Incidence of knee periprosthetic fractures after total knee arthropoasty is increased,and is a challenging clinical problem. Treatment options include conservative and operative methods. Only the doctor have sufficient and systematic understanding of periprosthetic fractures and consider both advantages and dis-advantages before deciding the appropriate treatment, the satisfying treatment outcome will be got. we re-viewde the type, treatment methods and outcomes of periprosthetie fractures of total knee arthroplasty repor-ted in recent years.

Objective To explore the locus of control and the relationship with parenting patterns of ado-lescents with first-onset major depressive disorder (MDD). Methods Patients with first-onset MDD (n= 98) and controls (n=98) were investigated by Sphere of Control Questionaire and EMBU, the results were compared and analyzed correlatively. Results The scores of the individual strength scale ( 37.47±13.66) and the relations with people scale ( 38.65±13.19 ) of patients were significantly lower(P<0.05 ) than the controls [(45.39± 12.84) and (45.90±11.20 ) each], while the scores of social-political management (39.01±10.28) were not significantly lower (P>0.05)than the controls' (39.12±9.50). The scores of patients' paternal excessive inter-ference factor(2.66±0.49) , maternal excessive protection/interference (2.79±0.55 ) and rejection/denial fac-tor(2.55±0.39) of EMBU were significantly higher(P<0.05)than controls' [(2.17±0.58),(2.17±0.49) and( 1.75±0.51 ) each]. The scores of patients' paternal affection/understanding factor were significantly posi-tively correlative with patients' scores of relations with people (r=0.27, P<0.05), maternal affection/under-standing factor was significantly positively correlative with patients' scores of individual strength (r=0.21, P <0.05) and relations with people(r=0.23, P<0.05 ) , while maternal excessive interference/excessive protection and individual strength (r=-0.24, P<0.05 ) and relations with people (r=-0.22, P<0.05), maternal rejec-tion/denial and individual strength (r=-0.26, P<0.05) were significantly negatively correlative. Conclusion Adolescents with MDD have abnormal locus of control,which might be correlative with their parenting patterns.

Health law teaching exists deficiencies in training students' practical ability while moot court has obvious advantages in this area and it is feasible. Specific program can be established from the following four aspects:curriculum mode,selection of cases,teaching methods and evalua-tion system.

Objective To investigate the causes and features of fever of unknown origin(FUO).Methods This study enrolled 89 patients who fullfilled the criteria of FUO and were admitted in China-Japan Friendship hospital from October 2005 to May 2008.Results The final diagnosis were made in 80 cases(89.9%).Etiologies of FUO were as follows:infections,41 cases(46.1%);rheumatic disease,15 cases(16.9%);neoplasm,18 cases(20.2%)(hematological malignancy,17 cases),miscellaneous diseases 6 cases(6.7%),unknown etiology,9 cases(10.1%).Conclusion Infection is the main cause of FUO;rheumatic disease and neoplasm are also important causes of FUO.Hematological malignancy is the most common neoplasm related to FUO.Detailed history contributes greatly to FUO diagnosis.

Atrial Fibrillation ; complications ; drug therapy ; Coronary Artery Disease ; complications ; drug therapy ; Fibrinolytic Agents ; therapeutic use ; Humans

Objective The purpose of this study was to determine if parafascicular nucleus of thalamus is involved in the nociceptive stimulation evoked by coronary artery occlusion-induced acute myocardial ischemia and to investigate the effect of fentanyl on this nociceptive stimulation. Methods Male SD rats weighing 260-300 g were operated upon under general anesthesia with intraperitoneal urethane (1.2 g ? kg -1 ) and local infiltration of the skin incision. The discharges of pain-sensitive neurons (PSN) were recorded for 20 seconds every 5 min using single-barrel glass electrode before and after the coronary artery occlusion ( CAO) . The study was divided into 3 groups: group Ⅰ CAO alone ( n = 9); group Ⅱ CAO + fentanyl ( n = 6) : fentanyl 0.01 mg ?kg-1 was administered iv 15 min after CAO; group Ⅲ CAO + fentanyl + naloxone ( n = 6) : naloxone 0.04 mg? kg-1 was administered iv 15 min after intravenous fentanyl administration. Results The discharge frequency was significantly increased following CAO and peaked within 5-10 min after CAO and maintained for 60 min. The increased frequency of nociceptive discharge was significantly inhibited within 10 min after fentanyl and intravenous naloxone could completely antagonize the inhibitory effect of fentanyl. Conclusion Visceral pain can be evoked by acute myocardial ischemia induced by coronary artery occlusion. Thalamic parafascicular nucleus is involved in the perception of nociception in CNS. Opioid receptors play a critical role in the modulation of the nociception.

Sepsis is one of the most common causes of mortality in the intensive care units (ICUs) with high mortality rates which may be related to the lack of thoroughly understanding of the specific pathophysiological mechanisms.Improved treatment protocols have resulted in most patients got out of the initial hyperinflammatory phase and entered into a protracted immune suppressed phase.Deaths in this immunosuppressive phase are typically due to failure to control the primary infection or the secondary nosocomial infections often with opportunistic pathogens.As the complexity in multiple systems and varied mechanisms involved in the development of disease,the disorder of immune system and inflammation reaction may be one of the main mechanisms,which were mainly characterized by inflammation cytokines storm and immune dysfunction.The mechanism in the later course of disease may include apoptosis and depletion of immune cells,increased suppression of T regulatory cell and increased myeloid-derived suppressor cell,and cellular exhaustion.In this review we focus on the pathophysiologic mechanism of sepsis with immune compromized,monitoring the immune response,the cellular immunoadjuvant therapy,and improving the recognition of sepsis immunosuppression.

Objective To study the influence on T-lymphocyte subsets in herpes zoster with adjuvant treatment of compound glycyrrhizin.Methods 93 patients with herpes zoster were randomly divided into two groups:control group(46 cases,treated with antiviral drugs) and 1 treatment group(47 cases,treated with compound glycyrrhizin and antiviral drugs).The expression of T-lymphocyte subsets on the T cell surface in patients and control group were determined by flow cytometry.Results The expression of CD3,CD4,CD8,CD4/CD8 ratio was significantly different in the treatment group and control group.Conclusion Compound glycyrrhizic adjuvant therapy could not only shorten check blister,acetanilide,scar tissue and recovery time,reduce the sequela of neuralgia,but also affect the expression state of T lymphocyte subsets with herpes zoster,improve the cellular immune function with herpes zoster.

Metformin as a cheap,safe and effective diabetes drug,has been used for many years. Recently,many studies have shown its variety inhibition of tumor cells. Its antitumor mechanism is not entirely clear;may be related to glucose metabolism and protein kinase or inflammatory cytokines mediating tumor kill-ing. Metformin has different cytotoxic effects to various tumor cell,as well as playing some auxiliary roles on other antitumor methods.

S-phase kinase associated protein (Skp2) assumes the high expression in the most of malignant tumors, with its occurrence, and the development and the prognosis is closely related with a latent diagnose and treat went value. This review will focus on unique feature, biology activity, the function mechanism and with malignant tumor relations of the Skp2.