After total knee arthroplasty, the hemoglobin descending level is not in accord with blood loss volume because of recessive blood loss. Recessive blood loss will delay wound healing, increase infected opportunity, prolong rehabilitation exercise time, effect clinical outcome, so prevention of recessive blood loss is very important. This review is about the effect of gender, age, height and weight, tourniquet, operative time and operative trauma, postoperative anticoagulation, unilateral or bilateral total knee arthroplasty, autoblood reinfusion on the recessive blood loss, which maybe is helpful for the prevention of recessive blood in total knee arthroplasty.
Arthroplasty, Replacement, Knee ; adverse effects ; Blood Loss, Surgical ; prevention & control ; Humans

OBJECTIVETo determin the prognostic factors that influence survival in patients with osteosarcma.

METHODSThe clinical data of 43 patients with osteosarcoma between March 2005 and March 2007 were retrospectively reviewed. Patient's sex, age, tumor site, course of disease, serum alkaline phosphatase (AKP) level, preoperative chemotherapy, Enneking surgical stage, surgical method, distant metastasis were analyzed by Kaplan-Meier method, Log-rank test and COX regression model. Kaplan-Meier method was used to calculate the 3-years survival rate, and Log-rank test was used to determin prognostic factors related with survival rate, and COX regression model was used to find the independent prognostic factors. The effect of neoadjuvant chemotherapy on the prognosis of osteosarcoma was analyzed by Fisher exact test.

RESULTSAll the patients were followed up. Twenty-eight patients were alive, while 15 patients were dead. The survival time ranged from 6 to 65 months with a median survival of 42 months. Overall 3-year survival rate was 65.1%. Univariate analysis revealed that the prognosis of osteosarcoma was significantly related to tumor site (P = 0.010), Enneking surgical stage (P = 0.002), surgical method (P = 0.000) and distant metastasis (P = 0.002). Multivariate analysis by COX regression model suggested Enneking surgical stage (P = 0.028),surgical method (P = 0.001) and distant metastasis (P = 0.007) were the independent prognostic factors. Though the preoperative chemotherapy was unrelated to the survival of osteosarcoma, the sensitivity to preoperative chemotherapy was an important factor that affected the prognosis of osteosarcoma (P = 0.007).

CONCLUSIONThe prognosis of osteosarcoma was significantly correlated with Enneking surgical stage, surgical method and distant metastasis, early detection and wide excision were interventional methods to improve the survival of osteosarcoma.

Adolescent ; Adult ; Aged ; Bone Neoplasms ; mortality ; therapy ; Female ; Humans ; Male ; Middle Aged ; Multivariate Analysis ; Osteosarcoma ; mortality ; therapy ; Prognosis ; Proportional Hazards Models ; Retrospective Studies

Background Neovascular glaucoma (NVG) is a serious ocular disease which may cause blindness.The primary pathogenesis of NVG is ischemic retinopathy derived by central retinal vein occlusion (CRVO) and diabetic retinopathy (DR).Clinical characteristics of NVG are variable based on the difference of primary diseases,such as CRVO and DR.However,there is a few studies regarding the diffcrcnces of NVG initiated by CRVO and DR.Objective This study was to compare the clinical characteristics in NVG patients secondary to CRVO and DR.Methods A series case observational study was carried out in Hiserve Hospital of Qingdao University from January 2009 to June 2012.Twenty-nine eyes of 27 patients with NVG caused by CRVO (10 eyes of 10 patients) and DR (19 eyes of 17 patients) were included.The history of underlying diseases,course of NVG,intraocular pressure(IOP),fundus findings and complications after treatment were analyzed and compared between the CRVO-derived NVG and DR-derived NVG.All patients underwent panretinal photocoagulation,improving microcirculation therapy,anti-glaucoma (drug or surgery) and causative disease treatment,and some of them received vitrectomy or/and cataract surgery.Two eyes from each group received intravitreal injection of ranibizumab.The follow-up time in both groups was (14.00±10.13) months and (17.89±12.52) months,respectively.Results The median time of underlying disease was 3.3 months (2 weeks to 6 months) in the CRVO patients and 11.1 months (4 to 36 mouths) in the DR patients,with a significant difference between them (Z =-2.40,P＜0.05).CRVO-derived NVG progress was much faster than that of DR-derived NVG.The number of the eyes with visual acuity improvement after treatment was 2 in the CRVO-derived NVG and 15 in the DR-derived NVG;while the number of the eyes with unchanged or worse visual acuity was 8 and 4 in the CRVO-derived NVG eyes and the DR-derived NVG eyes (x2 =9.38,P＜0.01).The difference of IOP in pre-and post-treatment was (37.00±9.91)mmHg in the CRVOderived NVG eyes and (8.92±12.05)mmHg in the DR-derived NVG eyes,showing a significant difference between them (t =6.30,P＜0.01).In the CRVO-derived NVG eyes,optic disc edema,retinal hemorrhage,and vein dilatation were seen in 6 eyes,and mild optic disc edema and retinal hemorrhage were observed in 4 eyes.After treatment,fundus could not be seen in 4 eyes,in other 2 eyes optic disc and retinal laser spots were unclearly observed.In addition,pale optic disc and retinal vessel occlusion appeared in 2 eyes,and silver wire-like arteries exhibited in 2 eyes.In pre-treated DR-derived NVG eyes,fundus could not be seen in 8 eyes and Ⅲ-Ⅳv stages of DR findings appeared in 11 eyes.After treatment,retinopathy was stabilized in 16 eyes of 15 cases.Advanced retinopathy(V-Ⅵ stages of DR findings) was revealed in 3 eyes of 3 cases.The incidence of the complication after treatment was 100.0％ in the CRVO-derived NVG eyes and 21.1％ in the DR-derived NVG eyes (x2=5.18,P＜0.05).Conclusions The clinical characteristics of NVG secondary to CRVO and DR are variable,an appropriate treatment option should be selected according to different features of NVG.

Objective To knockout interferon alpha/beta receptor subunit 1(IFNAR1) gene in human colorectal adenocarcinoma cells Caco-2 using clustered regularly interspaced short palinmic repeats(CRISPR)/CRISPR-associated protein 9(Cas9)system to construct IFNAR1 knockout Caco-2 cell line.Methods The single guide RNA(sgRNA)sequence was designed to specifically recognize the exon region of IFNAR1 gene using CRISPR/Cas9 technology,and the LentiCRISPRv2-IFNAR1-sgRNA recombinant plasmid was constructed.Caco-2 cells were infected with the plasmid packaged by lentivirus and screened by puromycin resistance.The obtained monoclonal cell lines were cultured by limited dilution method,which were verified for the effect of IFNAR1 gene knockout by target gene sequencing and Western blot,and detected for the mRNA levels of CXC chemokine ligand 10(CXCL10)and interferon-stimulatd gene 20(ISG20)in IFNAR1knockout cells by adding exogenous IFNβ.Results Sequencing results of plasmid LentiCRISPRv2-IFNAR1-sgRNA showed that the insertion sites were all located at the sticky end of BsmBⅠenzyme digestion.Two IFNAR1 knockout monoclonal cell lines were obtained.The sequencing results showed that Caco-2-IFNAR1-KO1 had 5 bp deletion in the sixth exon of IFNAR1,and Caco-2-IFNAR1-KO2 had 18 bp deletion and 1 bp insertion in the seventh exon.Compared with wild-type Caco-2 cells,Caco-2-IFNAR1-KO1 and Caco-2-IFNAR1-KO2 cells showed no expression of IFNAR1 protein.Compared with no IFNβ stimulation,the mRNA levels of CXCL10 gene(t = 0.566 and 1.268 respectively,P>0.05)and ISG20 gene(t =1.522 and 1.733 respectively,P>0.05)in Caco-2-IFNAR1-KO1 and Caco-2-IFNAR1-KO2 cells stimulated by 50 ng/mL IFNβ showed no significant increase.While compared with those of wild-type Caco-2 cells,the mRNA levels of CXCL10gene(t = 6.763 and 6.777 respectively,P<0.05)and ISG20 gene(t = 5.664 and 5.65 respectively,P<0.05)in Caco-2-IFNAR1-KO1 and Caco-2-IFNAR1-KO2 cells decreased significantly under the stimulation of 50 ng/mL exogenous IFNβ.Conclusion Caco-2 cell line with IFNAR1 knockout was successfully constructed by using CRISPR/Cas9 technology,and the downstream molecules activated by IFNAR(interferon alpha/beta receptor)in this cell line were obviously inhibited,which provided a powerful tool for further exploration of the innate immune response and replication packaging mechanism of Caco-2 cells after virus infection.

OBJECTIVETo study gene expression profiling in human type I and II endometrial carcinoma.

METHODSSix Affymetrix human genome genechips were utilized to investigate the differences in gene expression profiles between type I and II endometrial carcinoma with bioinformatic analysis.

RESULTSMany genes were highly expressed in estrogen-dependent endometrial carcinoma, and some of them were involved in the metabolism and conversion of estrogen, while some others in estrogen regulation. CYP2C9, for instance, was involved in the conversion of estrogen sulfate to 16-hydroxy sulfate metabolite, DDC in estrogen-dependent pathogenesis of endometrial carcinoma possibly by DDC interaction with AR to enhance steroid receptor transcription.

CONCLUSIONHigh expression of these genes in estrogen-dependent endometrial carcinoma may provide insights into their roles in the pathogenesis and prognosis of this malignancy.

Adenocarcinoma ; genetics ; pathology ; Adenocarcinoma, Clear Cell ; genetics ; pathology ; Endometrial Neoplasms ; classification ; genetics ; pathology ; Female ; Gene Expression Profiling ; Gene Expression Regulation, Neoplastic ; Humans ; Microarray Analysis ; Reverse Transcriptase Polymerase Chain Reaction

Placental site nodule as a kind of benign trophoblastic disease is rare.The features of placental site nodule are known very little. Pathological diagnosis is the gold standard, while the pathological features of atypical placental site nodule are known very little. Here we report a case of mass in uterus with atypical placental site nodule, which can supplement our knowledge of this disease.

Objective To evaluate the prognosis factors of carcinomatous meningitis (CM).Methods The medical records of 63 patients with CM treated in our hospital from 1998 to 2008 were retrospectively analyzed. The chief prognosis factors evaluated were gender, age, primary tumor type,Karnofsky performance status (KPS) scores, interval between diagnosis of primary tumor and CM,treatment, radiation dose and primary tumor control status. Kaplan-Meier method was employed to calculate the survival time and plot the survival curves. Log-rank test was used to evaluate the differences between the groups. Cox regressive model was used to analyze the prognostic factors. Results All patients died by the end of follow-up. The survival time ranged from 2 to 732 d and the overall one-year survival rate was 7.9% with a median survival time of 67 d. In multivariate analysis, KPS scores, primary tumor control status, interval between diagnosis of primary tumor and CM were independent prognostic factors. Conclusions The main prognostic factors of CM are KPS scores, primary tumor control status, and interval between diagnosis of primary tumor and CM. The most effective treatment modalities still need to be confirmed and individual treatment for each patient with CM should be recommended in clinic.

OBJECTIVE: To investigate the population genetic data of 3 SNP loci (rs25533, rs34388196 and rs1042173) of 5-hydroxytryptamine transporter (5-HTT) gene and the association with paranoid schizophrenia. METHODS: Three SNP loci of 5-HTT gene were examined in 132 paranoid schizophrenia patients and 150 unrelated healthy individuals of Northern Chinese Han population by PCR-RFLP technique. The Hardy-Weinberg equilibrium test was performed using the chi-square test and the data of haplotype frequency and population genetics parameters were statistically analyzed. RESULTS: Among these three SNP loci, four haplotypes were obtained. There were no statistically significant differences between the patient group and the control group (P > 0.05). The DP values of the 3 SNP loci were 0.276, 0.502 and 0.502. The PIC of them were 0.151, 0.281 and 0.281. The PE of them were 0.014, 0.072 and 0.072. CONCLUSION The three SNP loci and four haplotypes of 5-HTT gene have no association with paranoid schizophrenia, while the polymorphism still have high potential application in forensic practice.
Adult ; Asian People/genetics* ; Case-Control Studies ; Female ; Gene Frequency ; Genetic Predisposition to Disease ; Genotype ; Haplotypes ; Humans ; Male ; Polymerase Chain Reaction/methods* ; Polymorphism, Single Nucleotide/genetics* ; Schizophrenia, Paranoid/genetics* ; Serotonin Plasma Membrane Transport Proteins/genetics*

OBJECTIVE: To reveal the genetic polymorphisms of four SNP loci (rs77434921, rs2076907, rs6283, rs1800762) in D5 gene of dopamine receptor (DRD5) in Northern Chinese Han population. METHODS: Four SNP loci of the DRD5 gene of 206 unrelated individuals in Northern Chinese Han population were separately amplified and sequenced by PCR technique and statistically analyzed by Haploview v4.1 software. RESULTS: In Northern Chinese Han population, the genotype frequency distribution of rs77434921, rs2076907, rs6283 and rs1800762 loci in the DRD5 gene were all in accordance with Hardy-Weinberg equilibrium. DP value was 0.145, 0.532, 0.602 and 0.159, while PE value was 0.004, 0.079, 0.196 and 0.007. A linkage disequilibrium among these four SNP loci was also demonstrated, which might infer five haplotypes. CONCLUSION rs2076907 and rs6283 loci of DRD5 gene in the Northern Chinese Han population have high genetic polymorphisms, which can be useful for forensic identification of individuals.
Asian People/genetics* ; China/ethnology* ; DNA Primers/genetics* ; Forensic Genetics ; Gene Frequency ; Genetic Markers ; Genotype ; Haplotypes ; Humans ; Linkage Disequilibrium ; Polymerase Chain Reaction ; Polymorphism, Single Nucleotide ; Receptors, Dopamine D5/genetics*