Objective To evaluate the feasibility to detect Prototheca in a mouse model of Prototheca zopfii cutaneous infection by using fluorescence in situ hybridization (FISH).Methods The model of Prototheca zopfii cutaneous infection was established by abdominal subcutaneous inoculation of Prototheca zopfii suspensions into 20 male BALB/c mice.Seven days after the inoculation,the mice were sacrificed,and tissue specimens were obtained from abdominal skin and subjected to microscopic examination,fungal culture and paraffin embedding.A PZ-probe was artificially synthesized and used to detect Prototheca in paraffin-embedded sections by using FISH.Moreover,both periodic acid-Schiff (PAS) and hematoxylin-eosin (HE) staining were performed to examine the paraffin-embedded sections.Skin specimens obtained from normal mice and Candida albicans-or Cryptococcus neoformans-infected mice served as the negative control.Results Clinical presentations,pathological examination and fungal culture results all confirmed the successful establishment of Prototheca zopfii skin infection model in mice.Prototheca was identified by FISH with the PZ-probe in the paraffin-embedded skin tissue sections from the murine model of Prototheca zopfii cutaneous infection,but not detected in the negative control tissue specimens,which was consistent with the results of PAS and HE staining.Conclusion FISH can be used to detect Prototheca in paraffin-embedded skin sections from the mouse model of Prototheca zopfii cutaneous infection.

Deep vein thrombosis is the common complication of trafifc injury , it is one of the dififculties of forensic identiifcation to identify disability grade and the relationship between injury and disease. When post-thrombotic syndrome happens, circulatory system and leg will be dysfunction, caused by the destruction of valve and venous wall and by the blockage of thrombus. The quality of life and working ability will be seriously affected. The impact of different types of deep vein thrombosis on human body was analysised after looking up relevant literatures, then it was discussed that the identiifcation of following questions including: the relationship between injury and disease, how to identify disability grade and it’s best time.

Objective To evaluate the effect of biofeedback therapy for the treatment of myogenic fecal incontinence. MethodsA general assessment about anorectal function was made on 17 cases receiving biofeedback therapy including muscle power training,sensory training and coordination training. Results The clinical scores before and after biofeedback therapy were 1.66?0.23,3.80?0.42 respectively,with an effective rate of 82%. The anus maximum contracting pressure elevated,(73?20) mm Hg vs. (123?30) mm Hg; myoelectric amplitude increased,(122?32) ?V vs. (230?41) ?V;Contracting time prolonged,(4.1?2.0) s vs. (9.4?3.0) s; The sensory threshold was lowered,(50?12) ml vs. ( 20? 10) ml;The feel-contract time increased,(3.1?0.4) s vs. (1.2?0.3) s. Positive rectal contraction reflex was seen in 41% patients before therapy compared with 82% after therapy. Conclusions Biofeedback therapy increases contractility of sphincter,decreases threshold of rectal sensory,and is a therapy of choice for myogenic fecal incontinence.

ObjectiveTo investigate the effects of sex hormones( 17 β-estradiol and testosterone)on human omental preadipocytes proliferation and differentiation and on leptin and adiponectin secretions in adipocytes.Methods Omental preadipocytes were cultured and then differentiated into mature adipocytes in vitro.The proliferation and differentiation processes of preadipocyte were observed.The preadipocytes were incubated in the presence of sex hormones and were detected the contents and gene expressions of leptin and adiponectin.ResultsHuman preadipocytes were primarily cultured successfully.Estradiol stimulated preadipocytes proliferation (0.823±0.059 vs 0.276 ±0.032,P＜0.05 ),and inhibited lipid accumulation in cell differentiation ( P＜0.05 ).Testosterone had no significant effect on proliferation of preedipocytes,but inhibited adipogenic differentiation ( P＜0.05).Leptin could be detected during proliferation and differentiation of preadipocytes.Estradiol increased the leptin secretion,whereas testosterone reduced it ( all P ＜ 0.05 ).The adiponectin only could be detected during differentiation.Sex hormones reduced the adiponectin secretion.17β-estradiol stimulated leptin mRNA expression and suppressed adiponectin mRNA expression in adipocytes.Testosterone suppressed the mRNA expressions of leptin and adiponectin (all P ＜ 0.05 ).ConclusionIn vitro,17β-estradiol increases the leptin secretion and mRNA expression whereas reduced the adiponectin secretion and mRNA expression.Testosterone reduced the adiponectin and leptin secretion and mRNA expression.

Objective: To explore the endothelial microparticle (EMP) level in elderly patients with acute coronary syndrome (ACS) combining diabetic mellitus (DM)) and to study the relationship between EMP level and ACS combining DM in elder patients.
Methods: A total of 208 patients≥65 years with coronary angiography in our hospital were summarized including 124 male with the age of (71.9 ± 5.2) years. The patients were divided into 3 groups, Control group, n=51 normal subjects, ACS without DM group, n=83 and ACS+DM group, n=74. Plasma EMP levels were measured by FACSCalibur lfow cytometry as CD31+/CD42b-EMPS and the vascular stenosis degree was quantitatively calculated with Gensini score.
Results: The CD31+/CD42b-EMPs level in ACS + DM group >ACS without DM group > Control group, all P<0.01. Compared with ACS without DM group, the ACS+DM group had more patients with multiple vascular lesions and less patients with single vascular lesions, all P<0.01. The Gensini score was positively related to CD31+/CD42b-EMP level in both ACS+DM group and ACS without DM group (r=0.637, P<0.01).
Conclusion: Plasma CD31+/CD42b-EMPs level increased in elderly ACS patients and the elevation level related to vascular lesion degree/combining with DM, which indicated the endothelial dysfunction in such patients.

Objective To compare the early results of total knee arthroplasty using high flexion (HF) versus standard posterior-stabilized (PS) prosthesis tibial insert. Methods From February 2005 to July 2008, 203 patients (216 knees) underwent total knee arthroplasty using Genesis Ⅱ prosthesis and were randomly distributed into group A (98 patients with 107 knees, HF insert) or group B (105 patients with 109 knees, PS insert). There were no significant differences between the two groups in the preoperative Knee Society score (KSS) knee score, KSS function score, and range of motion. They were followed-up for 1 year and compared using KSS knee score, KSS function score and range of motion. Results 91 patients (98 knees)were followed up in group A, and 94 patients (96 knees) were followed up in group B. The postoperative knee active range of motion was 121.1°±6.9° in group A, and was 118.6°±8.1° in group B. The improvement of knee active range of motion was 17.1°±13.3° in group A, and was 16.1°±18.8° in group B. The postoperative range of passive motion of group A and group B were 127.2°±7.1° and 121.0°±7.8° respectively. The postoperative KSS knee score was 86.9±7.6 in group A, and was 87.5±6.8 in group B. The postoperative KSS function score was 91.2±8.7 in group A, and was 90.1±9.3 in group B. The range of passive motion of groupA was better than that of group B (P ＜0.05). There were no significant differences between the two groups in other aspects. Complications include deep vein thrombosis (DVT), 4 patients in group A and 3 in group B,wound fat liquefaction, 3 patients in group A and 5 in group B, synarthrophysis, 2 patients in group A and 3 in group B. Conclusion This prospective randomized clinical trial demonstrates no differences between PS and HF in early clinical outcomes, except the range of passive flexion.

Clinical data of 53 patients (69 knees), who were treated at the Division of Joint Surgery, Department of Orthopaedics, Changzheng Hospital from January 1998 to December 2006, were retrospectively analyzed. These patients suffered from wound-healing complications following total knee arthroplasty. Wound skin problems included skin flare, disruption of wound, local hematoma, skin necrosis and deep infection. Local wound care was performed in 58 knees, debridement and secondary closure in 6 kness, and primary management of the soft tissue defect was achieved with local muscle flaps in 3 knees, with the fasciocutaneous flap in 1 knee, and with fasciocutaneous flap and skin grafting in 1 knee. Mean follow-up was 1.9 years. All wound was healed well. It is indicated that corresponding management should be used for treating wound-healing complications following total knee arthroplasty.

BACKGROUND:Postoperative acute mental disorders refer to patients without mental disorders suffer from neurological dysfunction after surgery. OBJECTIVE:To analyze the association between psychological resilience and postoperative acute mental disorders after total knee arthroplasty (TKA). METHODS:Convenience sampling, the Chinese Version of Connor and Davidson's resilience scale (CD-RISC), was used to measure the levels of psychological resilience in 832 patients undergoing TKA. The questionnaire covered three dimensions:tenacity, self-improvement and optimism. The incidence of postoperative acute mental disorders was observed after operation. RESULTS AND CONCLUSION:(1) The CD-RISC scores of the patients with TKA surgery were (57.64±10.07), lower than the average scores of the elderly community in China. 20 (2.4%) patients had postoperative acute mental disorders. (2) Pearson correlation analysis demonstrated the negative correlation between the levels ofresilience and the incidence of postoperative acute mental disorders (r=-2.43, P<0.05). (3) Patients with lower psychological resilience levels had a higher incidence of postoperative acute mental disorders. Developing psychological resilience may become an important strategy to reduce the occurrence of postoperative acute mental disorders.

Objective To investigate the effect of different additional filtration thickness of DSA on image quality and radiation dose with cerebral angiography. Methods Prospective collected 90 patients with DSA examination of the whole cerebral artery, patients were divided into A, B and C group according to the time of the examination, each group included 30 cases. Patients underwent conventional DSA, the additional filtration of group A, B and C were (1.0 mmAl+0.1 mmCu), (1.0 mmAl+0.4 mmCu) and (1.0 mmAl+0.9 mmCu), respectively. Dose area product (DAP), air kerma (AK), tube current and tube voltage of anteroposterior and lateral radiography of the whole brain were recorded, and scored the image quality. Eye lens organ dose values were obtained by using simulation phantom and LiF dosemeter under A, B and C groups with three different additional filtrations for cerebral angiography. The image quality scores and the radiation dosewere analyzed by one-way ANOVA tests or Kruskal-Wallis tests. Results The image quality comprehensive score of three groups showed significant difference (F=40.07,P<0. 01), which were (3.8±0.4), (3.6 ± 0.5) and (3.0 ± 0.6), respectively. The DAP and AK value of anteroposterior and lateral radiography of three groups also showed significant difference (P<0.05), B and C group were lower than the A group. Left and right eye lens organ dose were decreased along with the increase of the additional filtration thickness, and the difference between the 3 groups also had significant difference (P<0.01). Conclusion Both the image quality and radiation dose can acquire when conducted the whole brain DSA with 1.0 mmAl+0.4 mmCu additional filtration.

Objective To assess the clinical significance of modular femoral component in restoring femoral offset after total hip arthroplasty.Methods Data of 75 patients,who had undergone THA with modular femoral component from June 2009 to June 2012,were retrospectively analyzed.There were 42 males and 33 females,aged from 44 to 83 years (average,64.7±12 years).There were 40 cases of left hip and 35 cases of right hip.The average Harris hip score was 54±6 (range,32 to 65) before operation.The Zimmer M/L Taper hip prosthesis with Kinectiv technology was used in all patients.Preoperative templating was utilized to accurately predict the prosthetic size and the femoral offset.During the surgery,the femoral offset was measured accurately,and the appropriate femoral neck prosthesis was selected in order to restore the femoral offset and reconstruct hip abductor moment arm.The femoral offset and leg length were measured according to X-rays after operation.The Harris hip score was used to assess the clinical results.Results The femoral offset was reconstructed in all patients,ranging from-3.0 to 3.0 mm (average,1.3±0.3 mm).The average leg length discrepancy was improved to 3.0±0.8 mm.All patients were followed up for 6 to 36 months (average,19.7 months).The average hip abduction angle was 40°±10° at 12 weeks after operation.The average Harris hip score was 86±13 (range,65-94) at 12 weeks after operation and 95±15 (range,78 to 98) at final follow-up.There was no hip dislocation and femoral acetabular impingement syndrome.Conclusion Modular femoral component can restore femoral offset without changing the leg length,which can result in good hip abductor strength,range of motion of the hip and stability,as well as less complications.