Objective To analyze contribution of varus knee with osteoarthritis and investigate the role of soft tissue balance in total knee replacement ( TKR) of that. Methods One hundred cases (145 varus knees) were operated with TKR. There were 18 males (25 knees) and 82 females (120 knees), with the average age of 64.6 years, from 45 to 80 years old. During the operation, accurate osteotomy and soft tissue balance was made to correct the varus knee joint. The contribution angles of varus knee was measured on weight bearing X ray images pre and postoperatively, in order to evaluate the results of the combination of the osteotomy and soft tissue balance. Results The gross varus angle was average 9.2? ? 3.1? , ranging from 5? to 30? preoperatively. In the total angle, the varus angle caused by soft tissue imbalance was 53.2% , the osseous varus angles caused by the tibia varus was 22.8% , the osseous varus angles caused by tibia plateau destruction was 24.0% . The measurement of the postoperative X ray films suggested that the average angle of the tibia plateau osteotomy was 4.3? , obtaining the correction of 27.9% of the total varus angle, and the angles corrected by soft tissue balance was 10.7? ,getting the correction of 72.1% of the total varus angle. According to HSS score system, the preoperative score was 38 points, ranging from 5 to 57, and postoperative scores was 87 points, ranging from 75 to 90. Conclusion The contribution of varus knee with osteoarthritis were include: 1) Bony structural varus angle composed of tibial varus and tibial plateau destruction; 2) Collateral ligaments and soft tissue imbalance around the knee. Articular surface destruction and soft tissue imbalance are the main contribution of varus knee. For TKR of varus knees like this, besides accurate osteotomy, correct soft tissue balance is the key of the operation. [

Objective To explore whether the 25 kD protein component was a specific decrease in skeletal muscles of the patients with myasthenia gravis (MG). Methods The muscular proteins were extracted from 21 cases of normal objects,18 cases of patients with myasthenia gravis and 20 cases of patients with other neuro-muscular disorders with Guba-Straub solution. The components of protein were analysed by SDS-PAGE in double blind. Components of glycoprotein were detected by using the ConA/HRP.Results SDS-PAGE patterns showed that the concentration of protein bands with mass of about 25 kD in the MG muscles was much lower than that of muscles in both normal and other neuro-musclular disorders. The value of density for 25 kD protein bands was 1.6?0.7 in the MG muscles,but was 3.4?1.5 and 3.7?1.5 in the muscles of normal and other neuro-musclular disorders,respectively. In addition,25 kD protein was found as a glycoprotein,but it was different from AChR in the molecular weight.Conclusion (1) It was suggested that the pathogeny or developing of MG could be associated with 25 kD protein of the skeletal muscle because of its specific decrease. (2) 25 kD protein was a glycoprotein which was unassociated with the AChR molecule.

AIM: To investigate the homing effect of immature dendritic cells (iDC) after injection of iDC into the mouse hepatoma treated by microwave ablation and the possibility of stimulating tumor immunity after thermal ablation. METHODS: The model of hepatoma was established with Hepa 1-6 cells injected into the subcutaneous tissue of C57BL/6J mice. The tumors were treated by microwave ablation under different temperatures, and then fluorescent-labeled iDCs (PKH26-DC) were injected into the ablated tumor tissues. The influences of ablation to homing of PKH26-DC, maturation and excitation ability towards T-cell were observed. RESULTS: There were no homing PKH26-DCs and expression of CCR7 in draining lymph nodes in (65?5)℃ and (90?5)℃ ablation groups after intratumoral injection of iDCs. The number of homing PKH26-DCs was 32?8 in (50?5)℃ ablation group vs 21?6 in un-ablated group, and the expression rate of CCR7 was 100% vs 90%. The number of clusters with immunological synapsis was 8-12 in (50?5)℃ ablation group vs 4-6 in un-ablated group under 100-magnification visual field, and the number of lymphocytes in each cluster was 12-25 vs 3-10. CONCLUSION: Thermal ablation of hepatoma under an appropriate temperature level may promote maturing and homing of iDCs and stimulate immunity of lymphocytes.

China has launched a general practice (GP)-orientated primary care reform in 2009 to develop a more productive, coordinated, and cost-effective system to maintain and improve the health and wellbeing of one-fifth of the world population. The restructure of the health care system with a focus on primary care requires practitioners working on GP as gatekeepers for service delivery that is responsive to the needs of people. It is particularly prioritised to establish a sound education and training system to ensure that the competencies of practitioners are aligned with local health care needs. This article aims to provide a brief review of the development of GP, including exemplary model of education and training currently implemented in southern China, as well as the challenges to be addressed in the next step. There is a shortage of well-trained and qualified general practitioners in China where more than half of the licensed clinicians in primary care are educated below the undergraduate level. Although there is a stepwise increase in recognition that the capacity of GP is pivotal to the success of primary care development in China, challenges coming from resource restriction, rural and urban disparity, social attitude, and community involvement are highlighted as major bottlenecks that currently hinder the rapid development of GP in China. Supportive policy and guidelines are necessary to build up strong GP recognition and ensure adequate resources to underpin a robust primary care system to deliver affordable and effective health care services for the world’s largest population. It might share some similar experiences with other countries that are struggling to develop a GP-based primary care system.
education ; General Practice ; Health Care Reform ; China

AIM:To investigate the mechanism responsible for albumin microbubbles adherence to activated leukocytes. METHODS: In vitro studies were performed in which activated or nonactivated leukocytes were incubated with albumin microbubbles and observed under microscopy. The suspensions of leukocytes and microbubbles which contained or absented of integrins were analyzed with flow cytometry.RESULTS: A minimum of 50 cells were identified under transillumination. 5 min after microbubbles were incubated with leukocytes, the number of cells interacting with microbubbles was greater for activated cells than for nonactivated cells(20 30?2 67 vs 4 50?1 43, P

Objective: To understand the prevalence of major human parasitic diseases and related factors in Henan province. Methods: This stratified sampling survey was carried out according to the requirement of national survey protocol of major human parasitic diseases, 2014-2015. The prevalence of soil-transmitted helminths infection, taeniasis and intestinal protozoiasis were surveyed in 104 sites selected from 35 counties (districts) and the prevalence of clonorchiasis was surveyed in 62 sites selected from 37 townships. In each survey spot, 250 persons were surveyed. A total of 26 866 persons and 15 893 persons were surveyed. Modified Kato-Katz thick smear was used to detect the eggs of intestinal helminthes. Tube fecal culture was used to identify the species of hookworm. The Enterobius eggs were detected in children aged 3 to 6 years by using adhesive tape. The cyst and trophozoite of intestinal protozoa were examined with physiological saline direct smear method and iodine stain method. Results: The overall infestation rate of intestinal parasites was2.02% in Henan, and the worm infection rate was higher than protozoa infection rate. Fourteen kinds of intestinal parasites were found, including nematode (5 species), trematode (2 species), and protozoan (7 species). The infection rate of Enterobius vermicularis was highest, and Qinba Mountain ecological area had the highest infestation rate of intestinal parasites in 4 ecological areas of Henan. There was no significant difference in intestinal parasite infection rate between males and females (χ(2)=3.630, P=0.057), and the differences in intestinal parasite infection rate among different age groups had significance (χ(2)=124.783, P=0.000 1). The infection rate reached the peak in age group ≤9 years and the major parasite was Enterobius vermicularis. Furthermore the overall human infection rate of parasite showed a downward trend with the increase of educational level of the people (χ(2)=70.969, P=0.000 1), the differences had significance (χ(2)=120.118, P=0.000 1). For different populations, the infection rate of intestinal parasites was highest among preschool children. The infection of intestinal helminth was mainly mild, only 2 severe cases were detected. The infection rate of Clonorchis sinensis in urban residents was only 0.006%. Logistic regression analysis showed that being preschool children (χ(2)=15.765, P=0.000 1) and drinking well water (χ(2)=45.589, P=0.000 1) were the risk factors for intestinal parasite infection, and annual income per capita of farmers was the protective factor against intestinal parasite infection. The infection rates of protozoa and intestinal parasites decreased sharply compared with the results of previous two surveys, and the rate of intestinal helminth infection also dropped sharply compared with the second survey. The numbers of protozoa, helminth and intestinal parasites detected in this survey were all less than the numbers found in the previous two surveys. Conclusions: Compared the results of three surveys in Henan, the infection rate of protozoa and intestinal parasites showed a downward trend. The prevention and treatment of Enterobius vermicularis infection in children should be the key point of parasitic disease control in the future.
Animals ; Child ; Child, Preschool ; Clonorchiasis/epidemiology* ; Farmers ; Feces/parasitology* ; Female ; Helminthiasis/epidemiology* ; Helminths ; Humans ; Intestinal Diseases, Parasitic/parasitology* ; Male ; Prevalence ; Protective Factors ; Risk Factors ; Rural Population ; Soil Microbiology ; Surveys and Questionnaires ; Taeniasis/epidemiology* ; Trematode Infections/parasitology* ; Urban Population ; Water Wells

OBJECTIVE: To analysis the short-term medicinal treating effects in senile sudden deafness. METHOD: According the age. The sudden deafness patients were divided into to groups, older age-group (age > or = 60, a total of 70 cases), control group (age < 60, a total of 70 cases), period of treatment was 7 days, the result of pure tone test were reviewed, compared the improvement before and after treatment. RESULT: After treatment, the average hearing threshold of the older age-patients was improved. There was statistical difference (P < 0.05); effective rate of the senile sudden deafness patients (disease time < or = 7 days) was 61.76%, (disease time > 7 days) was 38.89%. There was statistical difference (P < 0.05); the total effective rate of the senile sudden deafness patients was 49.9%; the senile sudden deafness patients which following moderate deafness (hearing threshold < 55 dB), effective rate was 52%, control group was 84.62%. There was statistical difference (P < 0.05), but there was no significant difference in the patients with severe hearing loss. CONCLUSION The Course of disease has important significance for the prognosis of the senile sudden deafness patients. As soon as possible to improve peripheral vascular microcirculation, the prognosis could be improve conspicuously the prognosis of the senile sudden deafness patients were worse than the young patients.
Age Factors ; Aged ; Combined Modality Therapy ; Female ; Hearing Loss, Sudden ; therapy ; Humans ; Male ; Middle Aged ; Presbycusis ; therapy ; Treatment Outcome

Objective:To prepare a kind of G418 resistance fibroblast feeder layers.Methods: In order to prepare a stock primary embryonic fibroblast (EMFI) cells, the pregnant Smad3ex8+/- mice containing heterozygous neo gene were killed 14 days after coitus to get the embryo. EMFI cells were tested by PCR to identify their gene types. Only one EMFI cell which contained heterozygous neo gene was chosen and treated with mitomycin C.The mitomycin C-treated EMFI feeders were stored at -70℃. Results: The EMFI feeder layers could support the growth of embryonic stem cell line TC-1 efficiently and could live in G418 resistance medium for 1-2 weeks.

Background The evaluation of visual function after laser in situ keratomileusis(LASIK) mainly focuses on the study of contrast sensitivity funetion (CSF).However,CSF measurement is a subjective method and therefore has a limiting in application.A point spread function (PSF) is becoming a study topic because of its objectivity in assessing visual quality.Objective Present study was to evaluate the change of the modulation transfer function (MTF) of eyes and compare the optical and visual quality of human eyes after LASIK.Methods Thirty-six patients(72 eyes) were included in this study.The patients were divided into low myopia(-2.72±0.52 D),moderate myopia (-4.89+0.80 D) and high myopia (-8.00+0.98 D) groups according to the spherical equivalent (SE)diopter before the sugery.The uncorrected visual acuity (UCVA),best corrected visual acuity (BCVA) were examined before and after operation,and PSF data was obtained with Topoeon PSF-1000 analyzer under the 3.0 mm and 6.0 mm pupil size conditions.The follow-up visits of the patients were scheduled at the 7th days,1 st and 3rd months.Written informed consent was obtained from each patient before this study. ResuIts The MTF values among the three refractive groups were significantly different between 3 mm and 6 mm pupil preoperatively (P＜0.05).Under the condition of 3 mm pupil size,the MTF values in the spatial frequencies of 2.98 cpd and 14.88 cpd were significantly declined in different time points after operation in comparison with preoperative ones (P＜0.05).However,the MTF changes had no statistical significance in the spatial frequencies from 18.85-37.70 cpd among various time points(P＞0.05).Under the condition of the 6 mm pupil size,MTF values in low and moderate myopia groups were reduced after operation in comparison with before operation at the spatial frequencies from 2.98-7.44 cpd(P＜0.05),however,there were no obvious difference was found in the spatial frequencies of 9.42-37.70 cpd(P＞0.05).The MTF values of high myopia group was decreased significantly at all spatial frequencies(P＜0.05).The MTF values improved gradually as the prolong of time after operation but was still lower at the 3rd postoperative month than that of preoperation. Conclusion The postoperative visual quality is associated with refractive power and pupil diameter.PSF is a feasible method in assessing the early visual quality after LASIK.