardiac MAPK through specific recepter, thus increases the absorption of proline and synthesis of collagen in the cardiac fibroblasts, and in turn, is responsible for the myocardial fibrosis.

[Objective]The patellar tendon lengths were compared in the knees with a history of patellar instability and in normal knees in Chinese,and the significance of patellar tendon length measurement in the knees of patellar instability was discussed.[Method]Totally 49 knees of 43 patients with patellar instability were reviewed from Jan.2003 to Dec.2005,including 15 males and 28 females and 6 paients with both instahle patellas.The mean age was 21.4 yrs(from 18~28 yrs),and the mean height was 163 cm(155~173 cm).And,50 normal control knees of 50 volunteers including 16 males and 34 females.The mean age was 24.2 yrs(from 18~35 yrs),and the mean height was 165cm(154~177 cm).The patellar tendon length,the distance between tibial tubercle and the anterior edge of tibial plateau and Insall-Salvati index on the lateral X-ray plain with 30? flexion of keens were measured and analyzed.[Result]The patellas tendon length of patients was longer than that of normal volunteers(53.3?2.7mm,47.3?3.3 mm,P0.05)of the distance from tibial tubercle to the anterior edge of tibial plateau between patients and volunteers.However,difference of Insall-Salvati index between patients and volunteers was significant(1.33?0.17,1.06?0.14,P

Objective To observe the injury to the heart,liver and kidney induced by hind limb ischemia/reperfusion(I/R),and to study the protective effect of H2S by attenuating this injury,in order to offer a theoretical basis for therapeutic application.Methods A model of hind limb I/R was reproduced.28 rats were divided randomly into 4 groups:normal control group(C,n=8),ischemia 4h group(I,n=8),ischemia 4h and reperfusion 4h group(I/R,n=6)and I/R+NaHS group(n=6)(NaHS can provide H2S for rats in vivo).The concentrations of CK,CK-MB,Tn-T,ALT,AST,Cr and urea in blood plasma were determined.The pathological changes in the heart,liver and kidney were observed with HE staining.Results The concentration of CK,CK-MB and Tn-T in I group increased significantly compared with that in C group,and that in I/R group was higher than in I group.No significant difference was found in plasma concentration of ALT,AST,Cr and Ur between C group and I group,while it they were increased significantly in I/R group compared with that in I group,and that in I/R+NaHS group were decreased significantly compared with that in I/R group.Pathological examination revealed pathological findings of injury to the heart,liver and kidney in I group,and even more serious injuries were found in I/R group than in I group,while the they were less marked in IR+NaHS group compared with that in I/R group.Conclusion Hind limb ischemia/reperfusion may result in injury to the heart,liver and kidney.H2S may attenuate injury to remote organs follawing hind limb ischemia/reperfusion.

Objective To study induction of myocardial fibrosis by high-cholesterol diet and its mechanism in rat. Methods Nineteen Wister rats aged 8 weeks were randomly divided into control group, high-cholesterol diet group and spironolactone treatment group. Collagen in left ventricular tissues was determined by oxyproline assay, contents of angiotensin Ⅱ(Ang Ⅱ) and aldosterone (Ald) and in left ventricular tissue their plasm concentration were determined by radioimmunoassay. Serum nitrite level was measured by Griess assay. Mitogen activated protein kinase (MAPK) was assessed by radioisotope labeled assay. Results The contents of collagen, cardiac Ald and plasma Ang Ⅱ in the myocardium of the left ventricle were increased 1.2, 1.1 and 3.0 fold, respectively, while serum level of nitrite (NO - 2) was significantly decreased in high-cholesterol diet group compared with control group. The contents of myocardial collagen and Ald, and plasma Ang Ⅱ and the activities of MAPK were decreased in high-cholesterol diet group treated with spironolactone for 8 weeks (P

Objective To investigate the changes of the activity and the distribution of the rat cardiac calcineurin (CaN) which is the signalling molecule of the hypertrophy induced by the external aldosterone(Ald), and to detect the mechanism of the regulation of CaN. Methods 21 male wister rats were randomly divided into 3 groups: group Ald(7 rats), treated with Ald 18?g/d, peritoneal injection (i p) for 4 weeks; group spironolactone (spiron) (7 rats), treated with Ald and with spiron 20mg?kg -1 ?d -1 oral for 4 weeks; and group control (7 rats). The plasma concentrations of Ald, angiotensin Ⅱ(Ang Ⅱ)and endothelin(ET), blood levels of NO, the tissue activity of the CaN and distribution of CaN A? in the myocardium of the left ventricle, were detected in the rats by the radioimmunoassay , by the nitrate assay, by the chromophoric assay and by the immunohistochemistry, respectively. Results The concentration of the plasma Ald increased by 1 62 times, the blood NO - 3 concentration was deceased, the ratio of Ald over NO - 3( Ald/ NO - 3) increased by 2 95 times, and the cardiac tissue levels of CaN activity was were 1 47 times higher, in the rats treated with ald than in the normotensive rats. CaN A? distributed over cardiac cytoplasm, and the positive dyeing of the local CaN A? in the cytoplasm was thick near the cell membrane in the rats treated with Ald. The treatment with spiron could decreased the blood levels of the AngII?Ald/ NO - 3?ET/NO - 3?AngII/ NO - 3 and the tissue activity of myocardial CaN, positive dyeing of the local CaN A? in the cytoplasm, and increased blood NO - 3 concentration. Conclusion The aldosterone may be the main stimuli factor which can damage the balance of the blood active factors, and then make a novel cardiac hypertrophic signalling molecule calcineurin activated and redistributed in the cytoplasm of the rat left ventricular myocardium

Objective To investigate the effect of self- management programme in home care of oncohematologic patients with peripherally inserted central catheters(PICC). Methods Seventy oncohematologic patients with PICC were divided into the control group and the intervention group with 35 patients in each group by random digital table method. The control group received the routine care. The intervention group received the self- management programme. Self- care ability, anxiety, catheter- related complications and maintenance cost were observed before and on the 10th day and 30th day after intervention. Results On the 10th day and 30th day after intervention, the total score and scores of each dimension of self- care ability in the intervention group were significantly higher than those in the control group, P<0.05 or 0.01, the differences were significant. The score of anxiety in the intervention group was significantly lower than that in the control group [for the patients on the 10th day, 47.64±4.40 vs. 51.14±6.28,on the 30th day,44.36±3.71 vs. 48.64± 5.54, t=3.40, 5.18, P<0.01; for the family members of patients on the 10th day, 47.36±2.12 vs. 50.57±3.99, on the 30th day,43.57±2.04 vs. 47.57±2.79, t=4.35, 7.42, P<0.01. The incidences of catheter- related complications were not significantly different between two groups, P>0.05. Conclusions Self- management programme can effectively improve the self-care ability, relieve the anxiety and prevent the catheter- related complications in home care of oncohematologic patients with PICC.

Objective To discuss the effect of family nursing intervention on the life quality and pulmary function of patients with chronic obstructive pulmonary disease (COPD). Methods We divided 72 patients with COPD into the test group and the control group with 36 cases in each group.The two groups received routine treatment and nursing but additional family intervention was given to the patients and fam-ily members in the test group.The life quality and pulmonary function after intervention in the two groups were appraised in the two groups. Results The evaluation of life quality and pulmonary function were alleviated after intervention compared with those before intervention (P ＜ 0.05).But the above items in the control group were not significantly improved (P ＞ 0.05). Conclusions Effective family intervention could improve the life quality and pulmonary function of patients with COPD.

Objective To study the relationship between serum insulin-like growth factor-1(IGF-Ⅰ) levels and prostatic cancer. Methods The levels of IGF-Ⅰwas measured with immunoradiometric assay(IRMA) in 37 cases of prostatic cancer,35 cases of benign prostatic hyperplasia (BPH) and in 20 healthy subjects as controls.The serum IGF-I levels were compared to the clinical and pathological grading of the prostatic cancer.8 cases of prostatic cancer after operation have been followed up. Results The mean levels of serum IGF-I in prostatic cancer (325.6?100.8 ng/ml) were significantly higher than those in BPH (201.6?53.8 ng/ml) and healthy subjects (179.0?57.2 ng/ml) (P0.05).Statistical difference was noted before ( 315.8?87.0 ng/ml) and after (224.8? 88.4 ng/ml) PCa operation(P0.05). Conclusions The levels of serum IGF-I may be a new marker to prognose and for early diagnosis of PCa in high risk population.

Objective:To investigate the mechanism of intravenous procaine analgesia. Method: Six adult patients, ASA grade Ⅰ-Ⅱ, scheduled for abdominal surgery were investigated. Anesthesia was induced with intravenous fentanyl and propofol. Endotracheal intubation was facilitated with vecuronium. Anesthesia was maintained with continuous intravenous infusion of procaine(1mg?kg~(-1)?min~(-1))and inhalation of isoflurane. All patients were artifically ventilated with 100% O_2. Cerebrospinal fluid(CSF)and plasma concentrations of procaine were measured with gascbromatography 10,20,30 and 60 min following initiation of the constant infusion of procaine,at 5th, 15th, 30th and 60th min after the discontinuation. Result: Plasma steady-state levels were achieved within 30 min after commencement of the continuous infusion of procaine, The mean plasma steady-state level was 14.8?2.95?g/ml. Fifteen min after discontinuing the procaine infusion, 78% of plasma procaine content was eliminated. CSF steady-stale level was not achieved until 15 min after discontinuing the procaine infusion. The mean CSF steady state level was 4.47?0.94?g/ml. The elimination of the procaine in CSF was quite slow,and at 60th min after discontinuing the infusion,the mean CSF procaine level was 1.85?0.19?g/ml. Conclusion: The delayed total subarachnoid blockade induced by procaine infusion may be the mechanism of intravenous procaine analgesia.