OBJECTIVETo discuss the clinical effects of using rotating hinge prosthesis in treating primary malignant tumor of the proximal tibia.

METHODSAfter the malignant tumor of the proximal tibia was extensively resected or radically resected, rotating hinge prosthesis replacement was performed for reconstruction, while neoadjuvant chemotherapy was used in treating the osteosarcoma.

RESULTSThe average follow-up period was 4.2 years. There was no local recurrence and metastasis in 22 patients, though there was recurrence in 8 patients. The MSTS functional scores of all different items 4 years after the operations were above 3, which showed the clinical results were satisfactory.

CONCLUSIONSIt is an efficacious method for the treatment of malignant tumor of the proximal tibia by using rotating hinge prosthesis. It has the advantage of early recovery of joint function.

Adolescent ; Adult ; Arthroplasty, Replacement, Knee ; methods ; Bone Neoplasms ; surgery ; therapy ; Combined Modality Therapy ; Female ; Follow-Up Studies ; Humans ; Knee Prosthesis ; Male ; Middle Aged ; Tibia ; surgery

Objective To explore the factors influencing the premarital medical examination in Chinese population and to discuss the related possible intervention strategies.Methods Data were collected through self-designed questionnaires on 2572 newly married respondents,selected under a stratified randomized sampling method,at Marriage Registration Office in 12 counties in Zhejiang province.Predictive factors were derived from the integrating complementary constructs of Health Belief Model,Theory of Reasoned Action as well as individual demographic characteristics.Multiple logistic multilevel analyses was used as the main statistical method,with individuals as the ' low' and counties as the 'high' levels.Results Behaviors on premarital medical examination showed a clustering trait at the county level (P=0.018) and variance partition coefficients (VPC) of each variables was between 15.40％ and 17.58％.There were no statistical significances found in the rates of premarital medical examination among gender,age,residence of Household Registration,education,income,health insurance and history of premarital medical examination.However,significant correlation was seen on occupation of the respondents.The rate of premarital medical examination among the respondents who had not attended medical examination during the last six moths was 1.31times (95％ confidence intervals,1.05 -1.65 ) more than those who had,with OR (odds ratio) as 1.51 (95％CI:1.14-2.00) for the pregnant respondents in their first marriage and 0.35 (95％CI:0.23-0.51 )for remarried respondents,compared with women at first marriage but remained unpregnant.Regarding premarital medical examination,the respondents reported greater benefits,less barriers,greater positive behavioral attitudes and normative beliefs to it,with an ORs as 2.32 (95％ CI:1.18-4.60),0.71 (95％CI:0.57-0.90),1.69 (95％CI:1.10-2.58) and 1.72 (95％CI:1.34-2.20)respectively,but with no significant association with perceived susceptibility,perceived severity and motivation to comply.Conclusion Factors such as individual perceived benefits,barriers,attitudes and normative beliefs etc.,were determinants of premarital medical examination accompanied by minor (16％) influence coming from the geographical environment.

Objective To understand the association between people under impaired glucose regulation (IGR) with poor quality of sleep and the occurrence of diabetes.Methods Based on a cohort of 1136 persons with IGR,the present study would include information on the duration of sleep and severity of insomnia.The cohort was followed for two years and the outcomes of impaired glucose regulation were summarized.Poisson regression was employed to analyze the relationship between the quality of sleep and the occurrence of diabetes.Results After the confounders were adjusted,when compared with 7-9 h sleep duration,the less than 7 h sleep duration showed a RR value of 1.77 (P＜0.001) while more than 9 h sleep duration had a RR value of 1.45 (P=0.067).When compared data from people having less than 14 scores of the Insomnia Severity Index (ISI),those people with more than 14 scores had a RR value of 1.58 (P＜0.001).Conclusion Causal relationship between the quality of sleep and the occurrence of diabetes did exist among the IGR population while the poor quality of sleep might increase the risk of diabetes at the end of the two-year following-up program.

Mr. ZHENG Yu-lin is one of the most outstanding acupuncture scientists in the modern times in our country. He inherits the learning handed down in a family and is bold in making innovations, successfully combines the exercises to benefit the internal organs with Chinese traditional acupuncture needling methods, forming a set of unique Zheng's needling methods, which is used for treatment of severe ophthalmopathy with excellent therapeutic effects, and is famed the world over. Main achievements: took on scientific researches of acupuncture and moxibustion, teaching and clinical works in the first stage of establishment of China Academy of Traditional Chinese Medicinel trains a large number of famous specificities of acupuncture and moxibustion for new China; advocates study on channel essence; cures stubborn diseases for leaders of friend countries undertaking the great trust of the central leaders for many times, becoming an important ties of Chinese political foreign affairs.
Acupuncture Therapy ; history ; History, 19th Century ; History, 20th Century ; Humans ; Moxibustion ; history

OBJECTIVETo investigate whether thrombus aspiration plus intra-infarct-related artery bolus administration of tirofiban via the aspiration catheter is superior to thrombus aspiration alone in improving myocardial perfusion in patients with ST-elevation myocardial infarction (STEMI) undergoing primary angioplasty.

METHODSIn this single center retrospective study, 108 patients with STEMI who underwent angioplasty after thrombus aspiration plus intra-infarction related artery 500 µg tirofiban administration, with subsequent 12-hour intravenous infusion of 0.1 µg×kg(-1)×min(-1) after angioplasty (thrombus aspiration + tirofiban group) and 108 matched control patients with STEMI who underwent angioplasty after thrombus aspiration (thrombus aspiration group). The primary end points included thrombolysis in myocardial infarction (TIMI) flow immediately after angioplasty, complete ST-segment elevation resolution (> 70%) at 90 minutes after angioplasty and the peak of creatine kinase-MB (CK-MB) and troponin I (TnI). The secondary end points were the left ventricular ejection fraction (LVEF) in the hospital and at 9 months follow-up as well as major adverse cardiac events (MACE: cardiac death, target vessel revascularization, re-infarction) at 9 months and any bleeding events.

RESULTSBaseline characteristics of the two groups were well-balanced. The TIMI 3 flow rate (97.22% vs. 87.04%, P = 0.011) and the complete ST-segment resolution rate (66.67% vs. 50.91%, χ(2) = 6.129, P = 0.047)were significantly higher in the thrombus aspiration + tirofiban group than in the thrombus aspiration group. The peak of CK-MB (83.9 U/L vs. 126.1 U/L, P = 0.034) and TnI (42.7 ng/ml vs. 72.5 ng/ml, P = 0.029) were significantly lower in the thrombus aspiration + tirofiban group than in the thrombus aspiration group. LVEF in the hospital favored thrombus aspiration + tirofiban the group (45.7% ± 10.8%, 42.9% ± 9.9%, t = 1.99, P = 0.049). There was a tendency to decreased MACE rate at 9-month follow-up, which favored thrombus aspiration + tirofiban the group (logrank χ(2) = 2.865, P = 0.09). Bleeding events were similar between the two groups.

CONCLUSIONThrombus aspiration plus intra-infarct-related artery bolus administration of tirofiban in patients with STEMI undergoing primary angioplasty may improve myocardium perfusion, attenuate myocardial ischemia and result in a better clinical prognosis compared to thrombus aspiration alone.

Adult ; Aged ; Angioplasty, Balloon, Coronary ; adverse effects ; methods ; Coronary Thrombosis ; therapy ; Female ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; therapy ; Retrospective Studies ; Tyrosine ; adverse effects ; analogs & derivatives ; therapeutic use

OBJECTIVETo understand the current status and its changing patterns of perinatal health care in some southern and northern areas of China from 1994 to 2000.

METHODSData was collected in 13 counties/cities covered by Perinatal Health Care Surveillance System which was part of the Sino-American cooperative project on neural tube defects prevention, established in 1992. The study population consisted of 368 589 women who delivered single live births of at least 20 gestational weeks from 1994 through 2000. Chi-square test was employed to test the difference on the proportions of women with prenatal checkup, women with early prenatal care onset, women with at least five prenatal visits, hospital delivery versus home delivery as well as the proportion of women with at least three postpartum visits. Two-way ANOVA was used to test the differences of mean of gestational weeks at first prenatal visit and the mean of prenatal visits between different year and areas.

RESULTSThe proportion of women with prenatal checkup remained over 99.0% from 1994 through 2000. The mean of gestational weeks at first prenatal visit changed from 13.1 weeks in 1994 to 10.7 weeks in 2000. The proportions of women with early prenatal care onset increased from 65.5% in 1994 to 79.4% in 2000 while women with at least five prenatal visit increasing from 34.1% to 71.8%, hospital delivery increasing from 91.3% to 98.8%, home delivery decreasing from 5.6 % to 0. 6%, women with at least three postpartum visits increasing from 80.5 % to 95.1%. Except for the proportion of women with early prenatal care onset, other proportions in northern areas were lower than those in southern areas in the same year. Greater differences between urban and rural areas in northern areas were found than in southern areas.

CONCLUSIONThe utilization of perinatal health care services was greatly improved in both southern and northern areas from 1994 to 2000. However, there were still obvious differences in the perinatal health care services between northern and southern areas as well as between urban and rural areas in northern China.

China ; Female ; Health Surveys ; Humans ; Perinatal Care ; utilization ; Pregnancy ; Rural Health ; Urban Health

This study aimed to evaluate the diagnostic and prognostic significance of serum bone sialoprotein (BSP) and prostate-specific antigen doubling time (PSADT) in patients with bone metastasis (BM) from prostate cancer (PC). A total of 116 patients with PC, 120 patients with benign prostatic hyperplasia (BPH) and 120 healthy controls were enrolled in this study. PC patients were divided into bone metastasis (BM) group (n=56) and non-bone metastasis (NBM) group (n=60). Serum BSP was detected by Sandwich ELISA. Severity of bone pain was evaluated using visual analogue score (VAS). Serum f-PSA and t-PSA levels were measured by using electrochemiluminescence immunoassay (ECLIA). PSADT was calculated according to the formula: PSADT=lg(2)/[log(PSA2)-log(PSA1)]. The mean serum BSP level in PC patients with BM was significantly higher than in PC patients without BM, BPH patients and controls (P<0.001 for all). Pearson's analysis showed that serum BSP level was positively correlated with VAS in PC patients with BM (P<0.05). Receiver operating characteristics (ROC) analysis demonstrated that BSP discriminated patients with BM from those without BM at the cutoff value of 33.26 ng/mL. The sensitivity and specificity were 78.21% and 79.28%, respectively. The optimal cutoff value of PSADT was 131 days, with sensitivity of 85.69% and specificity of 85.36%. Kaplan-Meier analysis revealed that subjects with higher BSP levels/shorter PSADT had a shorter BM-free period than those with lower BSP levels/longer PSADT. Serum BSP and PSADT are useful biomarkers for the diagnosis of BM from PC, and can be regarded as independent factors for predicting the prognosis of BM from PC. Combined determination of BSP and PSADT can improve accuracy and positive rate of BM from PC significantly.
Biomarkers, Tumor ; blood ; Bone Neoplasms ; blood ; pathology ; secondary ; Humans ; Male ; Osteopontin ; blood ; Prostate-Specific Antigen ; blood ; Prostatic Neoplasms ; blood ; pathology

OBJECTIVETo describe the secular trends and epidemiological characteristics of preterm birth among singletons in 10 counties (cities) of China during 1993-2005.

METHODSWe analyzed data on 542 923 women (gestational age > or =28 weeks) collected through Perinatal Healthcare Surveillance System established by the Institute of Reproductive and Child Health, Peking University. Chi-square tests were employed to test the differences in prevalence of preterm birth among different groups.

RESULTS25 784 preterm births were identified, including 1530 stillbirths. Preterm birth rate was 4.75% (95% CI:4.69-4.81) for all births and 4.49% (95% CI:4.44-4.55) for live births. Preterm birth rate declined steadily from 1993 to 2005 and had no significant seasonal variation. Preterm birth rate from the urban areas of the Southern part of the country,was higher than that in the rural areas which was also higher than that seen in the rural areas from the northern part of the country. Relations between women's age at delivery and preterm birth appeared to be U-shaped. Increased preterm birth rates were also observed in women with lower education level,more parities,and previous history of preterm birth or abortion.

CONCLUSIONPreterm birth rate decreased steadily from 1993-2005 in 10 counties (cities) but varied by areas of the country.

Adult ; Birth Rate ; trends ; China ; epidemiology ; Female ; Humans ; Pregnancy ; Premature Birth ; epidemiology ; Prevalence ; Rural Population ; Urban Population ; Young Adult

Objective The purpose of this study was to evaluate the effect of hemoglobin (Hb) level during early gestation on the cognitive development of children at 4-6 years of age.Methods A total number of 3609 children were randomly selected from all the live birth infants whose mothers participated in a community intervention trial during 1993-1996 in 13 counties or cities in Jiangsu and Zhejiang provinces. Hb concentration during early gestation was measured at first prenatal examination and intelligence quotients (IQ), including full-scale, verbal and performance were assessed using Chinese-Wechsler Intelligence Scale for Children in 2000-2001 when these children had a mean age of 68 months. Results Compared with children whose mothers were non-anemic during early gestation, children whose mothers were anemic had a 0.6 point higher mean verbal scale IQ, a 0.9 point higher mean performance IQ and a 0.8 point higher mean full-scale IQ.These differences were not statistically significant when children' s gender, age at intelligence test,region, parity and mother' s IQ, education level and occupation were adjusted for. When mother-child pairs were divided into 5 sub-groups of every 20 percentiles according to Hb concentration during early gestation, verbal IQ scores of the lowest(Hb＜ 103 g/L), the moderate(110 g/L≤ Hb＜ 116 g/L)and the highest Hb concentration group (Hb≥124 g/L) were 91.6 ± 18.9, 92.8 ± 18.2 and 90.3 ±18.6, respectively. The performance IQ scores were 104.7 ± 15.2, 1 04.5 ± 14.3 and 103.5 ±15.1, and full-scale IQ scores were 97.8 ± 17.3,98.4 ± 16.3 and 96.4 ± 17.4, respectively. After controlling for confounding factors, children whose mothers had highest Hb concentration were 54% (OR= 1.54,95%CI:1.13-2.11)more likely to have poor verbal scores and 53% (OR= 1.53,95%CI: 1.10-2.12)more likely to have poor full-scale scores than children whose mothers had moderate -Hb concentration. No statistical associations were noticed between high -Hb concentration and performance scores, or between low Hb concentration during early gestation and verbal, performance as well as full-scale score of pre-school children. Conclusion High maternal Hb concentration during early gestation might adversely affect children' s cognitive development.

Objective Our purpose was to evaluate the association between hemoglobin concentration (Hb) and cognitive ability of children at 4-6 years of age in 21 counties/cities in China.Methods A total number of 7331 children born during 1993-1996 were randomly selected from 21 counties or cities in Hebei,Jiangsu and Zbejiang provinces,Hb concentration of children were measured followed by three tests including full-scale,verbal and performance intelligence quotient (IQ) test performed by Chinese-Wechsler Intelligence Scale for Children,one year later.Results There were a 0.7 point difference in mean verbal scale IQ(P=0.144) and a 0.9 point difference in both mean performance and full-scale IQ (P=0.055 and 0.079,respectively) between anemia and non-anemia groups.Compared with children with non-anemia,children with anemia were 1.3-fold more likely to score poorly in verbal IQ and operational IQ (95%CI:1.1-1.6,1.1-1.5,respectively) and 1 A-fold more likely to have had poor scores in full-scale IQ(95%CI:1.2-1.6) after controlled for children's gender,age at intelligence test,region,parity and mother's IQ,education level,occupation.Participants were divided into 5 sub-groups according to Hb concentration of every 20 percentile.Verbal IQ scores of the lowest(Hb＜110 g/L),moderate (117 g/L≤Hb＜122 g/L) and the highest Hb concentration groups (Hb≥130 g/L) were 90.6±18.1,94.0±17.6 and 91.0±16.4,respectively.Performance IQ scores were 102.2±15.7,104.6±14.8 and 100.5±14.9,respectively.Full-scale IQ scores were 95.94±17.3,99.0±16.4 and 95.2±15.6,respectively.Children with both low and high hemoglobin levels did poorly in all intelligence tests than children with moderate Hb concentration (P＜0.001).After controlling for confounding factors,children with the lowest concentration were 1.4-fold more likely to have had poor verbal and performance scores than children with moderate Hb concentration (95% CI:1.1-1.7,1.1-1.8,respectively) and 1.5-fold (95% CI:1.2-1.8) more likely to have had poor full-scale scores than those with moderate Hb concentration.The association between high Hb concentration and low IQ scores disappeared in the multivariate model.Conclusion Low Hb concentration might have adversely affected children' s cognitive development.