There are various forms of rehabilitation after total knee arthroplasty.In this paper,we reviewed the relevant literature at home and abroad,summary and analysis of the current form of postoperative rehabilitation,respectively from the beginning and end of exercise time,the frequency,the indicators of measurement,etc..

Objective To investigate the diagnostic value of combined detection of serum carcinoembryonic antigen (CEA),car-bohydrate antigen 199 (CA199)and carbohydrate antigen 724 (CA724)for the diagnosis of gastric cancer.Methods Plasma levels of CEA,CA199 and CA724 were detected by using electrochemiluminescence in 95 patients with gastric cancer,63 patients with be-nign gastric diseases and 101 healthy subjects.Results Levels and positive rates of CEA,CA199 and CA724 in gastric cancer group were significantly higher than healthy control group (P<0.05).Levels and positive rates of CEA and CA724 in gastric cancer group were significantly higher than benign gastric diseases group (P<0.05).There was no statistically significant difference of level and positive rate of CA199 between gastric cancer group and benign gastric diseases group(P>0.05).The sensitivity of com-bined detection was obviously higher than any single detection or combined detection of two indexesConclusion Combined detection of the three tumor markers could improve the diagnostic sensitivity and coincidence rate,which have practical diagnostic value for gastric cancer.

Objective To provide the theoretical basis for clinical diagnosis and treatment of the related diseases by the com-parative analysis of serum thyroid stimulating hormone (TSH)and thyroid hormone (TH)[three iodine thyroid glycine (T3),thyroxine (T4),three free iodine thyroid former glycine (FT3)and free thyroxine (FT4)]levels between early preg-nant women and non-pregnant healthy women of childbearing age.Method Examined in the outpatient department of Yan’ an University Affiliated Hospital during 2013 November~2014 March,171 healthy women in 4~13 weeks of pregnancy were regarded as the observation group.In addition,149 non pregnant healthy women of childbearing age were regarded as the control group,who got physical examination in the hospital.The inclusion criteria were:no thyroid diseases history;no living history in local thyroid tumorarea;excluding the abnormal functionof thyroid diseases after history investigation and relevant examination.The detection method of serum TSH,T3,T4,FT3 and FT4 was the direct chemiluminescence assay. With reference of serum TSH and TH levels of the non-pregnant healthy women of childbearing age,the change of serum TSH and TH levels of early pregnant women was observed.Results Comparing the two groups,the pregnant women’s TSH level [1.97(1.17~2.65)mU/L],the non-pregnant women’s TSH level [2.42(1.73~3.58)mU/L],the difference was statistically significant (P<0.01).The pregnant women’s serum T3 level [1.94(1.58~2.37)nmol/L]and T4 level [131.00 (111.60~147.80)nmol/L],the non-pregnant women’s T3 level [1.55 (1.37~1.86)nmol/L]and T4 level [109.30(94.95~122.90)nmol/L],the difference was statistically significant (P<0.01).The pregnant women’s serum FT3 level [4.73(4.44~4.94)pmol/L]and FT4 level [14.88(13.83~16.33)pmol/L],the non-pregnant women’s FT3 lev-el [4.70(4.37~5.01)pmol/L]and FT4 level [15.06(13.54~17.35)pmol/L],they have no significant difference (P>0.05).Conclusion Serum TSH and TH levels of women in the first trimester of pregnancy have different degrees of chan-ges.Therefore,thyroid function testing is necessary for pregnant women during childbirth examination.It can avoid the women and offspring from negative influence of pregnancy women with abnormal thyroid function and achieve the goal of eu-genics.

Objective To investigate the cognition of nurse groups toward nurses' dual practice,and to analyze nurses' tendency to pursuc dual practice and its influencing factors.Methods A questionnaire survey was conducted,and 1010 registered nurses were recruited using stratified sampling method.Results Most (76.4％) nurses agreed with nurses' dual practice.The willingness about nurses' dual practice was significantly different(P=0.022,P=0.008) due to different age and length of service.The top three benefits of nurses' dual practice were to increase reasonable salary of nurses,improve quality of nursing care in community institutions for the aged and increase the utilization of health care resource.As for the disadvantages,disrupting the medical and nursing order,increasing difficulties of management and government's supervision,increasing medical risks.Nurses believed that the main obstacles for nurses' dual practice were the unclear medical risks and the unprotected nurses' interests.Conclusion The nurse groups had a positive and optimistic attitude towards nurses' dual practice.In the case that the government implements relevant laws and regulations,and the interests of nurses are well-guaranteed,nurses' dual practice is a good measure that can improve nurses' work motivation.

Future competition in the medical market will in essence be the contest of the core competitiveness of hospitals.It is therefore imperative for hospitals to do a good job in the following aspects in light of trends in medical development,the state of its resources and the needs of the market: enhancing their awareness of the importance of scientific and technological work,setting up a rationally distributed scientific research system,strengthening personnel and disciplinary development,improving the quality of scientific and technological management personnel,and establishing standardized systems for scientific and technological management.The goal is to enhance core competitiveness so as to gain competitive edges for sustainable development.

Bone marrow stromal cells are a kind of non-hematopoietic stem cells in the bone marrow.They possess self-renewing capability and multilineage differentiation potential.They are the ideal cell source for cell transplantation in the treatment of various diseases.A large number of animal model experiments shown that BMSC transplantation can promote brain structure and functional recovery after cerebral ischemia through a variety of mechanisms and provide new ideas and methods for the treatment of cerebrovascular diseases.This article reviews the mechanisms of BMSCs in the treatment of ischemic stroke in recent years.

Bone marrow stromal cells are a class of multipotent stem cells.They have self-renewal and multilineage differentiation potential and provide a basis for cell and gene therapy in a variety of diseases.Many experimental studies shown that bone marrow stromal cell transplantation has a significant therapeutic effect for cerebral infarction.This article reviews the method and effect of bone marrow stromal cells in treatment of cerebral infarction in recent years.

Objective:To investigate the psychological changes of leukemia children and their parents during treatment and rehabilitation,and provide the basis for medical staff giving humanistic care to them.Methods:20 leukemia children and their parents were interviewed and accepted one to one individualized intervention after ana-lyzing the information and posing problems.Results:Leukemia children need long-term treatment, and chemo-therapeutic drugs has obvious side effect, which make parents and children painful and easily cause negative emo-tion and psychological problems.Timely psychological intervention and humanistic care are good for disease recov-ery.Conclusion:According to children′s psychological characteristics in different treatment stages and parents′psy-chological needs conclusion was made that humanistic care on leukemia children should include:to make the pa-tient comfortable first, meet the psychological demands of children in different ages, improve medical technology, carry out painless therapy, enhance communication skills between doctors and patients, give the necessary social support, and improve the children′s quality of life.

Objective To identify the risk factors of postoperative delirium after cardiac surgery . Methods Setting the inclusion and exclusion criteria and establishing the retrieval strategies for primitive literatures, several databases were searched .The RevMan 4.3 software was adopted to perform the analysis of sensitivity and heterogeneity and to calculate the cumulative effects of risk factors using either fixed or random effects model .Results Fifteen studies were included in the final analysis .The independent risk factors of delirium after cardiac surgery were older age; history of artial fibrillation , diabetes mellitus , cerebrovascular disease , abnormal serum creatinine level , anemia and depression;valve replacement or combined procedure and prolonged operation time;prolonged mechanical ventilation time , massive use of sedative and postoperative atrial fibrillation.Conclusions The patients with a history of atrial fibrillation or with a complication of postoperative atrial fibrillation are at an increased risk of developing delirium following elective cardiac surgery .And the valve replacement or combined procedure and prolonged operation time are uniquely associated with postoperative delirium.

Objective To investigate the value of MRI diffusion-weighted imaging (DWI) technique in endocrine therapy for prostate cancer (PCa) based on PI-RADSv2.1. Methods A retrospective analysis of 57 patients with pathologically confirmed PCa was conducted. All patients underwent multi-parametric MRI (mpMRI) according to PI-RADS v2.1 technical specifications before biopsy and six months after endocrine therapy. The apparent diffusion coefficient (ADC) values were measured in cancer and non-cancer areas before biopsy and six months after endocrine therapy. Patients were grouped based on the mRECIST criteria and PSA level into responders (n=45) and non-responders (n=12). ROC curves were obtained to assess the correlation between changes in ADC values and PSA values before and after endocrine therapy. Results In the responder group, the ADC value of the cancer areas was increased significantly after endocrine therapy (P<0.001). No statistically significant difference of the ADC value of the cancer areas was found in the non-responder group before and six months after endocrine therapy (P=0.714). The ADC change of responders and non-responder groups were (0.411±0.178)×10^-3 mm²/s and (-0.014±0.125)×10^-3 mm²/s, respectively (P<0.001); the ADC ratio were (60.603±30.201)% and (-1.096±13.175)%, respectively (P<0.001). The cutoff value of the ADC change was 0.165 (AUC=0.974; sensitivity, 88.89%; specificity, 100.00%; PPV, 100.00%; NPV, 70.59%). The cutoff value of ADC ratio was 16.827% (AUC=0.980; sensitivity, 91.11%; specificity, 100.00%; PPV, 100.00%; NPV, 75.00%). The ADC values were negatively correlated with serum PSA before and after endocrine therapy. Conclusion The ADC change and ADC ratio may be facilitated to monitor the efficacy of endocrine therapy for PCa. The ADC values were negatively correlated with serum PSA.