[Objective] To measure the patella thickness and to investigate the techniques and safety of patella resurfacing during total knee arthroplasty in Chinese patients with rheumatoid arthritis.[Methods]From Jan.2005 to Jan.2006,the maximal and minimum thickness of the patella,the preserved thickness of bony patella after resurfacing and the total thickness of patella composite after patella replacement in 95 consecutive total knee arthroplasty for rheumatoid arthritis were measured.The patients were followed-up after operation,anterior knee pain and patella fracture were recorded.[Results]1)The mean maximal thickness before resurfacing was(22.01?1.64)mm(range,18~26 mm),the mean minimum thickness before resurfacing was(11.69?2.33)mm(range,6~16mm).2)The mean thickness of preserved bony patellar thickness was(13.23?0.96)mm,(range,11~16 mm),including 11 mm in 4 knees(4.2%),12 mm in 15 knees(12.7%),13 mm in 38 knees(40%),14 mm in 32 knees(33.7%),15 mm in 5 knees(5.3%)and 16 mm in 1 knee(1.1%).The mean thickness of the patella composite was 21.42 mm(range,20~25 mm),the thickness of resurfaced patella was equal to or thinner than the preoperative patellar thickness in 86 knees(90.5%).Anterior knee pain was found in 3 knees,but no patellar fracture or component loosening occurred.[Conclusion]1)The patellar thickness in rheumatoid arthritis is thinner than the thickness in normal patella.2)It is a safe option to retain bony patella thickness at 12~14 mm during patellar resurfacing in Chinese adults with rheumatoid arthritis.3)Patellar resurfacing in patients with rheumatoid arthritis has a good result in a short term.Careful attention to good surgical technique in component alignment and patellar resurfacing is crucial to obtain good results.

Objective:To retrospectively analyze the CT features among gastric cancer, gastric lymphoma and gastric malignant stromal tumors, evaluated the application value of MDCT in gastric malignant tumor.Methods: Sixty two patients with gastric malignancies tumor confirmed by pathology underwent MDCT plain scanning and triphasic contrasted scanning before operation. Referring to the pathological results, to observe the CT signs, include: scope of tumors and involvement, the density of tumors and enhanced characteristics, mucosal membrane, the change of the stomach softness, peripheral lymph node enlargement, the involvement of other organs, and to make statistical analysis for imaging features of these tumors byx2 testing.Results: Sixty two cases of gastric malignant tumor included 42 cases of gastric carcinoma, 12 cases of gastric lymphoma and 8 cases of gastric malignant stromal tumor, were confirmed by postoperative pathology. The CT manifestations were as follows: the stomach mucous membrane surface involvement in all the gastric cancer, the positive rate was significantly higher than gastric lymphoma and stromal tumor. The area involved by lymphoma were more than two partitions, significantly higher than that of gastric cancer and stromal tumor (x2=36.643,x2=20.00;P<0.05). 39 cases (92.8%) of gastric cancer and 8 cases (100%) of malignant stromal tumors were significantly enhanced, but all gastric lymphoma were not obvious enhancement. The positive rate of enlarged lymph nodes in gastric cancer(61.9%) and lymphoma(83.3%) were higher than stromal tumor(12.5%)(x2=9.731,x2=6.603;P<0.05).Conclusion: The CT manifestations of the gastric cancer, lymphoma, malignant stromal tumors had different characteristics. Multislice CT for the diagnosis and differential diagnosis of gastric malignant tumor has important value.

[Objective]To investigate the method and efficiency of operative modified rotational acetabular osteotomy for treatment of adult acetabular dysplasia. [Methods]Twenty-seven patients with 30 hips with acetabular dysplasia were treated with modified rotational acetabular osteotomy. The study group consisted of three men with 3 hips and twenty-four women with 27 hips,the average age of the patients was 29.4 years(range,fifteen to forty-two years ).The anteroposterior plevis view,lateral and abduction view of bilateral hip were taken,CE angle(center-edge angle) and AC angle(acetabular roof obliquity) were measured,the changes of the rotational center of the hip ,Shenton's line and the degree of osteoarthritis were recorded ,the Harris score was obtained before and after operation.[Results]The femoral head coverage was improved in all patients. On average ,the CE angle was improved from 3.2 (-15?～15?)to 28.5?(20?～40?),the AC angle was declined from 26.6?(15?～38?)to 3.9?(0?～12?). The rotational center of the hip was medialized in 19 hips(63.3%),the discontinuity rate of Shenton's line was declined from 67% to 23%. On average 4.2 years follow-up ,1 case lost follow-up,the degree of osteoarthritis in 28 hips was not aggravated,pain was aggravated in 1 hip ,the Harris score was improved from 82.7(67～96) to 97.8(87～100).Two patients have had Fibre-union of pubic and one patient has had stress fracture of the inferior pubic ramus postoperatively,non-union of iliac and posterior column of the osteotomy or the greater trochanter was not found.[Conclusion]The method of modified rotational acetabular osteotomy for treatment of adult acetabular dysplasia is effective and safety.