Objective To report the medium-term follow-up results for deep venous thrombosis(DVT) after total knee arthroplasty(TKA).Methods Between July 2003 and March 2004,55 patients(63 knees)who had had TKA were followed up for DVT.In follow-ups 1 to 2 weeks after TKA,their clinic symptoms,Doppler ultrasonograms and venograms were analyzed.In the following out-patient follow-ups done at every six months,we observed their clinic symptoms and Doppler uhrasonograms for the operated lower extremity.Venography was done only for those who had severe DVT symptoms.Results The venography one week after TKA conformed that DVT occurred in 34 patients(41 knees,61.8%).Two weeks after operation,DVT vanished in 12 cases,but deterio- rated to the proximal part in two cases.The follow-ups averaged 36.6 months(range,32 to 40 months).The results at five time points showed that the incidence of DVT did no decrease with lapse of time(P＞0.05).Conclusion No matter whether DVT occurs in the perioperative period,incidence of DVT in the medium term varies little.

Information Services ; Occupational Health Services ; organization & administration

Objective To observe the effect of acute retrograde gastric electrical stimulation (RGES) on gastric accommodation,emptying and gastrointestinal hormones releasing in obese patients. Methods Sixteen obese patients were examined. On the first day,a pair of mucosal gastric electrodes was placed under endoscope. The liquid meal load test and the standard solid meal gastric emptying test were carried out on the second day. RGES was performed starting at 30 minutes before each test and through the whole testing process. The serum leptin,ghrelin,resistin and peptide YY were examined before and after the standard solid meal gastric emptying test. On the third day,sham stimulation was given. The effect of acute RGES on related index was compared by self-control.Results BMI of the 16 patients was (32. 90±2. 99) kg/m2. Acute RGES significantly reduced the liquid meal volume of fullness [(460±148) ml and (630±219) ml,t=-7. 200,P＜0. 01] and the maximal tolerable meal volume [(699±215) ml and (926±295) ml,t=- 5. 390,P＜0. 01]. The effects of RGES and sham RGES on half-emptying time of standard solid meal was (109±26) min and (103±31) min (t=1. 009,P= 0. 329);on the retention rate of standard solid meal at one hour and two hour was (63. 37±9. 75)% and (59. 73±12.87)% (t=1. 834,P= 0. 087),(42.22±13.97)%and (38. 33±16. 87)% (t= 1.780,P= 0. 095),respectively. The ratio of gastrointestinal hormones after and before the stimulation also of the sham stimulation,leptin was 1. 03±0. 34 and 1. 08±0. 38(t=-0.386,P=0. 705),ghrelin was 0. 99±0. 11 and 0. 98±0. 12 (t= 0. 413,P=0.685),resistin was 1. 11±0. 25 and 0. 99±0. 24 (t= 1. 753,P= 0. 100),and peptide YY was 1. 56±0. 71 and 1. 33±0. 61 (t=1. 402,P= 0. 181). Conclusions In obese patients,acute RGES significantly reduce the liquid meal volume by lower gastric accommodation,to certain extent which will delay gastric emptying. There is no significant influence on gastrointestinal hormones releasing.

Objective There is still a concern that epidural labor analgesia could affect uterinecontraction.The purpose of this study was to investigate the effect of epidural labor analgesia on uterinecontraction.Methods Forty ASA Ⅰ-Ⅱ primiparous women aged 20-30 yr at full term in normal uncomplicateddelivery were enrolled in this study.They were taller than 1.5 m and weighed less than 100 kg.The amnioticmembrane was artificially ruptured at 3 cm cervical dilation and a catheter was inserted into uterine cavity beyondthe head of the fetus and connected to a maternal-fetal monitor.The patients were randomly divided into 2 groupswith 20 patients in each group:Ⅰ control group received no analgesia and Ⅱ epidural group received continuousepidural analgesia(PCEA).An epidural catheter was placed at L_2-3.After a loading dose of 8-10 ml of the PCEAsolution(0.1% ropivacaine+1 ?g?ml~(-1) fentanyl)PCEA was started(bolus 3 ml,lockout interval 15 min andback ground infusion 6-8 ml?h~(-1)).The height of block was controlled below T_10.Blood samples were taken frommaternal vein at 3 cm cervical dilation(T_1),1h later(T_2)and at delivery(T_3)and from umbilical vein andamniotic fluid was aiso collected for determination of cortisol,PGE_2 and pitocin levels.VAS scores,intrauterinepressure,the frequency and duration of uterine contraction,the use of pitocin(%),incidence of cesareansection,the length of labor and neonatal Apgar scores were recorded.Results The maternal blood eortisolconcentration was significantly lower during PCEA(T_2,T_3)in group Ⅱ than in control group(P

Objective To investigate the effect of dexamethasone on the pulmonary gas exchange in patients undergoing cardiac valve replacement under cardiopulmonary bypass(CPB).Methods Forty ASAⅡorⅢpatients aged 29-47 yrs weighing 50-69 kg undergoing cardiac valve replacement under CPB were randomly divided into 2 groups(n=20 each):dexamethasone group received dexamethasone 0.5 mg?kg~(-1) after induction of anesthesia and control group received normal saline(NS).Blood samples were taken before operation(T_0) immediately before CPB(T_1)and immediately after discontinuation of CPB(T_2)for determination of plasma total and active matrix metallo-proteinase-9(MMP-9)concentration(by enzyme-linked immuno-absorbent and fluorometric enzyme-linked immuno-absorbent assay respectively)and MMP-9 gene expression(RT-PCR).Blood samples were taken from radial artery at T_1 and T_2 for blood gas analysis.A-aDO_2 was calculated.Results MMP-9 gene expression and plasma total and active MMP-9 concentrations were significantly increased at T_2 as compared with those at T_0 in both groups and were significantly lower in dexamethasone group than in control group(P＜0.05 or 0.01).The A-aDO_2 at T_2 was significantly smaller in dexamethasone group than in control group.Conclusion Dexamethasone can inhibit the increase in gene expression,protein synthesis and activation of MMP-9 and decrease in gas exchange across alveolar-capillary membrane caused by CPB and protect the lungs during open heart surgery performed under CPB.

Objective To investigate the mechanisms of the inhibitory effects of peripheral electrical stimu- lation(PES)on chronic central pain(CCP)after spinal cord injury(SCI).Methods Twenty-four male Sprague- Dawley rats with CCP following SCI were randomly divided into three groups:a group without stainless steel needles implanted (NSSN group,n=8),a group with a stainless steel needle implanted but no peripheral electrical stimula- tion applied(NPES group,n=8)and a PES group(PES group,n=8).The rats' CCP was evaluated through ob- serving their response to nociceptive stimulation by means of the paw withdrawal pressure threshold(PWPT)and the paw withdrawal latency(PWL).Spontaneous pain behaviors including autophagia and scratching were observed at the same time.PES was applied via stainless steel needles inserted into standard acupoints on the hind limps and the back.The expression of the NMDA receptor 1(NR-1)subunit in the spinal cord horn was measured using immuno- chemical methods.Results Compared with the NSSN and NPES groups,CCP in the PES group was alleviated, PWPT and PWL were dramatically increased(P＜0.01)and the expression of NR-1 was obviously decreased (P＜0.01).Conclusion Peripheral electrical stimulation may alleviate chronic central pain after spinal cord injury in rats.

Objective To explore the relationship between the MRI enhancement ratios of liver parenchyma in hepatobiliary phase with gadobenate dimeglumine (Gd-BOPTA)and liver function.Methods Fifty-nine patients who underwent Gd-BOPTA-enhanced MRI were retrospectively enrolled in the study.The enhancement ratio of signal to noise ratio and enhancement ratio of the contrast ratio were calculated.The relationships between the enhancement ratio and CTP grading and MELD score were analyzed.Results The signal enhancement ratios in hepatobiliary phase in patients with CTP A classification were higher than those with CTP B classi-fication (P <0.01).Meanwhile,the ratios in patients with MELD scores less than 10 points were higher than those with MELD scores more than 10 points (P <0.01).Conclusion The MR enhancement degree of liver parenchyma in the hepatobiliary phase with Gd-BOPTA may reflect the liver function.

Objective:To investigate the effects of Bailing capsules on the expression of TGF-β1 in the peritoneal dialysis solution for peritoneal dialysis patients. Methods: Totally 40 patients treated with peritoneal dialysis ( PD) were randomly divided into two groups (20 cases in the control group and 20 cases in the experimental group). All the patients were treated with PD by 1. 5% perito-neal dialysis effluent (6 000 ml everyday), and the patients in the experimental group were additionally treated with Bailing capsules (5 capsules each time, three times a day after meals) for 6 months. The adequacy of PD (including Kt/V and Ccr) of the two groups was examined after the one-month treatment. The renal function and the level of TGF-β1 in the effluent in 1, 3 and 6 month were com-pared between the two groups. Results:The adequacy of PD ( Kt/V and Ccr ) had no significant difference between the two groups (P<0. 05). The level of serum creatine was decreased significantly in both groups after the one-month treatment (P<0. 05), and no significant change was shown in 3 and 6 month (P>0. 05). In the control group, the expression of TGF-β1 in the effluent in 1, 3 and 6 month was increased gradually with significant difference (P<0. 05). In the experimental group, the expression of TGF-β1 in the effluent had no significant difference in 1, 3 and 6 month (P>0. 05), which was lower than that in the control group (P<0. 05). Conclusion:Bailing capsules can decrease the expression of TGF -β1 in the effluent for the patients treated with PD and inhibit the peritoneal fibrosis.

OBJECTIVE: To investigate the allergens in patients with allergic rhinitis in Yichang, so that to find common allergens of Yichang and to provide statistic basis for a reasonable prevention and treatment to allergic rhinitis. METHOD: 1,979 patients with allergic rhinitis in Yichang were detected for allergens by skin prick test and the distribution of positive rates to inhaled allergens was compared between different genders and ages. RESULT: 1,545 (78.1%) of 1,979 suspected allergic rhinitis patients presented positive reaction. The positive rate in male was significantly higher than in female, and that in juvenile group was significantly higher than in adults. Among positive cases in inhalation group, the most common allergen was flour mite (80.4%), followed by house dust mite (64.9%), cockroach (13.3%) and artemisia pollen (8.2%). CONCLUSION The study shows that the flour mite and house dust mite are the most common inhaled allergens causing allergic rhinitis in Yichang. We should pay more attention to the prevention and treatment for the juvenile patients.
Adolescent ; Adult ; Aged ; Allergens ; immunology ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Humans ; Male ; Middle Aged ; Rhinitis, Allergic ; diagnosis ; epidemiology ; immunology ; Skin Tests ; Young Adult

Objective To translate the Water Orientation Test of Alyn 1 (WOTA1) into Chinese and investigate the test-retest reliability, inter-rater reliability and validity of this Chinese Version. Methods The Water Orientation Test of Alyn 1 was translated from English into Chinese. 25 children with cerebral palsy were tested with Chinese Version of WOTA1 by 2 raters. One of the raters accessed the same children again after 2 days. While the children were assessed with Brief Assessment of Motor Function (BAMF). The scores from both raters, twice of one rater, and of WOTA1 and of BAMF were analyzed with Pearson correlation coefficient. Results The correlation coefficient of test-retest of WOTA1 total score is 0.992 (95% CI: 0.982-0.996), and it was 0.887 to 1.000 of the scores of items. The correlation coefficient of inter-rater of total score is 0.992 (95% CI: 0.980-0.998), and it was 0.748 to 1.000 of the scores of items. The correlation coefficient between scores of WOTA1 and BAMF was 0.926 (P<0.01). Conclusion The Chinese Version of WOTA1 is good reliable and valid to assess the motor function in hydrotherapy pool.