BACKGROUND:At present, the placement of tibial anatomic landmarks has no gold standard during total knee arthroplasty. In order to achieve the most ideal rotation function of the tibial prosthesis, we should do the preparation before surgery, understand tibial rotational alignment to rationaly select and apply the prosthesis.
OBJECTIVE:To investigate the effect of tibial rotational alignment technique on patelofemoral joint biomechanics and related mechanisms.
METHODS:Ten pairs of human knee joint specimens were colected to prepare experimental platform. Specimens were fixed on the experiment frame, which was fixed on the material testing instrument for mechanics experiment. Weset different knee flexion angles, including 30°, 60°, 90° and 120°. Joint replacement was performed with the knee prosthesis. Samples were randomly assigned to two groups (n=5). Tibial nodule technology and ROM technology were used to identify rotationalalignment of the tibial prosthesis. The medial and lateral patelofemoral joint contact pressure peak and patelofemoral contact area at different knee angles, and the medial and lateral parts of patelofemoral contact area at deep knee angles were observed in both groups.
RESULTS AND CONCLUSION:(1) During flexion angle from 30° to 60°, the peak contact pressure of medial patelofemoral joint increased, and decreased gradualy in both groups. At flexion angle of 90°, contact pressure reached the minimum value, then increased gradualy, and reached the maximum value at 120°. No significant difference in peak contact pressure of medial patelofemoral joint at different knee angles was detected between the two groups (alP> 0.05). (2) During flexion angle from 30° to 60°, peak contact pressure of lateral patelofemoral joint decreased constantly, and then gradualy increased. No significant difference in peak contact pressure of lateral patelofemoral joint at different knee angles was detectable between thetwo groups (alP> 0.05). (3) During flexion angle from 30° to 60°, patelofemoral contact area decreased, and then increased gradualy in both groups. No significant difference in patelofemoral contact area at different knee angles was identified between the two groups (alP> 0.05). (4) At 90° and 120°, no significant difference in the area of medial and lateral contact parts was determined between the two groups (alP> 0.05). (5) Experimental results showed that tibial nodule technology and ROM technology for identifying tibial rotational alignment during total knee arthroplasty can obtain considerable biomechanical effects of patelofemoral joint.

Objective To study the effect of the ultra-filtration extract from Angelica sinensis and Hedysarum polybotrys’s mixture on the VEGF mRNA expression of ECV-304 cell. Method Angelica sinensis and Hedysarum polybotrys’s mixture were refined by ultra-filtration technique. ECV-304 cells were cultured as model, and its proliferation was detected by MTT colorimetry. VEGF mRNA expression was observed by semi-quantitative RT-PCR. Results The ultra-filtration extract from Angelica sinensis and Hedysarum polybotrys’s mixture could markly promote the growth of ECV-304 cells, there was significant difference between experimental and control group (P

Objective A loop-mediated isothermal amplification (LAMP)assay was developed for rapid detection of Brucella.Methods Using Primer 4.0,we designed four specific primers at brookings coli outer membrane protein (OMP31) gene conservative area,under the action of Bst polymerase larger pieces to realize the step-like isothermal amplification of DNA.In this method,on the basis of optimal amplification conditions,the specificity and sensitivity of this method was compared with conventional PCR,and LAMP visualization experiment was conducted.Results The detection results of Brucella abortus (B.abortus) strain 544,B.abortus strain 104M,Brucella melitensis (B.melitensis) strain Rev-1,B.melitensis strain 16M,Brucella suis (B.suis) strain S2,B.suis strainand 1330S,Brucella canis (B.canis) strain RM6/66,Brucellá ovis (B.ovis) strain 63/290,and Brucella neotomae.(B.neotomae) strain 5K33 were positive,and Yersinia enterocolitica (Y.enterocolitica) O ∶ 9,Escherichia coli (E.coli) O157 ∶H7,and (Salmonella typhimurium,S.typhimurium) 47729 were negative.The minimum detection limit was 8.5 × 10-8 mg/L.LAMP was more sensitive than PCR.The results can be determined by electrophoresis or through visual judgment.Conclusions LAMP is a simple,specific and sensitive method.LAMP assay is a useful tool for rapid detection of Brucella.

Objective To explore the techniques of epicanthoplasty with concurrent double eyelid plasty. Methods Epicanthoplasty was performed based on the principle of transverse-vertical plasty. The curvilinear incision of epicanthoplasty was made from the desired point of the new medial canthus to the point 1 mm below the lower lacrimal point, the malpositioned orbicularis oculi muscle excised after skin undermining, the superficial head of the medial canthal tendon plicated or anchored to the lateral nasal aponeurosis and the incision closed after skin redraping. Double eyelid plasty was performed as usual, however, the incision of eyelidplasty was connected with the incision of epicanthoplasty by skin tunnel in which a strip of orbicularis oculi muscle was excised. Results From Oct. 2006 to Feb. 2009, 189 cases were treated. The follow-up period ranged from 3 to 24 months. The cosmetic results of the medial canthi were satisfactory with inconspicuous scar and no recurrence. The contours of the double eyelids were natural. No incisional scar presented between the medial canthi and the upper eyelids. Conclusion The modified transverse-vertical epicanthoplasty with concurrent double eyelidplasty is a simple and reliable surgical approach for correction of epicanthus and creation of supratarsal fold.

Possessing the unique feathers of high targeting and inducing the active immunity of patients,magnetic-mediated hyperthermia(MMH)has been regarded as a very promising cancer-treatment approach.Researches about in-stent MMH for esophagus cancel have been widely carried out with focusing on heating mechanism,feasibility studies and clinical trials.

BACKGROUND:In recent years, the morbidity of chronic pancreatitis has been increasing dramaticaly with lifestyle changes. Fortunately, endoscopic pancreatic stenting for patients with chronic pancreatitis shows favorable clinical prospects.OBJECTIVE:To introduce the advantages and disadvantages of various stent materials and to review the development and clinical application of pancreatic stents.METHODS: With the key words of chronic pancreatitis, pancreatic stent in Chinese and English, respectively, a computer-based search was performed for articles published in CNKI and PubMed databases from January 2005 to November 2016. After the initial screening, articles related to endoscopic pancreatic stenting usedin vitro,in vivo or in clinic were included.RESULTS AND CONCLUSION: Endoscopic pancreatic stenting has become a recognized treatment for chronic pancreatitis in recent years. Therefore, the development and application of the materials of pancreatic duct stents appear to be particularly important. According to different materials, pancreatic duct stents can be classified into plastic stents, fully covered self-expandable metal stents, and biodegradable stents. The complications, including stent migration and secondary surgery, frequently appear in the clinical use of plastic pancreatic duct stents and self-expandable metal stents, although they have been widely used in clinical practice. Biodegradable pancreatic duct stents can be degraded completely in the pancreatic duct within the expected time, and thereby avoid several complications. Consequently, the exploitation and application of biodegradable pancreatic duct stents have become an issue of concern.

Objective To investigate the clinical efficacy of splenectomy combined with coronary-caval shunt in treatment of portal hypertension (PHT).Methods The retrospective descriptive study was conducted.The clinical data of 21 patients with PHT who underwent splenectomy combined with coronary-caval shunt at the First Affiliated Hospital of Xi'an Jiaotong University from January 2001 to December 2015 were collected.Observation indicators included (1) operation situations,changes of pre-and post-operative portal hemodynamics including operation time and volume of intraoperative blood loss,diameter and blood flow velocity of portal vein (PV),gastric coronary vein and superior mesenteric vein (SMV).(2) Clinical indexes in perioperative period (before operation,at postoperative 1 week and 1 month):① blood routine test:the counts of red blood cell (RBC),white blood cell (WBC) and platelet (PLT),② liver function:Child-Pugh score,alanine transaminase (ALT),total bilirubin (TBil),albumin (Alb),extended time of prothrombin time (PT) and international normalized ratio (INR).(3) Follow-up:postoperative 1-,3-,5-year complications [upper gastrointestinal re-bleeding,peritoneal effusion,hepatic encephalopathy,hepatic failure,portal vein thrombosis (PVT) and anastomotic stoma thrombosis].The follow-up using outpatient examination and telephone interview was regularly conducted once every 3 months within postoperative 1 year and once every 6 months after postoperative 1 year up to March 2016 or end of follow-up (death).Measurement data with normal distribution were presented as x ± s.The comparison of different time-point was analyzed by the repeated measures ANOVA and Student t test.Measurement data with sknewed distribution were presented as M (range).Results (1) Operation situations and changes of pre-and post-operative portal hemodynamics:21 patients underwent successful splenectomy combined with coronary-caval shunt,including 19 receiving splenic vein bypass combined with anastomosis of gastric coronary vein and inferior vena cava and 2 receiving anastomosis of gastric coronary vein and inferior vena cava.Operation time,volume of intraoperative blood loss were (187 ± 33)minutes and (233 ± 114)mL.Diameter and blood flow velocity of PV,gastric coronary vein and SMV were (1.39±0.20)cm,(0.66±0.15)cm,(0.74±0.32)cm,(11.2±3.4)cm/s,(6.6± 1.3)cm/s,(7.0 ±2.2)cm/s before operation and (1.36 ±0.22)cm,(0.42 ±0.11)cm,(0.81 ±0.23)cm,(10.4 ± 2.5) cm/s,(8.2 ± 2.5) cm/s,(6.9 ± 2.4) cm/s after operation,respectively,showing no statistically significant difference in the diameter and blood flow velocity of PV and SMV before and after operation (t =0.46,-0.81,0.87,0.14,P ＞ 0.05)and with statistically significant differences in the diameter and blood flow velocity of gastric coronary vein before and after operation (t =5.9 1,-2.60,P ＜ 0.05).(2) Clinical indexes in perioperative period:① routine blood test:the counts of RBC,WBC and PLT were (2.70 ± 0.50) × 1012/L,(2.6 ±2.3) × 109/L,(55 ±28) × 109/L before operation and (3.10 ±0.60) × 1012/L,(2.8 ±2.0) × 109/L,(248 ± 182) × 109/L at postoperative 1 week and (3.70 ±0.20) × 1012/L,(6.2 ± 1.9) × 109/L,(457 ± 184) × 109/L at postoperative 1 month,respectively,with statistically significant differences (F =31.91,11.03,30.74,P ＜ 0.05).There were statistically significant differences in the counts of RBC and PLT between 1 week postoperatively and before operation (t =-2.35,-4.81,P ＜ 0.05) and between 1 month postoperatively and 1 week postoperatively (t =-4.35,-5.65,-3.71,P ＜ 0.05).② Liver function:Child-Pugh score,ALT,TBil,Alb,extended time of PT and INR were 6.3 ± 1.2,(23 ± 17) U/L,(28 ± 18) μmol/L,(31.1 ± 6.8) g/L,(4.8 ±2.1) s,1.40 ± 0.20 before operation and 6.2 ± 0.9,(44 ± 24) U/L,(26 ± 11) μmol/L,(35.0 ± 7.4) g/L,(3.4 ± 2.0) s,1.30 ± 0.20 at postoperative 1 week and 6.0 ± 0.6,(36 ± 22) U/L,(23 ± 8) μmol/L,(34.2 ± 2.2) g/L,(3.7 ± 3.0) s,1.50 ± 0.30 at postoperative 1 month,respectively,showing no statistically significant difference (F =1.97,2.60,1.18,1.45,P ＞0.05).There were statistically significant differences in the ALT and extended time of PT (F =7.97,4.37,P ＜ 0.05) and in the ALT and extended time of PT between 1 week postoperatively and before operation (t =3.23,2.21,P ＜ 0.05).(3) Follow-up:21 patients were followed up for 3-168 months with a median time of 37 months.During follow-up,3 patients were dead.One,1,2 patients were complicated with upper gastrointestinal re-bleeding at postoperative 1,3,5 years and received hemostatic therapy under endoscopy,and then 2 were dead.Three,2 and 2 patients had peritoneal effusion and were improved by symptomatic treatment.One patient had hepatic encephalopathy and hepatic failure at postoperative 5 years and was dead after conservative treatment.PVT and anastomotic stoma thrombosis at postoperative 1,3,5 years were detected in 2,2,1 and 2,1,1 patients,with anticoagulant therapy,and 1 patient received vascular recanalization.Conclusion Coronary-caval shunt is a highly selective portosystemic shunt,it can significantly down regulate the regional pressure while ensure the normal blood flow of liver and decrease the rate of rebleeding,hepatic encephalopathy and thrombosis,meanwhile,it might be a potential therapy in management of PHT.

Along with the fast development of medical technology,the theory of holistic medical care is infiltrated into every aspect of clinical medical practices.In this paper,though the treatment of surgical hepatobiliary diseases under the direction of holistic medical care ,we emphasize the significance of holistic medical care in diagnosis and treatment ,recommend and canonize the usage of holistic medical care into the clinical practices.

The effects of two lipids lowering drugs, Xu Zhiping and Mixtura Dai Huai, on the LDL metabolism by receptor dependent and independent pathways in experimental hypercholesterolemia rats were obsvered using radioisotopic double-labelling trace technique. The results showed that in the receptor dependent or independent pathways, the FCR of LDL was increased by 43% and 34% respectively in Xu Zhiping group, and by 35% and 40% respectively in Mixtura Dai Huai group as compared with controls. Both drugs appeared to be more effective than colifibrate, in promoting clearance of LDL from plasma suggesting that the role in reducing plasma TC and LDL-C was depended on accelerating LDL degradation through both receptor dependent and independent pathways. It was also suggested that immune stimulus in combination with cholagogus may become a new way for prevention of hypercholesterolemia and atherosclerosis.

The effects of Da Huai Mixture on receptor dependent and independent pathways of LDL catabolism of the experimental hypercholesterolemic rats were observed by isotope trace-labelling, measurement of monocytic macrophage function and dot bloting. The results were as follows: (1) Serum total cholesterol was significantly decrcased(P