BACKGROUND: Some studies have considered the influence of body mass index (BMI) on the function following total knee replacement (TKR), but the cases were few and follow-up time is short in most of them.OBJECTIVE: To analyze the function outcome influenced by BMI after TKR. METHODS: A total of 320 osteoarthritis patients who were admitted in Department of Bone and Joint at Peking University People's Hospital, were involved in this study. They all received primary knee joint patellar resurfacing, including both knees replacement in 200 case of 520 knees, left 219 and right 301. The involved 320 patients underwent primary TKR performed by a single surgeon with the same type of prosthesis (Scorpio posterior stable prosthesis). The patients were divided into four groups based on obesity (overweight group, BMI 25.1-27.0 kg/m2; obese group, BMI 27.1-30.0 kg/m2; morbidly obese group, BMI > 30 kg/m2; control group, BMI < 25 kg/m2). According to the Hospital for Special Surgery (HSS) rating scale, their knee score and functional scores were recorded before replacement and at follow-ups, as well as maximal range of flexion and extension, complications. Preoperative and postoperative assessment was based on the HSS score. RESULTS AND CONCLUSION: A total of 320 patients received clinical recheck at 28.3 months (range 12-46 months). Compared with control group, patients in overweight, obese and morbidly obese groups had lower preoperative functional score (P < 0.05), but knee scores were not significantly different for any patient group. The postoperative mean HSS score of all the groups rose significantly at the last follow-up. These differences were not statistically significant among groups (P > 0.05). The rate of perioperative complications was significantly higher in the obese and morbidly obese patients (P < 0.05). Of the 181 knees in obese and morbidly obese patients, 14 knees (9.2%) had a wound complication, 1 knee (0.5%) had an infection, and 2 knees (1.3%) had an avulsion of the medial collateral ligament. The infected case developed within ten weeks after the operation, and was associated with a wound complication. Among 266 knees in the overweight patients, 6 knees (2.3%) had a wound complication. There was 1 knee (1%) of the 81 knees in the control group had a wound complication. No death or pulmonary embolism cases were observed in perioperative period. It is suggested that BMI has no obvious influence on the functional outcome following TKR in the short-term.

0.05). The operation time in the intertrochanteric fracture group was significantly longer than the femoral neck fracture group (P

OBJECTIVE To improve the standardized management of medical waste disposal and prevent the spread of the disease to protect the human health.METHODS Establishing hospital monitoring committee of medical waste through the director of hospitce as the first responsible figure.The management system and education training for all levels staffs and inspection were established.RESULTS By making the management measures scientific and effective,it was praised by many patients and social departments for providing good diagnosing environment.CONCLUSIONS Improving the standardized management of medical waste disposal is an important messure to secure the prevention of hospital cross-infection and improve the quality of medical care.

Diabetic Ketoacidosis (DKA) is a condition biochemically characterized by the combination of hyperglycemia, hyperketonemia and acidemia. The extracellular concentration of glucose and ketone bodies in human body can respectively increase 5 and 20 times as more as usual, and the pH of arterial blood can decrease below 7.0. Accumulation of gluccse, ketone bodies and hydrogen must be due to the imbalance of the rate of production, ulilization, and excretion of these substance. In DKA, the metabolism of several hormones and substances is probably involved in the initiation and maintenance of ketone body over-production. At present, 14 patients with DKA have been investigated and it has been found that relative insulin deficiency appears to be necessary, and the excess production of growth hormone, glucagon and catecholamincs (the urine adrenaline and noradrenaline were measured) may be also important in the pathogenesis of DKA.

The role of bulletin in subject information service was analyzed, followed by a description of the con-tents, columns, topic selection standards and principles in Bulletin of Global Pharmaceutical Innovation, and a summary of the experiences in subject service through the bulletin.

Objective To investigate the clinical efficacy of imipenem and cilastatin sodium on the clinical efficacy of elderly patients with severe bacterial infection, and to observe the clearance rate to different floras.MethodsA total of 206 elderly patients with severe bacterial infection as the research object in our hospital outpatient treatment, were divided into control group and observation group, the patients were collected with sputum, blood and urine samples sent for bacterial culture.All patients were given positive treatment and nursing care, the observation group was given imipenem and cilastatin sodium treatment,the control group was given cefotaxime sodium treatment.The clinical efficacy, bacterial clearance and adverse reactions of the two groups were recorded and compared.ResultsThe total efficiency rate was 91.26% in the observation group, and 79.61% in the control group.The number of effective cases was significantly higher in the observation group than in the control group (P<0.05), the number of ineffective cases was significantly lower than that of the control group (P<0.05);The bacterial clearance rate was 85.71% in the observation group, and 43.33% in the control group, the clearance rate of Bauman Acinetobacter, Klebsiella pneumoniae, Pseudomonas aeruginosa and Staphylococcus aureus was significantly higher in the observation group than in the control group (P<0.05).Through the detection of adverse reactions showed that the observation group and the control group after treatment, few patients mild symptoms of nausea and vomiting and itching rash, on the occurrence of adverse reactions of the two groups of patients were compared, the difference was not statistically significant.ConclusionFor elderly patients with severe bacterial infection with imipenem and cilastatin sodium for treatment, the effective rate is high and can timely remove a variety of pathogenic bacteria, and rare adverse reactions, high safety, worthy of clinical application.