Periprosthetic infection is one of catastrophic complications which appear anytime after joint arthroplasty. Resear?ches show that the patients′risk factors are the keys to affect prosthetic joint infection after primary hip and knee arthroplasty. The au?thor summarized new study progress about risk factors for prosthetic joint infection after primary hip and knee arthroplasty at home and abroad. To investigate risk factors for prosthetic joint infection, the condition were analyzed by investigator from the following three as?pects:the patients′features, comorbidity, and preoperative medication.

Objectve To find out an effective method for treatment of postoperative wounds of the patients with anal and rectal diseases.Methods Cryoprecipitate was smeared over postoperative wounds of the patients with anal and bowel diseases(the experimental group),and the mean healing time,infection rates and hemostatic effect were observed and compared to the patients who were treated by routine medicine(the control group).Results The mean healing time of patients with hemorrhoid,anal fistula and perianal abscess was shorter than the control group by 5.68 days,6.01 days and 1.87 days respectively.And the infection rates of the experimental and control group were 9.18%(9/98)and 44.68%(42/94)respectively,significant difference between them was found( P

Objective To investigate the CT and MRI features of intraductal papillary neoplasm of the bile duct (IPNB).Methods Thirty eight patients with IPNB finally diagnosed by puncture biopsy or surgery were enrolled in this study.All the CT or MRI data were investigated retrospectively.Twenty one patients underwent CT examinations,17 patients underwent MRI examinations.The features of IPNB including the distribution features of the nodules or masses,CT and MRI features of cholangiectasis,mucus were analyzed.The accuracy differences of CT and MRI for the preoperatively diagnosing mucus and tumor growing along mucous were compared by nonparametric test.Results The lesions (including 5 patients with solitary lesions and 19 patients with multiple lesions) were located in intrahepatic bile duct in 24 patients,3 patients occurred simultaneously in intrahepatic and portal bile duct,2 lesions occurred in portal bile duct,8 lesions occurred in common bile duct,the lesions of 1 patient occurred simultaneously in common bile duct,cystic duct and gallbladder.Seventeen and 11 patients appeared nodules locating in dilated bile duct on CT and MRI,respectively.Four and 5 patients appeared cystic lesions with multiple nodules of the liver on CT and MRI,respectively.Higher contrast enhancement on CT and MRI in arterial phase than that in portal vein and equilibrium phase were observed in 18 and 12 patients,respectively.Excluding the patients undergoing puncture,CT was better than MRI in evaluating whether the mucus was present,with the accuracies of 30.0％ (6/20) and 6.3％ (1/16) for CT and M RI,respectively (Z =2.58,P ＜ 0.05).CT was worse than MRI in preoperatively evaluating the features of tumor growing along mucous,with the accuracies of 77.8％ (14/18) and 92.6％ (13/14) for CT and MRI,respectively (Z =4.23,P ＜ 0.01).Conclusion IPNB had the features of growing along mucous of the bile duct,nodule or mass in dilated bile duct and other features,CT and MRI are important in diagnosing the IPNB.

Objective To investigate the effects of β-adrenoceptor (β-AR) activation on the apoptosis in human mesangial cells and it's mechanism.Methods Cultured HMC were used in experiments and were divied into four groups:the control group; β-AR activation (β-AR agonist NE/Pra) group; β-AR inhibitor (Prop) group; antioxidants group.The experiments technology including PCR,confocal scanning microscope,immunofluorescence and Tunel.Results The results of RTPCR and confocal scanning microscope showed that β1-AR and β2-AR were expressed in human HMC.β-AR activation induced reactive oxygen species (ROS) increase in human MCs,the relative levels of ROS were elevated as early as 0.5 h after β-AR activation,and gradually increased and peaked at 4 h on a concentration and time dependent manner.Tunel results demonstrated that β-AR activation induced apoptosis with ROS on a concentration and time dependent manner,β-AR blocking agent-propranolol significantly inhibited β-AR activation induced apoptosis.Antioxidants including vitamin C and NAC could inhibited β-AR activation induced apoptosis (all P ＜ 0.01).Conclusions β-AR is functionally expressed in human mesangial cell,furthermore β-AR activation-induced ROS increase mediate apoptosis.Antioxidants can inhibit β-AR activation induced apoptosis.

Objective To evaluate the efficacy and safety of Shuangyi Qushi Tongluo Capsules (SQTC) for the treatment of knee osteoarthritis (KOA).Methods A multi-center,randomized,parallel-controlled trial was carried out in 240 cases of KOA patients.The patients were divided into trial group (N =120) and control group (N =120),which was given SQTC,Xianlinggubao capsules respectively for 8 weeks.Before treatment,and 2,4 and 8 weeks after treatment,we recorded the scores of clinical symptoms and traditional Chinese medical syndromes,Western Ontario and McMaster Universities Arthritis Index (WOMAC) scores and knee function scores.After treatment,the clinical efficacy and adverse reaction were observed.Results (1) After treatment for 8 weeks,the clinical efficacy of the trial group was superior to that of the control group (P ＜ 0.05).(2) The trial group had better effect on improving the visual analogue scale (VAS) scores of knee pain,VAS scores of limitation of motion and time for morning stiffness than the control group after treatment for 8 weeks(P ＜ 0.05 or P ＜ 0.01).(3) After treatment for 4 and 8 weeks,the trial group had better effect on improving scores of traditional Chinese medical syndromes,WOMAC scores and Japanese Orthopedic Association(JOA) scores than the control group (P ＜ 0.05 or P ＜ 0.01).(4) Before and after treatment,the results of blood,urine and stool routine examination,liver and kidney function,and electrocardiography showed no significant changes.Conclusion SQTC are effective and safe in treating KOA,and can start an effect shortly.

Objective To explore the influence of renal insufficiency with microwave therapy in the treatment of liver cancer .Methods A retrospective clinical analysis with 80 patients who underwent microwave therapy of liver cancer ,was performed from June 2012 to March 2014 in the department of hepatobiliary and pan-creatic surgery ,the Affiliated Tumor Hospital of Harbin Medical University .According to perioperative presence of renal insufficiency,we divided the patients into renal dysfunction group (A)(n=44)and normal renal function group(B)(n=36);Preoperative ALT,TBIL,BUN,intraoperative hypotension,intraoperative urinary volume,age, the distance between the tumor and the main vessels in the liver ,postoperative microwave ablation time the differ-ences of the risk factors ,such as microwave ablation range and sex of the two groups were compared during micro -wave therapy .Results There was no statistical significant difference between the two groups on intraoperative u -rinary volume(P>0.05);The preoperative ALT,TBIL,BUN,intraoperative hypotension,age,microwave ablation time,the distance between the tumor and the main vessels in the liver ,scular microwave ablation range ,sex of two groups showed statistical differences (P<0.05).BUN with preoperative ALT,TBIL,preoperative BUN,intraoper-ative hypotension,age,the distance between the tumor and the main vessels in the liver ,time of microwave abla-tion,microwave ablation range,sex influence factors were positively correlated (r=0.63,0.60,0.58,0.49,0.45, 0.40,0.35,0.46,0.52,P<0.05).Strength and influencing factors of BUN are the distance between the tumor and the main vessels in the liver,microwave ablation range,intraoperative hypotension,preoperative ALT,sex,pre-operative TBIL,microwave ablation time,age,preoperative BUN(β=0.52,0.42,0.37,0.31,0.29,0.25,0.20, 0.18,0.16,P<0.05).Conclusion Microwave therapy leads to renal insufficiency in the treatment of liver cancer performs many aspects , including preoperative ALT , TBIL, preoperative preoperative BUN , intraoperative hypotension ,age,the distance between the tumor and the main vessels in the liver ,time of microwave ablation ,mi-crowave ablation range ,sex,which is closely related to the factors affecting the risk of kidney .

Objective To evaluate the changes of middle cerebral arterial (MCA) hemodynamics before and after intraluminal stent-assisted angioplasty for their stenosis. Methods A total of 11 patients with MCA stenosis treated by intraluminal stent-assisted angioplasty were selected. In these cases, their stenosis before treatment and the state of stents after treatment were observed using transcranial color Doppler ultrasonography(TCCD). Meanwhile, the blood flow velocities (including peak systolic velocity, end diastolic velocity and mean velocity) were measured and studied comparatively at stenosis and post-stenosis place before and after the treatment, respectively. Results ①Among 11 cases implanted stents, 10 stents were in good state after treatment, only one expanded incompletely. ②The blood flow velocities were significantly higher in patients at stenosis place than in normal adults, and lower at post-stenosis place before treatment (P<0.05). The blood flow velocity lowered obviously at stenosis place after treatment (P<0.05) ,among which 90.9% were restored. The one which expanded incompletely was slightly higher. The blood flow velocity increased at post-stenosis place after treatment (P<0.05) and all returned to normal.Conclusions TCCD can observe the MCA stenosis and the state of stent,and analyze the changes of their hemodynamics.

Objective To observe the multi-slice spiral CT manifestations of cavernous transformation of the portal vein (CTPV) secondary to tumor emboli from hepatocellular carcinoma (HCC). Methods MSCT manifestations of 31 patients of HCC with tumor emboli-induced CTPV proved by operation and pathology were collected and the data were retrospectively analyzed. Results Tumor embolus was detected in both the trunk, left and right branches of PV in 23 patients, accompanied with superior mesenteric vein and/or splenic vein and inferior vena cava's tumor embolus in 4 and infiltration of gallbladder in 1 of 23 patients, as well as in the trunk and left branch in 1, and in the trunk and right branch of PV in 5 patients, accompanied with right hepatic vein and/or inferior vena cava's tumor embolus in 2 and in the portal trunk and superior mesenteric vein in 1, only in the right branch in 1 patient, respectively. Tumor emboli were isodense in plain CT scan, but enhanced with obvious degrees in arterial phase and filling defects in portal venous phase. There were collateral vessels around portal vein. Lateral branches around hilar bile duct, the open of venous plexus around fossa of gallbladder, lateral veins around gastric fundus and lesser curvature, lateral veins of lower part of esophagus and expansion of splenic vein were found in 31 (100%), 19 (61.29%), 21 (67.74%), 7 (22.58%) and 15 patients (48.38%), respectively. Conclusion Tumor emboli-induced CTPV from HCC has specific MSCT findings being helpful to the diagnosis.

Objective To evaluate the arrival peak time (APT) of contrast medium to abdominal aorta at different dosages with 64-detector CT scanner.Methods Sixty cases with normal cardiac function were divided randomly into three groups(group A,B,C).The injection rate of group A,B,C was 4.5 ml/s,3.5 ml/s,4.5 ml/s respectively.A small test bolus and the enhancement dosage bolus were at the same injection rate.After the injection of contrast medium was done,20 ml saline chaser was followed in group A and B but group C.20 patients with cardiac dysfunction as group D received the same injection protocol as group A.The concentration of contrast medium was 370 mgI/ml and cine-modal was used in contrast-enhanced scanning.The time-density curve of abdominal aorta at the level of porta hepatic and APT were measured at the different group and the different dosage.Results APT of contrast medium of the small test bolus in group A,B,and C ranged from 19 s to 24 s with mean time(20?2) s,(19?3) s and(22?3) s respectively.In group D,APT ranged from 24 s to 42 s with mean time(28?14) s.APT of enhancement dosage ranged from 20 s to 26 s among group A, B,C with mean(22?3) s,(21?2) s and(24?2) s respectively.In group D,APT ranged from 26 s to 44 s,with mean time(32?14) s.The difference of APT between test bolus and enhancement dosage was 2~7 s among group A,B and C,and was 3~12 s in group D.Conclusion The APT of abdominal aorta at the level of porta hepatis between test bolus and enhancement dosage in the patients with normal cardiac function or with cardiac dysfunction is different.

Objective To investigate the clinical value of serum procalcitonin (PCT) in diagnosis of urinary tract infection(UTI) in elderly patients.Methods 114 elderly patients with UTI in the department of infectious diseases of a hospital from January 2013 to December 2014 were analyzed retrospectively, clinical data of patients with abnormal and normal serum PCT were compared, PCT levels in patients with positive and negative blood cultures were compared, PCT receiver operating characteristic (ROC) curve for the diagnosis of bacteremia were drawn.Results Among 114 elderly patients with UTI, 46 were with abnormal PCT, 68 were with normal PCT.In abnormal PCT group, the proportions of patients with highest body temperature within 24 hours of admission, white blood cell count, neutrophil granulocyte percentage, C-reactive protein (CRP), blood urea nitrogen(BUN), creatinine(Cr), and urinary tract obstructive disease were all higher than those with normal PCT (all P<0.05).Among 42 patients with blood culture, PCT level in positive blood culture group(n=12) was higher than negative blood culture group(n=30)(1.93 [0.57-8.32] μg/L vs 0.36[0.15-1.01]μg/L, P=0.028).The area under the ROC curve (AUC) of the patients with bacteremia diagnosed by PCT was 0.72(95%CI:0.54-0.90),at the optimal value of 0.52 g/L, sensitivity, specificity, positive predictive value, and negative predictive value were 83.3%, 63.3%, 47.6%, and 90.5% respectively.Conclusion Serum PCT level can well reflect the severity of elderly patients with UTI, and is of great value in early diagnosis of bacteremia in elderly patients with UTI.