OBJECTIVE To find out the situation of the use of preventive application of antimicrobial in orthopedic perioperative patients and to evaluate the rationality of use. METHODS To make a survey of the use of antimicrobials in orthopedic perioperative patients during Apr-Jun 2004 and to evaluate the kinds,frequency,combined administration,course,effectiveness,etc. RESULTS 99.2% patients had received antimicrobials involving 14 kinds.62.8% from them used one.34.5% used two and 2.7% used three. CONCLUSIONS It is necessary to strengthen the management of preventive antimicrobial in orthopedic patients during perioperative period.

Objective To select the optimum conditions of Echinococcosis ELISA kit and kit preparation by using orthogonal experiments,then to test their detection performance.Methods Taking the absorbance of the samples as the indicator,orthogonal experiments of three factors four levels were taken to optimize the conditions of hydatid disease detection ELISA kit.Through L16 (43)orthogonal experiments,the concentration of the antigen(A),the dilution multiple of the sample (B) and the dilution multiple of the enzyme labeled antigen (C) were studied.The specimen were provided by The First Affiliated Hospital of Xinjiang Medical University specimen library collected between March 2011 and June 2013,including 36 sera confirmed alveolar Echinococcus by the gold standard,56 sera confirmed Echinococcus granulosus disease by the gold standard and 72 sera as the control group(including healthy people,cirrhosis,hepatitis,etc).Detecting sensitivity and specificity were compared using F test for statistical analysis.Results Orthogonal design showed the size proportion of three factors of echinococcosis ELISA kit:antibody dilution ＞ sample dilution ＞ antigen coating concentration.The optimal preparation conditions were A1 B2 C4,that was,the concentration of antigen was 1 mg/L,sample dilution of 1∶ 100,dilution of secondary antibody of 1∶160 000.Through the 3-factor and 4-level orthogonal design using F-test analysis,the fact of the concentration of the kit antigen(A),F =1.181,P =0.393; the fact of the dilution multiple of the sample (B),F =2.544,P =0.152,the fact of enzyme labeled antigen dilution (C) F =2.544,P =0.039.The sensitivity of the kit to Echinococcus granulosus disease and alveolar Echinococcus were 83％ (30/36),and 91％ (51/56),respectively; the specificity was 91％ (29/32) and 83％ (33/40); the misdiagnosis rate of 17％ (6/36) and 9％ (5/56) ; the misdiagnosis rate 9％ (3/32) and 18％ (7/40) ; positive likelihood ratio 8.86％ (83/9) and 5.20％ (91/18) ; negative likelihood ratio of 0.18％ (17/91) and 0.11％ (9/83).Conclusion Orthogonal design is a good method that can find out optimal conditions of preparation for Echinococcosis ELISA kit and improve the test performance.

Objective To clarify the actions of tranilast,an anti allergic drug,on chronic constriction mononeuropathy through an experiment using an animal model according to the method of Bennett et al. Methods 36 rats were divided into 2 groups: one was treated with tranilast(200mg/kg?d-1,p.o every experimental day),the other was controlled with solvent only. Chronological changes of heat evoked withdrawal latencies on a hot plate,nerve coducting velocitics, and histopathological changes were compared between the two groups from one to four weeks after loose ligation in the sciatic nerve. Results The changes of the withdrawal latency and nerve conducting velocities in the tranilast treatment group were significantly longer than those in the control. The rats without tranilast treatment showed inflammation in and around the constricted nerve bundles,axonal degeneration,phagocytes invasion and interstitial edematous changes at 7 days,numerous axonal sprouts and remyelination at 14 days,and regeneration in the nerve bundles at 28 days. In contrast,the rats treated with tranilast showed less inflammation or nerve fiber degeneration,and better regeneration than those of the control. Conclusion The actions of tranilast appear to have beneficial effects on prophylaxis of a chronic constriction mononeuropathy and on preservation of the nerve functions in rats.

HCV NS5B, acting as a RNA dependent replication enzyme,has emerged as an attractive protein used as a target for screenig of drugs against HCV NS5B, and plays an important role in HCV replication. In the report the gene expression of NS5B in E.coli was investigated. PCR was performed to gain the gene of HCV NS5B from plasmid pBRTM/HCV 1 which contains whole sequence of HCV, and the truncated NS5B gene containing no hydrophobic domain was cloned into pGEM Teasy vector. The gene of the truncated NS5B was cut from pGEM Teasy vector and cloned into E.coli expression plasmid pET 21b, then pET 21b NS5B was transfected into E.coli cells. The protein E.coli lysates were purified and analyzed by sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS PAGE) and Western blotting assay. The RdRp activity of NS5B was examined by scintillation proximity assay (SPA). The truncated NS5B gene was successfully cloned into pET 21b. The results of SDS PAGE and Western blotting assay showed: ①the molecular weight of the expressed product was about 68 000 D, ②The truncated NS5B protein was existed in media of E.coli cells, ③The activity of NS5BDCT21 His from HCV 1b amounted to 6 900 cpm (total incorporation of approximately). These findings suggest that soluble NS5B can be successfully expressed in E.coli and could secret into media.

Objective To observe the clinical curative effect of selective bronchial arterial embolization for severe hemoptysis.Methods Thirty-eight hospitalized patients with severe hemoptysis was enrolled in this study.Of which 31 patients were recurrent hemoptysis,27 patients were with bronchiectasis,4 patients were with bronchial lung cysts,4 patients had unknown causes,3 patients were with tuberculosis.All patients were diagnosed by chest imaging examination,fiber bronchoscopy,bronchial arteriography,and they were all treated by selective bronchial arterial embolization.Results The most times of embolization was 3,and bronchial arterial imaging were performed for vascular malformation.After having bronchial arterial embolization,35 patients were immediately released of bleeding.Postoperative 24 h,8 patients had hemoptysis again,of which 1 case was performed with conservative treatment and subsequently had pneumonectomy,5 patients had effective conservative treatment,2 cases were performed embolization again after failed conservative treatments.Hemoptysis completely disappeared within 1 week.The total effective rate was 97.4％(37/38).Patients were followed up for 1 year,of which 13 patients relapsed again,11 patients'annual and each time's quantity of hemoptysis reduced 50％.Two patients had pneumonectomy after a number of embolization.The total effective rate was 94.7％ (36/38).After treatment,3 patients had mild chest pain in short time,2 patients had shoulder pain,3 patients had chest tightness,and 3 patients had subcutaneous passive congestion.After being treated for short-term,these symptoms disappeared eventually.Conclusion Selective bronchial arterial embolization for the treatment of acute or recurrent severe hemoptysis is very effective,and can avoid the risk of surgery.It is effective for recurrent cases and worthy of clinical application.

Objective To study the effect of the serum testosterone/estradiol ratio (T/E2) alteration on sperm defect and fertility. Methods The testosterone, estradiol, FSH, LH, PRL,sperm parameters and sperm morphology of 90 men were analyzed and the T/E2 and multiple anomalies index (MAI) were calculated. The patients were divided into 3 groups; T/E2≤10 (Ⅰ), T/E2＞10 (Ⅱ), and T/E2＞20 (Ⅲ). Results The sperm concentration and motility among the 3 groups were not significantly different (P＞0. 05). The percentages of the sperm whose head, neck and tail were abnormal declined gradually with the increase of the T/E2 in serum. The percentage of sperm head defeet of group Ⅰ was significantly higher than that of group Ⅲ (t=2. 482, P=0. 016) and that of sperm neck defect of groups Ⅰ and Ⅱ were significantly higher than that of group Ⅲ (t=4.113, 2. 050, P=0.000, 0. 046, respectively). The percentage of sperm tail defect among 3 groups was significantly different (t=2. 722, 3. 996, 3. 110, P=0. 008, 0. 000, 0. 003, respectively). The SDI of group Ⅱ was significantly higher than that of group Ⅰ (t= -2. 293, P= 0. 025). But the TZI increased gradually with the increase of the serum T/E2 and the TZI of groups Ⅱ and Ⅲ were significantly higher than that of group Ⅰ (t=2. 285, 2. 727, P=0. 025, 0. 009, respectively). The percentage of the men in group Ⅰ whose partners became pregnant was 29. 5% and those of groups Ⅱ and Ⅲ were 50% and 42.9%, respectively. Although the percentage among three groups was not different statistically (x2 = 3. 285, 0. 854, 0. 199, P= 0. 070, 0. 355, 0. 655, respectively), the relative risks of groups Ⅱ and Ⅲ were 2.4 and 1.8 times of that of group Ⅰ. There were 25, 15, 7 cases of idiopathic infertility among the 3 groups, respectively. The relative risk of I group was 1.5 and 1.3 times of that of Ⅱ and Ⅲ groups. The correlation analysis showed that the T/E2 in serum had significantly negative correlation with the percent of the sperm head or neck or tail defects (r= -0. 209, -0. 316 and -0. 335,respectively and P= 0. 048, 0. 002 and 0. 001, respectively). Conclusions The decrease of T/E2 in serum was correlative with the decrease of fertility probability, but it did not alter the sperm density and the sperm motility. It showed that the level of the T/E2 in serum was important for spermatogenesis and sperm fertilizing capability.

Objective To study the prevention and treatment of severe complications of percutaneous radiofrequency ablation(PRFA)for hepatic malignancy. Methods A series of 939 patients with primary hepatic carcinoma or hepatic metastasis confirmed by pathological examinations or clinical manifestations underwent 1098 treatments of PRFA between January 2006 and December 2009. All the patients were followed up to study the short-or long-term complications related to PRFA. Results Complications developed in 9 patients: bile duct injury (4 patients), hemothorax (2 patients), and intra-abdominal hemorrhage (3 patients). The incidence of complication was 0.82% (9/1098) and the complication-related mortality was 11.1% (1/9). Conclusions Although PRFA which is minimally invasive, is a safe and effective treatment, there were still risks for this procedure, especially when the tumor is located at the portahepatic region or the patient has coagulopathy. Some serious complications can be prevented. It is important to observe the strict indications for RFA and to carry out the procedure carefully. Early detection of complication is important.

ObjectiveTo investigate anatomical characteristics of the medial foot vessels and effects of different vascular pedicle skin flaps in repair of foot and ankle trauma.MethodsThirty adult cadaveric lower limbs were injected with red latex through the popliteal artery and posterior tibial artery to anatomically observe the cutaneous arterial origin,branches,distribution and anastomosis of the medial foot.Then,anterior medial malleolar artery perforator flaps and distally-based medial foot flaps were harvested and used for repairing foot and ankle trauma of 16 patients.Results The origin of cutaneous blood vessels of the medial foot was diversified and mainly included the anterior medial malleolar artery,medial tarsal artery,and arterial arcades anastomosing with anterior posterior branches of the two former arteries and the superficial branches of plantar digital artery and the medial plantar artery.According to distribution area of the anterior medial malleolar artery and the medial tarsal artery,the vascular anatomy of the medial foot skin was classified into three types.Clinically,all the flaps survived.Follow-up ranged from 2 weeks to 20 months,which showed normal color,good shape and good pain and warm sensation of the flaps.ConclusionThe anterior medial malleolar artery perforator flaps present good reconstruction of soft tissue defects around the ankle,whereas the distally-based medial foot flaps present good reconstruction of soft tissue defects of the mid-forefoot.

BACKGROUND:Smal-needle-knife therapy for knee osteoarthritis has no uniform location, operation and mechanisms of action. Studies have proved that exercise therapy can enhance muscle strength, increase stability of the knee, improve joint range of motion, and effectively relieve pain.
OBJECTIVE:To observe the clinical effect of smal-needle-knife therapy combined with exercise therapy for treatment of knee osteoarthritisvia a randomized controled clinical trial.
METHODS:122 patients were randomly divided into treatment group (n=61; smal-needle-knife therapy combined with exercise therapy) and control group (n=61; low-frequency therapy combined with exercise therapy). Then, clinical efficacy in the two groups were assessed by statistical analysis of visual analog scale, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), sweling degree of the knee joint, quadriceps circumference, flexion and extension of the knee joint before and after treatment. Meanwhile, adverse reactions in patients were recorded for safety evaluation.
RESULTS AND CONCLUSION:(1) The visual analog scale and WOMAC scores in the two groups were both significantly improved at 2 weeks after treatment (P < 0.05). Moreover, these scores in the treatment group were significantly lower than those in the control group (P < 0.05). (2) At 12 weeks after treatment, the WOMAC score in the treatment group was better than that in the control group (P< 0.05), and the range of motion of the knee joint was also better in the treatment group than the control group (P< 0.05). (3) According to the full analysis set and per protocol set, the total efficiency rats in the treatment group were both superior to those in the control group (P< 0.001). (4) In the treatment group, there were four cases of surgery, four cases lost to folow-up, and two cases of mild adverse reactions; in the control group, there were six cases of surgery, three cases lost to folow-up, and no adverse reaction. Taken together, smal-needle-knife therapy and physiotherapy both have certain clinical effects on knee osteoarthritis. Smal-needle-knife therapy combined with exercise therapy is superior to physiotherapy combined with exercise therapy in the total efficiency. Folow-up results of 3 months have been confirmed, but long-term effects need further exploration.

Objective To investigate the clinical effects of preoperative eye position training on femtosecond laser-assisted laser in situ keratomileusis(FL-LASIK)? Methods One hundred and sixty-eight myopia patients(328 eyes)scheduled for selective FL-LASIK were randomly divided into the experiment group of 85 cases(166 eyes)and the control group of 83 cases(162 eyes)?The patients in the control group were given the routine preoperative education and the patients in the experiment group received the preoperative intervention of eye position besides routine preoperative education? The two groups were compared in terms of intraoperative changes of eye position,corneal topography and the postoperative visual acuity? Results The frequency of eye position adjustment and machine stopping in the experiment group was significantly smaller than that of the control group(P < 0?001)? But no significant differences were found between the two groups in corneal topography and the postoperative visual acuity(P > 0?05)? Conclusion Preoperative training of eye position may maintain ideal eye position and reduce the frequency of downtime due to eye position adjustment during FL-LASIK,which may ensure the successful completion of FL-LASIK?