BACKGROUND:Severe knee pain after total knee arthroplasty is an important factor for the poor recovery of knee function after replacement. How to give a satisfactory postoperative analgesia scheme is currently a hot research. OBJECTIVE:To explore the clinical effects of different analgesic program methods on postoperative pain and functional recovery in patients undergoing total knee arthroplasty. METHODS:From March 2010 to February 2014, 60 patients with unilateral knee arthroplasty were randomly divided into three groups:epidural analgesia group, intravenous analgesia group, and continuous femoral nerve block analgesia group. 20 patients in each group received corresponding postoperative analgesia. Visual Analogue Scale score before replacement, 1, 6, 24, 48 and 96 hours after replacement, the recovery of range of motion at 24, 48 and 72 hours after replacement, KSS score of the knee and adverse reactions after replacement were recorded and compared in each group. RESULTS AND CONCLUSION:Compared with the preoperative data, Visual Analogue Scale score was reduced in continuous femoral nerve block analgesia group at 1, 24, 48 and 96 hours after replacement (P<0.05). The recovery of range of motion was best in the continuous femoral nerve block analgesia group, fol owed by epidural analgesia group, and it was poorest in the intravenous analgesia group (P<0.05). Compared with the preoperative data, postoperative KSS scores increased at 1 and 3 months after replacement in the three groups (P<0.05). Compared with the continuous femoral nerve block analgesia group, knee joint function score was decreased in the intravenous analgesia group (P<0.05). Results verified that continuous femoral nerve block analgesia had good overal effects, helped the recovery of postoperative joint function, and was safe and reliable.

OBJECTIVE: Usually, the balance tests of sitting and standing position are performed by balancing instruments clinicalty, but because of the restriction of foot pedal, this kind of instruments cannot measure balancing ability in continuous dynamic gait cycles in gait of cerebral palsy children. Using plantar pressure gait analysis system, this study sought to study balance characteristics in gait of children with spastic cerebral palsy.METHODS: A total of 78 healthy children served as normal control group, and 25 children with spastic cerebral palsy as cerebral palsy group at the Department of Rehabilitation, Shenzhen Children's Hospital from May 2004 to May 2007. A plantar pressure gait analysis system was used to perform plantar pressure gait analysis tests of children in both groups. All plantar pressure data of both groups was recorded. Main outcome measures contained quantized data including cadence, cycle time of gait, absolute symmetry index (ASI) of each gait phase, and visualized pressure diagram including dynamic plantar pressure diagram and center of Gravity's transfer track diagram.RESULTS: Comparing with normal control group, children of cerebral palsy group had fewer cadences and longer gait cycle time in gait (P<0.01). ASI of single-foot supporting phase, swing phase, double-foot supporting phase and gait cycle time of cerebral palsy group were higher than normal control group (P<0.05). Symmetry and repeatability of plantar pressure diagram of both feet were poorer than normal control group. Center of Gravity's transfer track diagram could not show as butterfly-shape graphics with good symmetry.CONCLUSION: ASI of each phase of gait cycle of spastic CP children increased significantly in gait. Plantar pressure gait analysis technology can be effectively applied to evaluate the balancing ability of children with spastic cerebral palsy in gait.

BACKGROUND: Due to differences in designs and methods,the results of effects of ankle foot orthosis(AFO)on kinematics,kinetics and energy consumption during walking in children with cerebral palsy remain controversial.OBJECTIVE: To explore the effects of AFO on gait characteristics in children with spastic cerebral palsy.METHODS: A total of 21 ambulatory children with cerebral palsy were selected.A plantar pressure gait analysis system was used to perform plantar pressure gait analysis tests of participants when walking with an AFO and without an AFO at the same time of one day,under the same physical condition.All plantar pressure data were recorded,including cadence,cycle time of gait,absolute symmetry index(ASI)of each gait phase,and visualized pressure diagram including dynamic plantar pressure diagram and Center of Gravity's transfer track diagram.Visualized pressure diagrams were described and analyzed.RESULTS AND CONCLUSION: Gait cycle time was shortened in the children walking with an AFO compared with walking without an AFO(P< 0.01).ASI of single-foot supporting phase,swing phase,double-foot supporting phase and gait cycle time of children walking with AFO was significantly reduced compared with children walking without AFO(P < 0.05).Center of Gravity's transfer track diagram of children with cerebral palsy was disordered and could not show as butterfly-shape graphics with good symmetry.After wearing an AFO,the diagram became more ordered.Results show that when wearing an AFO,the gait cycle time in gait was shortened,and the cadence was increased; the symmetry of gait was improved,and the general walking ability was increased.Plantar pressure gait analysis technology can be effectively applied to evaluate the balancing ability of children with spastic cerebral palsy in gait using accurate data and visualized diagrams.

Objective To establish a method for the determination of Paracetamol in Zihua Ganmao Capsule. Method Samples were separated on a Kromasil-C18 column with the mobile phase of methanol- water (35∶65), and the detection wavelength was set at 249 nm. Result The calibration curves were linear in the range of 0.165～0.99 ?g (r=0.999 9) for Paracetamol. The average recovery was 98.41% and RSD= 0.64% (n =6). Conclusion The method is accurate and repeatable, and can be used for the quality control of Zihua Ganmao Capsule.

Vitreous floaters is a common complaint in the ophthalmic care setting,and it is commonly caused by vitreous liquefaction and posterior vitreous detachment (PVD).Because vitreous floaters is considered to be a benign procedure,ophthalmologists have little to offer regarding treatment options.Although almost all patients accept the conservative management option,there are some patients with a significant visual disturbance who may desire a more aggressive treatment intervention for resolution of their visual symptoms.Vitrectomy has been used as a treatment option for patients with symptomatic vitreous floaters abroad.The risks and benefits for these treatment options are not fully covered.Therefore,safety of vitrectomy for floaters is being concerned.This article reviews the researching progression in the treatment options for symptomatic patients with vitreous floaters.

BACKGROUND:To evaluate the accuracy of National Early Warning Score (NEWS) in predicting clinical outcomes (28-day mortality, intensive care unit [ICU] admission, and mechanical ventilation use) for septic patients with community-acquired pneumonia (CAP) compared with other commonly used severity scores (CURB65, Pneumonia Severity Index [PSI], Sequential Organ Failure Assessment [SOFA], quick SOFA [qSOFA], and Mortality in Emergency Department Sepsis [MEDS]) and admission lactate level. METHODS: Adult patients diagnosed with CAP admitted between January 2017 and May 2019 with admission SOFA ≥2 from baseline were enrolled. Demographic characteristics were collected. The primary outcome was the 28-day mortality after admission, and the secondary outcome included ICU admission and mechanical ventilation use. Outcome prediction value of parameters above was compared using receiver operating characteristics (ROC) curves. Cox regression analyses were carried out to determine the risk factors for the 28-day mortality. Kaplan-Meier survival curves were plotted and compared using optimal cut-off values of qSOFA and NEWS. RESULTS: Among the 340 enrolled patients, 90 patients were dead after a 28-day follow-up, 62 patients were admitted to ICU, and 84 patients underwent mechanical ventilation. Among single predictors, NEWS achieved the largest area under the receiver operating characteristic (AUROC) curve in predicting the 28-day mortality (0.861), ICU admission (0.895), and use of mechanical ventilation (0.873). NEWS+lactate, similar to MEDS+lactate, outperformed other combinations of severity score and admission lactate in predicting the 28-day mortality (AUROC 0.866) and ICU admission (AUROC 0.905), while NEWS+lactate did not outperform other combinations in predicting mechanical ventilation (AUROC 0.886). Admission lactate only improved the predicting performance of CURB65 and qSOFA in predicting the 28-day mortality and ICU admission. CONCLUSIONS: NEWS could be a valuable predictor in septic patients with CAP in emergency departments. Admission lactate did not predict well the outcomes or improve the severity scores. A qSOFA ≥2 and a NEWS ≥9 were strongly associated with the 28-day mortality, ICU admission, and mechanical ventilation of septic patients with CAP in the emergency departments.

This retrospective study was to evaluate the sensitivity and specificity of X-ray and CT in diagnose of simple lumbar vertebral wedge.Thirty—two elderly patients with CT-confirmed simple lumbar vertebral wedge were analyzed retrospectively.Following X-ray examination,23 patients were found to have compression fracture,and 9 patients were diagnosed with simple lumbar vertebral wedge.Thus,CT scan may be more sensitive and specific than X-ray examination in the diagnosis of simple lumbar vertebral wedge after trauma in the elderly.

Imaging examination results of 50 breast cancer patients undergoing surgical treatment between January 2006 and December 2007 were retrospectively analyzed. Our data showed that 32 patients (64%) had positive results in contrast-enhanced CT, and metastases to lung, mediastinal lymph node, axillary lymph node, or chest wall were found in 22 (44.0%), 11 (22.0%), 10 (20.0%), and 3 patients (6.0% ), respectively. Only 10 patients (20%) had abnormal image manifestation in X-ray, 8 of which showed metastases to lung. In summary, contrast-enhanced CT examinations may be more useful in the detection of metastases in post-operative follow up of breast cancer.

The CT images of 42 pathologically confirmed cases of gastrointestinal stromal tumors were reviewed, and compared with pathological results. In 20 cases, the lesions were located in stomach, 21 in small intestine, 1 in mesentery. In 18 cases pathologically confirmed as benign tumors, 16 were positive on CT scan, which presented round solid mass with homogeneous density, mean diameter of 3.8 cm (2 -6 cm), homogeneous enhancement on post-contrast scan. In 21 malignant cases all were on CT scan, which presented irregular or lobulated solid mass with heterogeneous density and cystic change inside, mean diameter of 10. 1 cm (4 - 30 cm) , heterogeneous enhancement with no enhancement in cystic part. In 3 potentially malignant cases, CT images showed irregular solid mass with homogeneous density, diameter of 4 - 8 cm, homogeneous enhancement in post-contrast scan. CT scan can accurately show the location and size of gastrointestinal stromal tumors, and is of important diagnostic value.

Purpose To investigate the imaging features of breast phyllodes tumor on mammography(MG),ultrasound(US) and pathology, correlated with its clinical manifestation.Materials and Methods Twelve cases of pathologically confirmed breast phyllodes tumors were examined by US and MG. The imaging findings were retrospectively analyzed. Results Of the 12 cases of breast phyllodes tumors, 6 were benign, 3 were malignant and 3 were borderline. MG predicted 3 breast phyllodes tumors, 3 breast carcinomas and 6 adenomas. US predicted 2 phyllodes tumors, 8 breast masses and 2 adenomas. Conclusion The imaging findings of phyllodes tumors on MG and US are characteristic but not specific. Combined application of both US and MG are helpful for early detection but can not differentiate its malignancy which is determined by pathology.