[Objective]To estimate the results of the total knee replacement for osteoarthritis knee joint.[Method]Eighty-one patients(95 knees)with osteoarthritis of knee joint were selected for total knee replacement.The average age of the patients was 65.5 years with a range of 50~82 years,which involved 10 males and 71 females.Left knee was in 35 cases and right knee was in 26 cases.Bilateral knee replacement one time was 17 cases.The posterior crnciate ligament retaining prosthesis was 18 knees,posterior stabilizing prosthesis was 62 knees and mobile bearing prosthesis was 15 knees.[Result]All the patients were available at the follow-up,with a mean of 42 months(14~108 months).According to HSS system,80 knees(84.21%)had an excellent results;10 knees(10.53%),a good result;3 knees(2.86%),a fair result;and 2 knees(1.9%),poor result.The satisfactory rate was 95.23%.[Conclusion]Total knee replacement can decrease knee pain and improve knee function.The prosthesis choice,surgical technique and postoperative rehabilitation are key factors to the operation results.

BACKGROUND: At present, studies concerning human umbilical cord blood mesenchymal stem cells (UCB-MSCs) transplantation for repair of rat spinal cord injury, brain tumor, and myocardial infarction have been reported, and studies that human UCB-MSCs were induced differentiation into osteogenic cells under certain conditions have also been reported at home and abroad. But application of UCB-MSCs transplantation in the treatment of osteonecrosis of animals has not yet been reported. OBJECTIVE: To observe the repair results of recombinant lentivirus vector tracing enhanced green fluorescent protein (EGFP)-transfected UCB-MSCs transplantation in treatment of ischemic necrosis of the femoral head in rabbits. METHODS: Bone morphogenetic protein-2 gene plasmid, recombinant lentivirus vector carrying EGFP and UCB-MSCs were co-cultured. Rabbit models of femoral head defects were made and randomly divided into 3 groups. There was no treatment in the normal group, control group with bone defects and experimental bone defects filled with UCB-MSCs tracing transfected by recombinant lentivirus vector carrying EGFP. At 4 and 8 weeks after treatment, the imaging and histological of the femoral head were observed.RESULTS AND CONCLUSION: Imaging and histology results showed that there were osteogenic response and new bone formation in the experimental group at 4 weeks, and the bone defects were basically repaired at 8 weeks after treatment. In the control group, the bone defects filled with fibrous connective tissue fiber connective tissues at 4 weeks, and the osteosclerosis could be found surrounding femoral head, bone defects filled with fibrous connective tissue fibers and bone trabecula distributed disorderly. The recombinant lentivirus vector tracing EGFP-transfected into UCB-MSCs has strong effects bone conduction and can repair ischemic necrosis of the femoral head.

Objective:To establish a prognostic Nomogram model for predicting the risk of early death in polytrauma patients.Methods:Data extracted from a polytrauma study on Dryad, an open access database, was selected for secondary analysis. Patients from 18 to 65 years old with polytrauma in the original data were included. All patients with missing variables, such as blood lactic acid (Lac), Glasgow coma score (GCS) and injury severity score (ISS) at admission, were excluded. The differences of gender, age, Lac, ISS and GCS scores between the patients who died within 72 hours and those who survived were analyzed. The risk factors for 72-hour death were analyzed by Logistic regression, and the Nomogram prediction model was established using R software. The receiver operating characteristic (ROC) curve was used to evaluate the predictive ability of the model, and the Bootstrap method was used for internal verification by repeating sample for 1 000 times. Decision curve (DCA) was applied to analyze the clinical practical value of the model.Results:A total of 2 315 polytrauma patients were included. Logistic regression analysis showed that Lac, GCS score and age > 55 years old were the risk factors for early death in polytrauma patients [Lac: odds ratio ( OR) = 1.36, 95% confidence interval (95% CI) was 1.29-1.42, P < 0.001; GCS score: OR = 0.76, 95% CI was 0.73-0.79, P < 0.001; age > 55 years old: OR = 1.92, 95% CI was 1.37-2.66, P < 0.001]. The prediction model was established by using the above risk factors and displayed by Nomogram. ROC curve analysis showed that the area under the ROC curve (AUC) of Nomogram model to predict the risk of death within 72 hours was 0.858, and the predictive ability of Nomogram model was significantly higher than that of Lac (AUC = 0.743), GCS score (AUC = 0.774) and ISS score (AUC = 0.699), all P < 0.05. The model calibration chart showed that the predicting probability was consistent with the actual occurrence probability, and the DCA showed that Nomogram model presented excellent clinical value in predicting the 72-hour death risk for polytrauma patients. Conclusions:The prognostic Nomogram model presents significantly predictive value for the risk of death within 72 hours in polytrauma patients. Prognostic Nomogram model could offer individualized, visualized and graphical prediction pattern, and provide physicians with practical diagnostic tool for triage system and management of polytrauma according to precision medicine.