OBJECTIVE:To compare the effects of total knee arthroplasty performed with and without patellar resurfacing. METHODS:All randomized clinical trials relevant to comparison of total knee arthroplasty performed with and without patellar resurfacing between 1966 and 2008 were collected. The quality of the trials was assessed. The outcomes data including the prevalence of reoperations,postoperative anterior knee pain,patient satisfaction,and the improvement in various knee scores were extracted and reviewed systematically. RESULTS:1 731 knees were included in the 15 published trials,including 842 knees in the resurfaced group and 889 in the nonresurfaced group. During the four years following surgery,there was no significant difference between the resurfaced and the nonresurfaced groups in re-operation rate (relative risk=0.56,95% CI 0.17-1.85); whereas the re-operation rate of the nonresurfaced group was significantly greater than resurfaced group 4 years after surgery (relative risk=0.46,95% CI 0.25-0.84). On the prevalence of postoperative anterior knee pain,there was no significant difference between two groups (relative risk=0.65,95% CI 0.35-1.21). No significant difference was found in patient satisfaction (relative risk=1.00,95% CI 0.95-1.05). There was no significant difference between the resurfaced and the nonresurfaced groups in the KSS scores (weighing mean difference:-0.41; 95% CI:-3.08 to 2.26). CONCLUSION:The long-term rate of reoperations in total knee arthroplasty performed with patellar resurfacing was lower than that without patellar resurfacing. There were no significant differences in the terms of prevalence of postoperative anterior knee pain,patient satisfaction,and the improvement in various knee scores between the resurfaced and the nonresurfaced groups. The results of this systematic review should be explained prudently because of some limitations of included trials. For more reliable conclusions,more trials with high quality on methodology are needed.

Objective To introduce a method of reducing the postoperative syndrome of the uvulopalatopharyngoplasty(UPPP). Method UPPP was performed for 23 patients with obstructive sleep apnea hypopnea syndrom operation(OSAHS). Before or after the operation, dexamethasone was injected in oropharynx to control the edema of the oropharynx which caused by UPPP. Results Less syndrome had been occurred in these patients. Conclusion The edema of the oropharynx which caused by UPPP can be controlled by injecting dexamethasone in oropharynx. It can reduce the risk of the UPPP, and make the operation safer and more efficient.

Objective To study the effects of the soil factors on the yield and quality of Angelica dahurica originated from Sichuan Province.Methods The yield and contents of imperatorin,isoimperatorin,and other 11 different inorganic elements of A. dahurica,gathered from 15 different habitats of Suining in Sichuan Province were determined.And the basic soil nutrients and other 11 different mineral elements of the soil were analyzed.The effects of the soil factors on the yield and quality were analyzed through correlation analysis.Results The weight,length,circumference,and the contents of imperatorin and isoimperator in the roots of A.dahurica from different habitats were different.And the basic soil nutrients and other 11 different mineral elements of soil were different.The positive correlation between root length of A.dahurica,and soil available P content,root circumference of A.dahurica,and soil organic matter content,root weight of A.dahurica,and soil available P and K contents were all significant.The soil total nitrogen content had negatively significant correlation with the content of isoimperatorin.The correlation among the imperatorin,isoimperator contents of A.dahurica,and 11 other soil inorganic elements was not significant.Conclusion The soil factors have effects on the yield and quality of A.dahurica to some degree.

Zusanli (ST 36), Shangjuxu (ST 37) and Xiajuxu (ST 39) are considered as the lower He-sea points, which are located along the leg lines of stomach meridian of foot Yangming from top to bottom. According to the corresponding zang-fu of lower He-sea points, the distribution order from top to bottom is stomach, large intestine and small intestine. This is significantly different from digestive physiology function sequence of stomach, small intestine and large intestine in modern medicine. However, it conforms to their anatomical position from top to bottom. In order to make a further confirmation that the indication specificity of Zusanli (ST 36), Shangjuxu (ST 37) and Xiajuxu (ST 39) is closely associated with anatomical location, a great number of ancient and modern literature is reviewed. It is found that the functions of the three acupoints are obviously related to stomach, large intestine and small intestine, respectively, indicating that the sequence of Zusanli (ST 36), Shangjuxu (ST 37) and Xiajuxu (ST 39) is related to anatomical position of corresponding zang-fu. This study conclusion could play an important role for exploring the significance of anatomical location in indication specificity of acupoints.
Acupuncture Points ; Acupuncture Therapy ; history ; China ; History, Ancient ; Humans ; Intestine, Large ; physiopathology ; Medicine in Literature ; Meridians ; Stomach ; physiopathology

Objective To investigate the influence of c-myc on the growth, proliferation, apoptosis,invasion and cell cycle of the gastric line HFE145. Methods The cDNA of c-myc was subcloned into a constitutive vector pcDNA3.1 followed by transfection in HFE145 by using liposome. Then stable expression clones (HFE-myc) were selected. The apoptosis and cell cycles were detected using flow cytometry. The growth and proliferation were analyzed by making cell growth curves and colony formation assay respectively. The ability of invasion were tested using cell migration assay. Results HFE-myc group grew faster than HFE145and HFE-pc. The cell counts of HFE-myc in five of seven days were more than those of others significantly (P＜0.05). There was no difference between the two control group. Cell cycle analysis showed that HFE-myc group proliferated faster, mean proportion of cells in G2-M was about 25 % and higher significantly (P ＜0.05)than those of the two control groups. Results of colony formation assay showed that the mean colony formation rate of HFE-myc was 0.27 and higher than those of the control groups(P ＜0.05). The results of cell migration assay suggested that the cell migration rate of HFE-myc was not higher significantly than those of the control groups (P ＞0.05). Conclusion c-myc can promote the growth, proliferation. It can increase the proportion of cells in division stage, so promote the division. But it have little influence on the invasion of cells.

Objective To investigate the effect of perfusion and preservation with intragraft dipeptidyl peptidase Ⅳ (DPP Ⅳ) catalytic inhibitor on pulmonary function after lung transplantation in rats. Methods Pure SD rats were divided into six groups. Syngeneic rats (SD to SD) served as donors and recipients. Orthotopic lung transplantation model was used. Grafts of control groups (CONI and CON2) were flushed and preserved in LPD-glucoae exposed to 18 h of cold ischemia before transplantation. Peak airway pressure (PIP), blood gas (PO2), wet/dry weight ratio (W/D), the activity of myeloperoxidase (MPO) and the content of malonyldialdehyde (MDA) of CON1 group were analyzed at first day after transplantation. In CON2 group, the 7-day survival rate post-transplantation was observed. Experimental groups were divided into four sub-groups (EXP1-EXP4), and grafts were perfused and stored for 18 h with LPD-glueose plus DPPⅣ catalytic inhibitor. The pulmonary function was detected at 1st (EXP1), 3rd (EXP2), 5th (EXP3), and 7th day (EXP4) posttransplantation, respectively. Results The rats in CON2 were died at 7th day post-transplantation,and all rats in EXP4 group survived to the 7th day post-transplantation. As compared with CON1 group, PIP, W/D, MPO activity and MDA content were reduced (P<0. 01 or 0. 05), and PO2 increased (P<0. 05) in EXP4 group. The pulmonary function of DPPⅣ catalytic inhibitor-perfused grafts from 1 to 7 days was improved and all tested parameters were close to normal at 7th day.Conclusion Perfusion and preservation with an inhibitor of CD26/DPP Ⅳ enzymatic activity obviously reduced severity of ischemia-reperfusion injury and was beneficial to the rehabilitation of grafts'pulmonary function.

Objective To analyze the present situation of medical service prices in Beijing,and provide scientific basis in order to carry out the reform of medical service prices of the city.Methods Literature review method to collate the administration policy of medical service price in Beijing,and the method of statistical analysis to compare the Beijing medical service prices with 1 9 other provinces across the country.Results The number of medical service projects (4 613 )in Beijing is higher than the national average (4 507),but the average medical service prices (423 yuan)in Beijing is lower than the national average (609 yuan),and medical service price and the regional economic level has no statistical significance Conclusion Medical service prices of Beijing need to be adjusted,and a reform of medical service prices in Beijing should be implemented by the Development and Reform Commission,Health and Family Planning Commission.

Objective To investigate the outcome of endovascular treatment of large or giant intracranial aneu?rysm by long-term angiographic follow-up. Methods Clinical data of 72 patients with large or giant intracranial aneu?rysms receiving endovascular treatment were analyzed retrospectively. Thirty aneurysms were treated with coil emboliza?tion alone, 14 with stent-assisted coiling, 15 with covered stent-deployment and 13 with parent artery occlusion. Results complete occlusion was achieved in 10 cases of pure coil embolization, 7 cases of stent assisted coil embolization,11 cas?es of completely covered stent-deployment and,13 cases of parent artery occlusion. The postoperative immediate com?plete embolism rate was 56.9%. Nearly completely occlusion was achieved in 17 cases of pure coil embolization, in 6 cas?es of stent auxiliary coil embolization, 4 cases of covered stent-deloyment and zero case of parent artery occlusion. The total postoperative immediate nearly completely embolism rate was 37.5%. Incomplete occlusion was achieved in 3 cases of pure coil thrombosis, 1 case of stent assisted coil, zero case of ,covered stent-deloyment and zero case of parent artery occlusion. The total immediate postoperative incomplete embolization rate was 5.6%. Patients were followed up for 6 to 72 months, with an average follow-up of 24.2 months . All patients had no bleeding. The total periprocedural complica?tion rate was 9.7%and there were no death cases. The recurrence of aneurysm in pure spring coil embolization treatment was higher compared with other treatments. The overall recurrence rate was 23.6%. The recurrent 14 aneurysms were suc?cessfully treated endovascularly. Conclusions Endovascular embolization treatment of intracranial large or giant aneu?rysm is safe and effective but its long-term recurrence rate is high. Thus a close follow-up is needed. Endovascular inter?ventional therapy based on the location of aneurysm and shape characteristics can improve treatment effectiveness and re?duce recurrence rate.

Objective This retrospective study is to analyze and summarize the clinical features and therapeutic experience of the isolated abdominal aortic dissection(IAAD). Methods Totally 17 patients of IAAD, who were admitted to our hospital from January 2009 to January 2016, were included in this retrospective analysis. Five patients with obvious pain or abdominal aorta diameter of 30 mm accompanied with sub-renal anchorage area of 15 mm, underwent endovascular repair. In these 5 patients, 4 cases were subjected to bifurcated stent graft endovascular repair and 1 case received the aorta uni-iliac endovascular repair combined with femoral-femoral artery bypass treatment. Moreover, 2 patients with sub-renal anchorage area of less than 15 mm were subjected to surgical treatment. In these 2 patients, 1 case with obvious pain and abdominal aorta diameter of 30 mm underwent the abdominal aorta-right iliac artery bypass combined with femoral-femoral artery bypass, while the other case with abdominal aorta diameter of 30 mm but no pain received the abdominal aorta-bilateral iliac artery bypass. Furthermore, 8 patients with no obvious pain and abdominal aorta diameter of less than 30 mm received conservative medical treatment. In addition, there were 2 patients with obvious pain and abdominal aorta diameter of 30 mm suffering from sudden death during the surgical preparation. Important complications of these patients during hospitalization and follow-up period were recorded, analyzed, and compared. Results For the 5 patients undergoing endovascular repair, the averaged hospitalization duration was(15.4 ± 2.9)d, one of whom died during hospitalization. There were 3 cases with follow-up period of ≥ 12 months, and 1 case reported left iliac branch occlusion. For the 2 patients subjected to surgical treatment, the follow-up period was less than 12 months, and no serious complications occurred during hospitalization or follow-up period. For the 8 patients receiving conservative medical treatment, the averaged hospitalization duration was(11.1±5.2)d. There were 4 cases with follow-up period of ≥ 12 months, and no serious complications occurred during hospitalization or follow-up period. Conclusions Endo or open surgical treatment is recommended for patients with isolated abdominal aortic dissection with obvious pain or abdominal aortic diameter of 30 mm. For the patients with no pain and abdominal aortic diameter of less than 30 mm, conservative medical treatment is recommended.

Objective To explore the lesion types of renal branches and evaluate the clinical results of endovascular treatment for renal artery branch lesions associated with fibromuscular dysplasia (FMD).Methods Eight cases with renal artery branch lesions due to FMD from June 2014 to December 2015 in Department of Vascular and Endovascnlar Surgery,Henan Provincial People's Hospital were retrospectively reviewed.The computed tomography angiography was routinely performed to ascertain the property of renal artery lesion,and digital-subtraction angiography was further performed to confirm FMD diagnosis and analyze lesion characteristics.The renal artery branch lesion types,blood pressure (BP),renin activity,glomerular filtration rate (GFR) and restenosis after operation were observed,and the outcomes were recorded.Results In 8 patients,6 patients were found with the second grade renal branch lesions and 2 patients were found with tertiary branch lesions,involving 2 and more branch arteries for 4 cases and 1 branch for 4 cases.Five cases with branch-type cystic dilatation or aneurysms with coexisting stenosis including 1 case with dissecting aneurysm and renal local infarction,and 1 case with aneurysm located in the bifurcations of branches,and 3 cases with only branch stenosis were found.The angiography showed the small branch lesions of renal artery indicating FMD-mediated focal (5 cases) and multiple stenosis (3 cases).The branch stenosis was not operated in 1 case with dissecting aneurysm and renal local infarction,as BP could be controlled by antihypertensive treatment.Other 7 cases underwent endovascular angioplasties and the technical successful rate was 100％ without complications.After 1 week of operation,BP was improved,renal function remained normal,plasma renin activity was reduced and GFR was recovered for all patients.During the follow-up period (3 to 12 months),BP improvement was observed in 3 cases,and cure were found in 4 cases,and patient's GFR and plasma renin activity were improved in all patients.There were 2 cases with re-intervention during the follow-up period due to restenosis,and the involved branches were unobstructed without obvious stenosis after 1-year follow-up.Conclusions FMD can affect the renal branch artery with different lesions types and endovascular treatment is the first choice for the renal branch lesion of FMD.