[Objective]The patellar tendon lengths were compared in the knees with a history of patellar instability and in normal knees in Chinese,and the significance of patellar tendon length measurement in the knees of patellar instability was discussed.[Method]Totally 49 knees of 43 patients with patellar instability were reviewed from Jan.2003 to Dec.2005,including 15 males and 28 females and 6 paients with both instahle patellas.The mean age was 21.4 yrs(from 18~28 yrs),and the mean height was 163 cm(155~173 cm).And,50 normal control knees of 50 volunteers including 16 males and 34 females.The mean age was 24.2 yrs(from 18~35 yrs),and the mean height was 165cm(154~177 cm).The patellar tendon length,the distance between tibial tubercle and the anterior edge of tibial plateau and Insall-Salvati index on the lateral X-ray plain with 30? flexion of keens were measured and analyzed.[Result]The patellas tendon length of patients was longer than that of normal volunteers(53.3?2.7mm,47.3?3.3 mm,P0.05)of the distance from tibial tubercle to the anterior edge of tibial plateau between patients and volunteers.However,difference of Insall-Salvati index between patients and volunteers was significant(1.33?0.17,1.06?0.14,P

[Objective]To discuss the significance of tissue repairing and functional reconstruction in treatment of extremity malignant tumors by allogeneic bone graft and replanting devitalized bone after malignant bone tumor resection. [Method]A retrospective study of 56 patients with malignant bone tumor was conducted, including 35 male patients and 21 female patients. The age was between 9 and 60, with an average of 18.Tumor in 9 cases was in the proximal hunerus, 30 in the distal femur, and 17 in the proximal cnemis.Thirty-two cases were osteogenic sarcoma,17 cases were chondroma sarcomatosum,3 cases were maligant giant cell tumor of bone and 4 cases were metastatic.Soft tissue was repaired and extremity function was reconstructed by adopting allogeneic bone graft and replanting devitalized bone. Extremity functions, bone healing conditions, and complication were estimated according to Mankin metheds.[Result]Among these 56 patients,results in 20(35.7%) were excellent,11(19.6%) were good,8(14.3%) were fair,17 (30%) were poor. The satisfactory rate was 70%.Thirty-eight patients survived for two years without tumor.Thirty patients survived for 5 years with the survival rate of 55%. Except local relapsed, the major complications were infection (4 cases), fracture (3 cases),collapse of articular facet (1 cases), and arthrocleisis (5 cases),with the infection rate of 7%.No internal fixation was broken.[Conclusion]For extremity malignant tumor, effective tissue repairing and functional reconstruction not only offer a limb-sparing effect, but also keep the limb in good function. This is an effective method for bone malignant tumor.

Objective To investigate the relationship between head nurse's authentic leadership and degree of solidarity among nurses in operating room.Method A total of 120 nurses in the operation room of 3 general hospitals in Jiamusi City were enrolled in the study by way of the questionnaire on authentic leadership and the scale of solidarity.Results The mean score on the head nurse's authentic leadership (41.28 ± 8.48) was above the middle-high level.The mean score on the solidarity (68.67 ± 8.82) was in the middle-high level.There was a positive correlation between the head nurses' authentic leadership and the degree of solidarity among nurses in the operating room.Conclusion Hospital and nursing administrators should take active and effective measures to improve the leadership of head nurses so as to improve the degree of solidarity among nurses in the operating room as well as the quality of nursing.

Objective: To analyze the survival rate of stomach cancer patients and its variation during different periods in Linzhou city, Henan Province, from 1988 to 2004, and evaluate the level of secondary prevention and diagnosis of stomach cancer in this area. Methods: All of the incidence and death records of stomach cancer from 1988 to 2004 were collected and matched from Linzhou Cancer Registry. The records that were identified as duplicate cases or had only death certificate (DCO) were excluded. The tumor cause eliminated life tables in this area were calculated and linked to the data of incidence and death of stomach cancer. FivE-year observed survival rates and fivE-year relative survival rates in three periods (1990-1994, 1995-1999, and 2000-2004) were calculated using period survival analysis mehod. The relative survival curves in the three periods were plotted. Results:The 5-year relative survival rate of stomach cancer was 26.66% during 1990-1994, 32.01% during 1995-1999, and 40.43% during 2000-2004 in Linzhou city. It showed a gradually increasing trend. The 5-year survival rates were higher in males than those in females. During 1990-1994 and 1995-1999, the 5-year survival rates of gastric cardia cancer were higher than those of non-cardia cancer. During 2000-2004 period, the 5-year survival rate of gastric cardia cancer was lower than that of non-cardia cancer. Conclusion: The survival rates of stomach cancer in Linzhou city are increasing gradually since 1990s in 20 century. It indicates that the levels of secondary prevention and clinical diagnosis and treatment on stomach cancer kept increasing in this area.

Objective To explore the differences of the joint function and the patient's satisfaction between two different methods to reconstruct limb length for unilateral Crowe Ⅳ developmental dysplasia of the hip (DDH).Methods The clinical controlled study were used.21 cases with unilateral DDH Crowe Ⅳ treated with total hip arthroplasty were divided into 2 groups randomly.The patients in the first group were reconstructed the limb with the compensatory length and those in the second group were did with the real length.The patients were followed up 10 years.Two independent sample t-test was used to compare these two operations.Harris scores and SF-36 scores were used in the test.Survival analysis with Kaplan-Meier method was involved in the survival of the prosthesis and then test with Log-rank test.X-ray films of different period were compared to confirm the prosthetic loosening.Results Seventeen patients were followed up 8-10 years.There were no significant differences both in Harris score and most of the SF-36 scores at the median follow-up of 10 years.The item mental healthy of SF-36 expressed significant difference.Five patients required revision.There were 10 cases suffered with polyethylene wear,6 cases with severe osteoporosis in greater trochanter,and 3 cases with osteolytic reaction.Conclusion There are no significant differences between the two surgical method in the survival rate of prosthesis and the joint function in the median follow up.The satisfaction of the control groups is lower than the trial groups both at the early stage after the operation and the median follow up.The revision rate between the two groups is similar but the reason is different.

BACKGROUND: Previous artificial ligament is easy to break for material fatigue and to appear synonitis for materialbiocompatibility.OBJECTIVE: To observe the application effect of ligament advanced reinforcement system (LARS) artificial ligament inreconstruction of anterior cruciate ligament via follow-up.DESIGN, TIME AND SETTING: An own control, follow-up observation was performed between August 2004 andJanuary 2007 at the Department of Orthopedics and Joint Surgery, Shanghai Changzheng Hospital, Shanghai, China.PARTICIPANTS: Twenty-eight patients with anterior cruciate ligament injury, including 16 with sport injury and 12 withvehicle accident injury.MATERIALS: The main component of LARS artificial ligament (Laboratoire d'Applieation et de Recherche Scientifique,France) is the high-tenacity polyester fiber polyethylene terephthalate.METHODS: Twenty-eight patients with anterior cruciate ligament injury were performed arthroscopic reconstruction of theligament with LARS artificial ligament and were averagely followed up for 20 months.MAIN OUTCOME MEASURES: Patients' anterior drawer test, Lysholm score, range of motion prior to transplantationand in follow-up.RESULTS: The knee unstable symptom of 28 patients disappeared, anterior drawer test was negative, joint function wasgood with the flexion of 5.71 to 129.64 degrees. Average Lysholm score raised from (45.7±9.82) points prior totransplantation to (86.5±6.44) points after transplantation (P < 0.001). All patients resumed normal activities at 2 monthsafter transplantation, without acute or chronic synovitis and host response to materials.CONCLUSION: LARS artificial ligament is a relatively safe transplantation material and especially suitable to reconstructanterior cruciate ligament with sport injury. Mid-/short-term follow-up shows good result.

BACKGROUND:Some overseas searchers have shown that,the midvastus approach in total knee arthroplasty(TKA)can reserve the complete medial structure of quadriceps femoris,improve the functional recovery of knee extension apparatus,but also preserve the blood supply of medial knee joint and maintain proprioceptive sense of knee joint.OBJECTIVE:To evaluate the early functional outcome of midvastus approach and standard medial parapatellar approach in TKA.DESIGN:A prospective,randomized,double-blind,comparative study.SETTING:Changzheng Hospital Affiliated to the Second Military Medical University of Chinese PLA.PARTICIPANTS:From March 2004 to March 2006,34 patients undergoing bilateral TKA simultaneOusly were admitted to the Changzheng Hospital Affiliated to the Second Military Medical University of Chinese PLA,including 7 males and 27 females.They aged 56-78 years with a mean of 70.5 years,and consisted of 24 cases with osteoarthritis,and 10 cases with rheumatoid arthritis;24 cases with bilateral genu varum,9 cases with bilateral enu valgum,and 1 case with lateral genu varum and contralateral genu valgum.Informed consents were obtained from all the included patients.Materials:Press Fit Condylar(PFC)Sigma knee prosthesis(DUPUY Company),the central tibial pad was added with a polyethylene prominence,while the corresponding femoral prosthesis was treated with anterioposterior steotomy,identical with the remained prosthesis.METHODS:The surgical approach of 34 patients was randomized into a midvastus approach in one knee and a standard medial parapatellar approach in the other knee.The comparison included the surgical parameters and clinical parameters.mevemnt,the time of performing an active straight leg raise,the time of reaching 90°knee flexion,range of motion and complications.RESULTS:All of 34 patients were involved in the result analysis.There was no significant difference in the surgical time botween the two roups.The assessment revealed significantly less blood loss[(286±29.8)Ml,(368±35.8)Ml,P＜0.05],fewer lateral release in valgus knee(20%,50%,P＜0.05),less pain in the first week(P＜0.05),earlier return of active straight-leg raise[(1.8±0.3)days,(4.5±0.8)days,P＜0.01],earlier reach of 90° knee flexion [(3.2±0.8)days.(7.1±1.2)days,P＜0.01]and greater range of motion at 45 day[(107±20)°,(98±12)°,P＜.05]in the midvastus approach group.CONCLUSION:The midvastus approach,which is based on diminished disruption of extensor mechanism and peripatellar pIexus of vessels,relieves pain and improves range of motion in the early rehabilitation period following TKA.

In this article, the authors expounded the necessary and problems of animal experiment post-ap-proval monitoring ( PAM) , which included who should do PAM, how to do PAM, and what the PAM can do. The authors also exposed the following suggestion: formulating the detailed rules, regulations and SOP, strengthening the training of PAM team member and animal experiment personnel, and monitoring the whole process of animal protocol review using the software.

Objective To examine the effect function of platelet(Pt)assemble rate(PLTAR) and the change of protein kinase B(PKB) active by cilostazol (CS)and aspirin (AS)on elderly patients with acute coronary sydrome(ACS). Methods Forty-eight elderly patients with ACS were divided randomly into two groups:CS group (100 mg,n=26),AS group (300 mg,n=22).Twenty-six healthy elderly were into the group of normal control(NC group) . The CS group and AS group were treated by routine anticoagulation and antiplatelet.PLTAR and PKB activity were measured at 10 minutes before treatment and at 7 days after treatment 3.5,6.0,24.0 hours. Results The maximum PLTAR in elderly CS group and AS group was elevated significantly compared with NC group(P

Objective: To evaluate whether hemodialysis before percutaneous renal biopsy (PRB) reduces the risk of bleeding complications in patients with acute kidney injury (AKI). Methods: This study was a cohort observational study. Patients who were diagnosed as AKI and received PRB in Nanfang Hospital of Southern Medical University from January 2015 to December 2018 were included in the study. Patients were divided into preoperative dialysis group and preoperative non-dialysis group according to whether PRB patients received hemodialysis treatment. According to whether perirenal hematoma occurred after the operation, the patients were divided into the groups with and without the perirenal hematoma. The baseline clinical data of AKI stage, hemoglobin, coagulation function and renal pathological changes before PRB, and perirenal hemorrhage complications after operation, including the size of perirenal hematoma within 24 hours, gross hematuria, low back pain, decreased hemoglobin value and interventional treatment (such as interventional surgery, blood transfusion, etc) in the two groups were compared. The logistic regression model was used to analyze the risk factors of perirenal hematoma after PRB. Results: Ninety patients with AKI were enrolled in this study, including 41 in the preoperative dialysis group and 49 in the preoperative non-dialysis group. The proportion of patients AKI with stage 2-3 in the preoperative dialysis group was significantly higher than that in preoperative non-dialysis group (100.0% vs 75.5%, P<0.001). There were no significant differences in coagulation function indexes and platelet counts between the two groups. Renal ultrasound within 24 hours after PRB showed that there were no significant differences in the incidence of postoperative perirenal hematoma (56.1% vs 63.3%, P=0.489), the incidence of postoperative perirenal large size hematoma (≥5 cm, 26.1% vs 22.6%, P=0.766), and the magnitude of the decrease in hemoglobin (3.7% vs 1.2%, P=0.505) between the preoperative dialysis group and the preoperative non-dialysis group. No blood transfusion, arteriovenous fistula, renal vascular intervention or surgery, and no hospital death occurred in the two groups. The renal pathological manifestations of the patients with and without perirenal hematoma were mainly acute tubular necrosis (ATN) and there were no significant differences between the patients with and without perirenal hematoma in indicators such as age, gender, body mass index, diabetes percentage, hypertension percentage, AKI staging, preoperative dialysis or not, serum creatinine, blood urea nitrogen, hemoglobin, platelet count and renal pathological types. After adjusting for indicators such as preoperative AKI stage and renal pathological changes, logistic regression analysis results showed that perirenal after PRB was not independently correlated with preoperative dialysis (β=0.568, P=0.241); Multivariate logistic regression analysis resluts showed that hematoma (≥5 cm) after PRB was also not independently correlated with preoperative dialysis (β=0.967, P=0.958). Conclusions Preoperative hemodialysis does not reduce the risk of bleeding complications after PRB in patients with AKI. The role of preoperative hemodialysis in reducing the risk of bleeding complications after PRB needs further study and verification.