BACKGROUND:Total knee replacement is the main treatment for the end of the knee joint disease. How to choose prosthesis replacement according to the different situations of the patient is one of the focuses in the field of joint surgery.
OBJECTIVE: To evaluate middle or short term effects of rotating high-flexion prosthesis for the middle-aged patients with osteoarthritis of knee in total knee replacement.
METHODS: We retrospectively analyzed 48 osteoarthritis patients (55 knees) undergoing total knee replacement with rotating high-flexion prosthesis in the Liuzhou People’s Hospital from January 2009 to January 2013.
RESULTS AND CONCLUSION:(1) Forty-eight patients were folowed up for 23-42 months, mean (24±2.7) months. (2) Knee range of motion and Hospital for Special Surgery knee score were significantly increased after implantation. The excelent and good rate of Hospital for Special Surgery knee score was 85.4%. (3) No infection, loosening or dislocation occurred in al patients. (4) These findings suggest that curative effect of rotating high-flexion prosthesis is definite. After implantation, the range of motion was high, which was accorded with movement pattern of the human body. Prosthesis has a long life, and its repair rate is low. It is an ideal method for the middle-aged patients who want to perform high-flexion activities.

Objective To evaluate the short-middle term clinical effects of the fixed platform stabilized prosthesis in the treatment of the elderly patients with rheumatoid arthritis(RA).Methods The clinical data of 53 cases elderly RA patients who were admitted to the People's Hospital of Liuzhou from January 2009 to January 2013 and were treated with fixed platform and stable prosthesis in 62 knees were retrospective analyzed.Results Fifty-three patients were followed up for 24.0-43.0 months with average (25 ± 2.1)months.At the last follow-up,the degree of knee motion was improved significantly compared with the preoperative((116.0±6.0) ° vs.(46.0±7.0)°),the difference was significant(t=35.323,P＜0.01).The HSS score was significantly improved compared with the preoperative ((85.3±7.6) points vs.(50.2±11.3)points),the difference was significant (t=4.002,P＜0.05).At the last follow-up,35 cases (66.0％) of excellent,11 cases (20.8％) of good,and 7 cases (13.2％) of normal.After the operation,all patients obtained obvious improvement in joint pain,swelling,dysfunction,deformity and so on.Conclusion The fixed platform stabilized prosthesis is simple,effective,and less postoperative complications,and it is a better choice for the elderly patients with high flexion activity.

Objective To explore the current status and influencing factors of oral health knowledge and behavior among the elderly living in Gongshu District of Hangzhou City.Methods A total of 600 elderly individuals were selected by multi-stage stratified cluster random sampling and interviewed with a self-designed questionnaire which included demographic characteristics and oral health knowledge and behavior.The status and influencing factors of oral health behavior were analyzed by single and multiplefactor analysis methods.Results A questionnaire survey was conducted among 600 elderly residents,with a response rate of 99.3％ (596/600) and an effective response rate of 94.1％ (561/600).The rate of good oral hygiene was 50.4％.Those elderly with different age,education level,medical insurance and oral hygiene showed significant difference in qualified rate of oral health behavior (x2 values were 10.79,21.32,5.72 and 16.33,respectively; all P＜0.05).In Logistic regression model,education level was positively correlated with oral health behavior among the elderly,and the qualified rate of oral health behavior of the elderly with education level of junior school or above was 2.69 times higher than that of illiterate elderly (x2=10.53,P=0.001).Conclusion The awareness rate of oral health knowledge among the elderly living in Gongshu District of Hangzhou City is at a relatively higher level,though oral health behavior is moderate.Age,education level,medical insurance and oral hygiene could be impacting factors of oral health behavior.

Objective To study different surgical methods for breast cancer patients under the influence of the quality of life at different stages. Methods The clinical data of finishing our hospital 160 cases of breast cancer patients , ac-cording to the patient's surgical approach , divided into breast-conserving resection of breast conserving surgery group , mastectomy breast reconstruction group, modified radical group, using the method of returning scale investigation, the statistical quality of life of patients at different stages. Results The patients in the perioperative period, physical, psy-chological and other breast-conserving surgery group and mastectomy breast reconstruction group than modified radical group ( P<0 . 05 ) , with significant difference , but there were no significant difference in the quality of life between the two groups (P>0.05); after 2 years and 5 years, breast-conserving surgery and mastectomy breast reconstruction group's quality of life was higher than that in the modified radical group (P<0.05), with significant difference between the two groups. The patient's physiological , psychological and other aspects of the situation was not statistically signif-icant (P>0.05);perioperative period, after 2 years, a period of 5 years, breast-conserving surgery group and mastecto-my breast reconstruction patients physical, psychological status, quality of life was not statistically significance (P>0.05). Conclusion Breast cancer treatment involves the patient's physical structure , resulting in a greater impact on quality of life and psychological state of the patient's will to a large extent, in the optional cases, give priority to breast-con-serving surgery or mastectomy breast reconstruction may be to some extent , improve the quality of life of patients.

:To establish and verify a risk prediction nomogram for ipsilateral axillary lymph node metastasis in breast cancer stage T1 （mass ≤ 2 cm）. :The clinicopathological data of 907 patients with T1 breast cancer who underwent surgical treatment from January 2010 to June 2015 were collected，including 573 cases from the Second Affiliated Hospital of Zhejiang University School of Medicine （modeling group） and 334 cases from Zhejiang University Lishui Hospital （verification group）. The risk factors of ipsilateral axillary lymph node metastasis were analyzed by univariate and multivariate logistic regression. The influencing factors were used to establish a nomogram for predicting ipsilateral axillary lymph nodes metastasis in T1 breast cancer. The model calibration，predictive ability and clinical benefit in the modeling group and the verification group were analyzed by C index，receiver operating characteristic curve，calibration curve and decision curve analysis （DCA） curve，respectively. :Univariate analysis showed that lymph node metastasis was related with primary tumor size，vascular tumor thrombus，Ki-67，histopathological grade，and molecular type （<0.05 or <0.01）. Multivariate logistic regression analysis showed that the primary tumor > vascular tumor thrombus，Ki-67 positive，estrogen receptor （ER） positive，and histopathological grade 2-3 were independent risk factors of axillary lymph node metastasis （<0.05 or <0.01）. Based on the independent risk factors，a nomogram prediction model was established. The C indexes of the model group and the validation group were 0.739 （95%:0.693-0.785） and 0.736 （95%:0.678-0.793），respectively. The calibration curve and DCA curve of the modeling group and the verification group indicated that the model was consistent and had good clinical benefit. :Primary tumor size，histopathological grade，vascular tumor thrombus，Ki-67，and ER status are predictors of ipsilateral axillary lymph node metastasis in T1 breast cancer. The established prediction nomogram can effectively predict the risk of ipsilateral axillary lymph node metastasis in T1 breast cancer，which can be used as a reference for individualized axillary management.
Axilla ; Breast Neoplasms ; Female ; Humans ; Lymph Nodes ; Lymphatic Metastasis ; Nomograms ; Retrospective Studies