BACKGROUND: It is still controversial whether antibiotic-loaded bone cement can prevent wound deep infection in the primary hip arthroplasty. OBJECTIVE: To retrospectively observe the effect of antibiotic-loaded bone cements in primary hip arthroplasty. DESIGN, TIME AND SETTING: A retrospective case analysis was performed for the patients undergoing primary hip arthroplasty at Department of Orthopedics, Peking University Third Hospital from February 2004 to January 2007. PARTICIPANTS: 227 consecutive patients (233 hips) underwent primary hip arthroplasty with the same antibiotic-loaded bone cement, including 69 male and 115 female, and 184 cases (191 hips) were followed up for 3-46 months. METHODS: Fifty-four patients over 71 years old with femoral neck fracture were treated with bipolar femoral head replacement. 130 patients underwent total hip arthroplasty. Seventeen patients with massive acetabular bone defect were reconstructed with impaction autogenous and heterogenous bone grafting plus mesh; 3 patients underwent acetabular structural bone grafting. Both acetabular and femoral side prosthesis were antibiotic-loaded bone cements (Refobacin~-Palacos~R 40 or Cemex~ Genta). MAIN OUTCOME MEASURES: Deep infection after operation. RESULTS: 227 patients (233 hips) did not develop early deep infection after surgery. 184 cases (191 hips) did not occur deep infection during the follow up. However, 15 cases developed swelling on the affected site or skin temperature increase, or pain surrounding joint, and underwent blood sedimentation and C-reactive protein examinations; 12 cases had normal blood sedimentation and 3 had increased blood sedimentation including 1 with rheumatoid, 1 with senile chronic bronchitis, and 1 with undetermined cause. All the 3 patients restored one month later. Fourteen patients had C-reactive protein within normal scope, and 1 with increased C-reactive protein caused by rheumatoid arthritis, but restored 6 weeks later. CONCLUSION: Antibiotic-loaded bone cements in primary hip arthroplasty can reduce incidence of deep infection.

Objective To investigate the characteristics of pathogenic bacteria/the drug resistance/the correlated risk fators/the prophylaxis control strategy of the severe craniocerebral injury patients combined with intracranial infection .Methods The clinical data of 35 craniocerebral injury patients with intracranial infection were retrospectively analyzed .Results 35 patients′cerebrospinal fluid were separated and 54 pathogenic bacterium had been cultured ,including G+ bacterium(61 .11% ) ,the G - bacteria(33 .33% ) , fungi(5 .56% ) .The pathogenic bacteria showed a higher resistance .The single factor analysis found that the wound itself exists in-fection factors ,the postoperative drainage of incision ,liquorrhoea ,with other basic diseases ,surgery lasted for a long time (>4 h) reoperative ,surgery is placed foreign body is severe craniocerebral trauma combined with intracranial infection were the main rele-vant factors .The total effective rate was 62 .86% ,and the mortality was 11 .43% by the positive therapy .Conclusion G+ bacteria were the main pathogenic bacterium in the severe craniocerebral injury patients combined with intracranial infection .The iatrogenic factors leaded to the increase of the proportion of intracranial infection and the resistance increased year after year .The clinical in-travenous antibiotics combined intrathecal injections were beneficial to control intracranial infection ,shorten the course of treatment and enhance the curative effect .

Objective To evaluate the effects of Achilles tendon lengthening on talipes equinus in children with spastic cerebral palsy. Methods From December, 2013 to June, 2014, seventeen spastic cerebral palsy children with talipes equinus (34 feet) received Achilles ten-don lengthening. Ankle dorsiflexion range of motion (ROM) and surface electromyography from tibialis anterior and medial head of gastroc-nemius were measured before and 8 to 12 months after operation, respectively. ROM of passive and active dorsiflexion, root mean square (RMS) of tibia muscle group and co-contraction ratio (CR) when standing were compared. Results The ROM of ankle passive and active dorsiflexion increased (Z>4.867, P<0.001), while the RMS of gastrocnemius muscle decreased when ankle passively dorsiflex (t=4.31, P<0.001). RMS of tibialis anterior and gastrocnemius muscle changed little when standing (Z<1.291, P>0.05), while CR reduced (t=2.38, P<0.05). Conclusion Achilles tendon lengthening can improve the coordination of tibia muscle group to increase the ROM of ankle for chil-dren with talipes equinus after spastic cerebral palsy.

Objective To determine the morphology, bacteria and endotoxin content of bio-films on the inner surface of PVC tubes in hemodialysis water treatment system. Methods We dissolved biofilms of segments before and after reverse osmosis machine for bacterial count and identification. We studied biofilm structure of segments before and after reverse osmosis machine with eyes and scanning electron microscope. Biofilms of all 7 segments were dissolved for qualitative and quantitative assay of endotoxin. Results The inner surface of segment before reverse osmosis machine was homogeneously distributed with activated carbon powder deposition. The segment after reverse osmosis machine was normal. With scanning electron microscope, biofilm with successive surface and sandwich was found on the inner surface of segment before reverse osmosis machine, formed by clustering bacillus, activated carbon powder and some coccus. Bacteria of the same shape and length were found on segment after reverse osmosis machine, but fewer and looser. Bacterial culture and identification showed the former was mostly gram-negative bacillus, the latter was only a few micrococcus. Endotox-in of biofilm was between 2. 0 EU/mL and 4. 0 EU/mL. Quantitative assay showed: segment after softener (2.821 ±0. 807) EU/mL; segment after active charcoal canister(3. 635 ±0. 427) EU/ mL; segment before reverse osmosis machine (3.687 ±0.271) EU/mL; segment after reverse osmosis machine (2. 041 ±0. 295) EU/mL; exit of power pump (1. 983 ±0. 390) EU/mL; the 1st dead space (2. 373 ± 0. 535) EU/mL; and the 2nd dead space (2. 858 ± 0. 690) EU/mL. Conclusion Biofilms are found on the inner surface of segment before and after reverse osmosis machine . Endotoxin level from high to low is as follows: segment before reverse osmosis machine, segment after active charcoal canister, the 2 nd dead space, segment after softener, the 1 st dead space, segment after reverse osmosis machine, exit of power pump. The character of the bacteria and endotoxin of the biofilm can help us find better ways to control them.

OBJECTIVE: To investigate the level of life quality and the influence factors and to furnish basis for improving life quality and treatment compliance of patients with allerge rhinitis. METHOD: Adopt the rhino conjunctivitis quality of life questionnaire (RQLQ), visual analogue scales (VAS), curing to obey the sex grade point questionnaire. quality of life and patient's compliance on cross-sectional study. One hundred and twenty the examples enter the inquisitional sufferer to press whether accepted to is divided into the A1 set and B1 sets with the medicine leading and whether accepted to use the medicine the direct is divided into the A2 set and B2 sets, the A set accepts use the medicine leading and use the medicine direct. Multiple databases were established based on questionnaire. SPSS 17.0 software was used in statistical analysis. RESULT: Coefficient correlation of patient's compliance, cognition level, questionnaire with quality of life has statistical significance, and is positive correlation. CONCLUSION Treatment compliance of patients, duration and level of education have great impact on the quality of life for patients AR. Enhance patient compliance with treatment can improve the quality of life of patients with AR.
Cross-Sectional Studies ; Humans ; Patient Compliance ; Quality of Life ; Rhinitis, Allergic ; epidemiology ; therapy ; Risk Factors ; Surveys and Questionnaires

Objective:To analyze and summarize the causes of unscheduled suspension of knee and hip arthroplasty and to provide the method for optimizing the patient's pre-operative management and improving the efficiency of medical resources as well as the patient's satisfaction.Methods: The data for this report was retrospectively collected from September 2013 to August 2014 in our hospital,from cases of knee and hip arthroplasty that were suspended before the scheduled operation time.Acquisition data from the collected cases including the patients' gender,age and the surgical procedure.At the same time,the suspension reasons were recorded and analyzed.All the decisions of suspension was made by the surgeons and the anesthesiologists according to the abnormal result of preoperative examinations,after communicating with the patients and their families and obtaining their understandings.Results: In the collecting period,our department scheduled 1 146 cases of knee and hip arthroplasty,among which 1 003 were completed,143 suspended (12.5％ suspension rate).Among the causes of suspension,the top four common causes were cardiovascular disease (44/143,31％),other infections (20/143,14％),bacteriuria (18/143,13％) and inappropriate surgical indication (16/143,11％).Other causes include surgeon's reason,Blood system abnormalities,high inflammatory index,deep vein thrombosis,other diseases uncontrolled,abnormal liver function and poor diabetes mellitus control,etc.For the rate of suspension,there was no significant difference between the patients with different genders (male: 15.0％,and female: 11.7％,P=0.149),or age (≤50 years: 13.0％;51-65 years: 11.6％;66-80 years 13.3％;>80 years 11.1％;P=0.864).However compared with knee arthroplasty,hip arthroplasty had a higher suspension rate (knee arthroplasry 11.1％,hip arthroplasry 16.1％,P=0.021).Conclusion: It is important to educate and manage the patients before their knee and hip arthroplasty.Through clear diagnosis,detailed medical history analysis careful physical examination,and targeted outpatient examinations and tests for which priority was focused on cardiovascular or other system diseases we could minimize the occurrence of operative suspension post hospitalization,therefore improving the efficiency of the use of medical resources.

Objective To evaluate the effect of hyperlipidemia on pulmonary uptake in the patients inhaling sevoflurane for anesthesia.Methods A total of 103 patients of both sexes,aged 20-50 yr,with body mass index of 18-25 kg/m2,of American.Society of Anesthesiologists physical status Ⅰ or Ⅱ,undergoing elective operation under general anesthesia,were enrolled in the study.Anesthesia was induced with iv midazolam 0.1 mg/kg,vecuronium 0.1 mg/kg,fentanyl 0.l mg/kg and etomidate 0.3 mg/kg.Patients were mechanically ventilated after endotracheal intubation.Patients inhaled 2％ sevoflurane for 30 min at an oxygen flow rate of 2 L/min.The inspired concentrations (Fi) and expired concentrations (Fe,Fe≈alveolar concentration [Fa]) of sevoflurane were recorded at 1,3,5,7,10,15,20 and 30 min of inhalation (T0-7).Patients were divided into either control group group C) or hyperlipidemia group (group H) according to the results of blood lipid levels after the end of observation.The ratio of Fa/Fi and time spent in reaching the titration value (Fa/Fi =0.8) were calculated in each group.Results There were 67 cases in group C and 36 cases in group H.Compared with group C,the Fa/Fi ratio was significantly decreased at 5,7 and 10 min of inhalation,and the time spent in reaching the titration value was prolonged in group H (P ＜ 0.05).Conclusion The pulmonary uptake of sevoflurane is increased,which may be associated with increased blood/gas partition coefficient.

Objective We aim to evaluate the value of the current serum creatinine reference interval ( RI ) provided by Industry Standard WS /T 404.5 in clinical practice.Methods The first time serum creatinine levels and urinary albumin /creatinine ratio were obtained from 67 605 adult patients ( <60 years old) who were treated in the First Hospital of China Medical University between October 1, 2014 and September 30, 2015 in this cross-sectional study.Estimated glomerular filtration rate ( eGFR ) calculated by chronic kidney disease epidemiology collaboration (CKD-EPI) equation and urinary albumin /creatinine ratio (ACR) were used to evaluate the clinical practical significance of current and old serum creatinine RIs as the criteria.Results 4.3% of normal subjects based on current RI were showed decreased eGFR, 98% of abnormal subjects based on the current RI were founded to have decreased eGFR . 1378 subjects were evaluated as increased based on current RI but as normal based on old RI , and 93.5% of these subjects were showed decreased eGFR .In addition, ACR was measured in 26 cases, and 18 out of 26 cases (69.2%) were confirmed to have elevated ACR (≥30 mg/g) and proteinuria.On the other hand of analysis, screening positive rates of declined eGFR were 43.6% by old RI and 61.9% by current RI in the subjects with eGFR under 90 ml(min ×1.73 m 2 ), and the performance of the current RI was obviously improved(χ2 =212.648,P <0.001).Conclusions The current reference interval of serum creatinine is favorable for the detection of renal dysfunction in patients .It is recommended that the current reference interval can be applied in the clinical laboratories as early as possible .

AIM:To investigate the role of potassium channel expression alteration in chronic cigarette smoking-induced increase in pulmonary vascular responsiveness,the effect of chronic cigarette smoking on large-conductance calcium-activated potassium channel(BKCa) and voltage-dependent delayed rectifier potassium channel(Kv1.5) expression in rat pulmonary smooth muscle cells were investigated in vivo.METHODS: HE staining,immuno-histochemistry and in situ hybridization techniques were used.RESULTS:(1) Chronic cigarette smoking downregulates the protein and mRNA expression of BKCa in pulmonary arterial smooth muscles.(2) Chronic cigarette smoking downregulated the protein and mRNA expression of Kv1.5 in pulmonary arterial smooth muscles.(3) In big artery,BKCa decreased more makedly than Kv1.5,but in small artery,both of them decreased equally.CONCLUSION: Chronic cigarette smoking downregulates the levels of BKCa and Kv1.5 in rat pulmonary arterial smooth muscle cells in vivo,which maybe contribute to the mechanism of cigarette smoking-induced increase in pulmonary vascular responsiveness.

Animals ; Boron ; analysis ; urine ; Ion-Selective Electrodes ; Minerals ; chemistry ; Urine ; chemistry