BACKGROUND:The incidence of patel ar complications is decreasing, however, the necessity of patel ar replacement remains unclear. OBJECTIVE:To investigate the incidence rate of anterior knee pain and postoperative pain score in total knee arthroplasty without the patel ar replacement and to provide a reference for the formulation of clinical operation scheme. METHODS:151 patients with 193 knees receiving total knee arthroplasty were involved in this study. Al the patients were treated with patel ar forming but not resurfacing of the patel a. The Western Ontario and McMaster University (WOMAC) Osteoarthritis Index and America Hospital for Special Surgery (HSS) score were used to evaluate patients before surgery and at 6 and 12 months after surgery. The function of knee joint, the incidence rate of anterior knee pain and visual analogous scale score before and after operation were compared. RESULTS AND CONCLUSION:After 6 and 12 months of total knee arthroplasty, WOMAC osteoarthritis index was significantly lower and HSS score was significantly higher than those before surgery (P<0.05). At 12 months post-operation, the incidence rate of anterior knee pain was 11.3%, which was significantly lower than the preoperative rate (94.5%) (P<0.05). At 12 months post-surgery, visual analogous scale scores were also significantly lower than the preoperative score (P<0.05). Total knee replacement without resurfacing of the patel a can effectively improve knee joint function in knee osteoarthritis or rheumatoid arthritis patients, ameliorate the symptoms of anterior knee pain, has a good clinical effect within short term post-operation. The middle-and long-term effects need further exploration.

Objective To investigate the variation of lipid profile in patients with acute myocardial infarction (AMI) of different age groups.Methods Total 1214 patients of AMI were admitted to our hospital from May 2007 to July 2011.The age of patients ranged 40-89 years,and patients were divided into 5 age groups with 10-years step.Differences in lipid levels were observed by using pair-wise comparison among different age groups.Results Pair-wise comparisons among different age groups indicated that TC levels were higher in 40-69 years age groups [(4.71 ± 1.08),(4.80 ± 1.30),(4.69 ± 1.03) mmol/L,respectively] than those in the 70-89 age groups [(4.41 ± 0.96),(4.38 ± 1.03) mmol/L],all P ＜ 0.05(t values were 2.381,2.323,4.382,3.965,3.317,3.096).TG levels among three age groups ＜ 59 years had no significant difference,which were higher than those in groups over 60 years.Among 50-89 years age groups,TG gradually reduced with increase of age.HDL levels were lower in 40-59 years age groups [(1.03 ± 0.23),(1.05 ± 0.26) mmol/L,respectively] than those in 60-89 years age groups [(1.11 ±0.28),(1.11±0.28),(1.16±0.34) mmol/L,respectively],allP＜0.05 (t values were-2.777,-2.789,-3.731,-2.543,-2.566,-3.644).Total cholesterol (TC) (r =-0.123,P ＜0.01),lowdensity lipoprotein cholesterol (LDL) (r =-0.139,P ＜ 0.01) and triglyceride (TG) (r =-0.287,P ＜0.01) were negatively but high-density lipoprotein cholesterol (HDL) (r =0.125,P ＜ 0.01) was positively correlated with age of patients.TC levels in female patients were higher than those in male patients in 50-89 years age groups; LDL levels in female patients were higher than those in male patients in 50-69 years age groups and HDL levels in female patients were higher than those in male patients in 40-79 years age groups (all P ＜ 0.05,t values were-2.878,-3.007,-3.352,-3.333).Conclusions Results show that the non-elderly AMI patients (＜60 years) have higher levels of TC,LDL and TG,and lower level of HDL than the elderly patients; the TC,LDL and HDL levels are higher in female AMI patients than those in male patients at the same age groups.

Objective To determine the optimum dose of bupivacaine for spinal anesthesia with epidural volume extension (EVE) in patients undergoing cesarean delivery.Methods A total of 100 parturients,weighing 55-100 kg,with body height of 155-170 cm,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective cesarean delivery,were included and randomized to receive bupivacaine at 5 different doses (A,B,C,D,and E groups) using a random number table,with 20 patients in each group.In A,B,C,D,and E groups,bupivacaine 6.75,7.50,8.25,9.00 and 9.75 mg were injected into the subarachnoid space,respectively,and the volume was all 1.5 ml.After successful spinal anesthesia,an epidural catheter was placed,and normal saline 10 ml was given through the catheter to perform EVE.A successful spinal block was defined as attainment of sensory block of at least T5 within 15 min after EVE along without requirement for additional local anesthetics within 60 min after EVE.The rate of successful spinal anesthesia,time to reach sensory block of T5,the maximum level of sensory block,and the first requirement for local anesthetics were recorded.The occurrence of hypotension,tachycardia,bradycardia,nausea,vomiting,chest distress,dyspnea,shivering,and referred pain and consumption of metaraminol were recorded during spinal anesthesia.Apgar scores at 1 and 5 min after birth were recorded.Results With the increasing doses of bupivacaine,the efficacy of spinal anesthesia was enhanced,and the occurrence of adverse reactions was increased.Compared with group C,the rate of successful spinal anesthesia,and the maximum level of sensory block were significantly increased,the time to reach sensory block of T5 was shortened,and the incidence of hypotension and nausea and consumption of metaraminol were increased in group E;the time to reach sensory block of T5 was significantly shortened,Apgar scores at 1 min after birth were increased (P＜0.05),and no significant change was found in the rate of successful spinal anesthesia,the first requirement for local anesthetics,the rate of time to reach sensory block ofT5≤ 15 min,and the maximum level of sensory block in group D (P＞0.05).Compared with group D,the time to reach sensory block of T5 was significantly shortened,the incidence of nausea and consumption of metaraminol were increased (P＜0.05),and no significant change was detected in the rate of successful spinal anesthesia,the first requirement for local anesthetics,the rate of time to reach sensory block of T5 ≤ 15 min,and the maximum level of sensory block in group E (P＞0.05).Conclusion The optimum dose of bupivacaine for spinal anesthesia with EVE is 9.00 mg in patients undergoing caesarean delivery.

Ovarian carcinoid tumor is a very rare, low-grade malignant tumor, and most of the patients have no typical clinical symptoms. Some patients seek medical attention for pelvic masses often found incidentally, and about one-third of the patients may present with carcinoid syndrome. We report a case of ovarian carcinoid tumor clinically manifested by intractable constipation, which is a rare condition in these patients.
Carcinoid Tumor ; complications ; Constipation ; etiology ; Female ; Humans ; Middle Aged ; Ovarian Neoplasms ; complications

Adult ; Electrocardiography ; methods ; Epicardial Mapping ; Humans ; Male ; Tachycardia, Ventricular ; physiopathology

Objective To observe the effect of acupuncture on ghrelin,estradiol (E2) and bone mineral density (BMD) in postmenopausal osteoporosis rats.Methods According to the random number table method,60 female Sprague-Dawley rats aged 3 months,were randomly divided into surgery group (40 rats) and sham group (20 rats).The osteoporosis model was established by bilateral ovariectomy.Three months after the operation,a significant decrease in BMD of lumbar vertebrae and femur of the model rats as measured by dual energy X-ray absorptionmetry against the sham group indicated successful establishment of the osteoporosis model.Then surgery group was randomly divided into a model subgroup,a acupuncture subgroup and an estrogen subgroup,with 10 rats in each subgroup.The acupuncture subgroup was treated with electroacupuncture,estrogen subgroup with subcutaneous injection of estradiol benzoate,sham group and model subgroup without any treatment.After 3 months of intervention all the rats were sacrificed,BMD of the lumbar vertebrae and femur was measured,ghrelin and E2 were determined.Results Serum ghrelin in acupuncture subgroup (399 pg/ml) and estrogen subgroup (276 pg/ml) were significantly lower (P ＜ 0.01) than that in model subgroup (546 pg/ml); serum E2 in acupuncture subgroup (128.02 pg/ml) and estrogen subgroup (182.89 pg/ml) increased significantly (P ＜ 0.05) than that in model subgroup (72.10 pg/ml) ;lumbar vertebrae BMD in acupuncture subgroup (0.212 g/cm2) and estrogen subgroup (0.231 g/cm2) increased significantly (P ＜ 0.05) than that in model subgroup (0.191 g/cm2),but in acupuncture subgroup the effect on improving the level of E2,ghrelin and lumbar vertebrae BMD was less than that in estrogen subgroup (P ＜ 0.05).Conclusions Acupuncture intervention can improve lumbar vertebrae BMD and serum E2 level of postmenopausal osteoporosis rat model,down regulate serum ghrelin level,but the overall effect of acupuncture is less than estrogen.

Objective To observe the effect of electroacupuncture (EA) on intestinal vitamin D receptor (VDR) mRNA and protein expression in ovariectomized rat model,and to explore the possible mechanism of acupuncture treatment for postmenopausal osteoporosis.Methods Sixty 3-month-old female SD rats were randomly divided into operation group and sham group.3 months after osteoporosis model was successfully produced,rats in operation group were randomly divided into model group,EA sham group,EA group and drug group.12 weeks after intervention,bone mineral density (BMD) of lumbar spine and femur were detected,then rats were all sacrificed to extract the small intestinal mucosa.VDR mRNA and protein expressions were determined by real-time quantitative PCR and Western blotting.Results The model of postmenopausal osteoporosis was successfully established.The bone mineral density was significantly improved in EA group and drug group as compared with the model group at 12 weeks after intervention.Western blotting and realtime quantitative PCR showed that small intestinal VDR mRNA and protein expressions were increased in EA group and drug group,but the increment of VDR mRNA expression was less in EA group than in drug group.Conclusions One of the mechanisms of acupuncture treatment for postmenopausal osteoporosis may be related with increasing the intestinal VDR mRNA and protein expression levels and enhancing the bioactivity of vitamin D.

Objective To evaluate the value of chorionic villus cells karyotype analysis in prenatal diagnosis during the first tri-mester of pregnancy.Methods Pregnant women with prenatal diagnosis indications were punctured by guiding abdominal B-mode ultrasound to get villi tissue which was then to develop cell culture,chromosome preparation and karyotype analysis.Results A to-tal of 1 140 cases were successfully cultured,and the successful cultivating rate was 98.2% (1 140/1 160).Among them,chromo-somes of 62 cases were detected to be non-polymorphic structural abnormalities,including 32 abnormal chromosome number,5 chro-mosome balanced translocation,3 chromosome deletion,and 22 chimeras.What′s more,20 cases were detected to be chromosomal inversion,19 cases of chromosome 9 were inversion,and one with chromosome Y was inversion.Conclusion Karyotype analysis of villus cell could help to detect fetal chromosomal abnormalities during early pregnancy and get early intervention.It was significant to reduce the child′s birth with chromosome abnormalities.

Rheumatoid arthritis (RA) is a kind of chronic autoimmune disease and osteoporosis is one of its complications.

To evaluate the efficacy of Tuina and Chinese patent drug Shuxuetong injection in preventing patients undergoing total knee arthroplasty from deep venous thrombosis and in functional rehabilitation.