BACKGROUND:Total knee arthroplasty solves a great pain for patients with severe knee joint disease, and its clinical curative effects have been general y accepted. In the clinic, the formulation of clinical analgesic program of the two surgeries in patients undergoing double knee prosthesis lacks of the support of evidence-based medicine.
OBJECTIVE:To compare the differences in pain during early stage of primary and secondary surgeries in bilateral total knee arthroplasty, and to provide evidence for clinical analgesic programs.
METHODS:A total of 87 patients receiving staged bilateral total knee arthroplasty from January 2009 to January 2013 were retrospectively analyzed. Visual analogue scale was compared at 24, 48 and 72 hours after first and second staged total knee arthroplasty, including seating and maximum flexion position. In addition, the difference in early pain score was compared between second and first total knee arthroplasty in different intervals (less than 6 months, 6-12 months, more than 12 months).
RESULTS AND CONCLUSION:The visual analogue scale scores at seating and maximum flexion position at 24 and 48 hours after second total knee arthroplasty were significantly higher than the first surgery. No significant difference in visual analogue scale scores was detected between 72-hour seating and maximum flexion position. Visual analogue scale scores were significantly higher in the interval of less than 6 months than in the 6-12 month group and more than 12 month group in the 24-hour seating and maximum flexion position after second total knee arthroplasty. No significant difference in visual analogue scale scores was detected between the 6-12 month group and more than 12 month group at seating and maximum flexion position. Results suggested that the pain of second surgery was obviously higher than the first surgery within 48 hours after staged bilateral total knee arthroplasty, and this can provide a clinical evidence to enhance the analgesic strategy in the second staged bilateral total knee arthroplasty. The interval between two surgeries also affected the early pain after second surgery. Considered the aspect of postoperative pain, it is better to suggest the interval between first and second surgeries in staged total knee arthroplasty should be more than 6 months. This can reduce pain after second surgery, elevate patient’s satisfaction and accelerate the speed of recovery.

Objective To study the expression of metastasic suppressor gene( KAI1 / CD82)and cell adhesion molecules(CD44v6)in human laryngeal squamous cell carcinoma(LSCC),precancerous lesion,polyps,and normal mucosa. Methods Immunohistochemical technique( Envision)was used to detect the expression of KAI1 / CD82 protein and CD44v6 protein in 64 cases of LSCC,21 cases of laryngeal precancerous lesion(LPL),15 cases of polyp of larynx(LP)and 15 cases of normal laryngeal mucosa(NLM). Results The result turned out to be as follows:①KAI1 / CD82 protein was highly expressed in NLM and LP,and lowly expressed in LPL and LSCC,the positive rates of KAI1 / CD82 protein expression were 86. 67%(13 / 15),80. 00%(12 / 15),38. 10%(8 / 21)and 37. 50%(24 /64),respectively. There was statistically significant difference in NLM and LSCC. ② CD44v6 protein was lowly ex-pressed in NLM and LP and highly expressed in LPL and LSCC,the positive rates of CD44v6 protein expression were 26. 67%(4 / 15),33. 33%(5 / 15),80. 95%(17 / 21)and 75. 00%(48 / 64),respectively. There was statisti-cally significant difference in NLM and LSCC. Conclusion ① The down-regulation or deletion of KAI1 / CD82 and the up-regulation of CD44v6 are related to carcinogenesis,development of LSCC. ② The combined detection of KAI1 / CD82 and CD44v6 may provide clinical basis for the early diagnosis of LSCC.

There is an increasing demand for neonatal and juvenile animal toxicity studies during the research and development of new drugs. In this paper,we discussed general evaluation parameters of pediatric non-clinical safety with pediatric drugs,such as growth and development and food intake,and paramenters of other organs and systems, such as the central nervous system,reproductive system, behavior evaluation in combination with our own experience. In addition,the characteristics of non-clin?ical safety evaluation of new traditional Chinese medicine materia medica used for juvenile animals were analyzed. This paper is intended reference for non-clinical safety evaluation of pediatric drugs and to gain some experience related to formulation of new guidelines.

Purpose To study the expression of metastasis suppressor gene (KAI1/CD82) and cell adhesion molecules(CD44v6) in human laryngeal squamous cell carcinoma ( LSCC) and its clinical significance, and to investigate their relationship. Methods EnVi-sion immunohistochemistry was used to detect the expression of KAI1/CD82 and CD44v6 protein in 64 cases of LSCC tissues and 15 ca-ses of normal laryngeal mucosa ( NLM) tissues. Results The positive rate of KAI1/CD82 in LSCC tissues ( 37. 50%) was signifi-cantly lower than that of the NLM tissues(86. 67%) (P=0. 031), and the positive rate of CD44v6 in LSCC tissues(75. 00%) was significantly higher than that of the NLM tissues(26. 67%) (P=0. 011). The expression of KAI1/CD82 was associated with clinical stages, grade of tumor differentiation, neck lymph node metastasis ( P<0. 05 ) while not related with age, sex and prognosis ( P>0. 05). And CD44v6 with grade of tumor differentiation, neck lymph node metastasis and prognosis (P<0. 05), but not with age, sex and clinical stages (P>0. 05). In addition, KAI1/CD82 expression was negatively correlated with CD44v6 expression (rs = -0. 504, P=0. 036). Conclusion KAI1/CD82 and CD44v6 are mutually inhibited in the tumorigenesis, progress, invasion and metastasis, and detection of the expression of KAI1/CD82 and CD44v6 may be helpful for judging the biological behaviors of LSCC.

Objective:To observe the effect of Er:YAG laser on the proliferation of human periodontal ligament fibroblasts(hP-DLFs).Methods:Human periodontal ligament fibroblasts were cultured in vitro and identified by immunohistochemistry.The cells of 5th passage were divided into 5 groups.The cells in group A without treatment were used as the controls,in group B,C,D and E were treated with Er:YAG laser of 10 Hz at 50 mJ,100 mJ,150 mJ and E-200 mJ for 1 s respectively.The proliferation of the cells was examined on day 1,3,5,7,9 by CCK-8.Results:The proliferation of hPDLFs in group B,C,D and E increased more than that in group A(P <0.05)5 d after Er:YAG laser radiation.Conclusion:Low intensity of Er:YAG laser radiation can promote the prolifera-tion of human periodontal ligament fibroblasts.

Objective To investigate the clinical effect of pedicle screw internal fixation with different surgical approach in the treatment of thoracolumbar vertebral fractures. Methods Fifty?three cases with thoracolumbar vertebral fracture without nerve injury were selected as our subjects,who were hospitalized in the Central Hospital of Chaoyang from January 2008 to December 2013. They were randomly divided into observation group(27 cases) and control group(26 cases). The patients in the observation group were treated with pedicle screw internal fixation with Wiltse paraspinal approach and the patients in the control group were treated with pedicle screw internal fixation with traditional posterior open approach. The duration of operation,intraoperative blood loss,volume of drainage and length of hospital stay of all patients were recorded and the ratio of anterior vertebral body height to normal height before and after operation was compared between the two groups. Visual analog scores( VAS) for pain severity and Cobb’ s angle of the vertebrae was compared between the two groups 1 year after operation. Results The duration of operation and length of hospital stay of patients in both groups had no statistically significant differences ( P>0. 05 ) . The intraoperative blood loss and volume of drainage in observation group were less than that in control group respectively((146. 3±25. 1) ml vs. (240. 2±28. 7) ml, (73.1±15.3) ml vs. (150.5±20.1) ml;P=0.034,0.023).The ratio of anterior vertebral body height to normal height 1 week after operation was higher than that before operation in the observation group ( ( 93. 1 ±5.1)% vs. (70.3±8.6)%,P=0.048) and in the control group((93.0±6.0)% vs. (71.8±9.8)%,P=0. 049),the difference between two group had no statistically significant(P>0. 05). The Cobb′s angle of the vertebrae 1 year after operation was less than that before operation in the observation group((10. 10±4. 00)° vs. (19. 10±7. 81)°,P=0. 045) and in the control group ((9. 97±3. 78)° vs. (18. 87±6. 90)°,P=0. 045),the difference between two group had no statistically significant(P>0. 05). The VAS for pain severity 1 year after operation was less than that before operation in the observation group(1. 1±0. 5 vs. 6. 0±0. 9,P=0. 023) and in the control group ( 1. 7 ± 0. 6 vs. 5. 9 ± 0. 7, P= 0. 038 ) , the difference between two group had statistically significant( P=0. 046) . Conclusion Pedicle screw internal fixation with Wiltse paraspinal approach in the treatment of thoracolumbar vertebral fractures without nerve injury has advantages with traditional posterior open approach in less trauma, less bleeding, rapid recovery and reduces the incidence of postoperative lumbar pain. The treatment has a good clinical effect and is worthy of clinical application.

Taking the modern occupation education concept as the guide,oriented by adapting to the demand of occupation post,we established a new open education mechanism of medical occupation education to promote the reform of personnel training mode,curriculum and teaching content to explore the effective way of the sustainable development of local medical occupation education.

Objective To explore the effect ot atorvastatin on the levels of serum Interleukin-6 ( IL-6),Endothelin(ET) and MCP-1 in patients with acute cerebral infarction(ACI).Methods 100 patients with ACI were randomly divided into the atorvastatin therapy group(n =50) and the conventional therapy group(n =50).At the basic of conventional therapy,the atorvastatin therapy group was treated with Atorvastatin 20mg/d.Both groups were treated for 4 weeks.The levels of serum IL-6,ET and MCP-1 were measured and the scores of neurological deficit ( NDS ) were evaluated before and after treatment.A healthy control group which approximately matched the experimental group included 30 persons.Results The levels of serum IL-6,ET and MCP-1 in both two groups after 14d treatment were significantly lower than those before treatment(t =26.38,49.10,34.51,25.77,32.23,34.68,P ＜0.05),and the levels of serum IL-6,ET and MCP-1 in atorvastatin therapy group was significantly lower than that in conventional therapy group( t =10.10,13.18,23.85,P ＜0.05 ).NDS of both groups after treatment was lower than those before treatment(t =18.38,6.98,P ＜0.05 ),and the score of atorvastatin therapy group was significantly lower than that of conventional therapy group( t =12.00,P ＜ 0.05).Conclusion Atorvastatin could significantly decrease the levels of serum IL-6,ET and MCP-1,and it could promote the neurological fuction recovery in the patients with ACI.

Objective　To study the relation between mental emotion of top senior middle school students and college entrance examination achievement. Method　Using 16PF,STI,TTI and SAS, this year's graduates were measured. Result　The liberal arts had a significant defference from the science departments in the personality of 16PF. Applying the methods of judgement and more factors, the Q1 (experiment F=8.76 P<0.01) and Q2 factors (independence F=8.23 P<0.01) had a positive correlation with college entrance examination achievement, a negative correlation with the M factor (fantasy F=4.88 P<0.01).Conclusion　The personality of experiment, flexibility of nervous process in temperament and that of time characteristic had a positive correlation with college entrance examination achievement .Independence of high scores fantasy of low scores and the flexibility of temperament helped to upgrade the scores of college entrance examination .The division into liberal arts and science departments of students should refer to their personality.