Total joint replacement (e.g.total hip replacement,total knee replacement) is one of the most common and most successful orthopaedic procedures.Infection after total joint arthroplasty is a devastating complication that causes pain and dysfunction,increases the cost.It is important to prevent postoperative infection.There are preoperative,perioperative and postoperative risk factors of total joint replacement,and preventions should base on these risk factors.This article reviews muhiple preoperative,perioperative and postoperative risk factors of postoperative infection and the preventions based on these risk factors.

Objective To investigate the effects of doxycycline on the expressions of matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of metaloproteinase-1 (TIMP-1) in breast cancer lung metastasis model mice (BCML-TAⅡ99), and the mechanism thereof. Methods The BCML-TAⅡ99 mouse model was established. The immunohistochemical staining was performed to detect the expressions of MMP-9 and TIMP-1 in BCML-TAⅡ99 model mice and controls. Results The metastasis rate was significantly lower in treatment group than that of control group. The expression of MMP-9 was significantly reduced, but the expression of TIMP-1 was significantly increased, in treatment group compared with those of control group (P<0.05). Conclusion Doxycycline can inhibit tumor growth and metastasis in breast cancer with 1ung metastasis model mice by regulating MMP-9 and TIMP-1 expressions.

Objective:The envelope protein Domain I(DI) of type II mutated dengue virus from a DHF patient (B-E) was expressed,refolded and purified.Its immunogenicity was also identified.Methods:The 1-476 bp of B-E was cloned into pET28a(+),and it was transformed into E.coli after digestion and sequencing.The inclusion body was denatured and refolded after inducing with IPTG.Polyclone antibody was obtained by immunizing C57BL/6 and BALB/c mice with purified B-E,and identified with Western blot and ELISA.Results:The cDNA of B-E gene was inserted into pET28a(+) vector and transformed into Rosetta(DE3).The protein of B-E was mainly in inclusion body and the molecular weight was 20 kD as predicted.Western blot was used to identify the recommend protein with anti-his antibody.The soluble recombination protein was purified after denaturation and refolding.The polyclonal antibody was obtained by immunizing BALB/c and C57BL/6 mice and could be used in Western blot and ELISA assay.The titer of polyclonal antibody from C57BL/6 was 1:12 800 through ELISA assay,and titer of polyclonal antibody from BALB/c was 1:500 through Western blot.Conclusion:All the results suggests that B-E is immunogenic in BALB/c and C57BL/6 mice.

OBJECTIVE:To evaluate the economical efficiency of 3 therapeutic plans for acute upper respiratory tract infec-tion caused by group A β-hemolytic streptococcal (GAS). METHODS:In retrospective study,71 GAS positive patients with acute upper respiratory tract infection in our hospital during Mar. 2014-Mar. 2016 were selected and divided into group A(16 cases),B(30 cases),C(25 cases)according to medication method. Group A,B,C were given intramuscular injection of ben-zathine benzylpenicillin(1200000 U),oral administration of penicillin V potassium(0.5 g,q8 h,10 d)or oral administration of amoxicillin sulbactam(0.5 g,bid,10 d),respectively. Clinical efficacy and bacterial clearance were observed,and econom-ics of 3 therapeutic plans were evaluated. RESULTS:The cure rates of 3 groups were 87.50%,90.00%,and 92.00%;bacterial clearance rates were 88.24%,87.87%,and 92.59%,respectively;there was no statistical significance(P>0.05). Cost-minimi-zation analysis was adopted for pharmacoeconomic evaluation. The costs of 3 groups were 237.79,279.49,400.40 yuan,respec-tively. The cure rate and bacterial clearance rate of therapeutic plan C were the highest,but its cost also was the highest. The re-sults of sensitivity analysis were consistent with the results of cost-minimization analysis. CONCLUSIONS:The intramuscular in-jection of benzathine benzylpenicillin can be served as first choice therapeutic plan for recurrent upper respiratory tract infection caused by GAS and patients with rhenmatic fever risk. The patients who are reluctant to be treated with penicillin but guarantee medication time can take penicillin V potassium orally. The patients with poor efficacy of common penicillin can take amoxicillin sulbactam pivoxil.

BACKGROUND: The polarity and the layer-by-layer coating method which are utilized to improve the membrane surface of optical glasses is a new focus for researching in the world. OBJECTIVE: To prepare a stable hydrophilic anti-fogging coating by surface modification. METHODS: Hydrophilic anti-fogging coatings of complexes of polyacrylic acid (PAA), cationic polyacrylamide (CPAM) and sodium silicate were fabricated by layer-by-layer coating method. Subsequently, the stable multilayer films were obtained by thermal torrefaction. Then the transmittance, hydrophlicity, and hardness were tested. RESULTS AND CONCLUSION: In the wavelength coverage of 200 nm, the transmittance of the anti-fogging coatings was above 92.9%. In the wavelength coverage of 700-800 nm, the transmittance reached 98.1%, suggesting that the membrane had the good transmittance. Water drop dispersed completely after 230 ms when it contacted with the surface of the multilayer films, suggesting that it had the good hydrophilicity. The hardness of stable films structure was 4 H. The layer-by-layer coating method was simple and favorable for preparing the anti-fogging coatings with good product properties including good stability, anti-fogging function and the improved transmittance.

The innovative experiment programs are important teaching reform for improving the students' innovating spirit and practical ability.The innovative experimental studies for medical students in preclinical stage include scientific research topic selection,information retrieval,experimental study and manuscript preparation.The innovative experiments stimulated the research interests,improved the comprehensive quality and promoted the learning of preclinical theories.However,the supporting rules,the assessment methods and the quality of teachers remain to be further improved in order to execute the programs more successfully.

This paper discussed in detail on constructing periodical database by backtracking in terms of investigation and technique preparation before database construction.concrete carrying out plan of constructing and solving methods of difficulties during the construction,and database maintenance after tIle construction.

Objective To evaluate the clinical results of arthroscopic reconstruction of posterior cruciate ligament (PCL) via posteromedial,posterolateral and posterior trans-septal portals with the preservation of intact meniscofemoral ligaments and remnant PCL fibers.Methods Nine patients with PCL injuries were treated with autogenous hamstring tendons arthroscopically through routine arthroscopic portal,posteromedial portal,posterolateral portal and posterior trans-septal portal with preservation of intact meniscofemoral ligaments and remnant PCL fibers.Tibial tunnel of 1-1.5 cm was made below the lateral articular surface of PCL tibial attachment via arthroscopic posterolateral approach.Femoral tunnel of 1 cm was made posterior to the articular cartilage of the medial femoral condyle through anterolateral approach.Autogenous tendon graft was positioned in the knee joint through the navigation of tibial and femoral double-folded silk loops that traversed the bone tunnels and was fixed with bioabsorbable interface screws at both ends.Knee function was evaluated with Lysholm scale six months postoperatively.Results All patients were followed up for average 8.6 months (range,7-14 months).None of the patients had knee extension limitation six months postoperatively,but there were two patients with 10°-15° flexion limitation and one withⅠ degree positive result in posterior drawer test.Lysholm knee score was increased from preoperative (47.6 ± 14.9)points to (92.9 ±4.6) points at six months postoperatively (P ＜0.01).Conclusion PCL reconstruction via posteromedial,posterolateral and posterior trans-septal portals can obtain clear vision (with no blind area),safe operation,accurate positioning of tibial attachment and affirmative short term treatment results.

Objective To investigate the degree of pain for patients with esophageal cancer undergoing surgery, evaluate the influence of pain on life quality, and provide evidence for therapy and nursing. Methods The SF-MPQ and BPI were used to measure the quality and intensity of the pain, and the influence on the life quality. Results Non-manual workers feeled more pain than the manual workers; the degree of the patients' education background positively correlated with PRI emotional score;postoperative pain did not correlated with ages and gender. The more pain, the worse influence on life quality. The pain affected the daily life, emotions, locomotor ability, sleep and enjoyment of life significantly. Conclusions There still existed serious pain in patients with esophageal cancer underwent surgery,and the pain affects the quality of life and postoperative treatment. Nurses should pay close attention to pain management, adopt more accurate evaluation so as to guide the pain control and improve the life quality.