Objective To evaluate the correlation between osteophytes size and lower limb alignment in the knees of patients with Kaschin-Beck disease (KBD).Methods A total of 300 clinically diagnosed patients with KBD were X-rayed on knee-joints which ranged from the distal half of femur to proximal half of tibia.Meanwhile some related parameters in the X film with the anteroposterior position (including osteophytes length,femorotibial angle,femorotibial joint space ratio of inner side to outer side) were measured by DICOM 2.0,a software of medical graphic measuring,then followed by calculating the osteophyte spur index.The association between femorotibial angle,femorotibial joint space ratio and osteophytes spur index was evaluated by Pearson correlation test.Results The average of femorotibial angle of all the tested knee-joints was (165.97 ± 4.02)°,which positively correlated with both the osteophyte spur index of the medial femoral condyle [(6.54 ± 3.12)％,correlation coefficient (r) =0.524,P＜0.01] and the osteophyte spur index of medial tibil plateau [(7.14 ± 3.40)％,r =0.578,P ＜0.01].The femorotibial joint space ratio was 0.61 ± 0.13,which positively correlated with both the osteophyte spur index of medial femoral condyle (r =0.531,P ＜0.01) and that of the medial tibil plateau (r =0.563,P ＜0.01).Conclusions The results of this study indicate that there is a positive correlation between lower limb alignment and osteophyte size of both the medial femoral condyle and the medial tibial plateau.This finding may be evidenced by the fact that the changes of lower limb biomechanics may contribute to formation and development of osteophytes in the kneejoint.

Objective To observe the effect of different doses of butorphanol and sufentanil repeatedly epidural injected on the neurobehavior function in bone cancer model rats.Methods A PE-530 catheter was inserted into the epidural space of all male Sprague-Dawley rats(not mated,weighting 150-180 g) at L1-2 level.Three days after operation,64 rats without any motor dysfunction were randomly divided into eight groups (n=8):sham operated group (group C),normal saline with bone cancer pain group (group N),butorphanol groups(group B 1,B2,B3)and sufentanil groups (group S1,S2,S3).Bone cancer pain model was constructed in group N,B and S when rats in group C were sham operated.Rats in group C and N were epidurally injected NS 30μl each,and rats in group B1,B2 and B3 were respectively epidurally injected butorphanol 25,50,100 μg (all diluted to 30 μl with NS),when rats in group S1,S2 and S3 were respectively cpidurally injected sufentanil 1,2,4 μg (all diluted to 30 μl with NS) on time per day for 10-14 days after modeling.The neurobehavior paw withdrawal threshold (MWT) of the left hind claw was recorded to observe the changes in pain behavior.The neurobehavior function of rats were recorded by BBB (BASSO,BEATTIE and BRESNAHAN) score and the inclined plane test.Results Compared with group C((67.65±9.29) g),the MWT of the model groups obviously decreased before the first time of injection (N (15.23± 2.46) g,B 1 (16.14±2.28) g,B2(15.42±3.22) g,B3(14.35±2.32) g,S1 (15.37±2.11)g,S2(15.22±2.93) g,S3(16.25± 2.36) g) (all P＜0.05)).Compared with group N((16.13±2.37) g),the MWT of group B2,B3 and S3 increased obviously after the first time of injection ((35.12±5.16) g,(35.63± 1.53) g and (34.24±5.93) g) (P＜ 0.05).At the first day of injection,there was no significant difference in the BBB scores and the inclined plane test between the model groups (P＞0.05).At 6 h after the forth injection the inclined plane test and the BBB scores of group B3 were obviously decreased compared with group N ((34.72 ± 4.56) ° and (10.64 ± 1.82) points to (43.15±4.67)° and (14.05±1.78) points (P＜0.05)).Conclusion The results provide evidence that repeatedly epidural injection of butorphanol 50 μg or 100 μg or sufentanil 4 μg can reduce the pain of the rats with bone cancer pain.But repeated epidural injection of butorphanol 100 μg can injure the neurological function.

Objective To observe the condition of Keshan disease (KSD) in Gansu Province in order to provide a scientific basis for prevention and control of the disease. Methods In 2011, according to “The national Keshan Disease Monitoring Program (trial edition)”, based on searching of KSD cases, 12 villages of 12 towns in 6 counties of Gansu Province, were selected as surveillance sites. All the residents in surveillance sites were clinically examined and given 12-lead ECG tracings; suspected cases were taken anterior chest X-rays in the distance of 2 meters, while staple food and life conditions of the residents were surveyed. Diagnosis of KSD was based on“Keshan Disease Diagnostic Criteria”(WS/T 210-2011). Results Among investigated 5 484 residents, the incidence of abnormal electrocardiogram was 15.41%. Of the 196 X-ray films, 61 cases had enlarged heart(in which 22 of mild, 21 of moderate and 18 of severe). Two hundred and forty-three cases of KSD were detected, the general detection rate was 4.43%, in which 31 cases of chronic, the detection rate was 0.56%; 212 cases of potential, the detection rate was 3.87%. In all cases, 47 cases were under the age of 30, including 46 cases of potential and 1 case of chronic. The major abnormal electrocardiogram change of KSD cases was ST-T changes[22.68%(71/313)], followed by complete right bundle branch block[16.29%(51/313)], low voltage[12.46%(39/313)], and left anterior fascicular block[6.71%(21/313)]. Per-capita annual income in surveillance site was 1 763 Yuan;and the major staple food was flour, accounted for 87%, and the staple food rice accounted for 5%. Conclusion The detection rate of KSD in Gansu Province is mainly to potential, and there is a cosiderable portion of patients under the age of 30;monitoring and investigation should also be strengthened in the younger age of KSD cases detected village.

Objective To grasp the epidemic features of Kaschin-Beck disease in different ecotypic areas in Gansu Province,in order to provide ecological basis for Kashin-Beck disease control.Methods Totally 37 counties with Kashin-Beck disease were divided into four ecological areas,villages with historical serious condition in township and townships with historical serious condition in county were investigated.Clinical examination and Xray of right hand of all 7-12-year-old children in the villages were carried out,while investigation of prevention and control measures was performed.Results Among 27 966 children from four ecological areas,the clinical detection rate was 0.05％ (14/27 966) and the X-ray positive rate was 1.26％ (353/27 966),metaphyseal rate was 1.25％ (350/27 966),bone-side positive rate was 0.01％ (3/27 966) and no case of epiphyseal and carpal were discovered.The clinical detection rate in children in the four ecological areas was not statistically significant (x2() =7.757,P ＞0.05),the Loess Plateau-gully region of Longdong [0.09％ (10/11 604)] ＞ the Anyon area of Qinling of Longnan [0.04％ (3/7 969)] ＞ Alpine grassland meadow area of Gannan [0.02％ (1/4 021)] ＞ the Loess Plateau-hills region of Longzhong [0 (0/4 372)].The detected rate of X-ray in four ecological areas was statistically significant (x2 =18.133,P ＜ 0.05),the Anyon area of Qinling of Longnan [1.49％ (119/7 969)] ＞ the Loess Plateau-gully region of Longdong [1.41％ (164/11 604)] ＞ the Loess Plateau-hills region of Longzhong [0.89％ (39/4 372)] ＞ Alpine grassland meadow area of Gannan [0.77％ (31/4 021)].Comprehensive prevention and control measures on Kaschin-Beck disease were different in different ecotypic areas.Relocation,long-distance education and selenium supplement measures had not been implemented in the four ecological areas.Conclusion The epidemic situation of Kaschin-Beck disease is different in different ecotypic areas in Gansu Province,which maybe related to ecological environment,but is under a state of control.

Objective To study the correlation between patellar stability and keen clinical manifestation in adults with Kaschin-Beck disease (KBD).Methods Through a cross-sectional study in September 2016,one hundred and forty-three adult patients with KBD were asked to accept a digital radiographic X-ray (DR) which included positive and lateral slices of knee joint and axis slice of patellar.Meanwhile,every patient must undergo a Lysholm function evaluation for knee joint and morphological measurement on the DR film which included Insall index,lateral patellofemoral angle,sulcus angle,congruence angle,lateral migrating ratio of patella,and patellofemoral index.Then,the regression equation was built and the correlation analysis was made with multiple linear regression test.Results One hundred and forty-three patients' average scores of Insall index,lateral patellofemoral angle,sulcus angle,congruence angle,lateral migrating ratio of patella,patellofemoral index and Lysholm score were 1.10 ± 0.17,(14.49 ± 1.47)°,(138.08 ± 3.86)°,(11.55 ± 2.17)°,(1.34 ± 0.13)％,1.18 ±0.10,and (62.96 ± 6.11) scores.By multiple linear regression test,Insall index (X1),congruence angle (X4),lateral migrating ratio of patella (X5),and patellofemoral index (X6) were selected to enter into the equation;while,lateral patellofemoral angle and sulcus angle were rejected.The multiple linear regression equation was as follows:Y =17.529 + 15.232X5 + 0.950X4 + 15.957X6-4.224X1.The adjusted determination coefficient (R2) of the equation was 0.559.Those indexes which were selected to enter into the equation were ranked from big to small based on the impact on Lysholm as follow:congruence angle,lateral migrating ratio of patella,patellofemoral index,and Insall index.Among them,Lysholm score had a negative correlation with Insall index.Through variance analysis,F valve was 46.642,and P ＜ 0.05,which meant the fitted equation had statistical significance.Conclusion There is significant correlation between the patellar stability and knee Lysholm scoring in adult with KBD,which is reflected with the following parameters from big to small in turn:patellofemoral index,lateral migrating ratio of patella,congruence angle and Insall index.

Objective To compare the effects of sevoflurane and propofol anesthesia on endothelial glycocalyx degradation in the patients undergoing abdominal surgery.Methods Sixty American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients of both sexes,aged 25-75 yr,weigbing 45-80 kg,scheduled for elective open colon or rectal surgery,were divided into 2 groups (n =30 each) using a random number table method:sevoflurane anesthesia group (group S) and propofol anesthesia group (group P).In group S,1.5％-2.5％ sevoflurane was inhaled for maintenance of anesthesia.In group P,propofol was intravenously infused at 50-150 μg · kg-1 · m-1 to maintain the bispectral index value at 40-60.The concentrations of heparan sulfate (HS),syndecan-1 and vascular cell adhesion molecule-1 (VCAM-1) in serum were determined after tracheal intubation (T0),at 1 h after skin incision (T1),at 2 h after skin incision (T2),at the end of operation (T3) and at 24 h after operation (T4).Blood gas analysis and blood biochemical test were performed at T0 and T4,and strong ion gap (SIG) was calculated.Results Compared with the baseline at T0,the concentrations of serum HS at T2-4 and syndecan-1 at T3-4 and SIG at T4 were significantly increased,and the concentrations of serum ALB at T4 were decreased in S and P groups (P＜0.05).Compared with group P,the concentrations of serum HS at T3,4 and syndecan-1 at T4 and SIG at T4 were significantly decreased,the concentrations of serum ALB at T4 were increased (P＜0.05),and no significant change was found in the serum concentrations of VACM-1 and lactate in group S (P＞0.05).Conclusion Compared with propofol anesthesia,sevoflurane anesthesia is more helpful in decreasing endothelial glycocalyx degradation and in reducing vascular endothelial damage in the patients undergoing abdominal surgery.

Objective To study the correlation between knee biomechanics and clinical manifestation in adults with Kaschin-Beck disease(KBD). Methods Three hundred and eighty-nine digital radiographic X-ray (DR)anteroposterior keen films of adult KBD patients diagnosed at the Center for Disease Control and Prevention of Gansu Province from Sep 2012 to Sep 2016 were taken as subjects of observation and were retrospectively reviewed. Every patient must undergo a WOMAC function evaluation for knee joint and biomechanic angle measure for the lower limbs on the DR film which included femur angle, tibial angle, femur-tibial angle and joint space angle, Insall-Salvati index (LT/LP), and LT/HI index. Then, the regression equation was built and the correlation analysis was made with multiple linear regression test. Results Three hundred and eighty-nine patients' average scores of femur angle(X1),tibial angle(X2),joint space angle(X3),femur-tibial angle(X4),LT/LP index(X5),LT/HI index (X6) and WOMAC evaluation were (76.32 ± 2.05)°, (110.65 ± 4.68)°, (4.73 ± 0.91)°, (137.56 ± 2.29)°, 0.98 ± 0.12, 1.73 ± 0.11, and (61.35 ± 7.68) scores. By multiple linear regression test, femur angle, tibial angle, femur-tibial angle,LT/LP index, and LT/HI index were selected to enter into the equation; while, joint space angle was rejected. The multiple linear regression equation was as follows: Y = - 77.307 - 6.327X6+ 1.360X1+ 1.310X5+ 0.331X4-0.147X2.The adjusted determination coefficient (R2) of the equation was 0.958. Through variance analysis, the fitted equation had statistical significance (F = 1 790.391, P < 0.05). Through two- tailed significance test, the above-mentioned 5 indexes that were adopted to enter this question were in significant correlation with WOMAC scores(P<0.05).Conclusion There is a significant correlation between knee biomechanic angle and WOMAC scoring in adults with KBD,which is reflected with the following parameters from big to small in turn:femur angle,tibial angle, LT/LP index,femur-tibial angle,LT/HI index,.