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 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.

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

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.

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 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:Mobile-bearing prosthesis has advantages in theoretic design, in vitro kinematics and abrasion, but it remains unclear whether its clinical outcomes are better than fixed-bearing prosthesis at present. OBJECTIVE:To evaluate the medium-term results of total knee arthroplasty using mobile-bearing prosthesis to provide clinical evidence for the choice of prosthesis. METHODS:The patients who suffered from osteoarthritis or rheumatoid arthritis and underwent total knee arthroplasty with PFC Sigma RP in Beijing Tongren Hospital from December 2006 to June 2009 were included in this study. The postoperative Knee Society Score, Knee Society Score Function Score, Patel ar Score and the Pain Score, range of motion, maximun flexion and extension angle were col ected and compared with pre-operation. The complications, such as infection, patel a clicking, polyethylene insert dislocation, and deep vein thrombosis were recorded after replacement. The anterior-posterior, lateral and Merchant position X-ray images were taken to evaluate the tibiofemoral alignment, radiolucent lines, and patel ar dislocation. Then, the results of other medium-term fol ow-up researches were compared with fixed-bearing arthroplasty. RESULTS AND CONCLUSION:Final y, 31 patients (45 knees) were fol owed up. The average age was 64.56±10.33 years, and fol ow-up period was 3.9-7.6 years. The postoperative scores, range of motion, maximun flexion and extension angle were improved obviously, but there were no differences with other medium-term fol ow-up researches. No radiolucent lines, prosthetic loosening or polyethylene insert dislocation was found. Lateral patel ar release was done, but no patel ar dislocation or subluxation appeared in al patients. Two patients (2 knees) accompanied patel a clicking. Results indicated that the medium-term clinical result was satisfactory. No patel ar dislocation or subluxation was found, although only lateral patel ar release was done. This may be the superiority of mobile-bearing arthroplasty.

ObjectiveTo discuss the diagnosis and treatment of spontaneous carotid artery dissection (SCAD).Methods Clinical diagnosis and treatment data of 9 patients with SCAD were analyzed retrospectively.ResultsVascular ultrasound showed stenoses or occlusions of carotid artery.Angiography showed “flame-shaped ” sign in totally occluded proximal section and free intimal flap in stenoses section.One patient with total occlusion of bilateral internal carotid artery and 6 patients with total occlusion of unilateral internal carotid artery were treated with antiplatelet therapy.Two patients with incomplete occlusion of the carotid were operated with stent implantation in carotid arteries,and the clinical effect of both operations was satisfactory.ConclusionAngiography remains the gold standard in diagnosing SCAD,and stent implantation is an effective treatment of this disease.

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.