OBJECTIVETo explore clinical significance of rotational axis of distal femur on Chinese adults in total knee arthroplasty (TKA).

METHODSThere were 86 Chinese adults (106 normal knees) including 47 males (53 knees) and 39 females (53 knees), 54 knees were on left and 52 on right. The CT scan was employed in the distal femur. The scan direction was aligned to be on the plane perpendicular to the mechanical axis of the femoral. The CT images of cross sections across lateral and medial femoral epicondyle were moved to personal computer,lateral angle between anterior posterior line (APL) and surgical transepicondylar axis (STEA) (ATA),lateral angle between posterior condylar line (PCL) and APL (APA), angle between perpendicularity of APL and PCL (A-PA), posterior condylar angle (PCA), condylar twist angle (CTA), angle between clinical transepicondylar axis (CTEA) and STEA (CSA) were measured. These values were divided into different groups according to gender and side, the values of CTA, PCA, A-PA, angle PT (varus of tibia plateau), constant 3, ATA, APA and constant 90° were compared by statistically. A-PA and PCA, and CTA were analysed statistically with the liner regression, the relationship among CTEA, STEA ,PCL, APL and PLP were performed to assess by liner regression.

RESULTSATA was (89.79 ± 1.22)°, APA was (84.84 ± 1.83)°, A-PA was (5.16 ± 1.83)°, PCA was (4.80 ± 1.23)°, CTA was (8.23 ± 1.40), CSA was (3.45 ± 0.68)°. All the parameters had no differences on sex and side,but CSA had difference on male and female. There was no difference among angle PT, PCA, A-PA. There was significant difference in CAT, constant 30 and angle PT, PCA,A-PA. There was no difference between ATA and constant 90°, but there was difference between APA and constant 90°. There was relativity between PCA and CTA, and also PCA and A-PA, CTA and A-PA. There was significant relativity between STEA and CTEA, between STEA and APL, between STEA and PCL, and also between APLP, APL and PCL, but there was no significant relativity between PCL and CTEA.

CONCLUSIONTKA for Chinese, the section of femoral posterior condyle should be external 5° to obtain the optimum rotational orientation. The property is different entirely between STEA and CTEA, the rotational alignment is not performed according to parallel to the CTEA in distal femur. Among STEA, APL, PCL, the STEA is the most reliable mark ofrotational alignment of the distal femur, and the PCL is the less reliable mark.

Adult ; Arthroplasty, Replacement, Knee ; Female ; Femur ; anatomy & histology ; diagnostic imaging ; Humans ; Male ; Middle Aged ; Rotation ; Tomography, X-Ray Computed

In order to analyze the cai]ses of delayed diagnosis and raise the level of early diagnosis of atypical multiple myeloma (MM), the differences of presenting features between the patients presented to nephrologists and those presented to hematologists were compared. MM patients in our hospital were studied retrospectively. Those who referred renal impairment were divided into two groups: group I presented to nephrologists prior to MM diagnosis (n=29) and group II presented to hematologists directly (n=62). The age, sex, initial symptoms, haematological and biochemical parameters, the phenotype of paraprotein, bone marrow biopsy and cytology were undertaken and analyzed. The results showed that the median time between the initial symptoms and diagnosis in the patients of group I was longer than that in group II (P<0.001); patients in group I had significantly lower incidence of bone pain (P<0.01) and worse renal function (P<0.05) on presentation. There were lower level of myeloma cells (P<0.05), lower incidence of hypergammaglobulinemia (P<0.05), lower positive rate of monoclonal immunoglobulin (M protein) (P<0.05) and M protein level (P<0.05) in the patients of group I than those in group II. The ratio of monoclonal to lambda monoclonal proteins in a population was 1:3.67 in patients of group I, whereas 1:0.90 in patients of group II (P<0.01). Moreover, patients with λ type had a higher degree of renal insufficiency than those with κ type (P<0.05). It was suggested that the median time between the initial symptoms and diagnosis in the patients presented to nephrologists was longer than that in those presented to hematologists; the patients presented to nephrologists had the lower incidence of bone pain, lower level of myeloma cells and M protein, which made early diagnosis more difficult; more patients presented to nephrologists had the majority of λ light chain type, moreover, patients with λ light chain type had a higher incidence of renal insufficiency.

Objective To evaluate the effect of breathing exercise program (shrinking lips abdominal breathing combined with vertical breathing gymnastics) on dyspnea, pulmonary function, exercise tolerance and quality of life in patients with moderate to severe chronic obstructive pulmonary disease(COPD). Methods A total of 90 hospitalized patients with moderate to severe COPD were randomly divided into the experimental group and the control group with 45 cases in each group. The experimental group lost one case and the control group lost three cases, 86 patients finished the experiment. During hospitalization, on the base of conventional treatment and care, the experimental group
received training of shrinking lips abdominal breathing combined with vertical breathing gymnastics after medical staff′s care, with folk music as the background. Exercise frequency:morning, afternoon, 2 times per day, 15 min per time and continue to exercise with researchers′ guidance after discharge. In the control group:take exercises by self, take routine follow-up after discharge. The intervention continued for three months. The indicators such as dyspnea, pulmonary function, exercise tolerance and life quality of both groups were assessed respectively before and after the intervention. Results There were no significant differences in dyspnea symptoms, lung function, exercise endurance, quality of life between two groups before intervention (P>0.05). The dyspnea scored 1.43±0.87 after intervention in the experimental group, and 1.93 ±0.97 in the control group, there was significant difference (Z=-2.293, P=0.022). The 6 min walking test distance was (371.34 ± 67.74) m after intervention in the experimental group, and (301.57 ± 61.67) m in the control group, there was significant difference(t = 4.988, P =0.000). The St. George′s Respiratory Questionnaire (respiratory symptoms, limited activity, influence disease) score and total score were 54.73 ± 11.96, 52.55 ± 14.48, 55.45 ± 10.01, 54.56 ± 10.79 after intervention in experimental group respectively, and 61.19 ± 10.72, 61.35 ± 14.66, 60.48 ± 9.39, 60.93 ± 10.16 in the control group, there were significant differences(t=-2.815--2.397, P<0.05). There was no significant difference in lung function after intervention between two groups (P>0.05). Conclusions The program of shrinking lips abdominal breathing combined with vertical breathing gymnastics can relieve dyspnea in patients with moderate to severe COPD, improve exercise tolerance and quality of life, which is a safe and effective rehabilitation for patients with COPD.

Objective To analyse the causes of perinatal death and explore the preventive measures to reduce the perinatal mortality.Methods The cases with perinatal death in this hospital from January 2005 to December 2006 were reviewed to analyse the causes of death by categorization and sum-up.Results There were 166 cases with perinatal death and the mortality rate was 27.08‰,including 126 cases with fatal death,which accounted for 75.90%.In the analysis of dead causes,the first one was birth defects,which suffered 69 cases,41.57% of all,and mostly were with fetus edema syndrome.The cord factors had been elevated to the second cause,which suffered 51 cases,30.72% of all.Conclusion Improving the consciousness of gestational monitoring and self-care,strengthening the prenatal diagnosis and genetic counseling,controlling the perinatal birth defects,monitoring mother and fetus by poly-parameter and stopping the pregnancy in time can reduce perinatal death effectively.

Objective To study the effects of positive urine glucose on maternal pregnancy.Methods A total of 1 338 pregnant women were tested urine glucose.On the basis of their urine-glucose level,two groups were devided:experimental,68 cases of posi-tive urine-glucose gravidas,control group,199 cases of negative urine-glucose gravidas.Analyze on the outcome of pregnancy of the two groups.Results Compared between positive group and control group,the incidence of died(abnormal)fetus,gestational hyper-tension,abnormal amniotic fluid,fetal distress,and fetal macrosomia were not statistically different(P >0.05),but the incidence of premature rupture of membranes was statistically different (P <0.05 ).Conclusion Positive glucose urine of gravidas might in-crease the risk of premature rupture of membranes,positive urine glucose detected during pregnancy should be highly valued.

Objective To investigate the effects of abdominal breathing training on sleep disorders in elderly patients with chronic heart failure. Methods Total of 100 patients with chronic heart failure complain of sleeping disorders and Pittsburgh Sleep Quality Index (PSQI)>7 points were assigned into two groups by random digits table method, 50 cases in each group. The observation group and the control group were nursed in the same way except that abdominal breathing was adapted to the observation group. Sleep status, heart rate, blood pressure, SpO2 and brain natriuretic peptide (BNP) were evaluated before training, one week and eight weeks after training respectively. Statistics was used to analyze the differences between two groups. Results After training one week, the sleep status of the observation group was ameliorated, but without significant difference compared to the control group (P>0.05). And after training eight weeks, the PSQI, BNP and heart rate were (9.21 ± 6.38) points, (193.78 ± 152.16) μg/L, (63.5 ± 10.8) times/min in the observation group, and (12.92 ± 0.33) points, (417.55 ± 262.47) μg/L, (70.7 ± 8.5) times/min in the control group, and there was significant differences between 2 groups (t=3.627, 2.041, 2.767, all P < 0.05), while the blood pressure, SpO2 did not change obviously(P>0.05). Conclusions Abdominal breathing training could ameliorate sleep status in elderly patients with chronic heart failure.

To examine the effect of simulated weightlessness on inducible HSP70 expression in the heart and vessel tissues of rats, a tail-suspension rat model was used to simulate weightlessness. HSP72 mRNA and HSP70 expression in heart and vessel tissues of both simulated weightless and control rats exposed to heat stress (ambient temperature, Ta=43℃) and recovered at Ta of 25℃ for 1 h (CON-H1, SUS-H1) or 2 h (CON-H2, SUS-H2) were analyzed using Northern blot and Western blot. The expression of HSP72 mRNA in the myocardium significantly decreased in SUS-H2, as compared with that of CON-H2 rats. The amount of HSP72 in the myocardium tended to decrease in both SUS-H1 and SUS-H2 groups, as compared with the corresponding control groups, but the differences were not statistically significant. The levels of inducible HSP70 expression in the vessels were related with their anatomical locations, for that the expression of both HSP72 mRNA and HSP72 significantly increased in basilar arteries, whereas it showed a slight decline in femoral arteries. The blunted HSP70 expression in myocardium suggests that simulated weightlessness may induce myocardial changes similar to those in aging. However, the HSP70 expression changes in arteries are in accord with the trend of differential adaptation changes in vessels to simulated weightlessness.

Objective:To explore clinical significance of rotational axis of distal femur on Chinese adults in total knee arthroplasty (TKA). Methods:There were 86 Chinese adults (106 normal knees) including 47 males (53 knees) and 39 fe-males (53 knees),54 knees were on left and 52 on right. The CT scan was employed in the distal femur. The scan direction was aligned to be on the plane perpendicular to the mechanical axis of the femoral. The CT images of cross sections across lateral and medial femoral epicondyle were moved to personal computer ,lateral angle between anterior posterior line (APL) and sur-gical transepicondylar axis (STEA) (ATA),lateral angle between posterior condylar line (PCL) and APL (APA),angle be-tween perpendicularity of APL and PCL (A-PA),posterior condylar angle (PCA),condylar twist angle (CTA),angle between clinical transepicondylar axis (CTEA) and STEA (CSA) were measured. These values were divided into different groups ac-cording to gender and side,the values of CTA,PCA,A-PA,angle PT (varus of tibia plateau),constant 3°,ATA,APA and con-stant 90° were compared by statistically. A-PA and PCA ,and CTA were analysed statistically with the liner regression ,the re-lationship among CTEA,STEA,PCL,APL and PLP were performed to assess by liner regression. Results:ATA was (89.79± 1.22)°,APA was (84.84±1.83)°,A-PA was (5.16±1.83)°,PCA was (4.80±1.23)°,CTA was (8.23±1.40)°,CSA was (3.45± 0.68)°. All the parameters had no differences on sex and side,but CSA had difference on male and female. There was no dif-ference among angle PT,PCA,A-PA. There was significant difference in CAT,constant 3° and angle PT,PCA,A-PA. There was no difference between ATA and constant 90° ,but there was difference between APA and constant 90°. There was relativity between PCA and CTA,and also PCA and A-PA,CTA and A-PA. There was significant relativity between STEA and CTEA, between STEA and APL,between STEA and PCL,and also between APLP,APL and PCL,but there was no significant relativity between PCL and CTEA. Conclusion:TKA for Chinese,the section of femoral posteriorcondyle should be external 5° to obtain the optimum rotational orientation. The property is different entirely between STEA and CTEA ,the rotational alignment is not performed according to parallel to the CTEA in distal femur. Among STEA ,APL,PCL,the STEA is the most reliable mark of rotational alignment of the distal femur ,and the PCL is the less reliable mark.

OBJECTIVETo detect the relationship of plasma fibrinogen, platelet aggregation rate and peripheral arterial occlusive disease (PAOD) in the elderly.

METHODSCross-sectional survey for PAOD was implemented. Two thousands one hundred twenty-one subjects aged 60 - 89 years, male 941, female 1180, means aged 68.51 +/- 4.83 years, were randomly selected out of 20 411 elderly residents within 94 residential communities on the Wanshoulu area, Beijing. Case group involved 232 subjects, including 73 males and 159 females, with mean age 70.97 +/- 6.46 years, were randomly selected from the PAOD group on the PAOD cross-sectional study. 464 subjects were involved in the control group, including 217 males and 247 females, with mean age of 68.63 +/- 5.29, were randomly selected beyond the PAOD group on the PAOD cross-sectional study. Plasma fibrinogen level and platelet aggregation rate were determined in both groups. T test between the two groups was performed. The factors contributing to PAOD in this study (including: age, gender, smoking, obesity, family history of hypertension, diabetes, coronary artery disease, stroke and triglycerides, cholesterol, high density lipoprotein, low density lipoprotein, plasma fibrinogen, platelet aggregation rate) were performed using logistic regression analysis by diagnostic criteria of PAOD in this study. Stepwise selection was also used in this multivariate regression analysis.

RESULTSPlasma fibrinogen level (435.45 mg/dl +/- 115.25 mg/dl), was higher in the PAOD group than in the control group (360.96 mg/dl +/- 93.52 mg/dl, P = 0.001). Platelet aggregation rate at 3 minute (48.76% +/- 23.90%) in the PAOD group was higher compared with the control group (43.50% +/- 26.76%) with P = 0.012. Logistic regression analysis showed that factors, as plasma fibrinogen (OR = 0.994, 95% CI: 0.992 - 0.994), platelet aggregation rate at 3 minute (OR = 0.578, 95% CI: 0.403 - 0.829) were independent risk factors contributing to PAOD in this study.

CONCLUSIONPlasma fibrinogen level and platelet aggregation rate were higher in the older patients of PAOD. It is possible for clinical physicians to inhibit platelet aggregation and reduce plasma fibrinogen level in the PAOD patients.

Aged ; Aged, 80 and over ; Arterial Occlusive Diseases ; blood ; epidemiology ; China ; epidemiology ; Cross-Sectional Studies ; Female ; Fibrinogen ; metabolism ; Humans ; Male ; Middle Aged ; Platelet Aggregation ; Regression Analysis

Huperzine A is a potent,reversible,and blood-brain barrier permeable acetylcholinesterase irhibitor.The aim of this study was to compare the pharmacokinetics,tolerability,and bioavailability of two formulations with the established reference formulation of huperzine A in a fasting,healthy Chinese male population.This was a randomized,single-dose,3-period,6-sequence crossover study.The plasma concentrations of huperzine A were determined by liquid chromatography tandem mass spectrometry.Tolerability was assessed based on subject interview,vital sign monitoring,physical examination,and routine blood and urine tests.The mean (SD) pharmacokinetic parameters of the reference drug were Cmax,1.550 (0.528) ng/mL;t1/2,12.092 (1.898) h;AUC0-72h,17.550 (3.794) ng.h/mL.Those of the test formulation A and test formulation B were Cmax,1.412 (0.467),1.521 (0.608) ng/mL;t1/2,12.073 (2.068),12.271 (1.678) h;AUC0-72h,15.286 (3.434) ng.h/mL,15.673 (3.586) ng.h/mL.The 90％ confidence intervals for the AUC0-72h and Cmax were between 0.80 and 1.25.No adverse events were reported by the subjects or found with results of clinical laboratory test.The test and reference products met the regulatory criteria for bioequivalence in these fasting,healthy Chinese male volunteers.All three formulations appeared to be well tolerated.