[Objective]To compare clinical results of the mini midvastus approach with the traditional medial parapatellar approach for totall knee arthroplasty and to evaluate their advantages.[Methods]Sixty total knee arthroplasty(56 patients)have been freated during May 2002 to May 2006,28 patients(30 knee) were underwent TKA using either mini midvastus approach or traditional medial parapatellar approach.Two groups were compared according to skin incision length,postoperative pain score,total amount of drains,postoperative amount of decreasing Hb,active straight-leg raise time,postoperative length of stay,radiographic alignment of all the components,postoperative range of motion at 6 weeks and 12 weeks and 1 year,postoperative HSS score at 1 year.[Results]All the patients were followed from 1 to 1.5 year(mean,13.2 months).Position of all the components was normal in all patients except one case with abnormal position of tibial prosthesis in both groups.In the MIS group,the average skin incision length was 11.3 cm,average visual analog pain scale was 2.76 score,while the control group was 20.6 cm and 3.8 score.In the MIS group,the total amount of drains was 96.8 ml,postoperative amount of decreasing Hb was 22.5 g,while the control group was 276.3 ml and 32.5 g.In the MIS group,active straight-leg raise time was 3.8 days,postoperative length of stay was 8.6 days,while the control group was 5.8 days and 12.1 days.In the MIS group,the mean ROM at 6 weeks postoperatively was 107?and 117?at 12 weeks,while the control group was 98?and 108?.The differences between each factor group and operative results were significant(P0.05).[Conclusion]The mini midvastus approach wis associated with a more rapid functional recovery and a more satisfactory short-term result.

[Objective]To investigate the therapeutic results of grafting with bioactive glass and autologous bone marrow for simple bone cyst in teenagers. [Method]From April 2005 to October 2007,16 teenagers with simple bone cyst were reported.There were ten males and six females with a mean age of 18.5 years(range 12 to 30 years).Eight cysts were in the proximal humerus,five in the proximal femur,two in the proximal tibial and one in the distal end of radius.Lining of cavity was removed thoroughly with a curet.The cyst cavity was filled with the mixtures of 45s bioactive glass and autogenous red bone marrow.Five cases of pathologic fracture were fixed with steel plate or intramedullary nail.[Result]All 16 cases of cysts were ossified radiolo gically within six months,with an average time to syst healing of 18 week.A follow-up of 6 to 32 months(mean 18 months) showed satisfactory healing without complications.[Conclusion]The combined grafting with bioactive glass and autologous bone marrow appears to be an effective and simple treatment for simple bone cyst in teenagers.

BACKGROUND:When acute cerebral ischemia attacks, matrix metaloproteinases (MMPs) lead to the occurrence of cerebral edema through degrading the extracelular matrix, breaking the close connection between endothelial cels, increasing the permeability of capilaries, and destroying the blood brain barrier.
OBJECTIVE: From the aspects of MMPs and extracelular matrix, to discuss the therapeutic effects ofbuyang huanwu decoction combined with bone marrow mesenchymal stem cel (BMSCs) transplantation on cerebral ischemia-reperfusion injury.
METHODS:A total of 96 Sprague-Dawley rats were randomly divided into model group, tissue inhibitor of MMPs-1 (TIMP-1) group, TIMP-1+BMSCs group (BMSCs group) andbuyang huanwu decoction+BMSCs+TIMP-1 group (combined group that was divided into four subgroups, 12-, 24-, 36-, 48-hour groups). Rat models of cerebral ischemia-reperfusion were constructed, and TIMP-1 and BMSCs were injected to the brain of rats by a microinjector in a stereotaxic apparatus. Rats in the combined group were given buyang huanwu decoction (10 mL/kg), and rats in the other groups were given the same volume of normal saline at 7 days before surgery. After 10 days of administration, serum samples and brain tissues were colected to determine MMP-2 and MMP-9 levels using ELISA and to detect MMP-9 activity using gelatinases spectrometry method.
RESULTS AND CONCLUSION:Compared with the model group, the levels of MMP-2 and MMP-9 in the serum and MMP-9 activity in the brain were decreased in the other groups to different extents, especialy the levels of MMP-9 (P < 0.05). Compared with the BMSCs group, the levels of MMP-2 and MMP-9 in serum as wel as activities of MMP-9 and pro-MMP-9 in the brain were decreased significantly in the combined group at 36 and 48 hours after treatment (P< 0.01). The results show that thebuyang huanwu decoction can be mutualy cooperated with TIMP-1 to inhibit the degradation of extracelular matrix induced by MMP-2 and MMP- 9, repair the damaged blood brain barrier, prevent and cure cerebral edema after ischemia.

[Objective]To determine the content of Polygonum multiflorum thunb. Polysaccharide and the refined. [Methods] The sulfuric acid-phenol method was used. [Results] ?_ max = 486nm. The linear rang was 10.5～94.5?g?L -1 .And the average recovery was 101.23%(n=5,RSD=3.03%). The content of Polygonum multiflorum thunb. Polysaccharide was 14.28% and the refined was 19.03%. [Conclusion] The method was simple,rapid and reliable.

Objective To investigate the distribution and drug resistance of bacteria infection in children with pneumonia between pediatric intensive care ward and respiratory ward,in order to guide clinical treatment.Methods From 2010 January to 2014 January,two-hundred and sixty cases of pneumonia in hospitalized pediatric intensive care ward were included in the severe group,300 patients from respiratory ward into the common group,severe group were divided into the mechanical ventilation group (126 cases),non mechanical ventilation (134 cases),mechanical ventilation were divided into invasive ventilation group (94 cases),noninvasive ventilation group (32 cases).Conventional sputum specimens were detected,bacterial culture,identification and drug resistance of pathogenic bacteria ratio were done in each case,to compare the pathogenic bacteria and drug resistance rate of different groups.Results Both severe group and common group,gram negative bacteria were significantly higher than those of gram positive,But in the severe group,gram negative bacteria ratio was significantly higher than the common group (P ＜ 0.05),while the positive bacteria ratio was significantly lower than that of common group (P ＜ 0.05).Stenotrophomonas maltophilia,Acinetobacter and Pseudomonas aeruginosa ratio in severe group were significantly higher than that of common group (P ＜ 0.05),while the Haemophilus influenzae and Streptococcus pneumoniae in common group was significantly higher than the proportion of severe group (P ＜ 0.05).Stenotrophomonas maltophilia,Acinetobacter,Pseudomonas aeruginosa ratio in ventilation group was significantly higher than that of non ventilation group (P ＜ 0.05),and in the invasive ventilation group was significantly higher than the proportion of noninvasive ventilation group (P ＜ 0.05).Multi drug resistant bacteria detection rate in severe group was significantly higher than the common group (P ＜ 0.05).Conclusion Both pediatric intensive care ward and respiratory ward,bacterial lung infections are dominated by Gram negative bacteria,but bacteria spectrum and drug resistance have obvious difference,multi drug resistant bacteria detection rate in pediatric intensive care ward significantly higher than that of respiratory ward.Mechanical ventilation especially invasive mechanical ventilation may easily lead to drug-resistant strains.

Objective To investigate effective methodology for preventing infectious diseases from spreading within general hospitals at all levels. Methods Six hospitals at three levels in the city were made into two groups and investigated for their treatment of infectious diseases. The group of A1, A2 and A3 hospitals employs the five pre-triage, while the group of B2, B2 and B3 employs the routine pretriage. Results Comparison of undetected infectious cases between group A1, A2, A3 and group B1,B2,B3 identified significant difference with x2 testing, P＜0. 005. Conclusion Five pre-triage method can screen, identify and pinpoint confirmed or suspected infectious disease patients from all outpatients in the first time, thus preventing and controlling the nosocornial transmission of epidemic or even an outbreak of nosocomial infection effectively.

BACKGROUND:Cerebral ischemia often occurs in underlying pathological conditions, such as hypertension,
hyperlipidemia and diabetes. Therefore, it is of great significance to construct a cerebral ischemia rat model with hyperlipidemia and to study the effect of basic pathological changes on the cerebral ischemia.
OBJECTIVE:To observe the brain tissue pathological changes of rat models with coexistence of hyperlipidemia and cerebral ischemia, and the effect of hyperlipidmia on cerebral ischemia.
METHODS:The rats were fed with high-fat diet to establish the hyperlipidmia models, and then focal cerebral
ischemia models were prepared with suture method. At 3 and 7 days after modeling, the 2,3,5-triphenyltetrazolium chloride staining was used to observe the volume of brain tissue ischemia, and hematoxylin-eosin staining was
performed to observe pathological change of the margin of the brain tissue ischemia zone.
RESULTS AND CONCLUSION:2,3,5-Triphenyltetrazolium chloride staining staining results showed that the volume of cerebral ischemia was significantly reduced in the hyperlipidemia+cerebral ischemia 7 day group. Hematoxylin-eosin staining results showed there was typical ischemic changes in al the cerebral ischemia models, and the number of microglial cel s after cerebral ischemia for 7 days was significantly smal er than that after cerebral ischemia for 3 days, and the changes were more obvious in the hyperlipidemia+7-day cerebral ischemia group when compared with the hyperlipidemia+3-day cerebral ischemia group. Ultrastructure showed there were neuronal and glial nuclear membrane shrinkage in al the cerebral ischemia models, mitochondria cristae was disappeared completely, endothelial cel mitochondria was decreased, most of the synaptic vesicles of nerve synapse were dissolved;the damages above were improved after ischemia for 7 days, especial y
hyperlipidemia+cerebral ischemia for 7 days, the neuronal degeneration and necrosis were reduced, the
mitochondrial damage was repaired, the number of mitochondrial cristae was increased significantly, and the synaptic vesicles of nerve synapse were recovered significantly. The results indicate that hyperlipidemia can promote the recovery of cerebral ischemic injury,
probably because the hyperlipidemia factors can activate the protection mechanism.

To study the resistant mechanism and clinical significance of pseudomonas aeruginosa to beta-lactam antibiotics, the outer membrane permeability rate of 30 P. aeruginosa strains to 5 beta-lactam antibiotics was measured and their production of beta-lactamase and the beta-lactamase genes they carried detected. Furthermore, the relationship between the permeability, beta-lactamase and the clinical effects of beta-lactam antibiotics was observed. By using 14C-penicillin and liquid-scintillant isotope assay, the affinity of penicillin binding proteins (PBPS) was measured and their roles in the resistant mechanism studied. It was revealed that the permeability rate was higher in sensitive strains than in resistant ones (P < 0.05). All strains harbored 1-4 beta-lactamase genes and produced beta-lactamase. Higher permeability rate and higher degree of stability to beta-lactamase indicated better clinical therapeutic effects. The affinity of PBPs changed little without regard to the permeability and beta-lactamase. These results suggested that the permeability of outer membrane and beta-lactamase, but not PBPs, played important roles in the resistant mechanism of P. aeruginosa to beta-lactam antibiotics and affected the clinical therapeutic effectiveness of some patients.
Anti-Bacterial Agents/*pharmacology ; Bacterial Outer Membrane Proteins/metabolism ; Microbial Sensitivity Tests ; Permeability ; Pseudomonas aeruginosa/*drug effects ; beta-Lactam Resistance/*genetics ; beta-Lactamases/metabolism ; beta-Lactams/*pharmacology

To study the effect of HBx gene on the apoptosis of the cell lines (L02, HepG2) and the interaction between HBx and X-linked inhibitor of apoptosis protein (XIAP), the apoptosis of pcDNA3.1-HBx transiently transfected cell lines (L02, HepG2) was detected by flow cytometry and the mRNA expression of XIAP was assayed by real-time RT-PCR. Our study showed (1) the morphology of L02/pcDNA3.1-HBx was changed and the appearance of the cells mimicked that of HepG2 cells; (2) HBx gene could be detected in L02/pcDNA3.1-HBx and HepG2/ pcDNA3.1-HBx; (3) the apoptosis rate of L02/pcDNA 3.1-HBx was higher than that of L02 cells (P<0.01) and the apoptosis rate of HepG2/pcDNA3.1-HBx was lower than that of HepG2 cells (P<0.05); (4) the XIAP expression in L02 was about 3 times that in L02/pcDNA3.1-HBx cells (P<0.01), and the expression of XIAP in HepG2/pcDNA3.1-HBx was about 4 times that in HepG2 (P<0.01). It is concluded that HBx gene may promote the apoptosis of normal hepatocytes and inhibit the apoptosis of cells of hepatic carcinoma by regulating the expression of XIAP.

Objective To evaluate the relationship of high mobility group box 1 (HMGB1) and TLR4 with airway inflammation and the role of vitamin D.Methods Totally 24 BALB/c mice were randomly divided into control group,asthma group,and 1,25-(OH)2D3 group,each having 8 mice.The pathological changes in lung tissue of the mice were observed by hematoxylin-eosin (HE) staining,bronchial wall thickness was measured with computer pathological image analysis system software.The expressions of HMGB1 and TLR4 in lung tissue were detected by immunohistochemical method.Bronchoalveolar lavage fluid (BALF) was collected for cytological examination;the contents of HMGB1,TLR4,IL-4 and IFN-γ in BALF and the peripheral blood were detected by enzyme-linked immunosorbent assay (ELISA).Results The expressions of HMGB1 and TLR4 in lung tissue were stronger in asthma group,but weaker in intervention group.The total number of leukocytes as well as the percentages of eosinophils,neutrophils and lymphocytes increased significantly in BALF in asthma group,but significantly decreased in intervention group (all P ＜ 0.05).The ratio of monocyte/macrophage significantly decreased in asthma group,but increased significantly in intervention group (P＜0.05).The contents of HMGB1,TLR4 and IL-4 in BALF and the peripheral blood were significantly higher in asthma group than in control and intervention groups,whereas IFN-γ level was significantly lower than that in control and intervention groups (all P＜0.05).HMGB1 and TLR4 contents had a positive correlation with the total number of cells and IL-4 concentration in BALF,respectively (r1=0.796,0.730;r2=0.695,0.648;all P＜0.05).Conclusion HMGB1 and TLR4 were associated with airway inflammation and immune disorders.An appropriate amount of 1,25-(OH)2D3 can relieve airway inflammation,which may be associated with regulating Th1/Th2 cells balance.