BACKGROUND: The number of patients undergoing total knee replacement due to severe gouty arthritis is increasing rapidly in recent years, and the ages of patients also present younger and younger. However, its clinical efficacy remains controversial, and it is lack of retrospective systematic analysis. OBJECTIVE: To assess the clinical efficacy of total knee replacement for severe gouty knee arthritis from several aspects, such as pain, function, quality of life and complications. METHODS: From January 2006 to January 2015, 17 patients (20 knees) with severe knee gouty arthritis received total knee replacement in Department of Orthopedics of Nanjing General Hospital of Nanjing Military Region of Chinese PLA. They underwent knee joint surface replacement with posterior cruciate ligament, and patel a was not replaced. Posterior stabilized prosthesis was used. Al patients were successful y fol owed up postoperatively. The Hospital for SpecialSurgery Knee Score, range of motion of the knee, Visual Analogue Scale score and SF-36 scale scores were determined before and after replacement and during final fol ow-up. RESULTS AND CONCLUSION: Patients were fol owed up for 1-9 years. No serious complications occurred during and after replacement. The Hospital for Special Surgery Knee Score, range of motion of the knee, Visual Analogue Scale score and SF-36 scale scores were significantly higher after replacement and during final fol ow-up than those before replacement (P < 0.001). X-ray films showed good prosthesis position, satisfactory limb alignment without radiolucent lines or loosing. These findings verified that total knee replacement was considered as the final way to treat the severe gouty knee arthritis; its short-term clinical effect is significant, but systematic anti-uric acid, prevention and treatment of complications, pain control, function exercising, and healthy mood maintenance were needed to get a better long-term clinical efficacy.

Objective To explore the related factors for improving the effect of the staged bilateral multi-targets pallidotomy and thalamotomy on Parkinson's disease.Methods 387 patients were divided into different groups according to various factors,including the age of patient,operation method,interval of radiofrequency and the diameter of electrode. The relationship between the above mentioned factors and the effect or complication was analyzed.Results All the symptoms of PD were significantly improved after second operation in the near future. Staged bilateral pallidotomy was the most popular operation way in clinical practicing. The incidence of complication of staged bilateral thalamotomy was high (100%). The rate of complication in the patients over 55 years old (29.70%) was higher than that in the patients not more than 55 years old (12.66%)( P

[Objective]To retrospectively analyze 39 cases of surgical treatment of fibrous dysplasia of proximal femur,in order to propose a partition method which can be used to guide the surgical treatment,and probe the surgical treatment strategy according to the partition method of fibrous dysplasia of proximal femur. [Methods]The data on 39 cases of fibrous dysplasia of proximal femoral from 1998 to 2009 were retrospectively analyzed.The study determined extent of the lesion according to preoperative X-ray film and proposed partitioning method in accordance with the scope of proximal femoral involvement,analyzed the relation of partition type and surgical treatment,and evaluated the effect of surgical treatment through the postoperative localized lesions control and functional score(MSTS 93).[Results]According to the scope of 39 cases of lesions,combined with characteristics of proximal femoral anatomy,proximal femur was divided into four zones: area I,femoral shaft(below small protuberance);area II,intertrochanteric(small rotor to the neck base division);area III,femoral neck;area IV,the femoral head.Based on the above partition,lesions were divided into 7 types,type I,type II,type III,type I + II,type II + III,type II + III + IV,type I + II + III,type I + II + III + IV.Surgical treatment was performed mainly with curettage of bone lesions,bone grafting and fixation.Internal fixation included DHS,intramedullary nails,and artificial joint replacement,DHS was most common in area II involvement(57.58%),followed by area III involvement(24.24%).Intramedullary nail was most common in area I involvement(64.70%) and area II involvement(35.30%).For lesions involving ≥3 zones,joint replacement was carried out.The patients were all followed up,with a median time of 6.3 years(0.5-11 years).Local recurrence rate was12.82%(5 / 39),local deformity was not found deterious.The followed up results were satisfactory.The selected treatment was reasonable.[Conclusion]When making a surgical treatment regimen for fibrous dysplasia of the proximal femur,Surgeons should consider lesion characteristics,and choose a reasonable internal fixation to achieve better surgical results.Partition method proposed in this paper can be formulated as one of preoperative surgical treatment options.

Objective To discovery the attributes of Chinese geoherbs and find it’s study strategy. Method Literature analysis and theory model structure. Results Both natural science and literae humaniores are attributes of Geoherbs. Conclusions Natural science combined with literae humaniores is the necessary way to study Geoberbs. The conception of Geographical Indications was favorable to discovery the literae humaniores properties. The theory about continuous variation was the key to found the scientific properties of Chinese Geoherbs.

The characteristics and selection of dot matrix LCD module are introduced in this paper. Such aspects also get involved in as the interfaces of VK42 dot matrix LCD module with SCM's bus port and serial port as well as their programming realization.

Objective Compare the difference on vision,vision field between treating on central retinal artery with compound anisodine retrobulbar injection associate with emporat artery side injection and emporal artery side injection simply.Estimate the curative effect of the two ways on the disease.Methods Observe the patients'vision,vison field and cross-check,analyze the results who have central retinal artery and there are 20 who treated by compound anisodine retrobulbar injection associate with emporal artery side injection together with 20 who treated by emporal artery side injection purely.Results The therapeutics that is compound anisodine retrobulbar injection associate with emporal artery side injection is excellence to 10,effective to 6 and ineffective to 4;the therapeutics that is arter3,side injection purely is excellence to 5,effective to 5 and ineffective to 10.The two therapeuticses has significant difference on improving vision and ameliorating vision field.Conclusion It's quite effective to treat central retinal artery occlusion by compound anisodine retrobulbar injection associate with emporal artery side injection.

BACKGROUND:Infection is the catastrophic complication after total hip arthroplasty, moreover, its diagnostic criteria has not been unified, and treatment options were also controversial. The removal of the focus of infection was complete or not determines whether the joint could be reconstructed and the joint function could be restored. OBJECTIVE:To analyze the experience and efficacy of thorough debridement in two-stage revision surgery for treatment of infection after hip arthroplasty. METHODS:Total y 23 (24 hips) patients with infection after hip arthroplasty were treated at the Department of Orthopedics, Nanjing General Hospital of Nanjing Military Area Command of PLA from August 2008 to January 2013. The diagnostic criteria were in line with consensus. The repair options defined as two phrases:the first phrase was thorough debridement plus antibiotic-containing bone cement implanted with intervals;the second phrase was joint reconstruction. If the infection persisted in interval, debridement could be repeated, and then underwent joint reconstruction after the thorough control of infection. Harris scores of hip function were determined after revision during fol ow-up. Infection control condition was evaluated. RESULTS AND CONCLUSION:Al the patients were fol owed up, ranged from 1 to 5 years. The Harris scores increased from an average of 36.5 (27-45 scores) before treatment to an average of 88.6 (76-98 scores) after treatment. There was no infection recurrence. Infection control rates reached to 100%. These results suggest that two-stage revision is an effective method for treatment of infection after total hip arthroplasty. Thorough debridement plays a crucial role, and it can effectively control infection recurrence, improve prosthesis stability, so as to reconstruct joint function.

Objective:To analyze risk factors that were associated with loss of correction curvature after short-segment restoration and fixation in cases who had single-segment thoracolumbar fracture.Methods:87 Cases who had experienced single-segment thoracolumbar fracture and had underwent short-segment restoration and fixation in our department from Jan 2008 to Jan 2011,and had complete follow-up imaging were included.Cobb angles were measured on lateral thoracolumbar X-ray preoperatively,postoperatively and before removal of internal fixation.And these included the angle formed by vertebras that located above and below injured vertebrae (α angle),superior endplate of injured vertebrae and its superior vertebrae (β angle),inferior endplate of injured vertebrae and its inferior vertebrae (γ angle),inferior and superior endplate of injured vertebrae (δ angle).T-test was used to analyze these angles and their changes.And correlation analysis was used to analyze relationships between α angle change and other risk factors.Results:When compared with preoperative angles,the mean α angle,β angle,γ angle and δ angle were all significantly increased (p＜0.05) after the operation.The mean α angle and δ angle before the removal of internal fixation were both significantly smaller than those after the operation (p＜0.05),and the mean change ofα angle was-2.85 degrees.After the correlation analysis,we found significant correlations between the change ofα angle and postoperative correction curvature(-0.342,p=0.026),injured region in endplate(0.374,p=0.015),and change of the δ angle(0.231,p=0.041).Conclusion:There was significant loss in the correction curvature before the removal of internal fixation.And the loss was significantly associated with postoperative correction curvature,injured region in endplate,and change of the δ angle.

Objective The feasibility and the curative effect of bipolar hemiarthroplasty for hemiplegic side femoral neck fractures in elderly patients were evaluated.Methods The patients suffering from hemiplegic side femoral neck fractures and undergoing bipolar hemiarthroplasty in Beijing Tongren Hospital were followed-up during 2012-2015.The postoperative Harris Score and the complications such as infection,deep vein thrombosis and dislocation were collected.Results Totally 25 patients(25 hips)were followed-up.The average age was 70.1 years,and mean follow-up period was 24.3 months (10-42 months).The mean Barthel index score was higher (77.4 ± 14.7,ranging from 40-95 points) after operation than before operation[25.00 ± 5.95 (15-35 points)] with a statistically significant difference(t=-21.374,P＜＜0.05).The postoperative Harris Score was 83.5± 8.9(60-95 points).According to Harris score,the excellent and good rate was 80.0％.The patient's satisfaction rate was 88.0％.Conclusions Choosing proper prosthesis and fixing measure,and keeping the function and tension of short extorsion muscles can achieve the satisfactory results for hemiplegic side femoral neck fractures in elderly patients.

BACKGROUND: Although improvement could be achieved after the first operation, limb symptoms of patients would aggravate with the progress or reoccurrence of Parkinson disease (PD), thereby second operation would become necessary if symptom could not be controllel by medication.OBJECTIVE: To investigate the improving rate of symptoms and complications of patients with PD after the second operation.DESIGN: Case analysisSETTING: Neurosurgery Department of 153th Military Central Hospital and Neurosurgery Department of Tangdu Hospital Affiliated to the Fourth Military Medical University of Chinese PLA.PARTICIPANTS: Totally 387 primary PD patients were collected from Neurosurgery Department of 153th Military Central Hospital and Neurosurgery Department of Tangdu Hospital Affiliated to the Fourth Military Medical College of Chinese PLA from October 1997 to December 2002.Totally 350 patients received two operations in the same hospital, and other 37 patients received the first operation at other hospital and the second operation in our hospital. The intervals of two operations were within half a year in 36 cases, 0.5-0.9 year in 72 cases, 1.0-1.9 years in 108 cases and 2.0-5.0 years in 171 cases respectively.METHODS: Under the stereotactic microelectrode-guidance, the targets of all patients were subjected to iconographical orientation, microelectrode record, microelectrode stimulation and exploration and radio frequency microelectrode verification before just stage bilateral posteroventral pallidotomy (PVP) or thalamus ventral intermediate nucleus damage(TVIND),unified Parkinson's disease rating scale (UPDRS) was used at preoperative and postoperative "on" state (at the beginning of medication, patients move freely and stays in "on" state) as well as "off" state (when medication loss function, patients displays moving disability and stays in "off" state).complication between two operation .RESULTS: Data of 387 patients were remained in the results analysis.operation was lower than that of first operation (tremor 95.4%, 96.9%;rigidity 94.6%, 95.1%; bradykinesia 88.9%, 92.3%; gait 62.3%, 67.1%;balance 65.1%, 69.4%, akinesia and cramp 95.8%, 98.0%), but no diffor UPDRS were lower than that of preoperative scores (P ＜ 0.01). The mean total UPDRS scores improved by 46.8% in the "on" state and 53.5% in the "off" state after second operation, lower than that of first tive complications: The occurrenceof complications that was specific for the second operation including fatigue, salivation, reduced voice, fake bulbar paralysis, lethargy, hiccough, urinary incontinence, urinary retention were found higher than that of after the first operation (P ＜ 0.05).The occurrence of cerebral hemorrhage was also lower than that of after first operation.UPDRS were lower in the second operation, which may be due to that PD of postoperative complications which was specific for the second operation was obviously increased, which possibly associated with age, state of illness, constitution, operation type and interval between operations. But occurrence of non-specific postoperative complications was basically the same in two operations (cerebral hemorrhage and inflammation), suggesting that hemorrhage risk did not increased due to the second operation.