BACKGROUND: With the improvement of artificial joint materials, continuous consummation of prothesis design and the maturity of total knee replacement (TKR), excellent effects has been achieved in treatment of serious rheumatoid arthritis (RA) and osteoarthritis with TKR. At present, it is generally thought in China and abroad that staged rehabilitative treatment of step by step should be conducted as early as possible after TKR, which can promote the recovery of patient's knee joint function, and enable patients to freely care themselves so as to enhance their qualities of life.OBJECTIVE: To explain the rehabilitative treatment after TKR and relevant researches.DATA SOURCES: A computer based search of Medline database for relevant articles from January 1998 to August 2005 were conducted with the key words of "total knee replacement, rehabilitation, therapy" and the language was limited to English. Meanwhile, Chinese journal full-text database and Wanfang database were retrieved for relevant Chinese papers from January 1990 to December 2004 with the key words of "total knee replacement, rehabilitation, therapy".STUDY SELECTION: Data were checked in the first trial, accepting criteria:①Items, procedures, process and announcements in the rehabilitative treatment after TKR. ② Retrospective investigations about specific cases. Exclusive criteria: repetitive researches.DATA EXTRACTION: A total of 37 literatures in accordance with above requirements were retrieved and 22 repetitive researches were excluded.Fifteen articles were in accordance with the inclusive criteria: 3 were reviews about TKR and relevant rehabilitative treatment, 8 were clinical researches related to rehabilitative treatment after TKR, 4 were analyzing researches on relevant factors of rehabilitative treatment after TKR. Besides,there were 3 other relevant monographs.DATA SYNTHESIS: Rehabilitative treatment was extremely important to the clinical effects of TKR, which was the key reason why anticipated effects could be achieved after TKR. Exercise for power, training of motion of joint, proprioceptive sensation training and gait training were the most important contents of postoperative rehabilitation treatment. Comprehensive rehabilitative training was essential to maximum recovery of knee joint function including various agonistic muscle training plus extending and flexing power of knee joint; continuous passive training of motion of knee joint in early period plus motion of joint; proprioceptive sensation training in amelioration of motor controllability, postural rectification and balance-keep capability and gait training in correction of abnormal gait.CONCLUSION: Staged rehabilitative treatment of step by step after TKR should be conducted as early as possible, which is absolutely important to exercise for power, training of motion of joint, proprioceptive sensation training, gait training and promotion of functional recovery of knee joints in patients.

Adolescent ; Anesthesia ; methods ; Electrocardiography ; Humans ; Hypokalemia ; complications ; physiopathology ; Long QT Syndrome ; etiology ; Male ; Propofol ; adverse effects ; Ventricular Fibrillation ; chemically induced ; physiopathology

Objective To study the prospective memory and the severity of the impairment of event- based prospective memory(EBPM)and time-based prospective memory(TBPM)in normally aging adults. Methods We set a neuropsychological battery to measure the education-matched 40 adults and 40 normally aging adults who were given EBPM and TBPM tasks.Results Compared with the young controls(EBPM, 6.25?1.60;TBPM,5.38?0.87),both EBPM(2.50?0.85)and TBPM(4.93?1.07)in the elderly had been impaired,especially EBPM(t = 13.117,P

Rehabilitation is very important to the therapeutic effect of total knee arthroplasty, and it's also the key measure for the knee function to reach the expected effect after the surgery. The most important contents of rehabilitation therapies are the training of muscle strength, range of joint motion, joint position sense and gait. Integrated rehabilitation therapies was used to improve the knee function as possible, such as all kinds of training to improve the knee muscle strength of flex and extend; early training of continued positive motion of knee joint to improve the knee range of motion; the training of knee joint position sense to improve the ability of motion control, posture adjusting and balance keeping; the gait training to adjust the unusual gait.

Objective To investigate changes of surface electromyogr8phic(sEM G)signal of pelvic floor muscles in complete spinal cord injury(cSCI)patients with neurogenic bowel dysfunction.Methods Fifteen hospitalized patients with cSCI(observation group)and fifteen normal subjects(control group)were involved in this study.The root mean square(RMS)of sEMG signals were collected at pelvic floor muscles with rectal surface electrode when subjects'pelvic floor muscles were rest(10 s),fleetly contract(2 s×3),continually contract(10 s).Both groups'data of different contracting states of pelvic floor muscles were analyzed and compared.Results The max RMS and average RMS(16.61±2.83,13.52±2.22)at pelvic floor muscles'rest in observation group were higher than that in control group(8.41±5.55,3.45±1.53).There was statistical difference between two groups(P<0.01).In the subjects of observation group max RMS and average RMS(20.24±13.99,13.36±2.39)at continual contraction and average RMS(13.40±2.31)at fleet contraction were nearly the same as RMS value at pelvic floor muscles'rest.There was no statistical difference between these two states(P>0.05).Conclusion The sEMG could be a quantitative index in assessing function of pelvic floor muscles and the neurogenic bowel dysfunction after cSCI.It can supply some clinical value in framing the training of pelvic floor muscles and improving the bowel dysfunction.

A comprehensive physician authorization management system has been established at Renmin Hospital of Wuhan University in its effort of promoting the clinical standardization.This system covers authorization of prescription,disposition,surgery,and medical report among others,adhering to the principle of clear,complete quantitative competence-based,authorization.The training and assessment of physicians in parallel canimprove physicians' competence and quality of care.

Purpose To investigate the expression of GATA3 in breast tumors and its clinical significance. Methods Immunohisto-chemistry EnVision method was used to detect the expression of GATA3 protein in 132 cases of breast malignant tumor tissue, 29 cases of breast benign tumor tissue, 35 cases of breast carcinoma adjacent tissue. Besides, the GATA3 expression level was compared with several clinicopathological parameters. Result (1) All the breast normal tissues expressed GATA3, while 77% of the breast cancer tissue were found to be GATA3 positive. (2) GATA3 did not expressed in diffuse large B cell lymphoma and spindle cell malignant tumor of breast. (3) In the triple negative breast cancer, the expression of GATA3 was lower than that of any other subtypes of breast carcinoma (χ2 =29. 354, P<0. 001). Conclusion The positive expression of GATA3 is correlated to classification and grade in breast tumor. Detection of the expression of this biological maker may provide a valuable marker for the differential diagnosis and prog-nostic of breast carcinoma.

Purpose To investigate the clinicopathological and immunohistochemical features of primary renal lymphomas ( PRL) , and to discuss the diagnosis, differential diagnosis, treatment and prognosis of the tumors. Methods Clinical data of 19 patients with PRL from January 2005 to October 2014 were retrospectively analyzed. Result The 19 patients in this study, there were 11 males and 8 females and the age ranged from 37 to 85 years old (averaged 55). Patients were mainly presented with unilateral renal masses, with lumbodynia as the main symptom. 13 patients underwent nephrectomy, 6 patients underwent renal biopsy and 17 patients received CHOP or R-CHOP chemotherapy. All of them were diagnosed as non-Hodgkin’ s lymphoma, with 14 cases of diffuse large B cell lym-phoma (DLBCL) (73. 684%, 14/19), 4 cases of B cell small cell lymphoma (21. 053%, 4/19), and 1 cases of T cell lymphoma (5. 263%, 1/19). Follow-up information was available in 15 patients. 12 were still alive and survived for 1~78 months, while the other 3 were dead with 1 case who died of cerebral infarction, and survived for 3~38 months ( averaged 23 months) . Conclusion PRL is an extranodal lymphoma which is rare in kidney and is often misdiagnosed as renal carcinomas due to its nonspecific clinical manifestations. The diagnosis of PRL can be confirmed by histopathological examination, immunohistochemistry and molecular analy-sis. The majority of the lymphomas are B cell lymphomas and most of them are DLBCL. The recommended treatment is surgery com-bined with chemotherapy and the prognosis is associated with the age, clinicopathological characteristics, tumor types and treatment.

Objective: To explore the blood-saving effect of autologous platelet-rich plasma (PRP) back-transfusion in patients with Stanford type A aortic dissection surgery. Methods: A total of 59 consecutive patients who received Stanford type A aortic dissection surgery in our hospital from 2013-01 to 2015-10 were studied. The patients were at the age of (50±6) years with mean body weighting at (80±12) kg and were randomly divided into 2 groups: Traditional (T) group,n=31 and Autologous PRP back-transfusion (P) group,n=28. Blood levels of Hb, platelet counts, PT, APTT were measured at pre-induction of anesthesia (T1), before CPB (T2), prior ifnishing of CPB (T3) and at 1 h (T4), 24 h (T5), 48 h (T6) after the operation. The in-operative, 48 h post-operative volumes of allogeneic blood transfusion and the volume of chest tube drainage at 48h after operation were recorded; the complication occurrence at peri-operative period was recorded. Results: In P group, whole blood processing volume was (1269±197) ml, PRP volume was (753±78) ml, PRP separation time was (35±9) min and the separated platelets were about (22±3)% of total platelet counts. Compared with T group, P group had decreased Hb at T2 (131.0±15.0) g/L vs (101.0±10.0) g/L, decreased platelet counts at T3 (115.0±51.0)×109 /L vs (83.0±23.0)×109/L, while increased platelet counts at T4 (103.0±25.0)×109/L vs (151.0±27.0)×109/L, T5 (105.0±25.0)×109 /L vs (147.0±39.0)×109/L and T6 (101.0±26.0) ×109/L vs (149.0±35.0)×109/L, allP<0.05; P group presented reduced PT at T4 (17.6±2.1) s vs (14.1±1.1) s and T5 (17.6±2.7) s vs (13.5±0.8) s, allP<0.05. The in-operative transfusions of platelet, plasma, cold precipitation and post-operative transfusions of red blood cells, platelets, plasma, cold precipitation and the volume of chest tube drainage at 48h after operation were less in P group,P<0.05. Compared with T group, P group had the lower rates of acute post-operative lung injury (32.1% vs 19.4%), shorter mechanical ventilation time (69.1±5.9) h vs (43.1±1.5) h and ICU staying time (8.1±2.8) d vs (5.3±1.1) d, allP<0.05. Conclusion: Autologous PRP back-transfusion could reduce the post-operative bleeding and allogeneic blood transfusion for Stanford A aortic dissection surgery, it has obvious blood-saving effect.

Objective To evaluate whether visual exploration therapy could lead to the recovery of cognitive function and activities of daily living (ADL) of stroke patients with unilateral neglect. Methods From January, 2012 to June, 2014, 24 stroke patients with unilateral neglect were randomly divided into control group (n=12) and observaton group (n=12). The control group received conventional rehabilita-tion therapy, and the observation group received visual exploration therapy additionally. They were evaluated with Mini-Mental State Exami-nation (MMSE), Montreal Cognitive Assessment (MoCA), modified Barthel index (MBI) and Chinese Behavioral Inattention Test-Hong Kong version (CBIT-HK). Results All the scores improved after treatment in both groups (t>5.375, P<0.001), and were higher in the obser-vation group than in the control group (t>2.120, P<0.05), except MMSE (P>0.05). Conclusion Visual exploration therapy could not only fa-cilitate the recovery of unilateral neglect in stroke patients, but also improve their cognitive function and activities of daily living.