Adrenal Cortex Hormones ; therapeutic use ; Adrenergic beta-Agonists ; therapeutic use ; Anti-Asthmatic Agents ; therapeutic use ; Asthma ; drug therapy ; Humans ; Medication Adherence

OBJECTIVETo systematically evaluate the efficacy and safety of preoperative administration of cyclooxygenase-2 (COX-2) inhibitor on pain occurring with total knee arthroplasty (TKA).

METHODSWe electronically searched PubMed, Cochrane Library, EMBASE, CNKI, CBM, Wanfang data from inception to March 15, 2014 and manual searched journal of library collection to identify randomized controlled trials (RCTs) about preoperative administration of COX-2 inhibitor on pain occurring with TKA. The methodological quality of the included RCTs was assessed and the data were extracted according to the Cochrane Handbook 5.1.0. Meta-analysis was performed by using RevMan 5.2 software.

RESULTSA total of 6 RCTs involving 228 patients were included. The results of meta-analyses showed that: (1) Efficacy: The visual analog scale (VAS) of post-operation at 12-hour (WMD = -0.60, 95% CI -0.83 to -0.37, P < 0.000 01) and 24-hour (WMD = -0.74, 95% CI -1.29 to - 0.19, P = 0.008) was decreased when COX-2 inhibitor was used before operation. And compared with control group, experimental group decreased the modified numerical pain rating scale (MNPRS) at 24-hour (WMD = -0.50, 95% CI -0.70 to -0.30, P < 0.000 01), 48-hour (WMD = -0.55,95% CI -0.65 to -0.45,P < 0.000 01) under quiescent conditions, and the same result at 24-hour (WMD = -0.82, 95% CI -1.26 to -0.38, P <0.000 01), 48-hour (WMD = -0.71, 95% CI -0.82 to -0.60, P < 0.000 01) under active conditions. The morphine consumption postoperatively were fewer in experimental group at the first day (WMD = - 1.35, 95% CI -1.92 to -0.79, P < 0.000 01) and the second day (WMD = -1.60, 95% CI -2.68 to -0.52, P = 0.004). (2) Safety: COX-2 inhibitor could lessen the incidence of postoperative pruritus (RR = 0.35, 95% CI 0.15 to 0.84, P = 0.02), but not statistically decrease of nausea and vomiting (RR = 0.83, 95% CI 0.54 to 1.28, P = 0.40) and exhaustion (RR = 0.63, 95% CI 0.05 to 7.67, P = 0.72).

CONCLUSIONThe current evidence indicated that preoperative administration of COX-2inhibitor can effectively improve the effect of postoperative analgesia, reduce the consumption of morphine and lessen the incidence of pruritus. Due to the limited quantity of the included studies and the evidence with limited strength,further high-quality RCTs are needed to verify the aforementioned conclusion.

Arthroplasty, Replacement, Knee ; Cyclooxygenase 2 Inhibitors ; therapeutic use ; Humans ; Pain, Postoperative ; drug therapy ; Postoperative Complications ; prevention & control ; Pruritus ; prevention & control

Actins ; metabolism ; Adult ; Amputation ; Arthroplasty, Replacement, Knee ; Bone Neoplasms ; diagnosis ; metabolism ; pathology ; surgery ; Calmodulin-Binding Proteins ; metabolism ; Humans ; Leiomyosarcoma ; diagnosis ; metabolism ; pathology ; surgery ; Magnetic Resonance Imaging ; Male ; Radiography ; Tibia ; diagnostic imaging ; surgery

OBJECTIVETo screen serum biomarkers in patients with mycosis fungoides (MF) using surface-enhanced laser desorption and ionization with time-of-flight detection mass spectrometry (SELDI-TOF-MS) technique.

METHODSSerum was analyzed from 14 patients with MF and 17 controls using CM10 Protein-chip to capture serum proteins, followed by Biomarker Wizard software analysis.

RESULTSIn all specimens, about 131 protein peaks could be detected when the relative molecular weight ranged from 0 to 50 000. When comparing the protein fingerprint between these two groups, 14 differentially expressed protein peaks were found. By searching SWISS-PRO database, we found 7 670Da peaks accord with C-C motif chemokine 22.

CONCLUSIONSELDI-TOF-MS technique can be used for screening serum protein biomarkers in patients with MF.

Biomarkers, Tumor ; blood ; Blood Proteins ; analysis ; Humans ; Mycosis Fungoides ; blood ; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization ; methods

Total knee arthroplasty (TKA) has been successfully applied for the treatment of the knee pathology at the end stage such as osteoarthritis and rheumatoid arthritis. Although TKA has became a very mature technology, some patients still suffer from the persistent pain after surgery. The cause of this pain have been recognized as the operation or technical error in most cases, and it usually requires a surgical intervention. Only when the cause of pain is judged accurately, can the operation and other factors be estimated correctly, determining the appropriate treatment methods. In the article, the causes of the post-operative pain after TKA are reviewed, which may be helpful to study the causes of the pain, and to decrease the occurrence incidence of pain.
Adult ; Age Factors ; Aged ; Arthroplasty, Replacement, Knee ; adverse effects ; Female ; Humans ; Joint Instability ; complications ; Male ; Metals ; adverse effects ; Middle Aged ; Pain, Postoperative ; etiology ; Sex Characteristics

Animals ; Animals, Newborn ; Female ; Hippocampus ; physiopathology ; Hypoxia-Ischemia, Brain ; physiopathology ; Long-Term Potentiation ; Male ; Maze Learning ; Memory ; Rats ; Rats, Wistar

OBJECTIVETo analyze the incidence, clinical features, deformity categories and orthopedic treatment of foot and ankle deformities caused by spinal bifida.

METHODSThe charts of the patients received surgical treatment between January 1990 and July 2009 were studied retrospectively, and the data were analyzed.

RESULTSOne hundred and seven cases of foot and ankle deformities caused by spinal bifida received surgical treatment and were included. There were 44 male and 63 female patients. The average age was 17.7 years (range, 1.3 - 52.0 years). And 50.5% (54/107) of cases were over 18 years old and had spinal bifida occulta, and the other 49.5% had spinal bifida manifesta. There was only one case of thoracic spinal bifida (T(3-8)), while the other 106 cases had lumbosacral vertebrae cleft (mainly L(3) to Sacrum). Among a total of 165 feet, unilateral involvement was found in 49 cases (22 cases on the left side, 27 cases on the right side), bilateral involvement in 58 cases. Combined ankle-foot deformities included 76 varus talipes, 23 talipes valgus, 15 flail feet, and 51 other foot deformities. Other site deformities, as a result of spinal bifida, included knee flexion or hyperextension deformity in 4 cases, hip deformity (hip adduction, flexion, or hip dislocation, pelvic tilt, lower extremity discrepancy, etc.) in 17 cases, and urinatory dysfunction and defecation in 30 cases. Twenty-nine of 54 cases with spinal bifida occulta failed to be diagnosed in other hospitals and the misdiagnosed rate reached 53.7% (29/54). Corrective surgery was performed in only 26 patients. And 50.5% (54/107) of patients (over 18 years old) had severe foot and ankle deformities due to a failure of prior surgical treatment.

CONCLUSIONSSpinal bifida is the most commonly found in the lumbosacral vertebrae. Although the main pathogenesis is developmental abnormalities of spinal cord and nerve, the secondary deformity is usually located on the foot and ankle. Some young orthopedic surgeons may not have enough awareness and treatment experience about this disease due to over-specialty of the orthopaedics, so the delay of early diagnosis and treatment is often found and many severe foot and ankle deformities occur.

Adolescent ; Adult ; Child ; Child, Preschool ; Female ; Foot Deformities, Acquired ; diagnosis ; etiology ; surgery ; Humans ; Infant ; Male ; Middle Aged ; Orthopedic Procedures ; Retrospective Studies ; Spinal Dysraphism ; complications ; Young Adult

OBJECTIVETo investigate how network education can improve college students' knowledge on sexual and reproductive health in Ningbo city.

METHODSFrom December 2012 to June 2013, we conducted a questionnaire investigation among college students in Ningbo city about the effects of network education on their knowledge about sexual psychology, sexual physiology, sexual ethics, and reproductive health.

RESULTSA total of 7 362 college students accomplished the investigation, of whom 2 483 (42.1% males and 57.9% females) received network education, while the other 4 879 (24.1% males and 75.9% females) did not. Approximately 47.1% of the male and 28.0% of the female students acquired sexual and reproductive knowledge via network education. Reproductive health-related network education significantly enriched the students' knowledge about the reproductive system and sex, pubertal development, sexual physiology, conception and embryonic development, methods of contraception, sexual psychology, sexually transmitted diseases and their prevention, pregnancy care and eugenics, and environment- and occupation-related reproductive health (P < 0.01). It also remarkably improved their cognitive attitude towards reproductive health knowledge (P < 0.01). Those who received reproductive health-related network education showed a significantly higher rate of masturbation (P < 0.01) but markedly later time of the first masturbation (P < 0.01) than those who did not.

CONCLUSIONNetwork education can enhance the effect of reproductive health education among college students and improve their sexual experience and health.

China ; Contraception ; Female ; Health Education ; Health Knowledge, Attitudes, Practice ; Humans ; Male ; Masturbation ; Pregnancy ; Reproduction ; Reproductive Health ; Sexual Behavior ; physiology ; psychology ; Sexually Transmitted Diseases ; Students ; Surveys and Questionnaires ; Universities

Objective To study the influence of human leucocyte antigen(HLA) and major his-tocompatibility complex class Ⅰ chain-related gene A (MICA) specific antibodies on renal allograft function and graft rejective reaction by monitoring their changes from preoperative to postoperative pe-riods. Methods Twenty-seven patients with renal aliografts were tested with the specificity of anti-HLA antibodies (anti-HLA class Ⅰ and anti-HLA class Ⅱ) and anti-MICA antibodies and their posi-tive value changes by flow PRATM beads. The HLA genotype was integrated to distinguish donor specific antibody(DSA) and non-donor specific antibody(NDSA). Their serum creatinine levels and clinical data were analyzed simultaneously. Results Of the 27 patients, 22 cases accepted renal transplantation from dead bodies and 5 eases accepted from live donors. Except 1 failed patient, the other 26 patients had good functional renal allografts. Twenty-four survival patients were followed up on month 1, 3, 6 and 12 after transplantation. Seven out of 27 patients had pre-exist antibody before transplantation. Among them, 2 patients had anti-HLA antibody; 3 patients had anti-MICA antibody; 2 patients had both anti-HLA and anti-MICA antibody. Three patients with no anti-HLA and anti-MICA antibodies before transplantation created antibodies after transplantation from 3 to 6 months. One patient created NDSA after transplantation and appeared chronic rejection. There were 3 patients who had anti-MICA antibodies before transplantation. The expression levels of antibodies had changed from high to low, but the specific anti-MICA antibody had not changed during the follow-up on month 1, 3, 6 and 12 after transplantation. The patient with pre-transplantation low level of anti-HLA class Ⅱ antibody appeared acute rejection with fever and his CMV was positive as well. The patient's SCr levels changed from 171 μmol/L to 236 μmol/L after I to 3 months post-transplantation. Twenty-four patients were divided into positive and negative groups according to the specific antibody. There was significant difference of SCr levels between the 2 groups 1 month and 1 year after transplantation(P= 0.03, 0.05). Conclusions It is important to detect the specificity and positive value of anti-HLA antibodies and anti-MICA antibody regularly during the post transplantation follow-up. This will make an effective therapy for decreasing the occurrenee and development of acute or chronic rejection and hy-pofunction on renal allograft.

OBJECTIVETo evaluate the clinical difference of locking and non-locking plates in the treatment of distal radial fractures in the elderly.

METHODSForty-nine patients with an average age of 68 years were included. The mean follow-up was 30 months. Five cases were traffic related injury, and others were simple falls. Fractures were classified according to AO classification system: 9 cases of A3, 4 cases of B, 11 cases of C1, 18 cases of C2, 7 cases of C3. Patients were grouped as locking group (29 cases) and non-locking group (20 cases).

RESULTSSignificant difference was not found between the two groups in active range of motion, Gartland and Werley score, radiological measurements and score.

CONCLUSIONLocking and non-locking plates have the same clinical outcome in the treatment of distal radial fractures in the elderly.

Aged ; Bone Plates ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; instrumentation ; Humans ; Male ; Middle Aged ; Radius Fractures ; surgery ; Retrospective Studies ; Treatment Outcome