Total knee arthroplasty has become one of the effective operation methods on end-stage knee osteoarthritis. However,the postoperative pain has been plaguing the clinicians. The cause of postoperative pain can be divided into iatrogenic, prosthesis and patient. Pain treatment in perioperative period includes preoperative education, analgesia in advance, and the selection and design of reinforcement; during operation mainly includes the appropriate surgical approach, keep the balance of soft tissue around the knee joint, cocktail analgesia pain around the knee joint; after operation mainly includes oral analgesic drugs, femoral nerve tissue and patient controlled analgesia. And the multimodal analgesi.a which is the analgesic methods combined application in perioperative period raised in resent years fully intervene the pain in perioperative period,so that it can effectively reduce the pain of patients after knee replacement, promote the patients do functional exercise more better and get better operation result.
Analgesia, Patient-Controlled ; Arthroplasty, Replacement, Knee ; Humans ; Nerve Block ; Pain Management ; Pain, Postoperative ; drug therapy ; etiology

The aim was to investigate the cytolytic activity of cytotoxic T lymphocytes (CTL) induced by dendritic cells (DC) derived from human cord blood in vitro. Human cord blood mononuclear cells (CBMNC) were cultured in vitro with addition of various cytokines. DC was confirmed by morphology, immune phenotype and capacity of stimulating MLR (mixed lymphocyte reaction). CTL were generated through the co-culture of autologous T lymphocytes and DC. (51)Cr-release assays were performed for the measurement of cytotoxicity of CTL. The results showed that distribution of the subgroups of T lymphocytes in CBMNC was similar to that in adult peripheral blood. The percentage of CD1a-expressing cells in CBMNC was very low, merely (0.41 +/- 0.09)%. During culture, DC became larger and more irregular in shape. Spiny dendrites or multiple cell processes in morphology emerged on the surface of DC. Among the cell populations at 15 days of culture, there were (28.4 +/- 3.55)% of CD1a-expressing cells, (63.67 +/- 23.33)% of CD86-positive, (8.7 +/- 1.49)% of CD83-positive and (32.5 +/- 1.53)% of HLA-DR-positive cells. DC derived from CBMNC is capable of stimulating the proliferation of allogeneic lymphocytes in MLR. CTL derived from autologous T lymphocytes induced by dendritic cells pulsed with lysates of HL-60 cells, possessed specific cytolytic effects against HL-60 cells. In conclusions, relatively high percentage of CD1a-expressing cells can be generated in culture system of this study. DC derived from cord blood is able to induce the production of anti-leukemic CTL in vitro.
Antigens, CD1 ; analysis ; Cytotoxicity, Immunologic ; Dendritic Cells ; immunology ; Fetal Blood ; immunology ; Humans ; Immunophenotyping ; Leukemia ; immunology ; T-Lymphocytes, Cytotoxic ; immunology

Objective To compare the efficacy of ultrasound-guided fine-needle aspiration(US-FNA)biopsy in diagnosing solid and complex thyroid nodules with different size. Methods One hundred and seventy-five thyroid FNA biopsies were prospectively performed on 168 patients ranging from 4 to 75 years of age. Sixty-three nodules were surgically excised and the others were clinically followed-up. The cytology diagnoses were categorized into four groups: benign, malignant, suspicious and unsatisfactory. Results There was no significant complication in the all 115 solid and 60 complex thyroid lesions and there were 36and 3 malignant nodules respectively in solid and complex thyroid nodules. The nondiagnostic rates of solid and complex nodules were 7％ and 8％. The accuracy of US-FNA in diagnosing complex thyroid nodules was comparatively equal to that of in solid thyroid nodules. In solid thyroid nodules, the sensitivity and accuracy in ≤1 cm group were similar to that of in ＞1 cm group. Conclusions US-FNA was an accurate and reliable method to diagnose thyroid solid and complex lesions.

Objective To explore the clinical application value of core needle biopsy guided by fully digital mammography three-dimensional positioning system in the diagnosis of breast lesions.Methods A retrospective analysis of 21 patients who underwent guided core needle biopsy in a fully digital mammography system was performed.2 1 patients had 2 1 lesions,which included mass (4 cases),suspected calcification (15 cases)and glandular collection (2 cases)based on X-ray examination before biopsy.The needle depth was manually calculated according to the mammogram (0°and 90°),and automatically calculated with the full digital mammography three-dimensional positioning system. The needle depth was adjusted according to the combination of above two values with the patient’s skin elasticity and gland structure. After putting a small incision into the needle with local anesthesia,X-ray radiography was taken to observe the position of the puncture needle, and then the puncture gun was excited to take out the tissue at different positions of the lesion.Finally,X-ray radiography of the tissue was performed.Results 21 patients underwent biopsy with the average operation time of 45 minutes and puncture time of 25 minutes.The needle depth adjustment range was 3－5 mm,using 14G puncture needle and 4－8 pieces of tissue were pierced according to the lesions. X-ray radiographywas performed on the removed tissue strips. For all the cases of suspected calcification,the calcified lesions were found in the removed tissue strips.No serious adverse reactions occurred in 21 patients with lateral position (1 9 cases)and sitting position (2 cases).2 patients with sitting position developed dizziness, nausea,and palpitation,and recovered quickly after rest and psychological comfort.Puncture pathology confirmed 6 cases of breast cancer (1 case of intraductal papillary carcinoma,2 cases of ductal carcinoma in situ,3 cases of invasive breast cancer),and 1 5 cases of benign lesions,with no obvious changes after one year follow-up.Conclusion In the core needle biopsy guided by the fully digital mammography three-dimensional positioning system for breast lesions,the patient should be placed in the lateral position, which can effectively reduce the occurrence of adverse reactions.A 14G puncture needle and ≥4 tissue strips can achieve a higher pos-itive rate.The technology is simple and easy to perform with a high puncture accuracy,and has important application value.

Abdomen/diagnostic imaging* ; Artificial Intelligence ; Body Composition ; Magnetic Resonance Imaging ; Practice Guidelines as Topic