BACKGROUND:Early knee ioint prosthesis is used to relieve severe pain of patients．With continuous modification，the knee joint prosthesis with high flexion has developed．OBJECTIVE：To compare the clinical outcome between fixed platform high—flexion prosthesis and rotating platform high-flexion prosthesis following total knee arthroplasty．DESIGN：Non-randomized concurrent control trial of patients．PARTICIPANTS：Thirty-four patients(50 knees)with severe osteoarthritis underwent total knee replacement in Department of Bone and Joint,Tianjin Union Medicine Center from January to December 2006．METHODS：Of 34 patients，16(25 knees)underwent fixed platform high-flexion prosthesis replacement(LPS flexion，Zimmer，USA)，and 18(25 knees)underwent rotating platform high-flexion prosthesis replacement(PFC sigma RPF prosthesis．Johnson & Johnson,USA)．MAIN OUTCOME MEASURES：Knee joint function was evaluated using Hospital for Special Surgery Knee Score (HSS)before and 2 weeks，1，3 and 6 months after surgery．In addition，range of flexion of the knee was observed at 6 months postoperatively．RESULTS：Thirty-four cases completed the treatment and were followed up for 6 months．HSS scores of patients undergoing rotating platform high-flexion prosthesis replacement were higher than fixed platform high·flexion prosthesis replacement group at 2 weeks postoperatively(P<0．05)，while no differences were found in HSS scores at 1，3 and 6 months after surgery(P>0．05)．In addition，there were no significant differences in the range of flexion of the knee at 6 months postoperatively[(130．4±15．2)°，(129．9±13．8)°，P>0．05]．CONCLUSION：Fixed platform and rotating platform high-flexion prosthesis replacement exhibit similar early effects on severe osteoarthritis．

Objective To investigate the inhibitory mechanism of rabeprazole on acid secretion of parietal cells in rats. Methods Seventy two Spraque-Dawley rats were divided into control group(normal saline), low dose of rabeprazole group (rabeprazole 10 mg/kg) and high dose of rabeprazole group (rabeprazole 20 mg/kg) with 24 each. Four rats in each group were treated at 1 h, 2 h, 4 h, 6 h, 12 h and 24 h, respectively, pH value and activity of H+-K+-ATPase were tested by NaOH titrimetric method and chromatometry, respectively. The changes of ultrastructure of parietal cells were observed by electron microscope. Results Compared with control group(1.97±0.30), pH value in low (3.37± 0.97)and high (5.96±0.26)dose groups were significantly increased(P<0.01), and the activity of H+-K+-ATPase was inhibited obviously at 1 h after administration(3.28±0. 41 vs 1.47±0.27 and 0.92±0.07, P<0.05). Those differences could be found even at 12 h(P<0.01). The ultrastructural changes of parietal cells were consistent with the increase of pH value and decreased activity of H+-K+-ATPase. The significant difference was found in acid depression and excellent time between low and high dose of rabeprazole groups. Conclnsions The uhrastructural changes of parietal cells and the activity of H+-K+-ATPase can accurately reflect the acid secretion in rats. Rabeprazole has powerful and rapid effects in inhibiting acid secretion which correlates with the dosage.

Cell immobilization is a new biotechnology The definition, classification, and carrier selection of cell immobilization are presented in details The technique is efficiently applied to treating strength organic wastewater, nutrient and heavy metals removal of wastewater, as well as hardly biodegradated wastewater It has a widely applied prospect in wastewater treatment

BACKGROUND:From the biological structure, the posterior cruciate ligament is surrounded by the synovial folds of posterior capsule, arising from the inner side of the medial femoral condyle to the posterior part of tibial intercondyloid spine. The main traditional treatment method for posterior cruciate ligament tibial avulsion fracture is open operation, but it is difficult in anatomic reduction, cannot ful y restore knee joint stability and has a great negative impact on the normal function of posterior cruciate ligament. OBJECTIVE:To investigate the effects of arthroscopic implant internal fixation in the treatment of tibial avulsion fracture of the posterior cruciate ligament. METHODS:120 patients with tibial avulsion fracture of the posterior cruciate ligament were randomly assigned into treatment group and control group, with 60 cases in each group. The control group was given the traditional open surgery, and the treatment group was given the arthroscopic surgery. After 3 months, International Knee Documentation Committee (IKDC) scores and Lysholm scores were detected in the two groups;the knee joint range of motion was determined before and 3 months after treatment. RESULTS AND CONCLUSION:Wounds were healed at stage I in al patients with no serious complications. There was no difference in the knee joint range of motion between the two groups before treatment, but the range of motion was increased significantly in both two groups at 3 months after treatment (P<0.05), meanwhile which was higher in the treatment group than the control group (P<0.05). At 3 months after treatment, the excel ent knee function rate was significantly higher in the treatment group (97%) than the control group (88%) according to the Lysholm scores;the IKDC scores were significantly higher in the treatment than the control group in terms of claudication, support, pain, swel ing, and squat (P<0.05). These results indicate that the arthroscopic implant fixation of tibial avulsion fracture of the posterior cruciate ligament has better short-term effects to promote recovery of knee joint function, but no serious complications.

Objective Hypertension is a leading modifiable risk factor for cardiovascular disease .However , a lot of hyper-tension patients hold inactive attitudes to hypertension treatment .The purpose of this study was to investigate the relationship between previous treatment of hypertension and stroke severity in acute ischemic stroke . Methods We retrospectively analyzed the clinical data of 653 in-hospital ischemic stroke patients with hypertension between January 2011 and December 2014 .According to the National Institutes of Health Stroke Scale (NIHSS) at admission, the stroke patients were divided into a mild group (NIHSS≤3) and a severe group (NIHSS >3) and, based on their history of hypertension treatment , allocated to a regular treatment, an irregular treatment, a non-treatment , and an unawareness group .We studied the relationship of previous hypertension treatment with stroke severity by Spearman correlation analysis and identified the potential factors associated with stroke severity by multivariate logistic regression anal-ysis. Results Previous treatment of hypertension was positively correlated with stroke severity (r=0.146, P=0.000 2).Compared with the patients of the regular treatment group , those in the irregular treatment group (OR: 2.21; 95%CI:1.39 -3.52; P =0.001), non-treatment group ( OR: 2.18; 95%CI: 1.41 -3.36; P =0.0004) and unawareness group (OR:1.80;95%CI:1.12-2.88; P=0.015) tended to have more severe stroke. Conclusion Previous treatment of hypertension is closely related to the severity of ischemic stroke .

Objective To analyze the functional changes and the clinical significance of B cell specific mono-clonal murine leukemia virus integration site -1 (Bmi -1 )and Th1 /Th2 cells in children with newly diagnosed im-mune thrombocytopenia(ITP)by testing the mRNA expressions of Bmi -1,helper T cell -related cytokine interferon (IFN)-γand interleukin(IL)-4 in children with newly diagnosed ITP.Methods Thirty -six cases of patients with newly diagnosed ITP in the experimental group came from the inpatient and outpatient children admitted to the Depart-ment of Pediatrics of the First Affiliated Hospital of Xinxiang Medical University from April to December 201 3.In the control group,26 cases of children requiring selective operation were admitted to the Department of Pediatric Surgery during the same period.The mRNA expressions of Bmi -1,IFN -γand IL -4 in the peripheral blood lymphocytes were detected by means of the reverse transcription -polymerase chain reaction(RT -PCR)method,and were analyzed and compared by t test and linear correlation analysis.Results (1 )The mRNA expressions of Bmi -1,IFN -γand IL -4 in peripheral blood lymphocytes in the experimental group were 2.63 ±0.54,3.84 ±0.43 and 1 .44 ±0.39,respec-tively;while the mRNA expressions of Bmi -1,IFN -γand IL -4 in the peripheral blood lymphocytes in the control group were 3.91 ±0.92,2.88 ±0.57 and 1 .87 ±0.34,respectively.The levels of IFN -γof the experimental group were significantly higher than those of the control group (P <0.001 )and the levels of Bmi -1 and IL -4 in the experi-mental group were significantly lower than those in the control group (all P <0.001 ).(2)The mRNA expressions be-tween IFN -γand IL -4 in the peripheral blood lymphocytes in the experimental group were in negative correlation (r =-0.667,P <0.001 ).The mRNA expressions between IL -4 and Bmi -1 in the same group were in a positive correlation (r =0.776,P <0.001 ).There were no correlation in the mRNA expressions between IFN -γand Bmi -1 (r =-0.206,P >0.05).Conclusions Bmi -1 may be involved in the pathogenesis of ITP by regulating Th cell, and Th cell dysfunction may occur in the children with ITP,and the disproportion between Th1 and Th2 may be due to the advantages of Th1 .

Objective To investigate whether apathy during the acute stage of stroke was related to glycated hemoglobin and homocysteine(Hcy) and functional disability,and to elucidate possible factors that are related to poststroke apathy (PSA).Methods Totally 298 patients with acute cerebral infarction who met the inclusion and exclusion criteria were recruited from the Fourth Affiliated Hospital of China Medical University.The control group of 298 volunteers was recruited from medical center in our hospital during the same period.The apathy scale (AS) was used to assess PSA within 2 weeks after stroke.Patients with an AS score≥ 14 points were defined as PSA,and the patients were divided into apathy group (A group) and non-apathy group (NA group) according to AS score.Modified Rankin Scale (mRS) was used to assess functional disability.Functional disability in daily living activities was assessed with the Barthel Index(BI).Serum levels of Hcy,glycated hemoglobin A1C (HbA1 c),lipid series and fibrinogen of patients were determined.Results The prevalence of PSA in patients was significantly higher than the control group (P ＜ 0.01).In the case group,A group had an older age,higher mRS score,higher Hcy level,lower educational level,lower BI score,and lower HbA1C level than the NA group(P ＜0.05).In the A group,the mRS score was positively correlated with the AS score(B =1.508,P =0.003),serum Hcy level was positively correlated with the AS score(B =0.170,P =0.013),the HbA1C level was negatively correlated with the AS score(B =-0.872,P =0.031).Conclusions The serum Hcy level,HbA1C level and functional disability are closely related to apathy during the acute stage of ischemic stroke.

Objective To investigate the effect of progressive decompression elasticity socks therapy on life quality of the lower extremity deep vein thrombosis patients.Methods 50 qualified patients were divided into 2 groups receiving respectively compression therapy or not.Analysis and comparison were made based on results of SF36 questionnaire.Results There were no demographic differences between the two groups.Average follow-up time was (5.6 ± 2.4) months,the cronbach α coefficient was 0.8652 in compression therapy group,there was significant improvement on every evaluated stage and in every dimension after standard treatments (P ＜ 0.01),while in control group,only 4 dimensions (PF,RP,RE,BP) improved (P ＜ 0.05),there were statistical differences on every dimension between the two groups (P ＜ 0.01).Conclusions Progressive decompression elasticity socks therapy helps make the recovery of patients of acute deep vein thrombosis of the lower extremities.

OBJECTIVE: To explore the clinical effects of using custom-made tumor prosthesis replacement to treat malignant tumor located in the distal femur or proximal tibia. METHODS: A retrospective study of 29 cases malignant tumors around knee treated surgically from June 2001 to October 2008. In the study there were 19 males and 10 females, aging from 17 to 65 years, with an average of 38.5 years. The location of tumors was at distal femur in 22 cases and 7 cases at proximal tibia. After the tumor was extensively resected or radically resected, custom-made tumor prosthesis replacement was performed for reconstruction, simultaneously, neoadjuvant chemotherapy and radioactive-therapy were used in treating the tumor according the pathology. RESULTS: All patients were followed-up for 18-84 months, with average follow-up period of 54.2 months. The 3 year survival rate was 79.8%, and the 5 year survival rate was 63%. As for the complications, prosthesis breakage occurred in 2 patients, aseptic loosening in 1 patients, 2 had a recurrence of the soft tissue tumor for which the diseased limb amputation was performed. The mean MSTS score showed excellent limb function in 15 patients, good in 8 patients, fair in 5 patients and poor in 1 patient. The overall excellent and good function was obtained in 79% of the patients. No superficial or deep infection occurred. Two patients suffered common peroneal nerve injury, but were cured by symptomatic treatments. CONCLUSION: Application of tumor prosthesis can give a satisfactory functional outcome, which is an effect method in limb salvage treatment of malignant tumor around the knee.

Objective To evaluate the clinical effects of medial patellofemoral ligament reconstruction using the semitendinosus tendon autograft for the treatment of the patellar dislocation.Methods From January 2007 to January 2010,16 cases of patellar dislocation were included in this group.Lysholm score was averaged preoperatively.Arthroscopic-assisted in the semitendinosus tendon autograft reconstruction of the medial patellofemoral ligament,the central graft were fixed on the inner edge of the patellar in the upper 1/3 and the mid-point location,the end were fixed on the channel of femoral epicondyle and adductor tubercle.Results All the patients that lined progressive knee rehabilitation after operation,returned to normal walking for 3 months,6 months could be sports.Followed up for 7-54( 26.36 ± 20.48 ) months,all of patients incision were healed as grade Ⅰ,knee function were normal.Postoperative Lysholm score (93.21 ± 4.68) scores compared with preoperative ( 76.53 ± 8.35 ) scores was significant difference (P ＜ 0.05 ).Conclusions Using the semitendinosus tendon autograft for the treatment of the patellar dislocation method is simple and can effectively restore normal patellar trajectory.At the same time,which is an effective surgical method to treat recurrentdislocation of the patellar.