BACKGROUND:There are studies on three-dimensional finite element analysis of total knee replacement, but few research concerns contact pressure and contact area inside and outside polyethylene liner of fixed prosthesis and rotating platform prosthesis in total knee replacement. OBJECTIVE:To explore the contact pressure and contact area inside and outside polyethylene liner of fixed platform prosthesis and rotating platform prosthesis in total knee replacement. METHODS:We established three-dimensional finite element models of fixed platform prosthesis and rotating platform prosthesis in total knee replacement and compared contact pressure and contact area inside and outside polyethylene liner of fixed platform prosthesis and rotating platform prosthesis in total knee replacement. RESULTS AND CONCLUSION:The peak contact pressure inside and outside polyethylene liner of fixed platform prosthesis and rotating platform prosthesis in total knee replacement was minimum at 0° of genuflex. The peak contact pressure inside polyethylene liner was higher than that outside polyethylene liner of fixed platform prosthesis and rotating platform prosthesis in total knee replacement at 0°-90° of genuflex (P<0.05). The peak contact pressure inside and outside polyethylene liner of fixed platform prosthesis was higher than that of rotating platform prosthesis in total knee replacement at 60°-120° of genuflex (P<0.05). The contact area inside and outside polyethylene liner of fixed platform prosthesis and rotating platform prosthesis in total knee replacement was maximum at 0° of genuflex. The contact area inside polyethylene liner of fixed platform prosthesis in total knee replacement was lower than that of outside at 0°-30° of genuflex (P<0.05). The contact area inside polyethylene liner of fixed platform prosthesis in total knee replacement was lower than that of outside at 0°-90° of genuflex (P<0.05). The contact area inside and outside polyethylene liner of fixed platform prosthesis was lower than that of rotating platform prosthesis in total knee replacement at 30°-120° of genuflex (P<0.05). These results suggested that peak contact pressure inside polyethylene liner of fixed and rotating platform prostheses was higher than that outside in total knee replacement, and the inside contact area was lower than that of outside. Inside and outside contact pressure of the rotating platform prosthesis was lower than that of fixed platform prosthesis. Inside and outside contact area of the rotating platform prosthesis was higher than that of fixed platform prosthesis.

Objective　To investigate the abnormal distribution of lymphocytes in eutopic and ectopic endometrium of patients with endometriosis and its significance. Methods　In 43 cases, biopsies of ectopic tissues were taken by laparoscopy and laparotomy from patients with endometriosis and eutopic endometrium by curettage at the same time. In 19 cases, eutopic endometrium was taken from hysterectomy for myomatous uterus. Immunohistochemical techniques were employed to demonstrate the difference in the number and ratio of the lymphocyte subsets between the patients with endometriosis and the controls. Results　In the patients with endometriosis, in the proliferative phase, ectopic endometrium contained respectively CD+3、CD+8T cells and CD+68 macrophages (67.2±13.5)/5HP, (45.0±14.0)/5 HP and (37.2±10.6)/5 HP, significanly higher then that in the eutopic endometriun (52.4±11.3)/5HP (P<0.01), (32.5±10.0)/5HP (P<0.05)， and (30.7±10.3)/5HP， and also higher as compared with the control group (52.1±14.9)/5HP (P<0.05)， (28.9±12.7)/5HP (P<0.01), (26.3±9.3)/5HP (P<0.05); in the secretory phade, CD+8/CD+4, and CD+68 content was respectively 3.5±1.2，(40.3±12.2)/5HP, higher than that in the control group, 3.2±0.8 (P<0.05), (28.6±10.6)/5HP (P<0.01). The number of macrophages was also significantly increased. No cyclic changes in the number of lymphocytes in each subpopulation in ectopic endometrium were found. Conclusions　In the patients with endometriosis, the changes in T lymphocytes and macrophages are mainly on the endometriotic sites. The infiltration of many lymphocytes and macrophages into the ectopic endometrium formed a chronic inflammatory process. The lymphocytes are not able to clear the ectopic endometrium in the late stages of endometrium，on the contrary, they stimulate the further growth of the endometrium.

BACKGROUND: With the rapid development of tissue engineering, a single biological scaffold material is hard to meet the needs of tissue engineering. Therefore, composite scaffolds with excellent performance will be obtained by combining two or more kinds of materials.OBJECTIVE: To detect the adherence and proliferation of dental pulp stem cells on the Chitosan-fibrin composite scaffold.METHODS: Dental pulp stem cells were isolated and extracted from C57 neonatal rats through modified enzyme-digestion method, and subcultured to the third generation, followed by adipogenic and osteogenic induction in vitro. Then, induced cells were identified. The chitosan-fibrinogen composite scaffold was prepared, and the pore size and porosity were determined. The chitosan-fibrin composite scaffold was co-cultured with passage 3 dental pulp stem cells to observe the cell proliferation by MTT assay, and the morphology of the composite scaffold, cell adhesion,proliferation and extracellular matrix secretion were observed under scanning electron microscope. In addition, the cells were inoculated directly on the bottom of culture plate as controls.RESULTS AND CONCLUSION: The dental pulp stem cells were successfully isolated and cultivated, and positive for osteogenic and adipogenic differentiation. The pore size and porosity of the composite scaffold was (105.32±22.10) μm and (87.714±1.276)%, respectively. The S-shaped proliferation curve in the experimental group was similar with that in the control group; the proliferation rate in the experimental group was significantly higher than that in the control group after 4-8 days of culture (P < 0.05). At the 2nd day after co-culture, the cells adhered tightly and grew well onto the composite scaffold; at the 4th day, enlarged cells began to proliferate obviously with abundant extracellular matrix; the surface and pores of the scaffold were full of cells at the 6th day. These results indicate that the chitosan-fibrin composite scaffold is suitable for the adhesion and proliferation of dental pulp stem cells.

Contemporary medical education not only demands medical students to master knowledge of medical science and to possess good professional ethics and advanced duty, but also possess comprehensive quality, especially nice humane quality. So it is necessity to medical students for growing them into medical talent of advanced quality.

Objective To investigate changes of serum proteins and related enzymes in patients with schizophrenia and its relationship to metabolic syndrome.Methods Five hundred and three inpatients with schizophrenia and 60 healthy volunteer were selected in this study.The demographic information and medical history data of them were recorded and levels of serum proteins and enzymes were measured,and the metabolic syndrome (MS) was diagnosed according to IDF criteria.Results Serum protein contents of schizophrenic patients (total protein (71.14 ±6.13) g/L,albumin (44.56 ±4.24)g/L,globulin(26.35 ±5.04) g/L,apoprotein A(10.97 ± 0.27) g/L,and apoprotein B (0.69 ± 0.25) g/L) were significantly lower than control group (79.96 ± 6.10) g/L,(49.44 ±5.63) g/L,(30.52 ±4.00) g/L,(10.97 ±0.27) g/L,and(0.69 ±0.25)g/L (P＜0.01).Urea nitrogen ((4.36± 1.36) mmol/L) was lower than control group ((5.22 ± 1.31) mmol/L) and C-reaction protein ((3.17 ± 6.58) mg/L) was higher than control group (1.35 ± 1.83) (P ＜ 0.01).Alanine aminotransferase ((24.28 ± 32.76) IU/L),a-L Fucosidase((17.49 ± 4.83) U/L),adenosine dehydrogenase((17.81 ± 5.67) U/L),and creatine kinase isoenzyme((10.50 ±4.92)IU/L) were higher than control group (18.12 ±9.77)IU/L,(15.98 ± 3.58)U/L,(11.75 ±5.48) U/L,and (9.12 ±3.62)IU/L,P＜0.01),but AST isoenzyme ((5.97 ±4.97) U/L)was lower than control group ((7.05 ± 6.72) U/L).Alanine Aminotransferase,alkaline phosphatase,γ-glutamyl transpeptidase,and a-L Fucosidase,AST isoenzyme and cystatin-c of schizophrenic patients with MS were significantly higher than non-MS patients(P ＜ 0.05).Conclusion There are significant metabolic disorders of proteins and enzymes in patients with schizophrenia,and abnormal changes of many enzymes are significantly associated with metabolic syndrome.

Objective To compare the early analgesic effects of continuous femoral nerve block analgesia (CFNB) and patient controlled intravenous analgesia (PCIA) and their effects on functional recovery after total knee arthroplasty.Methods Retrospective analysis was conducted on 60 ASA Ⅰ and ASA Ⅱ patients with unilateral total knee arthroplasty in our hospital from January 2014 to January 2015.The patients were divided into two groups,CFBN group (treatment group) and PCIA group (control group),with 30 patients in each group.VAS scores of postoperative ipsilateral knee resting and movement pain,range of postoperative knee joint motion (ROM),muscle strength of femoral quadriceps,incidence rates of adverse reaction within 7 days after operation,HSS score 3 months before and after the operation,and discharge time were observed.Results Postoperative VIS score in CFNB group was lower than that in PCIA group.ROM and muscle strength of femoral quadriceps in CFBN group were better than those in PCIA group on day 1,2,3,5,and 7 after the operation.Postoperative adverse reaction rate within 7 days in PCIA group was significantly higher than that in CFNB group.HSS score three months after the operation in CFNB group was higher than that in PCIA group.Discharge time of CFNB group was significantly earlier than that of PCIA group (P＜0.05).Conclusion Compared with PCIA analgesia,CFNB analgesia shows better analgesic effect.It can alleviate early knee joint pain after TKA,increase joint motion,significantly shorten the hospitalization time,promote joint exercises which are effective in functional rehabilitation,and decrease the incidence of adverse reactions like nausea and vomiting.

Objective To screen for serum protein differentially expressed between women whose fetuses had congenital heart defects(CHD) and women who had normal fetuses. Methods Serum samples were collected from pregnant women whose fetuses had CHD and those whose fe?tuses had no CHD,including a CHD group of 40 women and a control group of 10 women. The CHD group included 4 subgroups as follows:tetralo?gy of Fallot,ventricular septal defects,persistent truncus arteriosus,and a mixture of relatively rare types of CHD(n=10 each). Samples in the same group were pooled to obtain equal amounts of proteins ,and the iTRAQ proteomic approach was used to identify and quantify the proteins dif?ferentially expressed among these groups. Results We successfully identified 606 proteins,among which 47 showed at least a 1.5?fold difference between the CHD and control groups. Among the 47 proteins,23 and 24 were upregulated and downregulated,respectively. Conclusion Several proteins associated with CHD could be identified by using the iTRAQ proteomic approach ,and various proteins were involved in the pathogenesis of CHD in this study.

Objective To explore the role of pregabalin on the expression of c-fos in spinal dorsal horn of the rat with neuropathic pain.Methods Thirty Wister rats (male) were divided into shamoperated group,model group and pregabalin group,with 10 cases in each group.The effect of the pregabalin on the heat pain threshold and expression of c-fos in spinal dorsal horn of the rat with neuropathic pain were observed.Results The heat pain threshold in model group at 3rd,4th,5th,6th,7th,10th and 14th day after operation was significantly lower than that in sham-operated group and pregabalin group at same time (P ＜ 0.05).The heat pain threshold in pregabalin group was lower than that in sham-operated group from 2nd day after operation,but there was no significant difference (P ＞0.05).At the 14th day after operation,the number of Fos-like-immunoreactivity (FLI) positive cells in sham-operated group,model group and pregabalin group was (16.4 ± 0.6),(66.7 ± 3.3) and (22.8 ± 1.5)cases,and the number of FLI positive cells in model group was significantly higher than that in shamoperated group and pregabalin group (P ＜ 0.05).Conclusions Pregabalin has analgesic activity on rat with neuropathic pain.Pregabalin activates spinal cord glial cells raisedby the injured peripheral nerve and infection,and also reduces the noxious stimulation of afferent pain to spinal dorsal horn neurons.

Objective: To observe the effectiveness of combinative use of gentamycin, metronidazole and rifampin in the treatment of ulcerative colonitis and explore the etiology of the disease.　Methods: 30 and 26 patients were allocated to treatment group and control group, respectively. Maintained clysis with a combination of gentamycin, metronidazole and rifampin in warm normal saline were administered to those in the treatment group twice a day for two weeks, while SASP and prednisone were administered to those in the control group for two weeks.　Results: The alleviation rate of the treatment group is higher than that of the control group.　Conclusion: Combinative use of gentamycin, metronidazole and rifampin for maintained clysis is a effective treatment for ulcerative colonitis.

Objective To study the clinical efficacy of external fixator and combined screwing at iliac crests and pubic symphysis for the treatment of unstable pelvic fractures.Methods From January 2013 to February 2014,12 cases of unstable pelvic fracture were treated at our department.They were 8 men and 4 women,from 32 to 57 years of age (average,42.5 years).Seven cases were caused by a traffic accident,and 5 by falling from a height.By Tile classification,8 cases were type B (including type B1 in 3 cases,type B2 in 3 and type B3 in 2),and 4 cases type C1.Associated injury included shock in 7 cases,bladder injury in one,limb long bone fracture in 6,joint injury in 3,and thoracic and lumbar injury in 4.The interval from injury to operation averaged 4 days,ranging from 12 hours to 7 days.The type B fractures were treated with an external fixator and combined screwing at iliac crests and pubic symphysis while the type C1 fractures with internal fixation with percutaneous S1 sacroiliac screws in addition to what was used for the type B fractures.Results The 12 patients were followed up for 5 to 12 months(average,9 months).No one died in this group.The fractures healed after 8 to 13 weeks (average,11.3 weeks).All the patients recovered normal walking.Superficial infection at the pin hole occurred in 7 cases,but there was no deep infection.Screw loosening was observed in only one case,and no reduction loss,injury to nerves or urinary canal was observed.According to the Majeed criteria,the efficacy was evaluated as excellent in 10 cases,good in one,and moderate in one.Conclusion External fixator and combined screwing at iliac crests and pubic symphysis can restore the stability of anterior pelvic ring,leading to good clinical outcomes.