BACKGROUND:After knee joint replacement, patients are often treated with Rivaroxaban and Enoxaparin Sodium for postoperative anticoagulation, avoiding the formation of deep vein thrombosis in lower limbs. OBJECTIVE:To explore the application effects of different anticoagulant drugs in patients with knee joint replacement. METHODS:Ninety patients underwent knee joint replacement in Xiangya Second Hospital of Central South University from July 2011 to July 2014, were randomly divided into two groups, with 45 patients in each group. The experimental group was treated with Rivaroxaban, while the control group was treated with Enoxaparin. RESULTS AND CONCLUSION:Postoperative drainage volume, total blood transfusion, bleeding index, quantity of blood platelet, activated partial thromboplastin time, thrombin reduction time, whole blood viscosity, plasma viscosity, D-dimer coagulation index, HSS score at postoperative 2 weeks, average ecchymosis area, average thigh circumference, and average leg circumference were significantly better in the experimental group, than in the control group (P<0.05). The incidence of deep vein thrombosis of lower limbs in the experimental group was lower than that in the control group (P<0.05). Experimental findings indicate that, both Rivaroxaban and Enoxaparin can exert anticoagulation effect during the knee joint replacement, and Rivaroxaban is better.

Objective To investigate the effect and the significance of soft tissue repairing and functional reconstruction in limb salvage operation on extremity malignant bone tumors by individulized prosthesis replacement after malignant tumor resection with the help of Neo-adjuvant chemo-therapy. Methods A total of 78 patients with malignant bone tumor were recruited, including 42 males and 36 females. Aged 19～61, with an average of (29.12±9.47).Tumor in 14 patients was in the proximal humerus, 11 in the proximal femur, 27 in the distal femur, 3 in femoral middle part, and 23 in the proximal tibial. There were 29 cases of osteogenic sarcoma, 18 chondroma sarcomatosum, 7 maligant enchondroma with pathological fracture, 20 maligant giant cell tumor,and 4 maligant inflammatory myofibroblastoma of the bone. Soft tissue repairing and functional reconstruction were carried out together with individualized prosthesis replacement. The type of the prostheses was as follows: 14 patients had long stem humerus head prosthesis, 50 made hinged knee prostheses with femoral or tibial component, 3 whole femur replacements, 7 long stem femoral head prostheses, 4 long stem hip prostheses.Results All patients were followed up for an average of (26.80±8.06) months (4～37 months) and postoperative functions were estimated according to Enneking system. Among the 78 patients, results in 48 (61.5%) were excellent, 17(21.8%) were good,10 (12.8%) were fair,and 3(4.9%) were poor. The satisfactory rate was 83.3%. Conclusion Soft tissue repairing and functional reconstruction in limb salvage operation on extremity bone malignant tumors by individualized prosthesis replacement not only spare the limbs, but also keep their function.It can remove the psychologic obstacles caused by extremity absence, and is effective for bone malignant tumor.

Background and purpose: The ataxia-telangiectasia mutated (ATM) gene results in ataxia-telangiectasia (A-T) and it is closely associated with tumors. ATM is an important signal transducer that is involved in the repair of DNA double-strand break damage by phosphorylating numerous target proteins . This study was aimed to investigate the correlation between a single nucleotide polymorphism (SNP) in ATM gene (IVS62+60G>A) and the risk of non-small cell lung cancer(NSCLC) in a case-control study. Methods: From June 2004 to December 2005, a total of 264 patients with NSCLC were recruited, 264 healthy people as control. All of specimens were collected from Zhejiang Tumor Hospital. DNA was extracted from peripheral blood and then was used to determine. ATM genotype by Taqman SNP genotyping assays. Logistic regression model was employed to analyze the relationship between SNP and NSCLC risk. Results: The percentage of NSCLC patients in 86 patients with A/A genotype, 139 patients with A/G and 39 patients with G/G were 32.6% (86/264), 52.6% (139/264), 14.8% (39/264), respectively. The percentage in 68 healthy people with A/A genotype, 139 healthy people with NG and 55 healthy people with G/G were 26.0% (68/262), 53.0% (139/262) and 21.0% (55/262), respectively. The proportion of G/G genotype in 264 patients was obviously lower than that in the 264 healthy control (14.8% vs 21.2%, P<0.05). The people with G/G genotype had lower risk to NSCLC than there with A/A genotype (OR=0.561, 95% CI=0.334-0.942, P=0.029). Conclusion: The ATM SNP(IVS62+60G>A)was associated with the NSCLC risk, and homozygous G alleles may be a protective factor to NSCLC.

Objective To investigate the causations, management and prevention methods on the complications of hysteroscopic procedures. Methods Retrospective analysis of 36 cases with hysteroscopic complication, focusing on their characteristics and clinical management as well as prevention methods during the ten years from 1993 to 2004. Results Among 36 cases, 11 cases with uterine perforation and incomplete perforation, which happened during the complicated procedures, were treated by both laparoscopy and laparotomy. Five cases with heavy bleeding were encountered because of the deeply injury to the uterine wall and Foley catheter was inserted into uterine cavity and it stopped the bleeding successfully except in one case done by hysterectomy. Three cases with fluid overload syndrome were cured by using diuretic agent and saline infusion. There is no serious consequence in one case with air embolism due to prompt diagnosis and treatment. Four cases with postablation-sterilization syndrome were treated effectively by performing hysterectomy plus single or bilateral salpingectomy, dilating cervical canal as well as resecting adhesions. Twelve cases with adhesion inside uterine cavity followed hysteroscopy were also treated by dilating cervical canal, underwent adhesionlysis and hysterectomy. Conclusions The potential factors causing complications of hysteroscopy include complicated procedures inside uterine cavity, higher pressure of irrigation, deep injury of endometrium as well as incomplete removal of endometrium during hysteroscopic operations. It is the necessary measures to reduce the complications by performing laparoscopy or B ultrasound monitoring simultaneously, standardizing the procedure and strengthening postoperation management.

Objective: To observe the clinical efficacy of herb-partitioned spreading moxibustion at Baliao points plus climen for diminished ovarian reserve (DOR). Methods: A total of 60 patients with DOR were randomized into a spreading moxibustion group and a Western medicine group by the random number table method, with 30 cases in each group. The Western medicine group was treated with climen, starting from the 5th day of the menstrual cycle for 21 d. The spreading moxibustion group was treated with herb-partitioned spreading moxibustion at Baliao points on the basis of the medication in the Western medicine group, 1 h per time, once a week. The treatment was performed for 1 month as one treatment course in both groups, for 3 courses in total. The serum follicle-stimulating hormone (FSH), luteinizing hormone (LH) and estradiol (E2) in the patients were measured before and after treatment. The peak systolic velocity (PSV) and resistance index (RI) were also detected. The traditional Chinese medicine (TCM) symptom score was evaluated. The clinical efficacy was evaluated after treatment. Results: The total effective rate in the spreading moxibustion group was 93.3％, which was significantly higher than 80.0％ in the Western medicine group, and the difference between the groups was statistically significant (P<0.05). After treatment, the TCM symptom scores, the serum FSH levels, FSH/LH ratios and RI in both groups decreased, and the intra-group differences were all statistically significant (all P<0.05). The serum E2 level and PSV increased compared with those in the same group before treatment, and the intra-group differences were statistically significant (all P<0.05). After treatment, the TCM symptom score, the serum FSH level, FSH/LH ratio and RI in the spreading moxibustion group were lower than those in the Western medicine group, while the serum E2 level and PSV were higher than those in the Western medicine group, and the differences between the groups were statistically significant (all P<0.05). Conclusion: Herb-partitioned spreading moxibustion at Baliao points plus climen can produce valid therapeutic efficacy for DOR. It can improve the clinical symptoms, regulate serum hormone levels and increase ovarian blood perfusion, thus improving ovarian reserve function, producing more significant efficacy than climen alone.

Objective To observe the effect of cognitive training combined with swallowing training real-time electrical stimulation on dysphagia and cognitive impairment after stroke. Methods 40 patients with dysphagia and cognitive impairment after stroke were randomly divided into observation group (n=20) and control group (n=20). The observation group accepted swallowing training (including routine vocal training and swallowing training real-time electrical stimulation) and cognitive training. The control group accepted routine vocal training and neuromuscular electrical stimulation. The cognitive function and swallowing function were accessed with Mini-Mental State Examination (MMSE) and Video Fluoroscopy Swallowing Study (VFSS) respectively before and 1 month after stroke. Results After treatment, the MMSE scores and the time for a bolus to pass the pharynx improved in both groups (P<0.05), and the observation group was superior to the control group (P<0.05). Conclusion Cognitive training combined with swallowing training real-time electrical stimulation can promote the recovery of swallowing function of patients with dysphagia and cognitive impairment after stroke.

Mild encephalopathy/encephalitis with a reversible spleniat (MERS) lesion is a clinic-radiological entity.The clinical features of MERS in neonates are still not systemically reported.This paper presents five cases of MERS,and the up-to-date reviews of previously reported cases were collected and analyzed in the literature.Here we describe five cases clinically diagnosed with MERS.All of them were neonates and the average age was about 4 days.They were admitted for the common neurological symptoms such as hyperspasmia,poor reactivity and delirium.Auxiliary examinations during hospitalization also exhibited features in common.In this report,we reached following conclusions.Firstly,magnetic resonance imaging revealed solitary or comprehensive lesions in the splenium of corpus callosum,some of them extending to almost the whole corpus callosum.The lesions showed low intensity signal on Tl-weighted images,homogeneously hyperintense signal on T2-weighted images,fluid-attenuated inversion recovery and diffusion-weighted images,and exhibited an obvious reduced diffusion on apparent diffusion coefficient map.Moreover,the lesions in the magnetic resonance imaging disappeared very quickly even prior to the clinical recovery.Secondly,all the cases depicted here suffered electrolyte disturbances especially hyponatremia which could be easily corrected.Lastly,all of the cases recovered quickly over one week to one month and majority of them exhibited signs of infections and normal electroencephalography.

OBJECTIVETo study the epdimiology characteristics and the diversity of VP6 gene of GCRV in Lulong, and to provide the basis for GCRV in-depth research.

METHODS793 stool specimens from porcine with diarrhea or not from Lulong in 2007 and 2008. GCRV was detected by nested multiple reverse transcription- polymerase chain reaction (nested RT-PCR) , and analyzed the identity and conducted phylogenetic tree by the seqences.

RESULTSThe positive rate of GCRV was 16.65%. Porcine GCRV strains of Lulong had significant homology differences. Phylogenetic analysis indicated porcine GCRVs were with significant diversity. Amino acid analysis showed GCRV strains with the same host shared the nearest kinship.

CONCLUSIONThe infection rate of GCRV was high from 2007 to 2008 in Lulong. Homology and phylogenetic analysis showed that VP6 gene diversity was widespread. The experimental data provided basis for molecular characteristics of porcine GCRVs.

Animals ; Antigens, Viral ; genetics ; Capsid Proteins ; genetics ; China ; Genetic Variation ; Humans ; Phylogeny ; Rotavirus ; classification ; genetics ; isolation & purification ; Swine

OBJECTIVETo evaluate the diagnostic value of full-field digital mammography for breast cancer.

METHODSThe clinical data and mammograms of 230 patients with breast diseases between January 2008 and July 2008 were collected and reviewed. Craniocaudal (CC) and mediolateral oblique (MLO) view mammograms were performed in all patients before surgery. Three experienced radiologists in breast imaging assessment analyzed and classified all the mammograms according to breast imaging reporting and data system (BI-RADS). The sensitivity, specificity and accuracy were evaluated according to their pathological diagnosis. The reasons resulting in false-negative and false-positive diagnosis were also analyzed.

RESULTSOf the 238 samples, 130 had a malignant breast tumors and 108 cases of benign breast lesions. One hundred and nine of the 130 malignant breast tumors were invasive ductal carcinoma. Fifty-seven of the 108 benign breast lesions were breast adenosis. Masses or masses with microcalcification were the most frequently seen signs of the malignant tumors, accounting for 40.8% and 20.8%, respectively. The sensitivity, specificity and accuracy of FFDM in detecting breast carcinoma were 90.8%, 87.0% and 89.1%, respectively. The false-negative signs including negative X-ray finding (5 cases) and focal asymmetric densities (4 cases). The false-positive signs were masses with spiculate, indistinctive or lobulated margin leading to misdiagnosing the lesions as malignant tumors.

CONCLUSIONFull-field digital mammography (FFDM) is helpful in detection of breast cancers in women, with a higher sensitivity, specificity and accuracy, and has an important clinical application value.

Adult ; Aged ; Aged, 80 and over ; Breast Diseases ; diagnosis ; diagnostic imaging ; Breast Neoplasms ; diagnosis ; diagnostic imaging ; Calcinosis ; diagnosis ; diagnostic imaging ; Carcinoma, Ductal, Breast ; diagnosis ; diagnostic imaging ; Diagnostic Errors ; Female ; Fibrocystic Breast Disease ; diagnosis ; diagnostic imaging ; Humans ; Mammography ; methods ; Middle Aged ; Radiographic Image Interpretation, Computer-Assisted ; Retrospective Studies

OBJECTIVETo study the differences in quality of life and psychosocial function between children with short stature and children with normal stature.

METHODSThe Pediatric Quality of Life Inventory (PedsQL) was used to survey 53 children aged 5-18 years who were diagnosed with short stature between June 2011 and June 2012, and their parents or guardians. Seventy-nine healthy children aged 4-17 years were selected as the control group.

RESULTSFor PedsQL Child-Self Report, the children with short stature had a significantly higher total score than the control children (25.3±11.2 vs 21.1±10.3; P<0.05), and the former had significantly higher scores than the latter on the following items: It is hard for me to walk more than one block; It is hard for me to lift something heavy; I hurt or ache; I worry about what will happen to me; I cannot do things that other kids of my age can do; It is hard to keep up when I play with other kids; It is hard to pay attention in class; I forget things; I have trouble keeping up with my schoolwork (P<0.05). For PedsQL Parent-Proxy Report, the children with short stature had significantly higher scores than the control children on the following items: troubled sleeping; paying attention in class; keeping up with schoolwork; forgetting things (P<0.05). There was no significant difference in total score, however, between the two groups (P>0.05).

CONCLUSIONSChildren with short stature have poorer development of psychosocial function than children with normal stature.

Adolescent ; Body Height ; Child ; Child, Preschool ; Female ; Growth Disorders ; psychology ; Humans ; Male ; Quality of Life